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Management of pilomyxoid astrocytomas: our experience
Hitoshi Tsugu1, Shinya Oshiro, Fumio Yanai
1Department of Neurosurgery, Fukuoka University Faculty of Medicine, Jonan-ku, Fukuoka 814-0180, Japan. h-tsugu@fukuoka-u.ac.jp
Background:
Pilomyxoid astrocytoma (PMA) shows a higher rate of recurrence and cerebrospinal fluid (CSF) dissemination than does pilocytic astrocytoma (PA). In this article, we discuss the treatment of PMA.
Materials And Methods:
Between 1992 and 2007, the authors treated 5 patients. Two of these were male, three female. Their ages ranged from 3 months to 11 years.
Results:
Three patients showed CSF dissemination on the initial radiographic examination. All patients received chemotherapy; the most commonly used combination drugs were cisplatin (CDDP)/carboplatin (CBDCA) and etoposide. When these drugs were unsuccessful, they were changed or other drugs added to the combination. After chemotherapy, four patients showed remarkable tumor regression. Nevertheless, one patient died 22 months after initial diagnosis, due to tumor progression.
Conclusion:
While our series was limited to a small number of patients, we have a positive impression of the value of chemotherapy. Even if initial chemotherapy is ineffective, we recommend continued CDDP/CBDCA-based chemotherapy with new drug combinations.
Insights
Pilomyxoid astrocytoma (PMA) treatment involves chemotherapy, often with cisplatin (CDDP)/carboplatin (CBDCA) and etoposide. Continued chemotherapy, even with new drug combinations, shows promise for tumor regression in recurrent cases.
Area of Science:
- Pediatric Oncology
- Neuro-oncology
- Clinical Research
Background:
- Pilomyxoid astrocytoma (PMA) presents a higher risk of recurrence and cerebrospinal fluid (CSF) dissemination compared to pilocytic astrocytoma (PA).
- This study focuses on the treatment strategies for pediatric PMA patients.
Observation:
- A cohort of 5 patients (2 male, 3 female; ages 3 months to 11 years) diagnosed between 1992 and 2007 were analyzed.
- Initial radiographic examination revealed CSF dissemination in three patients.
- All patients underwent chemotherapy, with cisplatin (CDDP)/carboplatin (CBDCA) and etoposide being the most frequent initial combinations.
Findings:
- Four out of five patients demonstrated significant tumor regression following chemotherapy.
- One patient experienced tumor progression and died 22 months post-diagnosis.
- Treatment adjustments, including changing or adding drugs, were made when initial chemotherapy proved ineffective.
Implications:
- Chemotherapy demonstrates a positive impact on PMA treatment outcomes, even in cases with initial ineffectiveness.
- Continued CDDP/CBDCA-based chemotherapy, incorporating novel drug combinations, is recommended for managing PMA.
- Further research with larger patient cohorts is warranted to solidify these findings.
