Low grade astrocytoma occurrs in adults and children. Radiotherapy is relatively contraindicated in children because it affects 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”.
Chintagumpala MM, Adesina A, Morriss MC, et al.: A pilot study using carboplatin, vincristine, and temozolomide for children with progressive/symptomatic low-grade glioma: A Children’s Oncology Group (COG) study. [Abstract] J Clin Oncol 28 (Suppl 15): A-9539, 2010.
Villano JL, Seery TE, Bressler LR: Temozolomide in malignant gliomas: current use and future targets. Cancer Chemother Pharmacol 64 (4): 647-55, 2009.
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