title: High-grade glioma in children under 5 years of age: a chemotherapy only approach with the BBSFOP protocol.
abstract: The aim of this study was to evaluate a chemotherapy strategy that avoids radiotherapy in first-line treatment of young children with high-grade glioma. A total of 21 children under 5 years of age received the BBSFOP protocol, comprising seven cycles of three drug pairs (carboplatin/procarbazine, cisplatin/etoposide and vincristine/cyclophosphamide) administered over a 16 month period. Radiotherapy was performed in case of recurrence/progression. Median age at diagnosis was 23 months. Histology was classified as World Health Organisation (WHO) grade III in 13 and grade IV in 8. Of the 13 children with a residual tumour, chemotherapy induced 2 partial responses (PR), 1 minor response (MR) and 1 stable disease (SD) with no recurrent disease. Five-year progression-free survival was 35% and 5-year overall survival was 59%, with a median follow-up of 5.2 years. At the last update, 12 children were alive (10 without radiotherapy). In conclusion, this study shows that an adjuvant chemotherapy first approach is safe and allows radiotherapy to be avoided in selected children.
authors.affiliation: Department of Pediatric and Adolescent, Institut Gustave Roussy, 39, rue Camille Desmoulins, 94805 Villejuif cedex, France. dufour@igr.fr <dufour@igr.fr>
authors.forename: C
authors.initials: C
authors.lastname: Dufour
authors.forename: J
authors.initials: J
authors.lastname: Grill
authors.forename: A
authors.initials: A
authors.lastname: Lellouch-Tubiana
authors.forename: S
authors.initials: S
authors.lastname: Puget
authors.forename: P
authors.initials: P
authors.lastname: Chastagner
authors.forename: D
authors.initials: D
authors.lastname: Frappaz
authors.forename: F
authors.initials: F
authors.lastname: Doz
authors.forename: F
authors.initials: F
authors.lastname: Pichon
authors.forename: D
authors.initials: D
authors.lastname: Plantaz
authors.forename: J C
authors.initials: JC
authors.lastname: Gentet
authors.forename: M A
authors.initials: MA
authors.lastname: Raquin
authors.forename: C
authors.initials: C
authors.lastname: Kalifa
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy*; D016190:Carboplatin / Q000008:administration & dosage; D002675:Child, Preschool; D002945:Cisplatin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005910:Glioma / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D008297:Male; D018365:Neoplasm, Residual; D011344:Procarbazine / Q000008:administration & dosage; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D011344:Procarbazine; D014750:Vincristine; D005047:Etoposide; D003520:Cyclophosphamide; D016190:Carboplatin; D002945:Cisplatin