Survival and late effects on development of patients with infantile brain tumor.
BACKGROUND
Most infants with brain tumor may have a poor prognosis. The aim of the present study was to retrospectively analyze the survival and outcome with regard to mental and physical development in 11 subjects with brain tumor; these tumors were diagnosed when the patients were under 1 year of age.


METHODS
The histological diagnoses of these tumors were astrocytoma, n = 3; pineocytoma, n = 2; teratoma, n = 1; ependymoma, n = 1; atypical teratoid/rhabdoid tumor, n = 1; glioblastoma, n = 1; medulloblastoma, n = 1; and choroid plexus papilloma, n = 1. Surgical resection was performed in eight patients, and adjuvant chemotherapy was administered to all except one patient with choroid plexus papilloma. Radiotherapy was additionally performed for four of the 10 chemotherapy patients.


RESULTS
Six patients survived. Among the surviving patients, five were under no treatment for 50-167 months after the diagnosis (median duration, 89 months), while one received chemotherapy for 20 months. Five patients exhibited mental retardation, and one patient experienced normal development after surgical removal of his choroid plexus papilloma. Diencephalic syndrome developed in one patient with pilomyxoid astrocytoma that necessitated hormone replacement therapy, and bodyweight over +2 SD was observed in two patients. The remaining five patients died 11-111 months after diagnosis (median duration, 24 months).


CONCLUSIONS
The prognosis of infantile brain tumor with regard to mortality and developmental outcome remains poor. Furthermore, survivors require comprehensive medical and social support for an extended period.
Nomura
Yuko
Y
Department of Pediatrics, School of Medicine, Fukuoka University, 45-1, 7-chome Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan. yuko-nomura@mvj.biglobe.ne.jp
Yasumoto
Sawa
S
Yanai
Fumio
F
Akiyoshi
Hidetaka
H
Inoue
Takahito
T
Nibu
Keiko
K
Tsugu
Hitoshi
H
Fukushima
Takeo
T
Hirose
Shinichi
S
D001254:Astrocytoma / Q000401:mortality* / Q000503:physiopathology / Q000601:surgery / Q000628:therapy; D001932:Brain Neoplasms / Q000401:mortality* / Q000503:physiopathology / Q000601:surgery / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D002657:Child Development; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D010871:Pinealoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery / Q000628:therapy; D011379:Prognosis; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant