High response rate to cisplatin/etoposide regimen in childhood low-grade glioma.
OBJECTIVE
The aim of this study was to avoid radiotherapy and to induce an objective response in children with low-grade glioma (LGG) using a simple chemotherapy regimen based on cisplatin and etoposide.


METHODS
Thirty-four children (median age, 45 months) with unresectable LGG were treated with 10 monthly cycles of cisplatin (30 mg/m(2)/d on days 1 to 3) and etoposide (150 mg/m(2)/d on days 1 to 3). Tumor originated in the visual pathway in 29 patients, in the temporal lobe in two, in the frontal lobe in two, and in the spine in one. Eight children were affected by neurofibromatosis type 1. Objective tumor response and toxicity were evaluated by magnetic resonance imaging and neurologic and functional tests at 3-month intervals.


RESULTS
An objective response was obtained in 24 (70%) of 34 patients, whereas the others had stable disease. None of the children were electively irradiated. In 31 previously untreated children, overall survival was 100% and progression-free survival was 78% at 3 years, with a median follow-up of 44 months. Acute toxicity was unremarkable; 28% patients evaluated for acoustic neurotoxicity revealed a loss of perception of high frequencies.


CONCLUSIONS
Cisplatin and etoposide combined treatment is one of the most active regimens for LGG in children and allows avoidance of radiotherapy in the vast majority of patients.
Massimino
Maura
M
Pediatric Oncology, Radiodiagnostic E and Radiotherapy Unit, Istituto Nazionale Tumori, Milan, Italy. massimino@istitutotumori.mi.il
Spreafico
Filippo
F
Cefalo
Graziella
G
Riccardi
Riccardo
R
Tesoro-Tess
John David
JD
Gandola
Lorenza
L
Riva
Daria
D
Ruggiero
Antonio
A
Valentini
Laura
L
Mazza
Elena
E
Genitori
Lorenzo
L
Di Rocco
Concezio
C
Navarria
Piera
P
Casanova
Michela
M
Ferrari
Andrea
A
Luksch
Roberto
R
Terenziani
Monica
M
Balestrini
Maria Rosa
MR
Colosimo
Cesare
C
Fossati-Bellani
Franca
F
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D016543:Central Nervous System Neoplasms / Q000175:diagnosis / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005910:Glioma / Q000175:diagnosis / Q000188:drug therapy*; D006311:Hearing Disorders / Q000139:chemically induced; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D016019:Survival Analysis
D005047:Etoposide; D002945:Cisplatin