Treatment of infants with malignant gliomas: The Pediatric Oncology Group Experience |
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Authors: | Patricia K. Duffner Jeffrey E. Krischer Peter C. Burger Michael E. Cohen James W. Backstrom Marc E. Horowitz Robert A. Sanford Henry S. Friedman Larry E. Kun |
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Affiliation: | (1) The State University of New York at Buffalo School of Medicine and Biomedical Sciences, 219 Bryant St., 14222 Buffalo, NY, USA;(2) Roswell Park Cancer Institute, Elm and Carlton Sts., 14263 Buffalo, NY, USA;(3) H. Lee Moffitt Cancer Center, 12902 Magnolia Dr., 33612 Tampa, FI, USA;(4) Johns Hopkins Hospital, 600 N. Wolfe St., 21287 Baltimore, MD, USA;(5) The State University of New York at Buffalo School of Medicine and Biomedical Sciences, 219 Bryant St., 14222 Buffalo, NY, USA;(6) Baylor College of Medicine, 6621 Fannin, 77030 Houston, TX, USA;(7) St. Jude Children's Research Hospital, 332 N. Lauderdale, 38101 Memphis, TN, USA;(8) Duke University Medical Center, P.O. Box 2916, 27710 Durham, NC, USA;(9) Pediatric Oncology Group, 645 N. Michigan Ave., 60611 Chicago, IL, USA |
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Abstract: | Although survivals of infants with malignant brain tumors are worse than any other age group, one possible exception to this rule are the malignant gliomas. Eighteen children less than 3 years of age with malignant gliomas (glioblastoma multiforme, anaplastic astrocytoma and malignant glioma) were treated on the Pediatric Oncology Group regimen of prolonged postoperative chemotherapy and delayed irradiation, (1986–1990). Of 10 children evaluable for neuroradiologic response, 6 had partial responses (> 50% reduction) to two cycles of cyclophosphamide and vincristine. Progression free survivals at l, 3 and 5 years were 54.25% ± 12, 43% ± 16 and 43% ± 23 respectively. Survivals at 5 years were 50% ± 14. Four children were not irradiated after 24 months of chemotherapy due to parental refusal and none have developed recurrent disease. Neither degree of surgical resection, presence or absence of metastases, nor pathology influenced survival but this may reflect small sample size. This study suggests that some malignant gliomas in infants are chemotherapy sensitive and may be associated with a good prognosis. Why infants with these high-grade gliomas fare better than adults is not clear. It is likely that there is something intrinsically different about them that cannot be identified on routine pathologic examination. |
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Keywords: | malignant gliomas infant brain tumors chemotherapy |
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