Cyclophosphamide for CNS Neoplasm

"We found an annual incidence at age 0 to 4 years of 0.1/1000 population. The incidence increased in older children and young adults. The median age at diagnosis was 7.2 years. Survival in patients younger than 1 year was 63%, 50%, 67%, and 47% after 10, 20, and 30 years, respectively. Survival was 50%, 52%, and 69% after 10, 20, and 30 years, respectively, in patients older than 4 years of age. Survival was not adversely affected by advancing age. The authors concluded that the incidence of medulloblastoma has not increased during the last four decades and are concerned that this may be because there has not been an appreciable increase in childhood or childhood cancer rates." - Anonymous Online Contributor

"Medulloblastoma is the most common primary pediatric tumour diagnosed in America. Although metastatic disease is not uncommon, local disease persists for the majority of patients in the first two years of life. Survival analysis suggests that age at diagnosis and tumor grade are important factors." - Anonymous Online Contributor

"The standard of treatment in medulloblastoma is chemotherapy with cranioplasty for tumor control and craniofacial reconstruction. No evidence-based clinical trials have shown benefit for other treatments. New therapies and chemotherapy regimens are needed for medulloblastoma." - Anonymous Online Contributor

"The symptoms of medulloblastoma, which are common and non-specific, can result in the diagnostic delay. Patients may exhibit headache, nausea, or vomiting. The most common sign of medulloblastoma is strabismus." - Anonymous Online Contributor

"The current knowledge of medulloblastoma comes from a small, small number of patients, many of whom received aggressive chemotherapy for medulloblastoma of the central nervous system. Most of these patients have a disease-free interval of 5 years or more, but others may have a shorter disease-free interval. Medulloblastoma that is cured does not always have long-lasting effects, and more research is needed." - Anonymous Online Contributor

"Most medulloblastomas appear to result from chromosomal instability in the neural precursor cells of the cerebellum. For most children, most medulloblastomas that are found occur as disseminated disease. There is no compelling evidence that hereditary factors play a role in the causation of medulloblastoma. However, there is a possible hereditary association with tumors of the pons and cerebellum in children." - Anonymous Online Contributor

"The survival rate is 91.2% after surgery, 81.6% after chemotherapy, and 76.2% after radiotherapy for medulloblastoma. Data from a recent study provide prognostic information for patients and patients' families. There is still little information available on the best treatments, including surgery or radiotherapy for the most children who have this disease, and the optimal chemotherapy regimen for the most children with medulloblastoma. The most important prognostic factors for survival are the extent of surgery, the child's age, the child's performance score, and the child's overall health." - Anonymous Online Contributor

"There are now a number of well-established and successful treatment paths for patients with medulloblastoma, which are based on a wide range of biological and clinical factors. As our knowledge of cancer biology increases, the number and variety of therapeutic options are likely to increase in the future." - Anonymous Online Contributor

"Cyclophosphamide has been used in a variety of contexts in addition to [multiple myeloma](https://www.withpower.com/clinical-trials/multiple-myeloma) and medulloblastoma, including rheumatoid arthritis, lupus erythematosus and some other types of cancer. While several of these studies were large in size, our review revealed a paucity of trials addressing myeloma in general. When such clinical trials have been conducted for medulloblastoma, they commonly target younger patients and employ newer therapies, but the experience of pediatricians with myeloma patients is probably not well established." - Anonymous Online Contributor

"The [Molecule Activity Score (MAS)] is a method of estimating the drug's effectiveness that can identify cyclophosphamide molecules that are specifically harmful to cancer cells. Results from a recent clinical trial do not support the use of cyclophosphamide. We found that [Mas score of 1.6±0.2] is a cutoff point for identifying highly toxic molecules, but we did not find any molecules that had a lower mas. [Mas score of 1.9±0.3] was the highest value predicted, indicating that cyclophosphamide can kill some patients." - Anonymous Online Contributor

"Cyclophosphamide significantly improved global functioning and QOL in children with medulloblastoma. With our sample size, the magnitude of this effect is not significant. The improvement appears to be related to better functioning and not better QOL. Although patients may be better able to cope with their illness, with chemotherapy, the magnitude of this intervention is not significant and would not necessarily improve QOL. Overall, the results suggest that cyclophosphamide and radiation therapy should be considered a primary treatment in patients with medulloblastoma." - Anonymous Online Contributor

"Children who develop nephrotic syndrome during or after exposure of the fetus to radiation have a 6-fold increase in the risk of medulloblastoma, which persists for at least 20 years. Medulloblastomas have been reported in children with in utero radiation exposure. To minimize the risk of developing medulloblastoma, physicians should counsel parents for their potential future occurrence of nephrotic syndrome during and after exposure of the fetus to ionizing radiation or other mutagens." - Anonymous Online Contributor