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Effectiveness of novel combination
chemotherapy, consisting of 5-fluorouracil, vincristine,
cyclophosphamide and etoposide, in the treatment of low-grade gliomas
in children Mee Jeong Lee1,
6, Young Shin Ra2, Jun Bum Park2,
Hyun Woo Goo3, Seung Do Ahn4,
Shin Kwang Khang5, Joon Sup Song1,
Yoon Jung Kim1 and Thad T. Ghim1,
7, *
1Department
of Pediatrics, Asan Medical Center, University of Ulsan College of
Medicine, Seoul, Korea. 2Department
of Neurosurgery, Asan Medical Center, University of Ulsan College of
Medicine, Seoul, Korea. 3Department
of Radiology, Asan Medical Center, University of Ulsan College of
Medicine, Seoul, Korea. 4Department
of Therapeutic Radiology, Asan Medical Center, University of Ulsan
College of Medicine, Seoul, Korea. 5Department
of Pathology, Asan Medical Center, University of Ulsan College of
Medicine, Seoul, Korea. 6Department
of Pediatrics, Dankook University College of Medicine, Cheonan, Korea.
7Department of Pediatrics,
Center for Ped. Hematology/Oncology, National Cancer Center, 809 Madu
1-dong, Ilsan-gu, Goyang-si, Gyeonggi-do, Korea. -- *Correspondence:
Thad T. Ghim, Email: tghim@ncc.re.kr. -- Received: 15 February 2006 Accepted:
21 April 2006 Published online: 29 June 2006.
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Low-grade gliomas (LGG), which account for
about 30% of brain tumors in children, are usually treated with
surgical excision and/or radiotherapy.
For patients who have significant residual
tumor after resection or relapse after radiation, the proper
chemotherapy regimen has not yet been identified.
Thirteen children diagnosed with LGG
outside the cerebellum between January 1999 and December 2004, all of
whom had significant residual tumor after surgical resection, relapsed
after radiation or showed visual deterioration, were treated for 18 months
with a multi-drug regimen of vincristine, etoposide, cyclophosphamide
and 5-fluorouracil.
Of the 7 patients who completed
chemotherapy, 1 showed complete response (CR), 5 showed partial
response (PR), and 1 had stable disease (SD).
In 5 patients, chemotherapy was
prematurely discontinued; 4 of these patients showed tumor progression
and 1 had SD.
One patient is still undergoing
treatment.
The side effects of chemotherapy were
manageable.
The median time to tumor response was 34 months
(range, 2–82 months).
The progression free survival was
67.3%.
Pediatric LGG patients with residual tumor
after surgery or who undergo relapse(s) may be successfully treated
using our combination chemotherapy regimen.
Keywords: Brain
tumor, Chemotherapy, Children, Low-grade glioma
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