Sawamura Yutaka, Kamoshima Yuuta, Kato Tsutomu, Tajima Toshihiro, Tsubaki Junko
Department of Neurosurgery, Hokkaido University Hospital, Sapporo, Japan.
Jpn J Clin Oncol. 2009 May;39(5):277-83. doi: 10.1093/jjco/hyp012. Epub 2009 Feb 17.
Optic pathway/hypothalamic astrocytomas (OPHA) in young children often show accelerated growth and require rather intensive induction chemotherapy.
Fifteen children (median age: 3 years) with a large OPHA were treated. All of them presented with progressive disease, and the tumor size was larger than 34 mm. Pilocytic astrocytoma was confirmed histologically in 10 patients. Eleven patients had visual disturbance, six had diencephalic syndrome and four had hydrocephalus.
The children received six to eight cycles of cisplatin (20 mg/m(2): days 1-5) and vincristine (1.4 mg/m(2): days 1, 8, 15), every 4 weeks. Objective response was obtained in 11 patients (73%); one complete response, eight partial responses and two minor responses. Although the remaining four cases were evaluated as stable disease, all tumors decreased in volume. All children tolerated the chemotherapy well under careful audiological monitoring.
Although the present series was small, this chemotherapy is a useful regimen for induction therapy in children with an aggressive deep-seated pilocytic astrocytoma.
幼儿的视路/下丘脑星形细胞瘤（OPHA）通常生长加速，需要相当强化的诱导化疗。
对15例患有大型OPHA的儿童（中位年龄：3岁）进行了治疗。所有患儿均表现为疾病进展，肿瘤大小超过34毫米。10例患者经组织学确诊为毛细胞型星形细胞瘤。11例患者有视力障碍，6例有间脑综合征，4例有脑积水。
这些儿童每4周接受6至8个周期的顺铂（20毫克/平方米：第1 - 5天）和长春新碱（1.4毫克/平方米：第1、8、15天）治疗。11例患者（73%）获得客观缓解；1例完全缓解，8例部分缓解，2例轻微缓解。尽管其余4例被评估为疾病稳定，但所有肿瘤体积均减小。在仔细的听力监测下，所有儿童对化疗耐受性良好。
尽管本系列病例数较少，但这种化疗方案对于侵袭性深部毛细胞型星形细胞瘤患儿的诱导治疗是一种有用的方案。
