BACKGROUND: Chemotherapy is widely accepted as first-line therapy for pediatric low-grade gliomas (LGG). Treatment modalities for further progression are not clearly established. The aim of the study was to determine the feasibility and long-term outcome of repeated chemotherapy for children with recurrent LGG. METHODS: The study group consisted of patients who received a second line of chemotherapy at progression of their LGG. We compared toxicity, progression-free survival (PFS), and overall survival (OS) of patients treated with chemotherapy at the time of initial diagnosis and patients who received another treatment with chemotherapy at further progression. RESULTS: Between 1985 and 2009, 118 patients received chemotherapy as primary treatment for LGG, 38 had repeated chemotherapy at further progression. Chemotherapy was tolerated extremely well. Ninety-two percent of patients completed their second line protocol and toxicity was comparable between initial and second line chemotherapy. Five-year OS and PFS were 86 ± 6% and 37 ± 8%, respectively, which were similar to first-line chemotherapy (P = 0.14). Repeated chemotherapy courses were not associated with worsening of visual, neuroendocrine, or other long-term organ sequelae. CONCLUSION: This study demonstrates high feasibility and low mortality of repeated chemotherapy treatment for progressive LGG. The chronic nature of LGG concerning tumor progression justifies consideration of non-toxic second-line treatment regimens at the time of recurrence. Prospective studies focusing on toxicity and long-term outcome are needed to substantiate this approach.
BACKGROUND: Chemotherapy is widely accepted as first-line therapy for pediatric low-grade gliomas (LGG). Treatment modalities for further progression are not clearly established. The aim of the study was to determine the feasibility and long-term outcome of repeated chemotherapy for children with recurrent LGG. METHODS: The study group consisted of patients who received a second line of chemotherapy at progression of their LGG. We compared toxicity, progression-free survival (PFS), and overall survival (OS) of patients treated with chemotherapy at the time of initial diagnosis and patients who received another treatment with chemotherapy at further progression. RESULTS: Between 1985 and 2009, 118 patients received chemotherapy as primary treatment for LGG, 38 had repeated chemotherapy at further progression. Chemotherapy was tolerated extremely well. Ninety-two percent of patients completed their second line protocol and toxicity was comparable between initial and second line chemotherapy. Five-year OS and PFS were 86 ± 6% and 37 ± 8%, respectively, which were similar to first-line chemotherapy (P = 0.14). Repeated chemotherapy courses were not associated with worsening of visual, neuroendocrine, or other long-term organ sequelae. CONCLUSION: This study demonstrates high feasibility and low mortality of repeated chemotherapy treatment for progressive LGG. The chronic nature of LGG concerning tumor progression justifies consideration of non-toxic second-line treatment regimens at the time of recurrence. Prospective studies focusing on toxicity and long-term outcome are needed to substantiate this approach.
Authors: Andrea Maria Cappellano; Antonio Sergio Petrilli; Nasjla Saba da Silva; Frederico Adolfo Silva; Priscila Mendes Paiva; Sergio Cavalheiro; Eric Bouffet Journal: J Neurooncol Date: 2014-11-01 Impact factor: 4.130
Authors: Anandani Nellan; Erin Wright; Kristen Campbell; Kurtis D Davies; Andrew M Donson; Vladimir Amani; Alexis Judd; Molly S Hemenway; Jennifer Raybin; Nicholas K Foreman; Sarah Rush; Kathleen Dorris Journal: J Neurooncol Date: 2020-06-06 Impact factor: 4.130
Authors: K Müller; A Gnekow; F Falkenstein; J Scheiderbauer; I Zwiener; T Pietsch; M Warmuth-Metz; J Voges; G Nikkhah; M Flentje; S E Combs; D Vordermark; M Kocher; R-D Kortmann Journal: Strahlenther Onkol Date: 2013-07-07 Impact factor: 3.621
Authors: Guillaume Bergthold; Pratiti Bandopadhayay; Wenya Linda Bi; Lori Ramkissoon; Charles Stiles; Rosalind A Segal; Rameen Beroukhim; Keith L Ligon; Jacques Grill; Mark W Kieran Journal: Biochim Biophys Acta Date: 2014-02-28