GCSF Therapy for Prevention of Treatment Interruption among CNS Tumor Patients on Irradiation

Craniospinal irradiation (CSI) is employed to reduce the risk of dissemination of primary CNS tumors through the CSF pathways and thereby improve survival. While it is the way of elective or therapeutic treatment in some patients with cranial ependymoma, primary cerebral lymphoma and germ cell tumors, it is of proven benefit in patients with medulloblastoma and other primitive neuroectodermal tumors (PNETS) of CNS and CSI therefore remains an important part of treatment. The increasing use of chemotherapy in patients with PNETS also means that CSI will be combined with systemic chemotherapy of increasing intensity with potential for more frequent and severe haematological toxicity (Sarah et al., 1998). Also the use of such treatment encompassing large volumes of bone marrow can significantly depress hematologic counts (Brada et al., 1990; Bailey et al., 1995). Although treatment interruption may allow recovery from such acute toxicities, it is undesirable, because interruption may compromise tumor control (Custer and Ahlfeldt, 1932).