Survival of children with malignant brain tumors receiving valproate: a retrospective study.

PURPOSE: The treatment of pediatric patients with malignant brain tumors has evolved considerably in the past decades. However, results are still unsatisfactory for some patients. Valproate has been shown to positively affect the survival of adult glioblastoma patients. We have been giving prophylactic antiepileptic drugs to newly diagnosed children with brain tumors. Since then, we noted a trend towards a better survival from our patients. In order to study this, we performed a retrospective evaluation in our institution. METHODS: Standard survival analysis was used, calculating survival until death by all causes or censoring. Comparisons were made by Cox's proportional hazards model regression. RESULTS: Between 2000 and 2010, 94 patients were treated (12 with high-grade gliomas, 56 medulloblastomas, and 26 ependymomas); median and mean ages were 7.7 and 7.8 years. Median follow-up was 60 months (35 for treated and 109 for untreated patients). Of these, 47 received valproate 10-15 mg/kg/day every 8-12 h and 47 did not. Patients who received valproate had a median survival of 34 months, whereas the other group had a median survival of 24 months (hazard ratios = 0.99, 0.57-1.75, p = 0.99). CONCLUSIONS: These results do not prove that valproate prophylactic treatment in pediatric patients with malignant brain tumors had an influence on their survival. However, our cohort showed an effect of higher size than the recent European Organization for Research and Treatment of Cancer trial analysis, even though not significant. Clinical trials with valproate in pediatric malignant brain tumors should be carefully planned, in order to detect a possible effect of this drug in survival.

Studies on the anti-oedematogenic properties of a fraction rich in lonchocarpin and derricin isolated from Lonchocarpus sericeus.

The acute anti-inflammatory properties of a fraction rich in the chalcones lonchocarpin and derricin, from the roots of Lonchocarpus sericeus (HFLS), were studied for the first time, using a paw oedema model induced in rats by various stimuli. Results showed that HFLS (100 and 200 mg kg(-1), i.p.) was ineffective in inhibiting dextran-induced paw oedema. The HFLS (200 mg kg(-1), p.o. or i.p.) also failed to inhibit the bradykinin-induced oedema. In the yeast-elicited oedema, the HFLS (200 mg kg(-1), i.p.) caused inhibitions ranging from 42 to 59% in the first to fourth hours. Orally administered HFLS (200 mg kg(-1)) was active only in the second (27%) and fourth (32%) hours after yeast injection. It was observed that HFLS (50, 100 and 200 mg kg(-1), i.p.) showed inhibitions of 34, 57 and 74%, respectively, in the third hour for the carrageenan-induced oedema. The inhibition was smaller when the HFLS (100 and 200 mg kg(-1)) was administered orally. The effect of the HFLS (20 mg kg(-1), i.p.) in the carrageenan-induced oedema was not modified by the L-NAME, but the association of pentoxifylline and HFLS increased its effect, suggesting an involvement of the PDE enzyme.