Weekly Vinblastine in Pediatric Optic Pathway/Hypothalamic Glioma:2 Cases Report Fumiyuki YAMASAKI 1 , Motoki TAKANO 1 , Ushio YONEZAWA 1 , Akira TAGUCHI 1 , Takeshi TAKAYASU 1 , Kazuhiko SUGIYAMA 2 , Kaoru KURISU 1 1Department of Neurosurgery, Hiroshima University Hospital 2Department of Clinical Oncology & Neuro-oncology Program, Hiroshima University Hospital Keyword: optic pathway/hypothalamic glioma , vinblastine , optic glioma pp.977-984
Published Date 2019/9/10
DOI https://doi.org/10.11477/mf.1436204057
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 It is reported that vinblastine monotherapy has promising activity in patients with pediatric optic pathway/hypothalamic glioma(OPHG)who experienced treatment failure after initial treatment with standard chemotherapy. However, there have been no reports on vinblastine monotherapy against OPHG in Japan. Since vinblastine is an unauthorized drug under the Ministry of Health and Welfare, we used it after completing an in-hospital institutional review board application for each case. In the first case, a 6-year-old boy with recurrent OPHG with hydrocephalus was referred to our hospital. Weekly vinblastine was started at a dose of 6mg/m2 and was then reduced to 5mg/m2 and 4mg/m2 sequentially due to hematotoxicity. After 11 cycles of vinblastine, improvement in hydrocephalus was observed. After 22 cycles of vinblastine, the best response was observed, and we continued treatment up to 35 cycles. Progression of the disease was observed after 47 cycles and then we changed treatment to another regimen after 48 cycles of vinblastine. In the second case, a 6-year-old boy with chemotherapy-naïve recurrent OPHG underwent chemotherapy with vincristine and carboplatin. After 9 treatment cycles with carboplatin, hypersensitivity was observed. Subsequently, he was treated using weekly vinblastine as per the same protocol as that in our first case. A moderate response was observed after 18 cycles of vinblastine. After 48 cycles of vinblastine, the best response was observed, and we completed treatment. In both cases, severe adverse events were not observed and the treatment was well-tolerated. Vinblastine administered once per week is well-tolerated and maintains quality of life in children with OPHG.

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