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Japanese Journal of Clinical Oncology Advance Access published online on February 17, 2009
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyp012
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© The Author (2009). Published by Oxford University Press. All rights reserved

Chemotherapy with Cisplatin and Vincristine for Optic Pathway/Hypothalamic Astrocytoma in Young Children

Yutaka Sawamura1, Yuuta Kamoshima1, Tsutomu Kato1, Toshihiro Tajima2 and Junko Tsubaki2

1 Department of Neurosurgery, Hokkaido University Hospital
2 Department of Pediatrics, Hokkaido University Hospital, Sapporo, Japan

For reprints and all correspondence: Yutaka Sawamura, Department of Neurosurgery, Hokkaido University Hospital, North-15, West-7, Kita-ku, Sapporo 060-8638, Japan. E-mail: ysawamu{at}med.hokudai.ac.jp

Received December 10, 2008; accepted January 28, 2009

Objective: Optic pathway/hypothalamic astrocytomas (OPHA) in young children often show accelerated growth and require rather intensive induction chemotherapy.

Methods: 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.

Results: The children received six to eight cycles of cisplatin (20 mg/m2: days 1–5) and vincristine (1.4 mg/m2: 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.

Conclusion: Although the present series was small, this chemotherapy is a useful regimen for induction therapy in children with an aggressive deep-seated pilocytic astrocytoma.

Key Words: chemotherapy • cisplatin • hypothalamus • pilocytic astrocytoma • vincristine


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