Astrocytic tumors in children: treatment results from a single institution.
OBJECTIVE
The aims of this study are to evaluate the patients with astrocytomas and to investigate survival rates and prognosis.


METHODS
Five hundred fourteen patients diagnosed with brain tumor between 1972 and 2003 were retrospectively analyzed. Three different chemotherapy regimens were used according to years. CCNU-based protocols were used in the early years; COPP (cyclophosphamide, oncovin, procarbazine, prednisolone) and CDDP+VP16 (cisplatinum + etoposide) were the other protocols used in the following years. Radiotherapy was used after 3 years of age according to protocols.


RESULTS
Ninety-eight (19%) out of 514 patients have astrocytic histopathology. The histopathologic distribution was as follows: low grade, 55 patients; high grade, 43 patients. COPP regimen was given to 24 patients, CCNU-based regimen to 13, and CDDP+VP16 to 10 patients. We did not use any chemotherapy in 51 patients. Overall survival (OS) and event free-survival rates were 59.2 and 45.7% in whole group. OS rates were 93.3 and 22.4% for low-grade and high-grade histopathology, respectively (p=0.0001). OS for CCNU, CDDP+VP16, and COPP were 35.9, 22.8, and 30.4%, respectively.


CONCLUSIONS
Low-grade astrocytomas are highly responsive to the surgery, and they do not need any further treatment unless the patient has relapse or recurrence. Still, the treatment of the high-grade tumors is a problem, and it needs new treatment approaches.
Varan
Ali
A
Department of Pediatric Oncology, Institute of Oncology, Hacettepe University, 06100 Ankara, Turkey. hupog@tr.net
Akyüz
Canan
C
Akalan
Nejat
N
Atahan
Lale
L
Söylemezoglu
Figen
F
Selek
Ugur
U
Yalçin
Bilgehan
B
Kutluk
Tezer
T
Büyükpamukçu
Münevver
M
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001254:Astrocytoma / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D001932:Brain Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007223:Infant; D008130:Lomustine / Q000008:administration & dosage; D008297:Male; D019635:Neurosurgical Procedures; D011241:Prednisone / Q000008:administration & dosage; D011344:Procarbazine / Q000008:administration & dosage; D011878:Radiotherapy; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
D011344:Procarbazine; D014750:Vincristine; D005047:Etoposide; D008130:Lomustine; D003520:Cyclophosphamide; D011241:Prednisone