Survival of infants with malignant astrocytomas. A report from the childrens cancer group

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Abstract
Background. Very young children with central nervous system malignant brain tumors have a poor prognosis. As compared with older children, survival is less likely, and those children who do survive frequently have severe impairment of growth and cognitive abilities, resulting partly from treatment with radiotherapy. Therefore, an intensive chemotherapeutic regimen was used to treat children younger than 2 years of age with a diagnosis of malignant astrocytomas. Patients and Methods. Thirty‐nine children younger than 24 months of age who were diagnosed with malignant astrocytoma were treated on a Childrens Cancer Group protocol with an eight‐drug chemotherapeutic regimen (vincristine, carmustine, procarbazine, hydroxyurea, cisplatin, cytosine arabinoside, prednisone, and dimethyl‐triazenoimidazole‐carboxamide) after surgery and postoperative staging. Radiation therapy was to be deferred until the completion of chemotherapy. Results. The objective response rate after two cycles of chemotherapy was 24%. Most patients did not receive radiotherapy.