Single agent vinorelbine in pediatric patients with progressive optic pathway glioma
Data
2015-01-01
Autores
Cappellano, Andrea Maria 
Petrilli, Antonio Sergio
Silva, Nasjla Saba da
Silva, Frederico Adolfo
Paiva, Priscila Mendes
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The management of progressive unresectable low-grade glioma remains controversial. Treatment options have included radiotherapy, and more recently chemotherapy, usually following an initial period of observation. Within this context, we evaluated vinorelbine, a semisynthetic vinca alkaloid that has shown evidence of activity against glioma. From July 2007 an institutional protocol with vinorelbine (30 mg/m 2 days 0, 8, 22) for a total of 18 cycles, has been conducted at IOP/GRAACC/UNIFESP for children with optic pathway glioma (OPG). the main objectives were clinical and radiological response, as well as toxicity profile. Twenty-three patients with progressive OPG with a mean age of 69 months (4-179) were enrolled. Three patients had a diagnosis of neurofibromatosis type 1. Twenty-two patients were assessable for response with an overall objective response rate of 63%, with eight patients showing stable disease. the most important toxicity was hematologic (grade III/IV neutropenia) observed in four patients. Gastrointestinal toxicity (grade I/II vomiting) was observed in seven patients and only 1 patient showed grade I peripheral neuropathy. the median progression-free survival (PFS) was 33 months (6.9-69) with a 3 and 5 year PFS of 64 +/- 19 and 37 +/- 20%, respectively, for an overall 3 and 5 year-survival of 95 +/- 10%. This study suggests that vinorelbine may be an interesting option for pediatric low-grade gliomas, showing low toxicity profile and providing a good quality of life for patients with such chronic disease.
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Journal of Neuro-oncology. New York: Springer, v. 121, n. 2, p. 405-412, 2015.