title: Does chemotherapy have a role in low-grade astrocytoma management? A report of 13 cases.
abstract: Surgery is the treatment of choice for low-grade astrocytoma while radiotherapy is carried out only when total resection is not possible. This study assessed the effectiveness of chemotherapy in nonresectable cases. Thirteen children with nonresectable astrocytoma were treated with carboplatin and etoposide and after four cycles the response to treatment was evaluated according to radiologic criteria. The results were: one with complete response (CR), three with minor response (MR), six with stable disease (SD), and three with progressive disease (PD). Moreover, in 77% there was an improvement in the neurologic picture. In particular, two cases with hypothalamic astrocytoma showed a regression of the diencephalic syndrome following chemotherapy. In six cases chemotherapy was carried out, at reduced dosage, after the first four cycles either because there was clinical improvement or because it was necessary to postpone radiotherapy in very young patients. After a follow-up period ranging between 11 and 63 months (average: 30 months), nine of the 13 patients are alive (69%) while four died of disease progression. Further studies would be useful to evaluate the role of chemotherapy in the management of low-grade astrocytoma.
authors.affiliation: Pediatric Oncology Service, La Sapienza University, Rome, Italy.
authors.forename: M A
authors.initials: MA
authors.lastname: Castello
authors.forename: A
authors.initials: A
authors.lastname: Schiavetti
authors.forename: A
authors.initials: A
authors.lastname: Padula
authors.forename: G
authors.initials: G
authors.lastname: Varrasso
authors.forename: E
authors.initials: E
authors.lastname: Properzi
authors.forename: G
authors.initials: G
authors.lastname: Trasimeni
authors.forename: P
authors.initials: P
authors.lastname: Operamolla
authors.forename: G F
authors.initials: GF
authors.lastname: Gualdi
authors.forename: A
authors.initials: A
authors.lastname: Clerico
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001254:Astrocytoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D013921:Thrombocytopenia / Q000139:chemically induced
chemical_list: D005047:Etoposide; D016190:Carboplatin