Recombinant human vascular endostatin injection to synchronize craniospinal radiotherapy for the treatment of recurrent medulloblastoma in children: A retrospective clinical study*

Abstract

Abstract Objective Medulloblastoma (MB) is the most common primary central nervous system malignancy in children. Nonetheless, there is no standard treatment for recurrent MB. The purpose of this study was to investigate the clinical value and toxicity of recombinant human endostatin injection (Endostar®) combined with craniospinal radiotherapy for the treatment of recurrent MB in children. Methods This study retrospectively analyzed 13 patients with recurrent MB aged 5-18 years. Endostar® 7.5 mg/m2/d was synchronized during craniospinal radiotherapy for 7 children with a portable micro uniform speed infusion pump. Endostar® was applied 3 days prior to the initiation of radiotherapy. The drug was in continuous use for 7 days. Similarly, the withdrawal of the drug took place over 7 days. This represented a cycle. During radiotherapy, the application was repeated until the end of radiotherapy (experimental group). In the other 6 cases, only craniospinal radiotherapy was used (control group). Results The complete remission rate was 71.4% in the experimental group and 16.7% in the control group. The median progression-free survival (PFS) was 14 months (95% CI: 0.0-29.60) and 19 months (95% CI: 0.0-39.53) in the experimental and control groups, respectively. The median overall survival (OS) was 19 months (95% CI: 0.0-38.20) and 23 months (95% CI: 2.47-43.53) in the experimental and control groups, respectively. The most common adverse events included grade 1 thrombocytopenia (7.7%), grade 3 neutropenia (38.5%), and grade 1 anemia (30.8%). Conclusion Endostar® synchronizing craniospinal radiotherapy significantly improved the complete response rate of children with recurrent MB. It did not increase the side effects of radiation therapy. However, it did not improve the PFS or OS.