BACKGROUND: To develop an effective therapeutic strategy for patients with diencephalic pilocytic astrocytomas (PA), we must understand the long-term effects and problems of conventional treatments. METHODS: We performed a retrospective follow-up of four infants with PA in the diencephalon. CONCLUSION: The initial treatment consisted of partial tumor removal and/or external radiation. The mean progression-free duration after the initial treatment was 108.5 months. All patients received a second course of radiation to treat recurrent tumors. These conventional treatments produced relatively long survival. Three patients died 105, 202, and 379 months after the initial treatment. One patient is still alive at 249 months after the initial treatment. However, mental retardation was obvious in all four patients 6 to 12 years after the first irradiation and within 2 years of the second course of irradiation. Therefore, new therapeutic strategies must focus on delaying the timing of radiation until the patients are at least 5 years old and avoiding a second course of radiation to treat recurrence.
BACKGROUND: To develop an effective therapeutic strategy for patients with diencephalic pilocytic astrocytomas (PA), we must understand the long-term effects and problems of conventional treatments. METHODS: We performed a retrospective follow-up of four infants with PA in the diencephalon. CONCLUSION: The initial treatment consisted of partial tumor removal and/or external radiation. The mean progression-free duration after the initial treatment was 108.5 months. All patients received a second course of radiation to treat recurrent tumors. These conventional treatments produced relatively long survival. Three patients died 105, 202, and 379 months after the initial treatment. One patient is still alive at 249 months after the initial treatment. However, mental retardation was obvious in all four patients 6 to 12 years after the first irradiation and within 2 years of the second course of irradiation. Therefore, new therapeutic strategies must focus on delaying the timing of radiation until the patients are at least 5 years old and avoiding a second course of radiation to treat recurrence.
Authors: R J Packer; J Ater; J Allen; P Phillips; R Geyer; H S Nicholson; R Jakacki; E Kurczynski; M Needle; J Finlay; G Reaman; J M Boyett Journal: J Neurosurg Date: 1997-05 Impact factor: 5.115
Authors: H J Hoffman; R P Humphreys; J M Drake; J T Rutka; L E Becker; D Jenkin; M Greenberg Journal: Pediatr Neurosurg Date: 1993 Jul-Aug Impact factor: 1.162
Authors: J C Suárez; J C Viano; S Zunino; E J Herrera; J Gomez; B Tramunt; I Marengo; E Hiramatzu; M Miras; M Pena; B Sonzini Astudillo Journal: Childs Nerv Syst Date: 2006-01-03 Impact factor: 1.475
Authors: Hideyuki Kano; Ajay Niranjan; Douglas Kondziolka; John C Flickinger; Ian F Pollack; Regina I Jakacki; L Dade Lunsford Journal: J Neurooncol Date: 2009-05-26 Impact factor: 4.130