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Published in: Child's Nervous System 3/2007

01-03-2007 | Original Paper

Astrocytic tumors in children: treatment results from a single institution

Authors: Ali Varan, Canan Akyüz, Nejat Akalan, Lale Atahan, Figen Söylemezoglu, Ugur Selek, Bilgehan Yalçin, Tezer Kutluk, Münevver Büyükpamukçu

Published in: Child's Nervous System | Issue 3/2007

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Abstract

Objective

The aims of this study are to evaluate the patients with astrocytomas and to investigate survival rates and prognosis.

Patients and 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.

Conclusion

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.
Literature
1.
go back to reference Arita K, Kurisu K, Sugiyama K, Itoh Y, Hotta T, Sogabe T, Uozumi T (2003) Long-term results of conventional treatment of diencephalic pilocytic astrocytoma in infants. Child’s Nerv Syst 19:145–151 Arita K, Kurisu K, Sugiyama K, Itoh Y, Hotta T, Sogabe T, Uozumi T (2003) Long-term results of conventional treatment of diencephalic pilocytic astrocytoma in infants. Child’s Nerv Syst 19:145–151
3.
go back to reference Duffner PK, Horowitz ME, Krischer JP, Friedman HS, Burger PC, Cohen ME, Sanford RA, Mulhern RK, James HE, Freeman CR, Glen Seidel F, Kun LE (1993) Postoperative chemotherapy and delayed radiation in children less than three years of age with malignant brain tumors. N Engl J Med 328:1725–1731PubMedCrossRef Duffner PK, Horowitz ME, Krischer JP, Friedman HS, Burger PC, Cohen ME, Sanford RA, Mulhern RK, James HE, Freeman CR, Glen Seidel F, Kun LE (1993) Postoperative chemotherapy and delayed radiation in children less than three years of age with malignant brain tumors. N Engl J Med 328:1725–1731PubMedCrossRef
4.
go back to reference Duffner PK, Krischer JP, Burger PC, Cohen ME, Backstrom JW, Horowitz ME, Sanford RA, Friedman HS, Kun LE (1996) Treatment of infants with malignant gliomas: the Pediatric Oncology Group experience. J Neuro-oncol 28:245–256CrossRef Duffner PK, Krischer JP, Burger PC, Cohen ME, Backstrom JW, Horowitz ME, Sanford RA, Friedman HS, Kun LE (1996) Treatment of infants with malignant gliomas: the Pediatric Oncology Group experience. J Neuro-oncol 28:245–256CrossRef
5.
go back to reference Finlay JL, Boyett JM, Yates AJ, Wisoff JH, Milstein JM, Geyer JR, Bertolone SJ, McGuire P, Cherlow JM, Tefft M, Turski PA, Wara WM, Edwards M, Sutton LN, Berger MS, Epstein F, Ayers G, Allen JC, Packer RJ, for the Children’s Cancer Group (1995) Randomized phase III trial in childhood high-grade astrocytoma comparing vincristine, lomustine, and prednisone with the eight-drugs-in-1-day regimen. J Clin Oncol 13:112–123PubMed Finlay JL, Boyett JM, Yates AJ, Wisoff JH, Milstein JM, Geyer JR, Bertolone SJ, McGuire P, Cherlow JM, Tefft M, Turski PA, Wara WM, Edwards M, Sutton LN, Berger MS, Epstein F, Ayers G, Allen JC, Packer RJ, for the Children’s Cancer Group (1995) Randomized phase III trial in childhood high-grade astrocytoma comparing vincristine, lomustine, and prednisone with the eight-drugs-in-1-day regimen. J Clin Oncol 13:112–123PubMed
6.
go back to reference Fisher BJ, Leighton CC, Vujovic O, Macdonald DR, Stitt L (2001) Results of a policy of surveillance alone after surgical management of pediatric low grade gliomas. Int J Radiat Oncol Biol Phys 51:704–710PubMedCrossRef Fisher BJ, Leighton CC, Vujovic O, Macdonald DR, Stitt L (2001) Results of a policy of surveillance alone after surgical management of pediatric low grade gliomas. Int J Radiat Oncol Biol Phys 51:704–710PubMedCrossRef
7.
go back to reference Gajjar A, Sanford RA, Heideman R, Jenkins JJ, Walter A, Li Y, Langston JW, Muhlbauer M, Boyett JM, Kun LE (1997) Low-grade astrocytoma: a decade of experience at St. Jude Children’s Research Hospital. J Clin Oncol 15:2792–2799PubMed Gajjar A, Sanford RA, Heideman R, Jenkins JJ, Walter A, Li Y, Langston JW, Muhlbauer M, Boyett JM, Kun LE (1997) Low-grade astrocytoma: a decade of experience at St. Jude Children’s Research Hospital. J Clin Oncol 15:2792–2799PubMed
8.
go back to reference Galanis E, Buckner J (2000) Chemotherapy for high-grade gliomas. Br J Cancer 82:1371–1380PubMed Galanis E, Buckner J (2000) Chemotherapy for high-grade gliomas. Br J Cancer 82:1371–1380PubMed
9.
go back to reference Horowitz ME, Kun LE, Mulhern RK, Kovnar EH, Sanford RA, Hockenberger BM, Greeson FL, Langston JW, Fairclough DL, Jenkins JJ III (1988) Feasibility and efficacy of preirradiation chemotherapy for pediatric brain tumors. Neurosurgery 22:687–690PubMedCrossRef Horowitz ME, Kun LE, Mulhern RK, Kovnar EH, Sanford RA, Hockenberger BM, Greeson FL, Langston JW, Fairclough DL, Jenkins JJ III (1988) Feasibility and efficacy of preirradiation chemotherapy for pediatric brain tumors. Neurosurgery 22:687–690PubMedCrossRef
10.
go back to reference Kleihues P, Cavenee WK (eds) (2000) Pathology and genetics of tumors of the nervous system. World Health Organization Classification of Tumours. IARC, Lyon, France Kleihues P, Cavenee WK (eds) (2000) Pathology and genetics of tumors of the nervous system. World Health Organization Classification of Tumours. IARC, Lyon, France
11.
go back to reference López-Aguilar E, Sepúlveda-Vildósola AC, Rivera-Márquez H, Cerecedo-Díaz F, Valdés-Sánchez M, Delgado-Huerta S, Wanzke-del Angel V, Ramón-García G, Rodríguez-Jiménez H, Hernández-Contreras I, Santacruz-Castillo E, Romo-Rubio HA (2003) Preirradiation ifosfamide, carboplatin and etoposide (ICE) for the treatment of high-grade astrocytomas in children. Child’s Nerv Syst 19:818–823CrossRef López-Aguilar E, Sepúlveda-Vildósola AC, Rivera-Márquez H, Cerecedo-Díaz F, Valdés-Sánchez M, Delgado-Huerta S, Wanzke-del Angel V, Ramón-García G, Rodríguez-Jiménez H, Hernández-Contreras I, Santacruz-Castillo E, Romo-Rubio HA (2003) Preirradiation ifosfamide, carboplatin and etoposide (ICE) for the treatment of high-grade astrocytomas in children. Child’s Nerv Syst 19:818–823CrossRef
12.
13.
go back to reference Packer RJ, Lange B, Ater J, Nicholson HS, Allen J, Walker R, Prados M, Jakacki R, Reaman G, Needles MN, Phillips PC, Ryan J, Boyett JM, Geyer R, Finlay J (1993) Carboplatin and vincristine for recurrent and newly diagnosed low-grade gliomas of childhood. J Clin Oncol 11:850–856PubMed Packer RJ, Lange B, Ater J, Nicholson HS, Allen J, Walker R, Prados M, Jakacki R, Reaman G, Needles MN, Phillips PC, Ryan J, Boyett JM, Geyer R, Finlay J (1993) Carboplatin and vincristine for recurrent and newly diagnosed low-grade gliomas of childhood. J Clin Oncol 11:850–856PubMed
15.
go back to reference Pollack IF (2004) Intramedullary spinal cord astrocytomas in children. Pediatr Blood Cancer 43:617–618PubMedCrossRef Pollack IF (2004) Intramedullary spinal cord astrocytomas in children. Pediatr Blood Cancer 43:617–618PubMedCrossRef
16.
go back to reference Pollack IF, Boyett JM, Finlay JL (1999) Chemotherapy for high-grade gliomas of childhood. Child’s Nerv Syst 15:529–544CrossRef Pollack IF, Boyett JM, Finlay JL (1999) Chemotherapy for high-grade gliomas of childhood. Child’s Nerv Syst 15:529–544CrossRef
17.
go back to reference Pollack IF, Claassen D, al-Shboul Q, Janosky JE, Deutsch M (1995) Low-grade gliomas of the cerebral hemispheres in children: an analysis of 71 cases. J Neurosurg 82:536–547PubMed Pollack IF, Claassen D, al-Shboul Q, Janosky JE, Deutsch M (1995) Low-grade gliomas of the cerebral hemispheres in children: an analysis of 71 cases. J Neurosurg 82:536–547PubMed
18.
go back to reference Rasheed BK, McLendon RE, Herndon JE, Friedman HS, Friedman AH, Bigner DD, Bigner SH (1994) Alterations of the TP53 gene in human gliomas. Cancer Res 54:1324–1330PubMed Rasheed BK, McLendon RE, Herndon JE, Friedman HS, Friedman AH, Bigner DD, Bigner SH (1994) Alterations of the TP53 gene in human gliomas. Cancer Res 54:1324–1330PubMed
19.
go back to reference Reddy AT, Packer RJ (1999) Chemotherapy for low-grade gliomas. Child’s Nerv Syst 15:506–513CrossRef Reddy AT, Packer RJ (1999) Chemotherapy for low-grade gliomas. Child’s Nerv Syst 15:506–513CrossRef
20.
go back to reference Strother DR, Pollack IF, Fisher PG, Hunter JV, Woo SY, Pomeroy SL, Rorke LB (2002) Tumors of the central nervous system. In: Pizzo PA, Poplack DG (eds) Principles and practice of pediatric oncology. Lippincott Williams & Wilkins, Philadelphia, pp 751–824 Strother DR, Pollack IF, Fisher PG, Hunter JV, Woo SY, Pomeroy SL, Rorke LB (2002) Tumors of the central nervous system. In: Pizzo PA, Poplack DG (eds) Principles and practice of pediatric oncology. Lippincott Williams & Wilkins, Philadelphia, pp 751–824
21.
go back to reference Tow SL, Chandela S, Miller NR, Avellino AM (2003) Long-term outcome in children with gliomas of the anterior visual pathway. Pediatr Neurol 28:262–270PubMedCrossRef Tow SL, Chandela S, Miller NR, Avellino AM (2003) Long-term outcome in children with gliomas of the anterior visual pathway. Pediatr Neurol 28:262–270PubMedCrossRef
22.
go back to reference Townsend N, Handler M, Fleitz J, Foreman N (2004) Intramedullary spinal cord astrocytomas in children. Pediatr Blood Cancer 43:629–632PubMedCrossRef Townsend N, Handler M, Fleitz J, Foreman N (2004) Intramedullary spinal cord astrocytomas in children. Pediatr Blood Cancer 43:629–632PubMedCrossRef
Metadata
Title
Astrocytic tumors in children: treatment results from a single institution
Authors
Ali Varan
Canan Akyüz
Nejat Akalan
Lale Atahan
Figen Söylemezoglu
Ugur Selek
Bilgehan Yalçin
Tezer Kutluk
Münevver Büyükpamukçu
Publication date
01-03-2007
Publisher
Springer-Verlag
Published in
Child's Nervous System / Issue 3/2007
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-006-0243-z

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