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Prevention of CNS recurrence in childhood ALL: Results with reduced radiotherapy combined with CNS-directed chemotherapy in four consecutive ALL-BFM trials
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1998
Year
Pediatric Brain TumorsCranial RadiotherapyCns RecurrenceGliomaHematological MalignancyNeuro-oncologyOncologyBrachytherapyNeurologyRadiation OncologyNuclear MedicineRadiologyHealth SciencesConsecutive All-bfm TrialsRadiation TherapyPediatric NeurosurgeryCns-directed ChemotherapyMalignant Blood DisorderAcute Lymphoblastic LeukemiaPediatricsCentral Nervous SystemMedicine
Background The introduction of cranial radiotherapy (CRT) has provided efficient control of overt or subclinical meningeosis in acute lymphoblastic leukemia (ALL). Especially due to the long-term toxicity of CRT, reduction or elimination of radiotherapy appeared mandatory after cure rates of more than 70% had been achieved in ALL. The Berlin-Frankfurt-Münster (BFM) Study Group initiated several attempts in certain ALL subgroups to omit or reduce CRT while using more CNS-directed chemotherapy but without extended intrathecal treatment during maintenance therapy. This analysis summarizes the essential results that are in particular relevant because irradiation of the central nervous system (CNS) has been further reduced in the most recent trial ALL-BFM 95.