COMBINATION CHEMOTHERAPY (CISPLATIN, VINBLASTIN) AND LOW-DOSE IRRADIATION IN THE TREATMENT OF PINEAL PARENCHYMAL-CELL TUMORS

Pineal parenchymal cell tumors (PPCTs with or without metastasis into the lumbar region by way of the cerebrospinal fluid were treated succe ssfully with combination chemotherapy using cisplatin, vinblastin, and bleomycin (PVB) or cisplatin and vinblastin (PV) and lour-dose irradi ation (25 similar to 30 Gy). Our series included a case of pineoblasto ma, two cases of mixed pinocytoma/pinesblastoma, and a case of pineocy toma, compared to which the data held by the All Japan Brain Tumor Reg istry (AJBTR) included information on 47 cases pineocytoma and 20 of p ineoblastoma. All our patients have survived, with scores of 90% or ov er on Karnofsky's performance scale, for 2-12 years of follow-up so fa r; however, the 5-year survival rates of the patients recorded by AJBT R wore 83% for pineocytoma treated with radiation and 43% without radi ation; and 42% for pineoblastoma treated with radiation and 50% withou t radiation. Incomplete or varied chemotherapeutic regimens used in di fferent medical centers to treat PPCTs precluded an evaluation such as was made by AJBTR. Our results suggested that combination chemotherap y with low-dose back-up radiotherapy may be the treatment of choice fo r primary or recurrent disease with or without dissemination in PPCTs.