Chemo with vincristine, carboplatin and Temodar

Low grade astrocytoma occurrs in adults and children but is more commonly a pediatric disease. Radiotherapy is relatively contraindicated in children because it stunts their intellectual growth. Chemotherapy may be used in young children to avoid or to delay radiotherapy because of its potential neurologic sequelae. To date, the most active chemotherapy regimen for these tumors is carboplatin and vincristine. These agents show objective response rates of 50-80% and produce prolonged stable disease. A COG study showed the procarbazine and topotecan to be effective. Another COG study used carboplatin, vincristine, and temozolomide” but it was only  a pilot study. The author’s conclusion was: “It is feasible to deliver cycles of vincristine and carboplatin alternating with temozolomide over a prolonged period of time with tolerable side effects. Preliminary data suggests that this combination is at least as effective as previous regimens in controlling disease progression. Further follow up is necessary to assess the efficacy of this regimen”.

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