TY - JOUR
T1 - Influence of valproic acid on outcome of high-grade gliomas in children
AU - Masoudi, Amirhadi
AU - Elopre, Marily
AU - Amini, Elham
AU - Nagel, Margaret E.
AU - Ater, Joann L.
AU - Gopalakrishnan, Vidya
AU - Wolff, Johannes E.A.
PY - 2008/7
Y1 - 2008/7
N2 - Background: Chemotherapy has limited effects in the treatment of high-grade gliomas (HGGs). Valproic acid (VPA), a histone deacetylase (HDAC) inhibitor, may sensitize HGGs to radiochemotherapy. As the drug has been given frequently as an antiepileptic drug, a retrospective analysis was conducted to ensure relevant information was not missed before a prospective study was launched. Materials and Methods: An analysis of 66 pediatric patients (range, 1-19 years of age) with glioblastoma multiforme (GBM) (n=40) or anaplastic astrocytoma (AA) (n=26) was retrospectively conducted for predictors of survival and response and for effects of VPA on outcome or toxicity. Results: The overall survival (OS) was better for AA (p=0.0114) and complete resection (p<0.00005) and event-free survival (EFS) was better for complete resection (p=0.0049). Nine patients received VPA (for seizure) plus further oncological treatment. The most severe adverse effect was a pulmonary embolism (n=1); no other severe side-effects were noted. The response to nonsurgical treatment after 8 weeks was: complete response (CR): O, partial response (PR): 3, stable disease (SD):4, progressive disease (PD): 2. Some of the patients with SD responded later resulting in best response: CR:O, PR:5, SD:2, PD:2. Conclusion: Treatment with VPA plus radiochemotherapy is well tolerated with an encouraging response rate.
AB - Background: Chemotherapy has limited effects in the treatment of high-grade gliomas (HGGs). Valproic acid (VPA), a histone deacetylase (HDAC) inhibitor, may sensitize HGGs to radiochemotherapy. As the drug has been given frequently as an antiepileptic drug, a retrospective analysis was conducted to ensure relevant information was not missed before a prospective study was launched. Materials and Methods: An analysis of 66 pediatric patients (range, 1-19 years of age) with glioblastoma multiforme (GBM) (n=40) or anaplastic astrocytoma (AA) (n=26) was retrospectively conducted for predictors of survival and response and for effects of VPA on outcome or toxicity. Results: The overall survival (OS) was better for AA (p=0.0114) and complete resection (p<0.00005) and event-free survival (EFS) was better for complete resection (p=0.0049). Nine patients received VPA (for seizure) plus further oncological treatment. The most severe adverse effect was a pulmonary embolism (n=1); no other severe side-effects were noted. The response to nonsurgical treatment after 8 weeks was: complete response (CR): O, partial response (PR): 3, stable disease (SD):4, progressive disease (PD): 2. Some of the patients with SD responded later resulting in best response: CR:O, PR:5, SD:2, PD:2. Conclusion: Treatment with VPA plus radiochemotherapy is well tolerated with an encouraging response rate.
KW - Anaplastic astrocytoma
KW - Glioblastoma multiforme
KW - High grade glioma
KW - Histone deacetylase inhibitor
KW - Pediatric
KW - Valproic acid
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M3 - Article
C2 - 18751431
AN - SCOPUS:48849103965
SN - 0250-7005
VL - 28
SP - 2437
EP - 2442
JO - Anticancer research
JF - Anticancer research
IS - 4 C
ER -