Brain tumors in children: long-term survival after radiation treatment.
OBJECTIVE
To determine the cause of death in children who survive more than 5 years after radiation treatment of a brain tumor.


METHODS
Nine hundred and twelve consecutive children with a primary brain tumor irradiated at the Princess Margaret Hospital or Toronto-Bayview Regional Cancer Center from 1958 to 1991, were evaluated for long-term outcome.


RESULTS
Overall 10- and 20-year survival rates were 44% and 37%. Subsequent survival of 377 5-year survivors was, at an additional 10 and 20 years, 78% and 67%. Most (83%) deaths that occurred more than 5 years from diagnosis were a result of relapse of the original tumor. The 10-year survival rate subsequent to relapse was 9% when the first relapse occurred less than one year from diagnosis, 17% for 1-2 years, and 31% when the time to relapse was 3 years or greater. The cumulative actuarial incidence of, and death from, second malignant tumors at 30 years from diagnosis was 18% and 13%, respectively.


CONCLUSIONS
Death later than 5 years from diagnosis of a brain tumor in children is common and is usually due to progressive disease in slowly evolving low grade tumors. Death from a second malignant tumor becomes more frequent than death from the original tumor after 15 years from diagnosis.
Toronto-Bayview Regional Cancer Center, University of Toronto, Ontario, Canada.
D
D
Jenkin
M
M
Greenberg
H
H
Hoffman
B
B
Hendrick
R
R
Humphreys
A
A
Vatter
D000293:Adolescent; D000367:Age Factors; D001932:Brain Neoplasms / Q000401:mortality* / Q000532:radiotherapy*; D002423:Cause of Death; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016609:Neoplasms, Second Primary / Q000401:mortality; D012737:Sex Factors; D016019:Survival Analysis