Temozolomide in pediatric low-grade glioma.
BACKGROUND
We describe a retrospective series of children with low-grade glioma who received temozolomide.


METHODS
Eligible patients had had a diagnosis of low-grade glioma with or without histological confirmation. Temozolomide was administered at a dose of 200 mg/m(2) daily for 5 days, in a 4-week cycle. Therapy was stopped on completion of the targeted 12 cycles of chemotherapy or on evidence of tumor progression.


RESULTS
Thirteen eligible patients were identified, eight male and five female. Median age at diagnosis was 5.5 years (range 2.6-15.0 years) and at commencement of temozolomide treatment was 9.0 years (range 3.8-15.2 years). Nine patients had a histological diagnosis of pilocytic astrocytoma. Twelve patients had received carboplatin prior to temozolomide, including three in combination with vincristine. A total of 111 cycles of therapy have been administered. Hematological toxicity and nausea were the most common adverse effects. Median time to progression was 6.7 months (range 1.5-41.8 months). Event-free survival rate at 3 years was 57%. Twelve of 13 patients remain alive at the time of report. Eleven have stable disease (SD).


CONCLUSIONS
Temozolomide appears to be active in pediatric low-grade glioma, with the advantage of oral administration and excellent tolerability.
Khaw
Seong L
SL
Children's Cancer Centre, Royal Children's Hospital, Melbourne, Australia. khaw@wehi.edu.au
Coleman
Lee T
LT
Downie
Peter A
PA
Heath
John A
JA
Ashley
David M
DM
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D001254:Astrocytoma / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003606:Dacarbazine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D018572:Disease-Free Survival; D005260:Female; D006402:Hematologic Diseases / Q000139:chemically induced / Q000401:mortality; D006801:Humans; D008297:Male; D009325:Nausea / Q000139:chemically induced / Q000401:mortality; D011859:Radiography; D012189:Retrospective Studies; D013120:Spinal Cord Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality; D015996:Survival Rate; D000077204:Temozolomide; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
D014750:Vincristine; D003606:Dacarbazine; D016190:Carboplatin; D000077204:Temozolomide