title: Diffuse brain stem gliomas. Are we improving outcome?
abstract: We reviewed our experience with diffuse brain stem glioma (dBSG) to evaluate whether any improvement of outcome had occurred in our patients over the years. Of the 24 children referred to our department with suspected dBSG from 1981 to 1997, 5 had a different final diagnosis based on the clinical course. Mean survival in the remainder was 16+/-9.8 months from diagnosis. Survival increased with a longer interval from onset of symptoms to diagnosis (12.9+/-9.0 months with an interval of 1-4 weeks; 19.50+/-10.8 months with a longer interval). Visual symptoms at presentation were associated with a poorer prognosis. Survival was better in the 3- to 5-year age group (at diagnosis). Overall, a trend toward a slight improvement in survival was seen over the years, which we presumptively attribute to the introduction of intensive chemotherapy for these patients. We suggest that chemotherapy may be important in the management of dBSG until a better modality is found.
authors.affiliation: Department of Pediatric Hematology/Oncology, Schneider Children's Medical Center of Israel, Beilinson Campus, Petah Tiqva, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Shuper
authors.forename: L
authors.initials: L
authors.lastname: Kornreich
authors.forename: D
authors.initials: D
authors.lastname: Loven
authors.forename: S
authors.initials: S
authors.lastname: Michowitz
authors.forename: M
authors.initials: M
authors.lastname: Schwartz
authors.forename: I J
authors.initials: IJ
authors.lastname: Cohen
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000532:radiotherapy*; D001933:Brain Stem; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005910:Glioma / Q000175:diagnosis / Q000188:drug therapy* / Q000532:radiotherapy*; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents