Cappellano Andrea Maria, Bouffet Eric, Cavalheiro Sergio, Seixas Maria T, da Silva Nasjla Saba
Department of Pediatric Oncology, IOP/GRAACC/Federal University of São Paulo, São Paulo, Brazil.
J Pediatr Hematol Oncol. 2011 Mar;33(2):116-8. doi: 10.1097/MPH.0b013e3181fe68e0.
Brainstem gliomas constitute 10% to 20% of all pediatric tumors of the central nervous system, and diffusely infiltrative brainstem gliomas are the most common brainstem tumors associated with a poor prognosis. A small subset of these tumors is benign, showing low-grade features on histology. The role of chemotherapy in the management of these tumors is ill defined, especially in the neonates. There are anecdotal reports of spontaneous remission, but the natural history of these tumors does not support a wait-and-see approach. Thus, we report a successful experience of chemotherapy in a 4-month-old girl with a diffuse brainstem fibrillary astrocytoma, treated with vinorelbine (30 mg/m/d on days 0, 8, and 22), a vinca alkaloid that has shown activity against glioma. Our experience suggests that vinorelbine may be effective in pediatric low-grade gliomas as this patient showed significant clinical improvement over a short period of time.
脑干胶质瘤占儿童中枢神经系统肿瘤的10%至20%，弥漫性浸润性脑干胶质瘤是与预后不良相关的最常见脑干肿瘤。这些肿瘤中有一小部分是良性的，组织学上表现为低级别特征。化疗在这些肿瘤治疗中的作用尚不明确，尤其是在新生儿中。有自发缓解的个案报道，但这些肿瘤的自然病史不支持观望策略。因此，我们报告了1例4个月大患弥漫性脑干纤维型星形细胞瘤女孩化疗成功的经验，使用长春瑞滨（第0、8和22天，30mg/m²/天）治疗，长春瑞滨是一种已显示对胶质瘤有活性的长春花生物碱。我们的经验表明长春瑞滨可能对儿童低级别胶质瘤有效，因为该患者在短时间内有显著的临床改善。
