Using chemotherapy to delay or avoid radiotherapy in children under three with a type of brain tumour called ependymoma reduces the risk of potentially damaging long term side effects, reveal trial results published online in the Lancet Oncology.
Researchers from the Children's Cancer and Leukaemia Group (CCLG), funded by Cancer Research UK and Samantha Dickson Brain Tumour Trust, undertook a ten-year trial involving 89 children from the UK, Scandinavia and The Netherlands with newly diagnosed ependymomas, and monitored their progress for up to 12 years.
All of the children on the trial underwent surgery to try and remove their tumours followed by an intensive course of chemotherapy to kill off any remaining cancer cells.
Radiation treatment was reserved only for those children whose disease had spread or progressed. Of these patients, the chemotherapy treatment managed to delay their need for radiotherapy by more than one and a half years, so that the average age of children when they were given radiotherapy was 3.6 years, when their brains were more developed. This was opposed to the children being given radiotherapy as a first-line treatment as soon as they were diagnosed, often at a much younger age.
Around 350 children under the age of 15 are diagnosed with brain cancer each year in the UK. Around a tenth of these cases are ependymomas – equating to around 35 cases each year – half of which occur in children under the age of four. The researchers hope these results will benefit infants with other types of brain cancers.
Overall, 42 per cent of the patients did not receive any radiation treatment for their cancer and almost two-thirds of the children – 64 per cent – were still alive five years after diagnosis. The three-year survival rate for children on the trial is equal to the best published radiotherapy results and the five-year survival rate is better than previous trials that have used radiotherapy as a matter of course.