Treatment of childhood astrocytomas with irinotecan and cisplatin
Previously we described the outcome of children with spinal cord astrocytoma treated with irinotecan and cisplatin (I/C). We here report the review of the initial institutional experience using this combination for children with low-grade glioma (LGG).
I/C chemotherapy consisted of weekly cisplatin (30 mg/m2) and irinotecan (50–65 mg/m2) for a total maximum of 16 doses, administered in an outpatient basis.
Between November 2002 and December 2009, 46 children (median age 6.3 years; range 0.3–17.7) with glioma were treated. We here report the cohort of 31 patients with LGG. Patients received a median of 16 cycles of I/C (range 8–16). The overall objective response [complete response (CR) + partial response (PR)] and disease control (CR + PR + stable disease) rates to I/C treatment were 6.5% [95% confidence interval (CI), 0.8–21.4%] and 93.5% (95% CI 78.6–99.2%), respectively. Disease control persisted for a median of 65 months. Toxicity was predominantly myelosuppression only seen in heavily pretreated patients. Survival analysis shows 5-year event-free survival (EFS) of 54% and 5-year overall survival (OS) of 80%.
I/C chemotherapy produced disease control and clinical improvement in a majority of children with low-grade glioma, with manageable toxicity.
KeywordsIrinotecan Cisplatin Childhood astrocytomas Low grade glioma
The authors thank the nursing and multidisciplinary staff for their support in the patient care.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed were in accordance with the ethical standards of the institution research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this retrospective study specific consent was not required.
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