Table 1.
Clinical features of four children with high-grade astrocytoma
| Case 1 | Case 2 | Case 3 | Case 4 | |
|---|---|---|---|---|
|
Sex |
F |
M |
M |
F |
|
Age at diagnosis |
≤ 13 years |
≤ 12 years |
≤ 8 years |
≤ 3 years |
|
Newly diagnosed tumor |
|
|
|
|
|
Tumor location |
P left |
F left |
FTP right |
FP left |
|
Resection |
GTR |
GTR |
GTR |
GTR |
|
Histology |
GBM |
GBM |
AA |
GBM |
|
Ki-67 (IHC) |
>10% |
50% |
7-10% |
60% |
|
Pre-radiation CT |
/ |
/ |
/ |
infant protocol (*) |
|
RT doses |
54 Gys plus TMZ |
54 Gys plus TMZ |
54 Gys plus TMZ |
59 Gys (at time of 3 year old) |
|
Post-radiation CT |
TMZ (6 courses) |
TMZ (6 courses) |
TMZ (6 courses) |
/ |
|
Recurrent tumor |
|
|
|
|
|
DFS (months) |
8 |
14 |
33 |
22 |
|
Recurrence |
local |
local |
local |
local |
|
Resection |
GTR |
GTR |
GTR |
GTR |
|
Histology |
GBM |
GBM |
AA |
GBM |
|
Ki-67 (IHC) |
40% |
50% |
60% |
50% |
|
Adjuvant CT |
TMZ /PCV (1 course)° |
TMZ /PCV (4 courses)° |
TMZ /PCV (6 courses)° |
TMZ /irinotecan (12 courses) |
|
Outcome |
dead |
dead |
dead |
alive |
|
LPS score |
/ |
/ |
/ |
90 |
|
Disease |
/ |
/ |
/ |
CR; off therapy |
| OS (months) | 10 | 26 | 40 | 57 |
P Parietal, F Frontal, FTP Fronto-temporo-parietal, FP Fronto-parietal, GTR Gross Total Resection, GBM Glioblastoma, AA Anaplastic Astrocytoma, IHC immunohistochemistry, RT Radiotherapy, CT Chemotherapy, TMZ Temozolomide, DFS Disease Free Survival, PCV Procarbazine-Lomustine-Vincristine, LPS score Lansky performance score (from 100 to 0, with 100= healthy status), CR Complete Remission, OS Overall Survival.
°Until progression and death.
*Infant protocol according to the National Therapeutic Indications for infant with GBM: Methotrexate and Vincristine (1 course), Etoposide (1 course), cyclophosphamide and Vincristine (1 course), thiotepa (2 courses) followed by stem cell auto-grafting.