S58 Monday 30 October 1995

265 POSTER
= = =
grade I-II (n 6), grade III (n 6). and grade IV (n 28)). (1) Median RADIATION THERAPY IN OPTIC GLIOMAS OF CHILDHOOD:
cytosolic levels of uPA and PAI1 as detennined by EUSA, were respec- PROGNOSIS AND LONG TERM SEQUELA
tively 0.03 ng/mg protein (range 0.003-0.16) and II. 9 ng/mg protein H. S. ErkaF, M. Serin, M. Berberoglu, H. Kumbasar, A. 9akmak
(range 0.25-161.8). The highest levels of PAIl were found in grade IV Department of Radiation Oncology
tumors as compared to grades I-III (P < 0.001). Expression of uPA and Department of Pediatric Endocrinology
PAIl was confinned by Northern blot and in situ hybridization which Department of Psychiatry, Ankara University, Faculty of Medicine, 06100,
localized PAl I predominantly around neoangiogenic foci, both in tumor
Ankara, Turkey
and endothelial celIs. (2) Expression ofPAI2 antigen was heterogeneously Thirty-three children with the diagnosis of optic glioma were admitted
distributed among tumors (median = 0.18 ng/mg protein, range 0.02-
to Oepartment of Radiation Oncology in Ankara University Faculty of
6.8) but was undetectable in control tissues. This data was confirmed by Medicine between 1973 and 1994. Twenty-two patients were female and
in situ hybridization. (3) Univariate analysis demonstrated that high lev-
11 were male, with a female:male ratio of2: 1. Their ages ranged between
els of PAIl are associated with a shorter disease-free survival both for the 1 to 18 (mean:8.4, median:7). Six patients (18.2%) presented with neu-
= =
overall population (P 0.02), and the grades IV (P 0.06). In grade rofibromatosis. Twenty-nine patients (87.9%) had histopathological di-
IV gliomas, high levels of PAI2 are, in contrast, highly correlated to a agnosis of astrocytoma. Tumors were confined to the optic nerve in 5
better overall survival rate at 18 months (48% vs 0%, P = 0.015). Our patients (15.1 %), confined to the chiasma in 6 patients (18.2%) and in-
preliminary results suggest that, in malignant gliomas, PAIl and PAI2 volved both the optic nerve and chiasma in 22 patients (66.7%). Subtotal
may be useful in the analysis of therapeutic protocols. Further studies resection of the tumor was perfunned in 20 patients (60.6%). Thirteen
should precise their biological role, in order to evaluate them as potential patients received irradiation as sole therapy. Two patients were irradi-
therapeutic target. ated for recurrent tumors. Mean fullow-up was 158 months. Actuarial
survival for 5 and 10 years were 91.9% and 77.9% respectively. Age, sex
and subtotal resection did not appear to correlate with survival. Presence
263 ORAL
of neurofibromatosis reminded bad prognosis. One patient developed
INTRALESIONAL RADIOIMMUNOTHERAPY OF MAUGNANT
precocious puberty, two others developed panhypopituitarism and one
GUOMAS AS ADJUVANT SETIING IN NEWLY DIAGNOSED
posterior hypopituitarism. One patient was diagnosed as organic brain
TUMOUR OR AS RESCUE TREATMENT IN RECURRENT
LESIONS syndrome at the age of 30 and two patients had anxiety disorder. Ra-
P. Riva', C. Sturiale 2 , A. Arista', G. Franceschi', N. Riva', R. Rossini', diotherapy proved to be an effective for tumors involving chiasma where
M. Casi'
surgery is not feasible. Long tenn follow-up would disclose either treat-
'Nudear Medical Department and 1st Oncology Romagnolo ment or tumor induced sequela.
2Neurosurgical Department, "M. Bufalini" Hospital, Cesena, Italy
Two 1-131 labelled murine Monocolonal Antibodies (MAbs) BC-2 and
BC-4 raised against tenascin (TN), were intralesionally infused in 48 pa-
tients bearing a malignant glioma: 28 with recurrent disease (Rec) and 20 266 POSTER
cases with newly diagnosed tumour (New). All patients were previously PET-FDG UPTAKE AS A PROGNOSTIC INDICATOR IN
treated with surgery and radio-chemotherapy. Twenty-four Rec cases GLIOMAS
underwent further surgery which obtained a total or subtotal removal of M.M. Fitzek, H. Aronen, J. Efird, F. Hochberg, A. Fischman, F. S. PardD
tumour mass in 10 of these. In total 25 patients had intralesional RIT Department of Radiation Oncology, Massachuserts General Hospital, Boston
when the disease was minimal. The radiopharmaceutical was given at a 02114, U S.A.
dose of 4 mg of MAbs and 2405 MBq of 131 I. The infusions were re- Positron Emission Tomography (PET) with 18-Fluorodeoxyglucose
peated up to six. The local treatments were always well tolerated. The (FOG) provides quantitative and qualitative data on cerebral glucose
radiation dose to the tumour was on average >300 Gy per cycle. The consumption and is used in the evaluation of intracranial neoplasms. We
median survival was, in total, 18 months. Intralesional RIT produced have examined the value of PET-FOG uptake on glial tumor prognosis.
12 complete remissions (6 in Rec and 6 in New), 6 partial remissions (4 Material and Methods: PET scans of 31 patients with Grade 2-4
in Rec and 2 in New). In 19 cases (15 Rec and 5 New) the progression gliomas were evaluated prospectively on a semiquantitative scale from
of disease was recorded. The overall response rate was 37.5% (35.7% 0-4 according to avidity of 18-FOG uptake. Mean age of the patient
in Rec and 40% in New). These data demonstrate the capability of this group was 40.4 years, mean follow-up period was 42 months. Actuarial
new therapeutic technique to achieve, in a significant number of cases, a progression free survival was calculated as correlative endpoint.
long lasting control of malignant gliomas and suggest the opportunity to Results: High FOG-uptake scores correlated with a worse prognosis
apply this treatment when the disease is reduced owing to previous tra- (42% vs. 22% actuarial 5 year progression free survival, P < 0.05, high
ditional cares. (Wlrk supported by National Research Council program vs. low scores,). Age and Grade however were stronger indicators (P
(Italy): Clinical Applications of Oncology Research, subproject n.8.) < 0.001). PET-FOG scores appeared more germane in the case of high
grade tumors, indicating a better ability to discriminate the tumors with
the poorest prognosis.
264 POSTER Conclusion: Avidity of FOG uptake in our patient group provided ad-
EMBOLIZATION AND RADIATION THERAPY OF ditional and complementary infonnation to conventional factors such as
CHEMODECTOMA OF THE TEMPORAL BONE age and grade with regard to prognosis.
W. Alberti', H. -C. Nahser 2, W. Krischke J , C. Huyer 1 , D. KUhne
'Klinikfiir Strahlentherapie und Nuklearmedlzin
2Rantgendiagnostik und Neuroradiologie, Alfried Krupp K rankenhaus Essen,
Germany
Between September 1986 and January 1993, a total of 12 patients with 267 POSTER
primary (8) or recurrent (4) chemodectomai of temporal bone were CHEMOTHERAPY FOR LOW GRADE GLIOMAS
treated. Oiagnosis was assessed by clinical examination and radiographic C. Kalifa, M.A. Raquin, D. Plantaz, F. Doz, P. Chastagner,
studies (7) or by histological confinnations (5). All patients presented M.e. Baranzelli, E. Bouffet, D. Couanet
with group III disease and four presented with brain involvement. All French SocIety of Pediatric Oncology ( SFOP)
patients were treated with embolization either within one week befure Complete surgical resection is the standard treatment for low grade
initiation of radiation therapy (10), or 3 and 4 years before, respectively. gliomas (LGG) but it is sometimes impossible to perform. Radiation
All patients were irradiated with a wedged field technique using 60 Co therapy has been extensively used as a complementary treatment or as
gamma rays or 12 MV photons. The total tumour doses were 45 Gy/25 the only treatment in inoperable tumors. Anyway, because of its dele-
fx (4) or 50.4 Gy/28 fx (8). Ten evaluable patients have been followed for terious long tenn effects, recent attempts have been made in order to
13 to 84 months (median 32). Nine evaluable patients had local tumour investigate the efficacy of chemotherapy (CT) in young children and/or
control defined as having no evidence of progression of disease clinically huge inoperable tumors. Since 1990, 35 low grade glioma patients (pts)
or radiographically to the date ofanalysis, whereas in one patient tumour have been treated with the SFOP BB CT protocol which includes: 7
progressed Cranial nerve paresis improved in 6 patients after a latency cycles of carboplatin, procarbazine, etoposide, cisplatin, vincristin, cy-
of 22 to 72 months (median 44). This study demonstrates that radiation clophosphamide, for 16 to 18 months. They were 16 males and 19 fe-
therapy with preceeding embolization therapy is an effective treatment males aged 6 m to 104m (median 25 m). The tumor was located in the
for advanced chemodectomas optic pathway/hypothalamus in 22 pts, cerebral hemispheres in 3, basal