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Titolo:
LOW-GRADE ASTROCYTOMA - A DECADE OF EXPERIENCE AT ST-JUDE-CHILDRENS-RESEARCH-HOSPITAL
Autore:
GAJJAR A; SANFORD RA; HEIDEMAN R; JENKINS JJ; WALTER A; LI YL; LANGSTON JW; MUHLBAUER M; BOYETT JM; KUN LE;
Indirizzi:
ST JUDE CHILDRENS HOSP,LE BONHEUR CHILDRENS MED CTR,BRAIN TUMOR TEAM,332 N LAUDERDALE ST MEMPHIS TN 38105 ST JUDE CHILDRENS HOSP,DEPT HEMATOL ONCOL MEMPHIS TN 38105 ST JUDE CHILDRENS HOSP,DEPT PATHOL & LAB MED MEMPHIS TN 38105 ST JUDE CHILDRENS HOSP,DEPT DIAGNOST IMAGING MEMPHIS TN 38105 ST JUDE CHILDRENS HOSP,DEPT BIOSTAT MEMPHIS TN 38105 ST JUDE CHILDRENS HOSP,DEPT RADIAT ONCOL MEMPHIS TN 38105 UNIV TENNESSEE,DIV NEUROSURG MEMPHIS TN 00000 UNIV TENNESSEE,DEPT PEDIAT MEMPHIS TN 00000 UNIV TENNESSEE,DEPT PATHOL MEMPHIS TN 00000 UNIV TENNESSEE,DEPT RADIAT ONCOL MEMPHIS TN 00000 UNIV TENNESSEE,DEPT RADIOL MEMPHIS TN 00000
Titolo Testata:
Journal of clinical oncology
fascicolo: 8, volume: 15, anno: 1997,
pagine: 2792 - 2799
SICI:
0732-183X(1997)15:8<2792:LA-ADO>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Soggetto:
CEREBRAL HEMISPHERES; PILOCYTIC ASTROCYTOMAS; HYPOTHALAMIC GLIOMAS; RECURRENT GLIOMAS; BRAIN-TUMORS; MANAGEMENT; CHILDHOOD; CHEMOTHERAPY; VINCRISTINE; CARBOPLATIN;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
39
Recensione:
Indirizzi per estratti:
Citazione:
A. Gajjar et al., "LOW-GRADE ASTROCYTOMA - A DECADE OF EXPERIENCE AT ST-JUDE-CHILDRENS-RESEARCH-HOSPITAL", Journal of clinical oncology, 15(8), 1997, pp. 2792-2799

Abstract

Purpose: To evaluate the impact of primary tumor site, age at diagnosis, extent of resection, and histology on progression-free survival (PFS) in pediatric low-grade astrocytoma. Patients and Methods: Medical,pathologic, and imaging information were reviewed reviewed for 142 children (ages 2 months to 19 years) with low-grade astrocytoma treated between January 1984 and July 1994. Gross total resection (GTR) was attempted for cerebellar and cerebral hemisphere tumors, with biopsy or less aggressive resection used predominantly for rumors in other sites. Surgery was followed by observation in 107 cases, radiation therapy in 31, and chemotherapy in four. Results. The overall survival rate was 90% +/- 3% (SE) at 4 years. PFS was significantly better for patients with cerebellar and cerebral hemisphere tumors (n = 75) than those with rumors in all other sites (P =.0006). Within the former group, there was no significant difference in PFS for patients in whom GTR was achieved versus those with incomplete resections (4-year estimates, 89%and 77%, respectively). Histology (juvenile pilocytic v astrocytoma not otherwise specified [NOS]) was not related to PFS in an analysis that controlled for tumor site and patient age, Patients younger than 5 years at diagnosis had a significantly poorer PFS than older children,regardless of histology (P <.03) or tumor site (P <.002). Treatment for progressive/recurrent disease was effective in a majority af patients, but appeared more successful in patients with hemispheric than thalamic or hypothalamic tumors. Conclusion: The overall survival in thisseries of pediatric low-grade astrocytomas is excellent. Age at diagnosis and tumor location, but not histology, had a significant impact on PFS, Efforts to improve treatment outcome should focus on young patients (< 5 years) and an those with central midline tumors. The majority of patients with completely resected hemispheric tumors were monitored without further therapy, which supports attempted GTR of cerebral and cerebellar hemisphere low-grade astrocytoma.

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Documento generato il 04/04/20 alle ore 02:48:55