Management of pilomyxoid astrocytomas: our experience.
BACKGROUND
Pilomyxoid astrocytoma (PMA) shows a higher rate of recurrence and cerebrospinal fluid (CSF) dissemination than does pilocytic astrocytoma (PA). In this article, we discuss the treatment of PMA.


METHODS
Between 1992 and 2007, the authors treated 5 patients. Two of these were male, three female. Their ages ranged from 3 months to 11 years.


RESULTS
Three patients showed CSF dissemination on the initial radiographic examination. All patients received chemotherapy; the most commonly used combination drugs were cisplatin (CDDP)/carboplatin (CBDCA) and etoposide. When these drugs were unsuccessful, they were changed or other drugs added to the combination. After chemotherapy, four patients showed remarkable tumor regression. Nevertheless, one patient died 22 months after initial diagnosis, due to tumor progression.


CONCLUSIONS
While our series was limited to a small number of patients, we have a positive impression of the value of chemotherapy. Even if initial chemotherapy is ineffective, we recommend continued CDDP/CBDCA-based chemotherapy with new drug combinations.
Department of Neurosurgery, Fukuoka University Faculty of Medicine, Jonan-ku, Fukuoka 814-0180, Japan. h-tsugu@fukuoka-u.ac.jp
Hitoshi
H
Tsugu
Shinya
S
Oshiro
Fumio
F
Yanai
Fuminari
F
Komatsu
Hiroshi
H
Abe
Takeo
T
Fukushima
Yuko
Y
Nomura
Shinji
S
Matsumoto
Kazuki
K
Nabeshima
Koichi
K
Takano
Hidetsuna
H
Utsunomiya
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001254:Astrocytoma / Q000134:cerebrospinal fluid / Q000188:drug therapy* / Q000473:pathology; D001932:Brain Neoplasms / Q000134:cerebrospinal fluid / Q000188:drug therapy* / Q000473:pathology; D016190:Carboplatin / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000134:cerebrospinal fluid / Q000188:drug therapy* / Q000473:pathology; D011379:Prognosis
D005047:Etoposide; D016190:Carboplatin