CISPLATIN THERAPY IN RECURRENT CHILDHOOD BRAIN-TUMORS

Abstract

Twenty-two patients with brain tumors were initially treated with surgery, radiation therapy and/or adjuvant chemotherapy. Histologic diagnosis included 11 gliomas, 7 ependymomas, 1 dysgerminoma, 1 teratocarcinoma, 1 pinealoma and 1 small cell tumor. At recurrence, documented on computerized tomographic scan, cisplatin (60 mg/m2 per day i.v. .times. 2) was given every 3-4 wk. Seventeen patients received 2 or more courses and were considered to be evaluable for response. Response parameters included change in the size of tumor on computerized tomographic scan and/or in clinical findings. Four patients had complete response, 5 had partial response, 4 had stable disease and 4 had disease progression. Toxic effects were manageable. The number of patients with grade 3-4 toxic reactions, by category, were as follows: thrombocytic, 10; leukocytic, 4; renal, 5; metabolic, 4; gastrointestinal, 0; neurologic, 7. Two of the 14 patients tested had grade 3-4 ototoxicity. Acute fluid retention with decreased serum electrolytes and serious but reversible changes in the mental status, which were experienced in earlier patients, decreased in severity with increasing experience of the investigator. Cisplatin appears to be active in a spectrum of brain tumors and should be studied further for therapeutic efficacy.