Treatment Results of Low-Grade Gliomas in Children (a Retrospective Data Analysis)


Authors: Z. Pavelka 1;  K. Zitterbart 1;  T. Pavlík 2;  P. Šlampa 3;  J. Ventruba 4;  E. Brichtová 4;  M. Smrčka 5;  T. Paleček 6;  J. Jakubec 7;  M. Houdek 8;  L. Křen 9;  J. Skotáková 10;  H. Ošlejšková 11;  T. Turbová 1;  J. Štěrba 1
Authors‘ workplace: Klinika dětské onkologie LF MU a FN Brno – PDM 1;  Klinika dětské radiologie LF MU a FN Brno – PDM 10;  Klinika dětské neurologie LF MU a FN Brno – PDM 11;  Institut biostatistiky a analýz PřF MU a LF MU Brno 2;  Klinika radiační onkologie, Masarykův onkologický ústav, Brno 3;  Neurochirurgické oddělení, KDCHaT LF MU a FN Brno – PDM 4;  Neurochirurgická klinika LF MU a FN Brno – PMDV 5;  Neurochirurgická klinika FNsP Ostrava 6;  Neurochirurgická klinika LF UK a FN Hradec Králové 7;  Neurochirurgická klinika LF UP a FN Olomouc 8;  Ústav patologie LF MU a FN Brno – PMDV 9
Published in: Cesk Slov Neurol N 2008; 71/104(2): 206-214
Category: Short Communication

Overview

Children with low-grade gliomas (except brain stem gliomas) have good prognosis, 80–90 % of them are long time survivors. Their optimal management is influenced by the anatomical location of the tumour and the patient age. We present the retrospective analysis of 108 children treated in our institution between 1998 and 2006 years according to SIOP CNS 9702 study. The median age at diagnosis was 5.5 years with the prevalence of boys (58,3 %). Histological types distribution were follows: pilocytic astrocytoma (46,3 %), fibrillary astrocytoma (20,4 %), oligodendroglioma (5,6 %). In the whole cohort 5-year overall survival (OS5) was 96,2 %, 5-year event-free survival (EFS5) was 83,8 %. In the gross total resection group EFS was 90 %, median EFS for incomplete surgery was 77,4 months (p = 0,007). Unfavourable localizations represent diencephalon, metastatic spread and more structures affected, with median EFS of 78,8 months (p = 0,005). 36 children were treated with chemotherapy with EFS of 6 0%, and PFS of 50 %. Only 4 children have died, 3 of them from progression or relapse. We have proven 2 significant factors influencing outcome: extent of resection and tumor localization. Chemotherapy allows the delay of radiotherapy in a certain proportion of children. The risk subgroup, for which new therapeutic options are needed, are mainly inoperable tumors of diencephalon.

Key words:
children – low-grade gliomas – chemotherapy – radiotherapy – prognostic factors


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Labels
Paediatric neurology Neurosurgery Neurology
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