[Treatment of XXXX in childhood and adolescence: results of the multicenter therapy study @entity981 -BFM 81].

@entity1 @entity1499 @entity981 @entity149
In therapy study @entity981 -BFM 81 633 previously untreated @entity1 with @entity981 ( @entity981 ) less than 18 years of age have been recruited from April 1, 1981 to September 30, 1983 and treated in 37 institutions throughout West-Germany and Austria. Here only therapy results of 611 @entity1 with non-B- @entity981 are presented. @entity1 with @entity981 of B-type are described elsewhere. In this fourth consecutive trial of the BFM study group three major questions have been asked: 1. Is it possible to assess the individual risk for relapse more accurately by the use of a risk factor rather than by the risk score which was the discriminator in studies @entity981 -BFM 76 and @entity981 -BFM 79? Does this risk factor discriminate more precisely @entity1 at the highest risk for relapse? Offers more intensive risk-adapted therapy to this @entity1 group a better chance for disease-free survival? 2. In @entity1 at a standard risk for relapse with a risk factor below 1.2--approximately 60% of @entity1 with non-B- @entity981 --can radiotherapy for prevention of @entity149 effectively be replaced by chemotherapy (intermediate dose @entity1499 )? 3. It is possible to reduce duration of maintenance therapy by 6 months to a total duration of 18 months with no unfavorable effect? To assess the radiation problem in standard risk @entity1 and to evaluate the importance of duration of maintenance therapy two randomisations have been utilized. After a median duration of study @entity981 -BFM 81 of 4 1/2 years and 3 1/4 years after the study had been closed (date of evaluation January 1, 87) the answers are as follows: 1. For the majority of @entity1 risk-adapted therapy had a curative effect. The probability for event-free survival (EFS) in standard risk @entity1 in slightly above 70%, in medium risk @entity1 67%. In high-risk @entity1 risk-adapted therapy did not improve prognosis, the EFS being still in the order of 50%. A good assessment of the individual risk for relapse is possible by the newly introduced risk factor. This principle is superior to the risk score used in former studies @entity981 -BFM 76 and @entity981 -BFM 79 because a low risk group (risk factor below 0.8) could be identified including approximately 25% of all @entity1 with non-B @entity981 . Selection, quality, and timing of therapy elements remain the decisive prognostic factors, however. 2. Standard risk @entity1 with a risk factor below 0.8 can effectively be protected for CNS relapse by treatment with intermediate dose @entity1499 .(ABSTRACT TRUNCATED AT 400 WORDS)
