Pediatric Neurosurgery · 2008 · 150 citations · 0 references
MedicineCancer BiologyOncologyNeuro-oncologyPediatric NeurologyPediatric OncologyBrain TumorsPediatric Brain TumorsPediatric Central Nervous System RadiotherapyPediatric Neuro-oncologyPediatric Neurosurgical OncologyBrainstem InvolvementClinical SymptomsPediatric Brain Tumor BiologyPediatric Brain Tumor RadiotherapyPediatric Neuro-oncology TrialsTumor Grade Assessment
Brainstem gliomas in children are aggressive, often extensive, and have poor prognosis despite current therapies, though neuroimaging helps differentiate malignant from benign subgroups, and better outcomes will require advances in tumor biology and novel treatments. The study analyzed 119 children with BSG treated with hyperfractionated radiotherapy (7,200–7,800 cGy) to identify risk groups and prognostic indicators. Overall survival was very poor and unrelated to age, sex, clinical features, or tumor grade, except that longer survival correlated with brainstem symptoms lasting more than one month before diagnosis.
Brainstem gliomas (BSG) with intrinsic and extensive brainstem involvement continue to have a poor outlook despite current treatment approaches. Neuroimaging studies have aided in the differentiation of malignant brainstem tumors from more 'benign' subgroups. A Children's Cancer Group protocol evaluating outcome in children with BSG after treatment with hyperfractionated radiotherapy (7,200–7,800 cGy) was recently completed. The clinical aspects of 119 children entered into this study were reviewed in an attempt to determine risk groups and prognostic indicators. The overall survival of this group was very poor and there was no statistically significant correlation of survival with age, sex, clinical symptoms and signs, or tumor grade. Longer survival was only associated with prolonged duration of brainstem symptoms and signs greater than 1 month prior to diagnosis of the tumor. Improved outlook for children with BSG will require further research in tumor biology and newer therapeutic modalities.