title: Pattern of recurrence in paediatric malignant glioma: an institutional experience.
abstract: BACKGROUND
  The purpose of this retrospective study was to investigate the pattern of recurrence in paediatric malignant gliomas.
  
  
  METHODS
  We reviewed the notes, diagnostic imaging and treatment charts of 30 consecutive paediatric patients (age less than 18 years at diagnosis, range 0.5-17 years) presenting with a malignant glioma presenting to the paediatric oncology unit at the Royal Marsden Hospital over a 10-year period. The imaging at the time of first relapse was compared with the initial diagnostic scans to define a relapse as local, marginal or distant.
  
  
  RESULTS
  Median follow-up was 13 months (range 1-99 months). Twenty-four of 30 patients (80%) showed evidence of progression with a median time to progression of 8.5 months (range 3-64 months). Thirteen out of 24 patients developed local or marginal recurrences while 11/24 patients recurred at distant sites as site of first relapse (46%).
  
  
  CONCLUSIONS
  Our series suggests that the pattern of relapses in paediatric malignant gliomas could be different from that reported in adult studies as we observed a significant incidence of distant relapses. Larger prospective series need to be conducted to investigate the clinico-biological characteristics of the population at high risk for leptomeningeal dissemination.
authors.affiliation: Paediatric Unit, The Royal Marsden Hospital NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK. Sucheta.Vaidya@icr.ac.uk
authors.forename: Sucheta J
authors.initials: SJ
authors.lastname: Vaidya
authors.forename: Darren
authors.initials: D
authors.lastname: Hargrave
authors.forename: Frank
authors.initials: F
authors.lastname: Saran
authors.forename: Juliet
authors.initials: J
authors.lastname: Britton
authors.forename: Rubin
authors.initials: R
authors.lastname: Soomal
authors.forename: Eric
authors.initials: E
authors.lastname: Bouffet
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000473:pathology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005910:Glioma / Q000473:pathology* / Q000628:therapy; D006801:Humans; D007223:Infant; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000628:therapy; D011878:Radiotherapy; D012189:Retrospective Studies