Recurrent cerebellar gliomas: salvage therapy with oral etoposide.

The purpose of this investigation was to assess the toxicity and activity of chronic oral etoposide in the management of children with recurrent juvenile pilocytic cerebellar astrocytomas. Twelve children with recurrent juvenile pilocytic cerebellar astrocytomas, refractory to surgical resection, radiotherapy, and chemotherapy were treated with chronic oral etoposide. Treatment related complications included alopecia, diarrhea, weight loss, and thrombocytopenia. Three children required transfusion and one child developed neutropenic fever. No treatment related deaths occurred. Six children demonstrated either a radiographic response or stable disease with a median duration of 7 months. Oral etoposide was well tolerated, produced modest toxicity, and had apparent activity in this small cohort of children with recurrent juvenile pilocytic cerebellar astrocytomas.