Treatment of pediatric low-grade gliomas with a nitrosourea-based multiagent chemotherapy regimen

J Neurooncol. 1997 May;32(3):235-41. doi: 10.1023/a:1005736104205.

Abstract

Between March 9, 1984 and January 29, 1992, 42 children with newly diagnosed symptomatic or previously diagnosed progressive low-grade gliomas received outpatient chemotherapy as their primary treatment. This study was a single arm, phase II trial designed to estimate the time to tumor progression and toxicity of this regimen. Procarbazine, 6-thioguanine, and dibromodulcitol were given before lomustine (CCNU) and vincristine was given 1 and 3 weeks after CCNU. Patients were treated for six treatment cycles or until the tumor progressed, whichever came first. Twenty-three patients had juvenile pilocytic astrocytomas, 11 had astrocytomas, one had oligodendroglioma, one had ganglioglioma, and six had radiographically diagnosed low-grade gliomas. The mean age of the patients was 5 years (median, 3 years). The median time to treatment failure was 132 weeks (95% confidence interval: 106, 186 weeks). Only eight patients have died the estimated 5-year survival rate is 78% (95% confidence interval, 60% 87%). There were two episodes of grade 4 neutropenia, and three episodes of grade 4 thrombocytopenia. This regimen was safe, able to be delivered in the outpatient setting, and produced prolonged periods of disease stabilization in children with low-grade gliomas.

Publication types

  • Clinical Trial
  • Clinical Trial, Phase II
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / mortality
  • Child
  • Child, Preschool
  • Disease Progression
  • Female
  • Glioma / drug therapy*
  • Glioma / mortality
  • Humans
  • Infant
  • Lomustine / administration & dosage
  • Lomustine / adverse effects
  • Male
  • Mitolactol / administration & dosage
  • Mitolactol / adverse effects
  • Procarbazine / administration & dosage
  • Procarbazine / adverse effects
  • Thioguanine / administration & dosage
  • Thioguanine / adverse effects
  • Treatment Outcome
  • Vincristine / administration & dosage
  • Vincristine / adverse effects

Substances

  • Procarbazine
  • Vincristine
  • Lomustine
  • Thioguanine
  • Mitolactol