{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T15:33:16Z","timestamp":1781105596377,"version":"3.54.1"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2007,12,10]],"date-time":"2007-12-10T00:00:00Z","timestamp":1197244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2008,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND.<\/jats:title><jats:p>The rate of durable responses in embryonal and certain germ cell tumors of the central nervous system (CNS) is unsatisfactory. Intraarterial chemotherapy and osmotic blood\u2010brain barrier disruption (IA\/BBBD) increases drug delivery to the CNS.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS.<\/jats:title><jats:p>Data of patients treated with carboplatin or methotrexate\u2010based IA\/BBBD on prospective phase 2 trials conducted at 3 centers were collected. Study outcomes included overall survival (OS), time to progression (TTP), and toxicity.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS.<\/jats:title><jats:p>Fifty\u2010four patients were treated. Twenty\u2010seven patients received IA\/BBBD as salvage treatment. The median OS was 2.8 years for all patients, 2.5 years for supratentorial and disseminated primitive neuroectodermal tumors (PNETs, n = 29), 1.7 years for medulloblastomas (n = 12), and 5.4 years for germ cell tumors (n = 13). OS and TTP for all patients were better with a Karnofsky Performance Status \u226570% (<jats:italic>P<\/jats:italic> = .0013 and .0070) and IA\/BBBD as first\u2010line treatment (<jats:italic>P<\/jats:italic> = .0059 and .029). In PNETs, OS was higher with pineal location (<jats:italic>P<\/jats:italic> = .045) and IA\/BBBD as first\u2010line treatment (<jats:italic>P<\/jats:italic> = .0036), and TTP was improved with radiotherapy before IA\/BBBD (<jats:italic>P<\/jats:italic> = .036) and IA\/BBBD as first\u2010line treatment (<jats:italic>P<\/jats:italic> = .0079). Seventeen of 54 patients (31%) are alive, and 16 are alive at 4+ to 18+ years. Three survivors were not treated with radiotherapy and 4 were treated with focal radiotherapy only. The patients who were not irradiated did not develop dementia.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS.<\/jats:title><jats:p>Survival and toxicity data appear promising, considering the cohort's adverse prognostic profile. A plateau in survival curves suggests a cure for some patients. Long\u2010term survival may be achieved with focal or reduced\u2010dose radiotherapy in some IA\/BBBD patients. Cancer 2008. \u00a9 2007 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.23221","type":"journal-article","created":{"date-parts":[[2007,12,10]],"date-time":"2007-12-10T12:19:40Z","timestamp":1197289180000},"page":"581-588","source":"Crossref","is-referenced-by-count":50,"title":["Intraarterial chemotherapy and osmotic blood\u2010brain barrier disruption for patients with embryonal and germ cell tumors of the central nervous system"],"prefix":"10.1002","volume":"112","author":[{"given":"Kristoph","family":"Jahnke","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dale F.","family":"Kraemer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin R.","family":"Knight","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Fortin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Bell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy D.","family":"Doolittle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie L.","family":"Muldoon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward A.","family":"Neuwelt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2007,12,10]]},"reference":[{"key":"e_1_2_5_2_2","volume-title":"Pathology and Genetics of Tumours of the Nervous System","author":"Kleihues 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