title: Long-term outcomes in children with glioblastoma.
abstract: OBJECTIVE
  Glioblastoma is the most common primary malignant brain tumor; however, glioblastoma in children is less common than in adults, and little is known about its clinical outcome in children. The authors evaluated the long-term outcome of glioblastoma in children.
  
  
  METHODS
  Twenty-seven children were confirmed to have harbored a glioblastoma between 1985 and 2007. The clinical features and treatment outcomes were reviewed retrospectively. All patients underwent resection; complete resection was performed in 12 patients (44%), subtotal resection in 12 patients (44%), and biopsy in 3 patients (11%). Twenty-four patients (89%) had radiation therapy, and 14 (52%) patients received chemotherapy plus radiation therapy. Among the latter, 5 patients had radiation therapy concurrent with temozolomide chemotherapy. Four patients with small-size recurrent glioblastoma received stereotactic radiosurgery.
  
  
  RESULTS
  The median overall survival (OS) was 43 months, and the median progression-free survival was 12 months. The OS rate was 67% at 1 year, 52% at 2 years, and 40% at 5 years. The median OS was significantly associated with tumor location (52 months for superficially located tumors vs 7 months for deeply located tumors; p = 0.017) and extent of removal (106 months for completely resected tumors vs 11 months for incompletely resected tumors; p < 0.0001).
  
  
  CONCLUSIONS
  The prognosis of glioblastoma is better in children than in adults. Radical resection followed by concurrent chemoradiation therapy may be the initial treatment of choice.
authors.affiliation: Division of Pediatric Neurosurgery, Seoul National University Hospital, College of Medicine, Seoul, Republic of Korea.
authors.forename: Kyung Sun
authors.initials: KS
authors.lastname: Song
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Phi
authors.forename: Byung-Kyu
authors.initials: BK
authors.lastname: Cho
authors.forename: Kyu-Chang
authors.initials: KC
authors.lastname: Wang
authors.forename: Ji Yeoun
authors.initials: JY
authors.lastname: Lee
authors.forename: Dong Gyu
authors.initials: DG
authors.lastname: Kim
authors.forename: Il Han
authors.initials: IH
authors.lastname: Kim
authors.forename: Hyo Seop
authors.initials: HS
authors.lastname: Ahn
authors.forename: Sung-Hye
authors.initials: SH
authors.lastname: Park
authors.forename: Seung-Ki
authors.initials: SK
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage; D001932:Brain Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003606:Dacarbazine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D005909:Glioblastoma / Q000188:drug therapy / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000601:surgery; D016634:Radiosurgery; D018714:Radiotherapy, Adjuvant; D012086:Reoperation; D056910:Republic of Korea; D012189:Retrospective Studies; D015996:Survival Rate; D000077204:Temozolomide
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide