Abstract
In this chapter we describe the experience gained using cisplatin and etoposide in childhood progressive low-grade glioma. After successfully adopting this combination in ten 3-day courses for progressive low-grade gliomas, the subsequent protocol, reducing the daily doses of cisplatin and etoposide, aimed at achieving the same response and 3-year PFS rates with lower neurotoxicity and myelotoxicity. In this second series we have treated 37 pts; 9 were metastatic cases. Treatment was prompted by radiological evidence of progression and/or clinical deterioration. A MRI volume reduction was appreciable in 65%; response was maximal 12 months after starting treatment. The 3-year EFS and OS rates were 65% and 97%, respectively for the whole series. Clinical, neurological or functional improvements were seen in 26/37 cases. Audiological toxicity caused alterations in 4/34 cases. The previous protocol had achieved volume reductions in 70% of cases, causing audiological damage (data updated) in 11/31 (p = 0.023), with 3-year PFS and OS rates of 70% and 100%, respectively. The updated 3-year PFS and OS rates were 85% and 96%, respectively, for those children treated in Milan. Lower doses of cisplatin/etoposide are still effective in progressive low-grade glioma, with less acute and persistent morbidity.
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Massimino, M., Biassoni, V., Schiavello, E. (2012). Pediatric Low-Grade Gliomas: Advantage of Using Lower Doses of Cisplatin/Etoposide. In: Hayat, M. (eds) Pediatric Cancer, Volume 2. Pediatric Cancer, vol 2. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-2957-5_29
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