Chemotherapy in Complex Treatment of Children with Glial High-Grade Tumors

Holodov B.*, Zheludkova .**, Tarasova .*, Petrov Yu.*, Pritiko .*

* Scientific Practical Center of Healthcare for Children, Moscow, Russia;
** Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia

 

There were 39 children and teenagers, aged 4-18, who were treated in January 1997-June 2005. They had high-grade glial tumors of the brain (37 cases) and spinal cord (2 patients). They were represented by glioblastomas (25), anaplastic astrocytomas (10) and unverified brain stem tumors (4), which were supposed to be anaplastic astrocytomas. All the cases underwent chemotherapy (ChT), preceded by radiation therapy in a total dose of 55-64 Gy. Partial tumor removal was performed in 32 patients; 91% of cases had residual tumor at the moment of chemotherapy beginning. There were 3 modes of chemotherapy: cyclic polychemotherapy, based on platinum preparations (13 cases, group I); standard polychemotherapy, carried out in the PVC regimen (9 cases, group II); monochemotherapy with temodal (17 cases, group III). A number of chemotherapy cycles varied from 4 up to 12. Chemotherapy in its full and planned volume was carried out only in 23% of cases of group I, 37% of cases of group II and 50% of cases of group III.

A chemotherapeutic effect, watched by the end of 4 cycles, was estimated by such indices as CR+PR (a complete or partial effect), tumor stabilization and disease progression. They were as follows: group I - 61%, 31% and 8%; group II - 25%, 63% and 12%; group III - 38%, 55% and 7% respectively. Since the beginning of chemotherapy total survival was 3-74 and more months (groups I and II) and 6-60 months (group III). It should be mentioned, that use of temodal started in 2001. Mean survival without disease progression was 16.4 months (group I), 17.7 months (group II) and 15 months (group III).

Thus, all chemotherapy regimes had similar and rather low efficacy.