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Child's Nervous System
Published in: Child's Nervous System 3/2013

01-03-2013 | Original Paper

Pilocytic astrocytoma with leptomeningeal dissemination

Authors: Shelly X. Bian, Mary F. McAleer, Tribhawan S. Vats, Anita Mahajan, David R. Grosshans

Published in: Child's Nervous System | Issue 3/2013

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Abstract

Purpose

Pilocytic astrocytoma (PA) is a common pediatric glioma that is generally characterized by indolent growth. However, there are reports of PA disseminating throughout the central nervous system. Given the rarity of dissemination, the appropriate treatment for these patients is poorly defined. In this case series, we describe the clinical characteristics and treatment outcomes of six children treated for disseminated PA at our institution and review the current published literature.

Methods

Six cases of disseminated PA treated at the University of Texas MD Anderson Cancer Center were identified. Demographics, disease characteristics, and follow-up data were compiled. Fifty-three reported cases were identified in the published literature.

Results

Our cohort’s mean age at presentation was 7 years, and the mean time to identification of disseminated disease was 12 months after initial diagnosis. Two patients underwent chemotherapy, and all underwent proton beam radiation therapy to all or part of the craniospinal axis. With a median follow-up of 24 months after radiation therapy, five of six patients were alive, four with stable disease and one with progressive disease.

Conclusions

Treatment of disseminated PA is frequently multi-modal, including surgical resection, chemotherapy, and radiation therapy. On the basis of early clinical data, extended-field radiation therapy is a viable option for treating disseminated PA.
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Metadata
Title
Pilocytic astrocytoma with leptomeningeal dissemination
Authors
Shelly X. Bian
Mary F. McAleer
Tribhawan S. Vats
Anita Mahajan
David R. Grosshans
Publication date
01-03-2013
Publisher
Springer-Verlag
Published in
Child's Nervous System / Issue 3/2013
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-012-1970-y

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