title: High response rate to cisplatin/etoposide regimen in childhood low-grade glioma.
abstract: 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.
authors.affiliation: Pediatric Oncology, Radiodiagnostic E and Radiotherapy Unit, Istituto Nazionale Tumori, Milan, Italy. massimino@istitutotumori.mi.il
authors.forename: Maura
authors.initials: M
authors.lastname: Massimino
authors.forename: Filippo
authors.initials: F
authors.lastname: Spreafico
authors.forename: Graziella
authors.initials: G
authors.lastname: Cefalo
authors.forename: Riccardo
authors.initials: R
authors.lastname: Riccardi
authors.forename: John David
authors.initials: JD
authors.lastname: Tesoro-Tess
authors.forename: Lorenza
authors.initials: L
authors.lastname: Gandola
authors.forename: Daria
authors.initials: D
authors.lastname: Riva
authors.forename: Antonio
authors.initials: A
authors.lastname: Ruggiero
authors.forename: Laura
authors.initials: L
authors.lastname: Valentini
authors.forename: Elena
authors.initials: E
authors.lastname: Mazza
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Genitori
authors.forename: Concezio
authors.initials: C
authors.lastname: Di Rocco
authors.forename: Piera
authors.initials: P
authors.lastname: Navarria
authors.forename: Michela
authors.initials: M
authors.lastname: Casanova
authors.forename: Andrea
authors.initials: A
authors.lastname: Ferrari
authors.forename: Roberto
authors.initials: R
authors.lastname: Luksch
authors.forename: Monica
authors.initials: M
authors.lastname: Terenziani
authors.forename: Maria Rosa
authors.initials: MR
authors.lastname: Balestrini
authors.forename: Cesare
authors.initials: C
authors.lastname: Colosimo
authors.forename: Franca
authors.initials: F
authors.lastname: Fossati-Bellani
mesh_terms: 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
chemical_list: D005047:Etoposide; D002945:Cisplatin