Is there a role for myeloablative chemotherapy with autologous hematopoietic cell rescue in the management of childhood high-grade astrocytomas?
High-grade or malignant glioma represent 10% of pediatric brain tumors and are, taken as a whole, the second more frequent malignant histotype after medulloblastoma. Apart from a complete excision followed by full dose local radiotherapy, chemotherapy seems to give some beneficial to final outcome. Different trials have explored the role of high-dose chemotherapy that theoretically could give an advantage to these patients by overcoming blood-brain barrier, tumor cell chemo-resistance and inducing a wider number of responses. It is, however, still doubtful if better responses translate into improved outcome and which patients can have a true beneficial from this treatment strategy.
Massimino
Maura
M
Pediatric Neuro-Oncology at Pediatrics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy. maura.massimino@istitutotumori.mi.it
Cohen
Kenneth J
KJ
Finlay
Jonathan L
JL
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001254:Astrocytoma / Q000628:therapy*; D001932:Brain Neoplasms / Q000628:therapy*; D002648:Child; D002986:Clinical Trials as Topic; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D014182:Transplantation, Autologous
D000970:Antineoplastic Agents