Oral methotrexate for recurrent brain tumors in children: a Pediatric Oncology Group study.

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J Pediatr Hematol Oncol. 2000 Jan-Feb;22(1):41-4.
 
Oral methotrexate for recurrent brain tumors in children: a Pediatric Oncology Group study.
Mulne AF, Ducore JM, Elterman RD, Friedman HS, Krischer JP, Kun LE, Shuster JJ, Kadota RP.
University of Texas-Southwestern Medical School, Dallas, USA.
PURPOSE:
Children with recurrent or progressive central nervous system (CNS)
tumors have an unfavorable prognosis. Based on Pediatric Oncology Group
(POG) institutional pilot data, low-dose oral methotrexate (MTX) was
studied.
 
METHODS: Eight dosages of MTX 7.5 mg/m2 every 6 hours were
administered on a weekly schedule for as long as 18 months. Patients in
six different brain tumor strata were accrued.
 
RESULTS: The response
rates (complete or partial responses) were as follows: astrocytoma 2 of
10, malignant glioma 1 of 19, medulloblastoma 0 of 18, brainstem tumor
0 of 12, ependymoma 1 of 7, and miscellaneous histologic types 0 of 12.
The main toxicities, mucositis, myelosuppression, and hepatic
transaminase elevation were considered tolerable.
 
CONCLUSION: Low-dose
oral MTX showed no significant activity against malignant glioma,
medulloblastoma, brainstem tumors, and miscellaneous histologic types.
Indeterminate but low response rates were observed in children with
astrocytoma and ependymoma. This regimen will not be recommended for
front-line therapy.