Chemotherapy for spinal cord astrocytoma.

BACKGROUND

The optimal management of spinal cord astrocytomas remains to be defined, as aggressive surgery and radiotherapy are associated with a high risk of morbidity. The value of chemotherapy has not been assessed.

PROCEDURE

The patient in the present report harbored an infiltrating spinal cord tumor causing paraplegia. A limited biopsy showed a grade II astrocytoma. Following biopsy, the patient received sequential chemotherapy with vincristine and carboplatin.

RESULTS

Full neurological recovery and complete radiologically-confirmed remission were achieved after eight months of treatment. Chemotherapy was discontinued after eleven months due to carboplatin hypersensitivity. No adjuvant radiotherapy was given, and the patient remains in complete remission fourteen months after completion of treatment.

CONCLUSIONS

Chemotherapy demonstrates a promising activity and could change the standard practice if its efficacy is confirmed in larger studies. It could be used alone or combined with radiotherapy when post-operative treatment is recommended.