Outcomes of pediatric low-grade gliomas treated with radiation therapy: a single-institution study.
Radiation therapy is often considered the treatment of choice for low-grade gliomas. However, given the long-term effects of radiation on the developing brain, the appropriate use of radiation therapy in pediatric patients remains controversial. The purpose of this study was to evaluate progression-free survival (PFS) of pediatric low-grade glioma patients treated with radiation therapy. Data were obtained through a retrospective chart review of patients treated between 1991 and 2008 from a single tertiary care center in the midwest. The study population consisted of 17 patients, of whom 8 (47%) had tumor recurrence after radiation therapy. The median follow-up time was 8.2 years, with a range of 2.3 to 17.2 years. The median age at diagnosis was 5.4 years, and the median age at radiation therapy was 9.4 years. The 3- and the 10-year PFS were 69%± 11.7% and 46%± 13.3%, respectively. A significant difference in PFS was seen when comparing brainstem tumors with hypothalamic/optic pathway tumors (P=0.019). Differences in PFS based on the age at diagnosis, the extent of initial surgery, and indication for radiation therapy were not significant. A larger multicenter study is needed to better assess PFS in these patients.
*Department of Pediatrics, Division of Pediatric Hematology/Oncology, Emory University School of Medicine, Atlanta, GA †Department of Pediatrics, Saint Louis University School of Medicine ‡Division of Biostatistics, Saint Louis University School of Public Health §Department of Medicine, Division of Oncology ¶Department of Pediatrics, Division of Pediatric Hematology/Oncology, Washington University School of Medicine, Saint Louis, MO ∥Department of Medicine, Henry Ford Health System, Detroit, MI.
Sunil S
SS
Raikar
Donna R
DR
Halloran
Michael
M
Elliot
Michele
M
McHugh
Shaun
S
Patel
Karen M
KM
Gauvain
D000293:Adolescent; D001932:Brain Neoplasms / Q000473:pathology* / Q000532:radiotherapy* / Q000601:surgery; D020295:Brain Stem Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000473:pathology* / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D007029:Hypothalamic Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D008297:Male; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014795:Visual Pathways / Q000473:pathology; D055815:Young Adult