Long-term results of conventional treatment of diencephalic pilocytic astrocytoma in infants.
BACKGROUND
To develop an effective therapeutic strategy for patients with diencephalic pilocytic astrocytomas (PA), we must understand the long-term effects and problems of conventional treatments.


METHODS
We performed a retrospective follow-up of four infants with PA in the diencephalon.


CONCLUSIONS
The initial treatment consisted of partial tumor removal and/or external radiation. The mean progression-free duration after the initial treatment was 108.5 months. All patients received a second course of radiation to treat recurrent tumors. These conventional treatments produced relatively long survival. Three patients died 105, 202, and 379 months after the initial treatment. One patient is still alive at 249 months after the initial treatment. However, mental retardation was obvious in all four patients 6 to 12 years after the first irradiation and within 2 years of the second course of irradiation. Therefore, new therapeutic strategies must focus on delaying the timing of radiation until the patients are at least 5 years old and avoiding a second course of radiation to treat recurrence.
Arita
Kazunori
K
Department of Neurosurgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-Ku, 734-8551 Hiroshima, Japan. karita@hiroshima-u.ac.jp
Kurisu
Kaoru
K
Sugiyama
Kazuhiko
K
Itoh
Yoko
Y
Hotta
Takuhiro
T
Sogabe
Takashi
T
Uozumi
Tohru
T
D001254:Astrocytoma / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D001932:Brain Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004027:Diencephalon; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008607:Intellectual Disability; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011881:Radiotherapy, Computer-Assisted / Q000379:methods; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome