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Loss of efficacy of subsequent nonsurgical therapy after primary treatment failure in pediatric low-grade glioma patients: report from the German SIOP-LGG 2004 cohort

First-line treatment of pediatric low-grade glioma using surgery, radio- or chemotherapy fails in a relevant proportion of patients. We analyzed efficacy of subsequent surgical and nonsurgical therapies of the German cohort of the SIOP-LGG 2004 study (2004-2012, 1558 registered patients; median age...

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Autori principali: Kandels, Daniela (Autore) , Pietsch, Torsten (Autore) , Bison, Brigitte (Autore) , Warmuth-Metz, Monika (Autore) , Thomale, Ulrich-Wilhelm (Autore) , Kortmann, Rolf-Dieter (Autore) , Timmermann, Beate (Autore) , Hernáiz Driever, Pablo (Autore) , Witt, Olaf (Autore) , Schmidt, René (Autore) , Gnekow, Astrid K. (Autore)
Natura: Article (Journal)
Lingua:inglese
Pubblicazione: 26 October 2020
In: International journal of cancer
Year: 2020, Volume: 147, Fascicolo: 12, Pages: 3471-3489
ISSN:1097-0215
DOI:10.1002/ijc.33170
Accesso online:Verlag, kostenfrei, Volltext: https://doi.org/10.1002/ijc.33170
Verlag, kostenfrei, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1002/ijc.33170
Testo
Note sull'autore:Daniela Kandels, Torsten Pietsch, Brigitte Bison, Monika Warmuth-Metz, Ulrich-Wilhelm Thomale, Rolf-Dieter Kortmann, Beate Timmermann, Pablo Hernáiz Driever, Olaf Witt, René Schmidt, Astrid K. Gnekow
Descrizione
Riassunto:First-line treatment of pediatric low-grade glioma using surgery, radio- or chemotherapy fails in a relevant proportion of patients. We analyzed efficacy of subsequent surgical and nonsurgical therapies of the German cohort of the SIOP-LGG 2004 study (2004-2012, 1558 registered patients; median age at diagnosis 7.6 years, median observation time 9.2 years, overall survival 98%/96% at 5/10 years, 15% neurofibromatosis type 1 [NF1]). During follow-up, 1078/1558 patients remained observed without (n = 217), with 1 (n = 707), 2 (n = 124) or 3 to 6 (n = 30) tumor volume reductions; 480/1558 had 1 (n = 332), 2 (n = 80), 3 or more (n = 68) nonsurgical treatment-lines, accompanied by up to 4 tumor-reductive surgeries in 215/480; 265/480 patients never underwent any neurosurgical tumor volume reduction (163/265 optic pathway glioma). Patients with progressing tumors after first-line adjuvant treatment were at increased risk of suffering further progressions. Risk factors were young age (<1 year) at start of treatment, tumor dissemination or progression within 18 months after start of chemotherapy. Progression-free survival rates declined with subsequent treatment-lines, yet remaining higher for patients with NF1. In non-NF1-associated tumors, vinblastine monotherapy vs platinum-based chemotherapy was noticeably less effective when used as second-line treatment. Yet, for the entire cohort, results did not favor a certain sequence of specific treatment options. Rather, all can be aligned as a portfolio of choices which need careful balancing of risks and benefits. Future molecular data may predict long-term tumor biology.
Descrizione del documento:Gesehen am 14.09.2026
Descrizione fisica:Online Resource
ISSN:1097-0215
DOI:10.1002/ijc.33170

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