DOES CHEMOTHERAPY HAVE A ROLE IN LOW-GRADE ASTROCYTOMA MANAGEMENT - AREPORT OF 13 CASES

Surgery is the treatment of choice for low-grade astrocytoma while rad iotherapy is carried out only when total resection is not possible. Th is study assessed the effectiveness of chemotherapy in nonresectable c ases. Thirteen children with nonresectable astrocytoma were treated wi th carboplatin and etoposide and after four cycles the response to tre atment was evaluated according to radiologic criteria. The results wer e: one with complete response (CR), three with minor response (MR), si x with stable disease (SD), and th ree with progressive disease (PD). Moreover, in 77% there was an improvement in the neurologic picture. I n particular, two cases with hypothalamic astrocytoma showed a regress ion of the diencephalic syndrome following chemotherapy. In six cases chemotherapy was carried out, at reduced dosage, after the first four cycles either because there was clinical improvement or because it was necessary to postpone radiotherapy in very young patients. After a fo llow-up period ranging between 11 and 63 months (average: 30 months), nine of the 13 patients are alive (69%) while four died of disease pro gression. Further studies would be useful to evaluate the role of chem otherapy in the management of few-grade astrocytoma. (C) 1995 Wiley-Li ss, Inc.