Chemotherapy for unresectable and recurrent intramedullary glial tumors inchildren

Adjuvant treatment for intramedullary tumours is based on radiotherapy. The place of chemotherapy in this setting has yet to be determined. Between Ma y 1992 and January 1998, eight children with unresectable or recurrent intr amedullary glioma were treated with the BE SFOP protocol (a 16-month chemot herapy regimen with carboplatin, procarbazine, vincristine, cyclophosphamid e, etoposide and cisplatin). Six children had progressive disease following incomplete surgery and two had a post-operative relapse. Three patients ha d leptomeningeal dissemination at the outset of chemotherapy. Seven of the eight children responded clinically and radiologically, while one remained stable. At the end of the BE SFOP protocol four children were in radiologic al complete remission. After a median follow-up of 3 years from the beginni ng of chemotherapy, all the children but one (who died from another cause) are alive. Five patients remain progression-free, without radiotherapy, 59, 55, 40, 35 and 16 months after the beginning of chemotherapy. The efficacy of this chemotherapy in patients with intramedullary glial tumours calls f or further trials in this setting, especially in young children and patient s with metastases. (C) 1999 Cancer Research Campaign.