Chemotherapy for Progressive Low Grade Astrocytoma in Children Less Than Ten Years Old

Date de début de l'étude : 1 avril 1997

DISEASE CHARACTERISTICS: Pathologically confirmed low grade residual astrocytomas or other eligible residual tumors of the brain interpreted as low grade (WHO grades I and II) such as the following: Glial Tumors Astrocytic tumors Low grade astrocytoma (variants: fibrillary, protoplasmic, gemistocytic) Pilocytic astrocytoma Pleomorphic xanthoastrocytomas Subependymal giant cell astrocytoma Infantile desmoplastic astrocytoma Low grade oligodendroglial tumors Low grade oligodendroglioma Low grade mixed gliomas Oligo-astrocytoma Neuronal Tumors Ganglioglioma (excluding tumors with anaplastic astrocytic components) Infantile desmoplastic ganglioglioma Chiasmatic-hypothalamic tumor without histologic confirmation All of the following diagnostic tests (radiological or clinical evidence of progression, surgery, or confirmatory MRI) must be carried out within 6 weeks of enrollment into this study Progressive disease following surgical excision based on clear radiological or clinical evidence of progression, or an incomplete excision (less than 95% or greater than 1.5 cm2) with necessity to begin treatment because of a risk of neurologic impairment with progression Chiasmatic lesions that have contiguous extensions of tumor into other regions of the visual pathways demonstrated on contrast MRI will be eligible for study without histopathological confirmation Patients with neurofibromatosis who have radiographic diagnosis of chiasmatic-hypothalamic tumor are eligible for the study, without requiring a biopsy confirmation of tumor histology, but not unless tumor progression is documented radiographically No intrinsic brain stem tumors of the pons or isolated optic nerve tumors without definitive involvement of the optic chiasm PATIENT CHARACTERISTICS: Age: Under 10 Performance status: Not specified Life expectancy: Not specified Hematopoietic: Absolute neutrophil count greater than 1,000/mm^3 (arm II) Platelet count greater than 100,000/mm^3 (arm II) Hepatic: Not specified Renal: Creatinine less than 1.5 times upper limit of normal for age OR Creatinine clearance or radioisotope GFR greater than 70 mL/min or equivalent GFR as determined by the institutional normal range PRIOR CONCURRENT THERAPY: Biologic therapy: Not specified Chemotherapy: No prior chemotherapy for the tumor Endocrine therapy: Prior corticosteroid therapy allowed Radiotherapy: No prior radiotherapy for the tumor Surgery: See Disease characteristics Other: Prior diuretic therapy allowed