LG-31: SUCCESSFUL TREATMENT OF BRAINSTEM PILOMYXOID ASTROCYTOMA USING RECOMBINANT HUMAN ENDOSTATIN COMBINED WITH VINCRISTINE AND CARBOPLATIN: A CASE REPORT

Brainstem glioma of children, especially recurrent pilomyxoid astrocytoma with CNS spread is neuro-oncology challenge. Recombinant human endostatin (rh-ES), an inhibitor of angiogenesis and tumor growth, has been used for treatment of lung cancer, but no experience for pilocytic astrocytoma. Here we report a case of recurrent pilomyxoid astrocytoma that was successfully treated using rh-ES in combination with vincristine (VCR) and carboplatin (CBP). A 12-year-old girl experienced difficulty in walking, dysphagia, bucking and coughing episodes and was diagnosed with a recurrent pilomyxoid astrocytoma in the medulla oblongata, with spreading of supprasellar region, left cerebellar hemisphere and the myelon. She firstly was received chemotherapy with VCR and CBP once a week. Three weeks later, her tumor was progressed and her clinical status deteriorated. Then she was started on rh-ES once per day, on a schedule of two weeks on, two weeks off, in combination with VCR and CBP. Two months after starting with rh-ES treatment, the enhancing mass was decreased. Four months later, the girl experienced improvement in clinical symptoms and significant decrease of tumor. This case suggests that rh-ES may strengthen the effect of VCR and CBP on recurrent pilomyxoid astrocytoma with CNS spread.