A lower-dose, lower-toxicity cisplatin-etoposide regimen for childhood progressive low-grade glioma. 2010

Maura Massimino, and Filippo Spreafico, and Daria Riva, and Veronica Biassoni, and Geraldina Poggi, and Carlo Solero, and Lorenza Gandola, and Lorenzo Genitori, and Piergiorgio Modena, and Fabio Simonetti, and Paolo Potepan, and Michela Casanova, and Cristina Meazza, and Carlo A Clerici, and Serena Catania, and Iacopo Sardi, and Felice Giangaspero
Division of Paediatrics, Fond. IRCCS Istituto Nazionale Tumori, Via Venezian 1, 20133, Milan, Italy. maura.massimino@istitutotumori.mi.it

After successfully using cisplatin (30 mg/m(2)/day) and etoposide (150 mg/m(2)/day) in ten three-day courses for progressive low-grade gliomas, a subsequent protocol reduced the daily doses of cisplatin (to 25 mg) and etoposide (to 100 mg), with the objective of achieving the same response and three-year PFS rates with lower neurotoxicity and myelotoxicity. We treated 37 patients (median age 6 years); 23 had optochiasmatic tumours and nine were metastatic cases. Diagnoses were clinical in 13 cases and histological in 24, and comprised: pilocytic astrocytoma (17), ganglioglioma (3), pilomyxoid astrocytoma (2), and fibrillary astrocytoma (2). Treatment was prompted by radiological evidence of progression and/or clinical deterioration a median 18 months after the first diagnosis. After initial MRI staging, neurological and clinical examinations were performed before each chemotherapy cycle, with MRI after the first three courses and every three months thereafter. After a median 48 months, a volume reduction was appreciable in 24 cases (65%) and response was maximum 12 months after starting treatment. The three-year EFS and OS rates were 65 and 97%, respectively. Clinical, neurological, or functional improvements were seen in 26/37 cases. No children had a WBC nadir below 2,000/mm(3). Audiological toxicity caused damage 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 three-year PFS and OS rates of 70 and 100%, respectively. Lower doses of cisplatin/etoposide are still effective in progressive low-grade glioma, with less acute and persistent morbidity.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D008137 Longitudinal Studies Studies in which variables relating to an individual or group of individuals are assessed over a period of time. Bogalusa Heart Study,California Teachers Study,Framingham Heart Study,Jackson Heart Study,Longitudinal Survey,Tuskegee Syphilis Study,Bogalusa Heart Studies,California Teachers Studies,Framingham Heart Studies,Heart Studies, Bogalusa,Heart Studies, Framingham,Heart Studies, Jackson,Heart Study, Bogalusa,Heart Study, Framingham,Heart Study, Jackson,Jackson Heart Studies,Longitudinal Study,Longitudinal Surveys,Studies, Bogalusa Heart,Studies, California Teachers,Studies, Jackson Heart,Studies, Longitudinal,Study, Bogalusa Heart,Study, California Teachers,Study, Longitudinal,Survey, Longitudinal,Surveys, Longitudinal,Syphilis Studies, Tuskegee,Syphilis Study, Tuskegee,Teachers Studies, California,Teachers Study, California,Tuskegee Syphilis Studies
D008279 Magnetic Resonance Imaging Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D008297 Male Males
D001932 Brain Neoplasms Neoplasms of the intracranial components of the central nervous system, including the cerebral hemispheres, basal ganglia, hypothalamus, thalamus, brain stem, and cerebellum. Brain neoplasms are subdivided into primary (originating from brain tissue) and secondary (i.e., metastatic) forms. Primary neoplasms are subdivided into benign and malignant forms. In general, brain tumors may also be classified by age of onset, histologic type, or presenting location in the brain. Brain Cancer,Brain Metastases,Brain Tumors,Cancer of Brain,Malignant Primary Brain Tumors,Neoplasms, Intracranial,Benign Neoplasms, Brain,Brain Neoplasm, Primary,Brain Neoplasms, Benign,Brain Neoplasms, Malignant,Brain Neoplasms, Malignant, Primary,Brain Neoplasms, Primary Malignant,Brain Tumor, Primary,Brain Tumor, Recurrent,Cancer of the Brain,Intracranial Neoplasms,Malignant Neoplasms, Brain,Malignant Primary Brain Neoplasms,Neoplasms, Brain,Neoplasms, Brain, Benign,Neoplasms, Brain, Malignant,Neoplasms, Brain, Primary,Primary Brain Neoplasms,Primary Malignant Brain Neoplasms,Primary Malignant Brain Tumors,Benign Brain Neoplasm,Benign Brain Neoplasms,Benign Neoplasm, Brain,Brain Benign Neoplasm,Brain Benign Neoplasms,Brain Cancers,Brain Malignant Neoplasm,Brain Malignant Neoplasms,Brain Metastase,Brain Neoplasm,Brain Neoplasm, Benign,Brain Neoplasm, Malignant,Brain Neoplasms, Primary,Brain Tumor,Brain Tumors, Recurrent,Cancer, Brain,Intracranial Neoplasm,Malignant Brain Neoplasm,Malignant Brain Neoplasms,Malignant Neoplasm, Brain,Neoplasm, Brain,Neoplasm, Intracranial,Primary Brain Neoplasm,Primary Brain Tumor,Primary Brain Tumors,Recurrent Brain Tumor,Recurrent Brain Tumors,Tumor, Brain
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D002945 Cisplatin An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. Platinum Diamminodichloride,cis-Diamminedichloroplatinum(II),cis-Dichlorodiammineplatinum(II),Biocisplatinum,Dichlorodiammineplatinum,NSC-119875,Platidiam,Platino,Platinol,cis-Diamminedichloroplatinum,cis-Platinum,Diamminodichloride, Platinum,cis Diamminedichloroplatinum,cis Platinum
D004334 Drug Administration Schedule Time schedule for administration of a drug in order to achieve optimum effectiveness and convenience. Administration Schedule, Drug,Administration Schedules, Drug,Drug Administration Schedules,Schedule, Drug Administration,Schedules, Drug Administration

Related Publications

Maura Massimino, and Filippo Spreafico, and Daria Riva, and Veronica Biassoni, and Geraldina Poggi, and Carlo Solero, and Lorenza Gandola, and Lorenzo Genitori, and Piergiorgio Modena, and Fabio Simonetti, and Paolo Potepan, and Michela Casanova, and Cristina Meazza, and Carlo A Clerici, and Serena Catania, and Iacopo Sardi, and Felice Giangaspero
February 2014, Neuropediatrics,
Maura Massimino, and Filippo Spreafico, and Daria Riva, and Veronica Biassoni, and Geraldina Poggi, and Carlo Solero, and Lorenza Gandola, and Lorenzo Genitori, and Piergiorgio Modena, and Fabio Simonetti, and Paolo Potepan, and Michela Casanova, and Cristina Meazza, and Carlo A Clerici, and Serena Catania, and Iacopo Sardi, and Felice Giangaspero
September 2012, Journal of neuro-oncology,
Maura Massimino, and Filippo Spreafico, and Daria Riva, and Veronica Biassoni, and Geraldina Poggi, and Carlo Solero, and Lorenza Gandola, and Lorenzo Genitori, and Piergiorgio Modena, and Fabio Simonetti, and Paolo Potepan, and Michela Casanova, and Cristina Meazza, and Carlo A Clerici, and Serena Catania, and Iacopo Sardi, and Felice Giangaspero
January 1994, Journal of cancer research and clinical oncology,
Maura Massimino, and Filippo Spreafico, and Daria Riva, and Veronica Biassoni, and Geraldina Poggi, and Carlo Solero, and Lorenza Gandola, and Lorenzo Genitori, and Piergiorgio Modena, and Fabio Simonetti, and Paolo Potepan, and Michela Casanova, and Cristina Meazza, and Carlo A Clerici, and Serena Catania, and Iacopo Sardi, and Felice Giangaspero
February 2015, The Laryngoscope,
Maura Massimino, and Filippo Spreafico, and Daria Riva, and Veronica Biassoni, and Geraldina Poggi, and Carlo Solero, and Lorenza Gandola, and Lorenzo Genitori, and Piergiorgio Modena, and Fabio Simonetti, and Paolo Potepan, and Michela Casanova, and Cristina Meazza, and Carlo A Clerici, and Serena Catania, and Iacopo Sardi, and Felice Giangaspero
December 2015, Current opinion in neurology,
Maura Massimino, and Filippo Spreafico, and Daria Riva, and Veronica Biassoni, and Geraldina Poggi, and Carlo Solero, and Lorenza Gandola, and Lorenzo Genitori, and Piergiorgio Modena, and Fabio Simonetti, and Paolo Potepan, and Michela Casanova, and Cristina Meazza, and Carlo A Clerici, and Serena Catania, and Iacopo Sardi, and Felice Giangaspero
January 2014, Chemotherapy,
Maura Massimino, and Filippo Spreafico, and Daria Riva, and Veronica Biassoni, and Geraldina Poggi, and Carlo Solero, and Lorenza Gandola, and Lorenzo Genitori, and Piergiorgio Modena, and Fabio Simonetti, and Paolo Potepan, and Michela Casanova, and Cristina Meazza, and Carlo A Clerici, and Serena Catania, and Iacopo Sardi, and Felice Giangaspero
April 2007, Neuro-oncology,
Maura Massimino, and Filippo Spreafico, and Daria Riva, and Veronica Biassoni, and Geraldina Poggi, and Carlo Solero, and Lorenza Gandola, and Lorenzo Genitori, and Piergiorgio Modena, and Fabio Simonetti, and Paolo Potepan, and Michela Casanova, and Cristina Meazza, and Carlo A Clerici, and Serena Catania, and Iacopo Sardi, and Felice Giangaspero
March 2018, American journal of clinical oncology,
Maura Massimino, and Filippo Spreafico, and Daria Riva, and Veronica Biassoni, and Geraldina Poggi, and Carlo Solero, and Lorenza Gandola, and Lorenzo Genitori, and Piergiorgio Modena, and Fabio Simonetti, and Paolo Potepan, and Michela Casanova, and Cristina Meazza, and Carlo A Clerici, and Serena Catania, and Iacopo Sardi, and Felice Giangaspero
January 1987, Pediatric hematology and oncology,
Maura Massimino, and Filippo Spreafico, and Daria Riva, and Veronica Biassoni, and Geraldina Poggi, and Carlo Solero, and Lorenza Gandola, and Lorenzo Genitori, and Piergiorgio Modena, and Fabio Simonetti, and Paolo Potepan, and Michela Casanova, and Cristina Meazza, and Carlo A Clerici, and Serena Catania, and Iacopo Sardi, and Felice Giangaspero
September 1991, British journal of urology,
Copied contents to your clipboard!