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Chemotherapy for pilocytic astrocytomas

1993; Wiley; Volume: 71; Issue: 10 Linguagem: Inglês

10.1002/1097-0142(19930515)71

1097-0142

Mark T. Brown, Henry S. Friedman, Beverley Hockenberger, W. Jerry Oakes, Orest B. Boyko, S. Clifford Schold,

Neurofibromatosis and Schwannoma Cases

CancerVolume 71, Issue 10 p. 3165-3172 Original ArticleFree Access Chemotherapy for pilocytic astrocytomas Mark T. Brown M.D., Corresponding Author Mark T. Brown M.D. Neuro-Oncology Section, Department of Medicine and Division of Neurology, Duke University Medical Center, Durham, North CarolinaNeuro-Oncology Section, Box 3963, Duke University Medical Center, Durham, NC 27710===Search for more papers by this authorHenry S. Friedman M.D., Henry S. Friedman M.D. Department of Pediatrics and Division of Hematology-Oncology, Duke University Medical Center, Durham, North CarolinaSearch for more papers by this authorBeverley Hockenberger P.A., Beverley Hockenberger P.A. Department of Pediatrics and Division of Hematology-Oncology, Duke University Medical Center, Durham, North CarolinaSearch for more papers by this authorW. Jerry Oakes M.D., W. Jerry Oakes M.D. Department of Surgery and Division of Neurosurgery, University of Alabama, Birmingham, Birmingham, AlabamaSearch for more papers by this authorOrest B. Boyko M.D., Ph.D., Orest B. Boyko M.D., Ph.D. Department of Radiology, Duke University Medical Center, Durham, North CarolinaSearch for more papers by this authorS. Clifford Schold Jr. M.D., S. Clifford Schold Jr. M.D. Department of Neurology, University of Texas Southwestern, Dallas, TexasSearch for more papers by this author Mark T. Brown M.D., Corresponding Author Mark T. Brown M.D. Neuro-Oncology Section, Department of Medicine and Division of Neurology, Duke University Medical Center, Durham, North CarolinaNeuro-Oncology Section, Box 3963, Duke University Medical Center, Durham, NC 27710===Search for more papers by this authorHenry S. Friedman M.D., Henry S. Friedman M.D. Department of Pediatrics and Division of Hematology-Oncology, Duke University Medical Center, Durham, North CarolinaSearch for more papers by this authorBeverley Hockenberger P.A., Beverley Hockenberger P.A. Department of Pediatrics and Division of Hematology-Oncology, Duke University Medical Center, Durham, North CarolinaSearch for more papers by this authorW. Jerry Oakes M.D., W. Jerry Oakes M.D. Department of Surgery and Division of Neurosurgery, University of Alabama, Birmingham, Birmingham, AlabamaSearch for more papers by this authorOrest B. Boyko M.D., Ph.D., Orest B. Boyko M.D., Ph.D. Department of Radiology, Duke University Medical Center, Durham, North CarolinaSearch for more papers by this authorS. Clifford Schold Jr. M.D., S. Clifford Schold Jr. M.D. Department of Neurology, University of Texas Southwestern, Dallas, TexasSearch for more papers by this author First published: 15 May 1993 https://doi.org/10.1002/1097-0142(19930515)71:10 3.0.CO;2-NCitations: 30AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Abstract Background. Although pilocytic astrocytomas (PA) generally are considered benign, a subset of patients with PA have disease progression despite standard treatment with surgery and radiation therapy. The authors report their experience with chemotherapy in this patient group. Methods. The authors treated 11 patients (4 males and 7 females; median age at diagnosis, 8 years) with pathologically confirmed PA with chemotherapy. In eight patients, tumor progression or recurrence despite prior surgery and radiation therapy led to chemotherapy treatment. In three children younger than 5 years, chemotherapy was given in lieu of radiation therapy immediately after diagnosis (in one patient) or at the time of disease progression after surgery (in two patients). The authors used ten different chemotherapy regimens to treat the 11 patients. Results. Chemotherapy produced clinical and radiographic improvement (R/R) in four (36%) patients, clinical stabilization and radiographic improvement (SD/R) in 1 (9%), clinical and radiographic stabilization (SD/SD) in 3 (27%), and was associated with clinical and radiographic progression (PD/PD) in 3 (27%). Three of the five patients with radiographic improvement had a greater than 75% reduction of maximal cross-sectional tumor area. Hematologic toxicity resulted in dose reductions in 43 of 110 (39%) total courses of chemotherapy. There were three hospital admissions for fever and neutropenia and one chemotherapy-related death. Conclusions. The authors conclude that chemotherapy may benefit those with progressive inoperable PA. Chemotherapy may delay the need for radiation therapy in young patients with unresectable PA requiring treatment. PA may be a chemosensitive primary brain tumor. Citing Literature Volume71, Issue1015 May 1993Pages 3165-3172 ReferencesRelatedInformation