Long-Term Remission of Recurrent Brainstem Pilocytic Astrocytoma with Neuraxis Dissemination Using Recombinant Human Endostatin After Failure of Vincristine and Carboplatin

World Neurosurg. 2018 Feb:110:397-402. doi: 10.1016/j.wneu.2017.11.150. Epub 2017 Dec 2.

Abstract

Background: There is no standard salvage treatment for recurrent and/or unresectable brainstem low-grade gliomas after failure from carboplatin and vincristine chemotherapy. Recombinant human endostatin (rh-ES), a mild inhibitor of angiogenesis, has been used for treating lung cancer. But so far as we know, there is no experience for brainstem gliomas.

Case description: The authors present a pediatric case of recurrent brainstem pilocytic astrocytoma with neuraxis dissemination who experienced tumor progression with carboplatin and vincristine chemotherapy but then had a dramatic and long-term remission for at least 29 months after combined treatment of rh-ES with carboplatin and vincristine.

Conclusion: This case suggests that the addition of rh-ES to carboplatin and vincristine regimens may be synergistic and results in a long-term remission in patients with brainstem low-grade gliomas, even if the tumor is widely spread in the central nervous system.

Keywords: Brainstem; Carboplatin; Chemotherapy; Low-grade glioma; Pilocytic astrocytoma; Recombinant human endostatin; Vincristine.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Agents / administration & dosage*
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Astrocytoma / diagnostic imaging
  • Astrocytoma / drug therapy*
  • Brain Stem Neoplasms / diagnostic imaging
  • Brain Stem Neoplasms / drug therapy*
  • Carboplatin / administration & dosage*
  • Carboplatin / adverse effects
  • Child
  • Drug Resistance, Neoplasm / drug effects
  • Endostatins / administration & dosage*
  • Endostatins / adverse effects
  • Female
  • Humans
  • Neoplasm Metastasis / diagnostic imaging
  • Neoplasm Metastasis / drug therapy
  • Neoplasm Recurrence, Local / diagnostic imaging
  • Neoplasm Recurrence, Local / drug therapy
  • Recombinant Proteins / administration & dosage
  • Recombinant Proteins / adverse effects
  • Vincristine / administration & dosage*
  • Vincristine / adverse effects

Substances

  • Antineoplastic Agents
  • Endostatins
  • Recombinant Proteins
  • Vincristine
  • Carboplatin