Carboplatin and vincristine chemotherapy for children with newly diagnosed progressive low-grade gliomas

Roger J. Packer, Joanne Ater, Jeffrey Allen, Peter Phillips, Russell Geyer, H. Stacy Nicholson, Regina Jakacki, Elizabeth Kurczynski, Michael Needle, Jonathan Finlay, Gregory Reaman, James M. Boyett

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430 Scopus citations

Abstract

The optimum treatment of nonresectable low-grade gliomas of childhood remains undecided. There has been increased interest in the use of chemotherapy for young children, but little information concerning the long- term efficacy of such treatment. Seventy-eight children with a mean age of 3 years (range 3 months- 16 years) who had newly diagnosed, progressive low- grade gliomas were treated with combined carboplatin and vincristine chemotherapy. The patients were followed for a median of 30 months from diagnosis, with 31 patients followed for more than 3 years. Fifty-eight children had diencephalic tumors, 12 had brainstem gliomas, and three had diffuse leptomeningeal gliomas. Forty-four (56%) of 78 patients showed an objective response to treatment. Progression-free survival rates were 75 ± 6% at 2 years and 68 ± 7% at 3 years. There was no statistical difference in progression-free survival rates between children with neurofibromatosis Type 1 and those without the disease (2-year, progression-free survival 79 ± 11% vs. 75 ± 6%, respectively). The histological subtype of the tumor, its location, and its maximum response to chemotherapy did not have an impact on the duration of disease control. The only significant prognostic factor was age: children 5 years old or younger at the time of treatment had a 3-year progression-free survival rate of 74 ± 7% compared with a rate of 39 ± 21% in older children (p < 0.01). Treatment with carboplatin and vincristine is effective, especially in younger children in controlling newly diagnosed progressive low-grade gliomas.

Original languageEnglish (US)
Pages (from-to)747-754
Number of pages8
JournalJournal of neurosurgery
Volume86
Issue number5
DOIs
StatePublished - May 1997

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Keywords

  • brainstem tumor
  • chemotherapy
  • chiasmatic glioma
  • children
  • glioma
  • low-grade glioma

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Packer, R. J., Ater, J., Allen, J., Phillips, P., Geyer, R., Nicholson, H. S., Jakacki, R., Kurczynski, E., Needle, M., Finlay, J., Reaman, G., & Boyett, J. M. (1997). Carboplatin and vincristine chemotherapy for children with newly diagnosed progressive low-grade gliomas. Journal of neurosurgery, 86(5), 747-754. https://doi.org/10.3171/jns.1997.86.5.0747