Chemotherapy in low-grade astrocytoma management

Childs Nerv Syst. 1998 Jan-Feb;14(1-2):6-9. doi: 10.1007/s003810050165.

Abstract

The role of chemotherapy (CHT) in the management of low-grade astrocytoma (LGA) is still unclear. Nineteen children with nonresectable symptomatic LGA were treated with carboplatin (CBDCA) and etoposide (E). There were 15 newly diagnosed cases and 4 were relapses; 6 of the children were under 5 years old. In all children radiological evaluation by CT scan and/or MRI was performed after four courses of CHT. We observed complete response (CR)+ minor response (MR) in 37% of these cases and an improvement in neurological symptoms in 63%. Radiological evaluation performed in 6 patients who received CHT for longer periods (8-12 courses) showed major responses (CR+PR) in 67%. Local radiotherapy (40 Gy) was administered after CHT in 14 cases, but in 3 of these radiotherapy was delayed for 2 years. Five patients did not receive radiotherapy. The overall survival was 58% after an average follow-up of 60 months. All patients with brain stem tumors died of progressive disease even though 3 of these had shown clinical improvement after chemotherapy. In conclusion, in the treatment of nonresectable symptomatic LGA, CHT with CBDCA associated with E can be used to postpone radiotherapy in young children and even to avoid radiotherapy in some cases.

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Astrocytoma / drug therapy*
  • Astrocytoma / mortality
  • Astrocytoma / radiotherapy
  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / mortality
  • Brain Neoplasms / radiotherapy
  • Carboplatin / administration & dosage
  • Carboplatin / adverse effects
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Cranial Irradiation
  • Etoposide / administration & dosage
  • Etoposide / adverse effects
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Magnetic Resonance Imaging
  • Male
  • Radiotherapy, Adjuvant
  • Survival Rate
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Etoposide
  • Carboplatin