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Responsiveness of progressive optic pathway tumors to cisplatin-based chemotherapy in children.
- Source :
-
Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery [Childs Nerv Syst] 2008 Dec; Vol. 24 (12), pp. 1457-61. Date of Electronic Publication: 2008 Sep 04. - Publication Year :
- 2008
-
Abstract
- Background: Though the pathology of optic pathway tumor is mostly pilocytic astrocytoma, the benign tumor behaves like malignant tumor because total resection is not feasible. Adjuvant chemotherapy might be a reasonable strategy for management of these low grade tumors which keep growing. We evaluate the responsiveness of optic pathway tumor to cisplatin-based chemotherapy.<br />Methods: Patients with unresectable and progressive optic pathway tumors received conventional chemotherapy including cisplatin, etoposide, and vinblastine were enrolled in this study from 1992 to 2007. Patients treated with radiotherapy previously were excluded. Brain MRI was performed every 3 months to evaluate the objective response to chemotherapy.<br />Results: There are seven girls and nine boys enrolled in this study. The median age at diagnosis was 30 months old (range from 3 months to 11 years old). The median follow-up duration was 81.5 months (range from 24 months to 14.5 years). The pathology showed pilocytic astrocytomas in 11 patients, astrocytoma in one patient, and anaplastic astrocytomas in two patients. The 6-month progression-free survival (PFS) is 100%, 12-month PFS is 81.3%, 3-year PFS is 71.4% and 5-year PFS is 55.5% respectively. The toxicity of the cisplatin-based chemotherapy showed mild bone marrow suppression in 13 patients (81.3%), infection in nine patients (56.3%), gastrointestinal discomfort in seven patients (43.8%), renal insufficiency in two patient (12.5%), cerebral salt wasting syndrome with hyponatremia in one patient (6.25%) and high pitch hearing loss in two patients (12.5%).<br />Conclusion: Cisplatin-based chemotherapy is an effective regimen for control of progressive optic pathway tumors.
- Subjects :
- Antineoplastic Combined Chemotherapy Protocols administration & dosage
Antineoplastic Combined Chemotherapy Protocols adverse effects
Astrocytoma pathology
Astrocytoma physiopathology
Bone Marrow Diseases chemically induced
Child
Child, Preschool
Cisplatin administration & dosage
Cisplatin adverse effects
Disease-Free Survival
Drug Administration Schedule
Etoposide administration & dosage
Etoposide adverse effects
Female
Gastrointestinal Diseases chemically induced
Humans
Infections chemically induced
Magnetic Resonance Imaging
Male
Optic Nerve Neoplasms pathology
Optic Nerve Neoplasms physiopathology
Treatment Outcome
Vinblastine administration & dosage
Vinblastine adverse effects
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Astrocytoma drug therapy
Optic Nerve Neoplasms drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1433-0350
- Volume :
- 24
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 18769928
- Full Text :
- https://doi.org/10.1007/s00381-008-0707-4