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Recurrent Childhood Cerebellar Astrocytoma
Current Clinical Trials
Recurrence may take place in childhood cerebellar gliomas and may develop many
years after initial treatment. Disease can be at the primary tumor site or,
especially in malignant tumors, at noncontiguous central nervous system sites.
Systemic relapse is rare, but may occur. At the time of recurrence, a complete
evaluation to determine the extent of relapse is indicated for all patients.
Biopsy or surgical resection may be necessary for confirmation of relapse
because other entities such as secondary tumor and treatment-related brain
necrosis may be clinically indistinguishable from tumor recurrence. The need
for surgical intervention must be individualized on the basis of the initial
tumor type, the length of time between initial treatment and the reappearance
of the mass lesion, and the clinical picture.
Patients with cerebellar astrocytoma (pilocytic or diffuse) who relapse after
being treated with surgery alone should be considered for another surgical
resection.[1] If this is not feasible, local radiation therapy is the usual
treatment.[2] If there is recurrence in an unresectable site after irradiation,
chemotherapy should be considered.[2] There is little information regarding
the activity of chemotherapy in this disease. Studies of novel therapeutic
approaches that are designed to test the activity and toxicity of chemotherapy
in recurrent brain tumor patients should be considered.
Current Clinical Trials
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent childhood cerebellar astrocytoma. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.
References
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Austin EJ, Alvord EC Jr: Recurrences of cerebellar astrocytomas: a violation of Collins' law. J Neurosurg 68 (1): 41-7, 1988.
[PUBMED Abstract]
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Garcia DM, Marks JE, Latifi HR, et al.: Childhood cerebellar astrocytomas: is there a role for postoperative irradiation? Int J Radiat Oncol Biol Phys 18 (4): 815-8, 1990.
[PUBMED Abstract]
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