Outcome of primary childhood central nervous system tumors: results from a single center in Iran.
BACKGROUND
Childhood primary central nervous system (CNS) malignancies are one of the most important concerns in pediatric oncology.


METHODS
In this historical cohort, 82 patients treated in Ali-Asghar Children's Hospital between 1996 and 2005 were evaluated for age, gender, type of treatment, tumor pathology, and survival.


RESULTS
The records of 38 female (46.3%) and 44 male (53.7%) patients were included. The mean age was 6.8 ± 3.39 years (6 months to 14 years); the frequency of medulloblastoma was significantly more than others (p = 0.012). Complete resection, radiotherapy, and chemotherapy were done in 47.5, 82.9, and 97.56%, respectively. Estimated 5 years overall and event-free survivals (EFSs) were approximately 68.5 and 35%, respectively. The patients with complete resected tumors had significantly better outcome (p = 0.013). Also, low-grade versus high-grade astrocytoma was significantly a better outcome (p = 0.01).


CONCLUSIONS
The poor EFS with consideration of high number of progressive disease among our patients (50% unresectable tumor) suggests that children in Iran with CNS tumors had high quality of care but availability of advanced treatment protocol and sharing of cooperative trial study is essential for survival improvement. In addition to use more advanced methods and equipments of radiotherapy and chemotherapeutic drugs, we should seriously consider development of better surgical techniques to increase the rate of complete resection of malignant CNS tumors.
Department of Pediatrics, Pediatric Hemato and Oncology, Ali-Asghar Children's Hospital, Tehran University of Medical Sciences, SIOP Member, Tehran, Islamic Republic of Iran.
Kh Arjmandi
KhA
Rafsanjani
Gr
G
Bahoush
F
F
Nikpoor
P
P
Vossough
D000293:Adolescent; D000367:Age Factors; D000970:Antineoplastic Agents / Q000627:therapeutic use; D016543:Central Nervous System Neoplasms / Q000145:classification / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D007492:Iran; D008297:Male; D019635:Neurosurgical Procedures / Q000379:methods; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
D000970:Antineoplastic Agents