The role of PCV chemotherapy in the treatment of central neurocytoma: illustration of a case and review of the literature.
BACKGROUND
Most central neurocytomas follow a benign clinical course. However, more aggressive variants have been described requiring additional surgical resection, radiation, or chemotherapy. Chemotherapy has rarely been used as an adjuvant therapy for central neurocytomas.


METHODS
We report a case of a 20-year-old girl who underwent four subtotal resections, over the course of 3 years, for a large central neurocytoma that continued to progress. She was not a candidate for stereotactic radiosurgery, given the large tumor size. To avoid radiation injury in a young patient, she was treated with six cycles of chemotherapy including procarbazine, CCNU, and vincristine. Procarbazine was stopped after 2 cycles because of the development of a rash. Serial magnetic resonance imaging was used to follow treatment response.


RESULTS
Her tumor started to decrease in size after 2 cycles of chemotherapy and continued to shrink until it stabilized after 5 cycles of chemotherapy. A small area of residual tumor with minimal enhancement persisted along the left lateral ventricle and remained stable for at least 16 months after the completion of chemotherapy.


CONCLUSIONS
To our knowledge, this is only the fourth report describing the use of chemotherapy for progression of central neurocytomas as a treatment alternative to radiation therapy. The use of procarbazine, CCNU, and vincristine has not been previously described for the treatment of a central neurocytoma and presents an additional treatment option.
von Koch
Cornelia S
CS
Department of Neurological Surgery, University of California San Francisco, San Francisco, California 94143-0112, USA.
Schmidt
Meic H
MH
Uyehara-Lock
Jane H
JH
Berger
Mitchel S
MS
Chang
Susan M
SM
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008130:Lomustine / Q000627:therapeutic use*; D018306:Neurocytoma / Q000188:drug therapy*; D011344:Procarbazine / Q000627:therapeutic use*; D014750:Vincristine / Q000627:therapeutic use*
D011344:Procarbazine; D014750:Vincristine; D008130:Lomustine