Outcome of Pediatric Patients with Low-Grade Astrocytoma of the Brain and Spinal Cord

Background: Low-grade astrocytomas are the most common pediatric central nervous system tumours. They can occur anywhere in the central nervous system and are often challenging to treat. Methods: A retrospective review to compare the response to therapy for spinal cord astrocytomas to that of brain astrocytomas. Results: Five patients had low-grade spinal cord astrocytoma and 43 had low-grade brain astrocytoma. One spinal cord and 16 brain patients underwent complete resection, and 2 and 20, respectively, partial resection. Of the 56% total patients with a partial resection, 31.8% and 4.5% received adjuvant chemotherapy and radiotherapy, respectively. 14% of all patients received chemotherapy, without resection. Three patients with spinal cord tumours underwent subtotal resection/biopsy followed by chemotherapy. They showed a mean tumour decrease of 36.9%, and none relapsed. The remaining patients showed tumour progression which responded to chemotherapy. Ten brain tumour patients received chemotherapy and 4 received radiation. Tumour size decreased by 44.5% with surgery/adjuvant therapy, and 27.1% with adjuvant therapy alone. Ten patients relapsed at a mean of 9.6 months. Those treated underwent resection (n=3) or adjuvant therapy (n=5) and 4 relapsed again. Conclusions: All patients with low-grade spinal cord astrocytomas responded to chemotherapy and none received radiation while 81.8% of those with brain astrocytoma responded to adjuvant therapy including radiation.