title: Use of high-dose chemotherapy in front-line therapy of childhood malignant glioma.
abstract: Brain tumors are the second most common cancer in pediatric patients and the main cause from death of malignant tumors in this age group. High-grade or malignant glioma, among which anaplastic astrocytomas and glioblastoma are the most prevalent histotypes, represent 10% of pediatric brain tumors and, taken as a whole, are the second most frequent malignant histotype after medulloblastoma. Apart from complete excision followed by full-dose local radiotherapy, chemotherapy appears to provide some benefit to the final outcome. Different trials have explored the role of high-dose chemotherapy that, theoretically, could give an advantage to these patients by overcoming the blood-brain barrier, cell chemoresistance and inducing a wider number of responses. However, it is still doubtful if more responses translate into better outcome and it is not fully understood which patients can experience a true benefit from this treatment strategy. New protocols under evaluation include new agents with specific biological targets, multiple cycles of high-dose chemotherapy, and vaccination, as an immunotherapeutic approach.
authors.affiliation: Pediatric Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, 20133 Milan, Italy. maura.massimino@istitutotumori.mi.it
authors.forename: Maura
authors.initials: M
authors.lastname: Massimino
authors.forename: Veronica
authors.initials: V
authors.lastname: Biassoni
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D020295:Brain Stem Neoplasms / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005910:Glioma / Q000188:drug therapy*; D006801:Humans