Castello M A, Schiavetti A, Padula A, Varrasso G, Properzi E, Trasimeni G, Operamolla P, Gualdi G F, Clerico A
Pediatric Oncology Service, La Sapienza University, Rome, Italy.
Med Pediatr Oncol. 1995 Aug;25(2):102-8. doi: 10.1002/mpo.2950250210.
Surgery is the treatment of choice for low-grade astrocytoma while radiotherapy is carried out only when total resection is not possible. This study assessed the effectiveness of chemotherapy in nonresectable cases. Thirteen children with nonresectable astrocytoma were treated with carboplatin and etoposide and after four cycles the response to treatment was evaluated according to radiologic criteria. The results were: one with complete response (CR), three with minor response (MR), six with stable disease (SD), and three with progressive disease (PD). Moreover, in 77% there was an improvement in the neurologic picture. In particular, two cases with hypothalamic astrocytoma showed a regression of the diencephalic syndrome following chemotherapy. In six cases chemotherapy was carried out, at reduced dosage, after the first four cycles either because there was clinical improvement or because it was necessary to postpone radiotherapy in very young patients. After a follow-up period ranging between 11 and 63 months (average: 30 months), nine of the 13 patients are alive (69%) while four died of disease progression. Further studies would be useful to evaluate the role of chemotherapy in the management of low-grade astrocytoma.
手术是低级别星形细胞瘤的首选治疗方法，只有在无法完全切除时才进行放疗。本研究评估了化疗在不可切除病例中的有效性。13例不可切除的星形细胞瘤患儿接受了卡铂和依托泊苷治疗，四个周期后，根据放射学标准评估治疗反应。结果如下：1例完全缓解（CR），3例轻度缓解（MR），6例病情稳定（SD），3例病情进展（PD）。此外，77%的患儿神经症状有所改善。特别是，2例下丘脑星形细胞瘤患儿化疗后间脑综合征消退。6例患儿在前四个周期后因临床症状改善或因非常年幼的患者需要推迟放疗而减少剂量进行化疗。在11至63个月（平均30个月）的随访期后，13例患者中有9例存活（69%），4例死于疾病进展。进一步的研究将有助于评估化疗在低级别星形细胞瘤治疗中的作用。
