This protocol applies to patients under 18 years of age with pilocytic astrocytoma in whom gross total resection was attempted or considered but did not — or could not — achieve the expected outcomes.
The first-line approach — gross total resection of the tumor — is performed whenever feasible to obtain a histological and molecular diagnosis and to achieve tumor control. In children with a developing brain, early operative intervention may be especially important for seizure control.
Escalation to the next treatment step is indicated when this approach has not achieved long-term local tumor control or cure (no local tumor progression on imaging) and seizure-freedom.
For pediatric low-grade glioma that cannot be completely resected, the next step involves chemotherapy with the goal of avoiding or delaying radiotherapy. Multiple chemotherapy protocols are employed in this setting.
The complete regimen options, sequencing, and all clinical details are available in the structured protocol — accessible via the button below.
Radiographic tumor response — reduction in tumor size — without disease progression.
DOI: 10.1093/neuonc/noac188
The management of pediatric LGG that cannot be completely resected has evolved considerably over the recent decades.
Observation and chemotherapy are increasingly used to avoid or delay radiotherapy.
Various protocols of chemotherapy are currently employed, including the combination of carboplatin and vincristine, vinblastine, and the thioguanine/procarbazine/CCNU/vincristine (TPCV) regimen as the most common options.
These treatments are usually administered over a period of 12–18 months.
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