Brain tumours under the age of three. The price of survival. A retrospective study of 20 long-term survivors.
Between 1975 and 1989, 98 children with brain tumours under the age of three at time of diagnosis were entered into a retrospective study. Twenty of them are alive and free of tumour more than five years after treatment and were evaluated in this study. Thirteen tumour localizations were infratentorial and 7 were supratentorial. A histological examination was performed in 15 patients: 5 ependymomas, 6 medulloblastomas and 4 astrocytomas were identified. Fifteen patients underwent surgical removal of tumour, all but one received radiotherapy and 8 were given chemotherapy. Only two children have not late effects. Analysis of long-term sequelae in survivors showed central endocrinopathies in 14 (70%), a neurological handicap in 13 (65%) and impaired cognitive functions in 17 (85%). Irradiation was clearly responsible for mental sequelae in 7 patients and endocrinopathies in 6 patients. The other possible causes are tumour injury, hydrocephalus or surgery. The risks incurred with radiotherapy and advances in infant brain tumour therapy are discussed.
Suc
E
E
Service de Pediatrie, Institut Gustave Roussy, Villejuif, France.
Kalifa
C
C
Brauner
R
R
Habrand
J L
JL
Terrier-Lacombe
M J
MJ
Vassal
G
G
Lemerle
J
J
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001254:Astrocytoma / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D001921:Brain / Q000528:radiation effects*; D001925:Brain Damage, Chronic / Q000209:etiology*; D001932:Brain Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D002528:Cerebellar Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D002648:Child; D003131:Combined Modality Therapy; D004806:Ependymoma / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005909:Glioblastoma / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D008297:Male; D008527:Medulloblastoma / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology*; D011832:Radiation Injuries / Q000209:etiology*; D015996:Survival Rate