title: Treatment Outcomes and Prognostic Factors in Pediatric Non-brainstem Astrocytoma in North East of Iran.
abstract: BACKGROUND
  Central Nervous System (CNS) tumors have accounted for approximately one fourth of all pediatric malignancies. CNS tumors have been the most common solid malignancies among the children. In this study, we have evaluated survival and prognostic factors in children with non-brain stem astrocytoma.
  
  
  METHODS
  Children with non-brain stem astrocytoma, referring to radiation oncology centers of Ghaem and Omid hospitals of Mashhad, have included in this retrospective study, in years 2000-2010. Patients' demographic data, past medical history, clinical symptoms, extent of tumor resection and treatment modality have recorded. Disease-free survival and overall survival have measured using Kaplan-Meier method.
  
  
  RESULTS
  We studied 87 patients with male to female ratio of 44/43 (1.02), and median age of 10 yrs (range: 2-15 yrs). Tumor grade distribution was as follows: grade I: 20 (23%) subjects; grade II: 34 (39.1%) subjects; grade III: 20 (23%) subjects; and grade IV: 13 (14.9%) subjects. The median follow-up duration was 38 months (6 to 110), and 16 months (4 to 100) for patients with low- and high-grade tumors. The 2-year survival rates in grades I-IV were 100%, 84.7%, 60% and 10.8%, respectively. Tumor resection less than gross total and non-ambulation have associated with a significantly inferior survival in both groups multivariate analysis, with high- and low-grade tumors.
  
  
  CONCLUSIONS
  For all the cases of the pediatric non-brainstem astrocytoma, tumor grade had dramatic influences on their survival. Performing gross total resection was crucial for achieving favorable outcomes in both low-grade and high-grade cases. Moreover, according to the results, having major motor deficits has associated with lower survival.
authors.affiliation: Solid Tumor Treatment Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Kazem
authors.initials: K
authors.lastname: Anvari
authors.affiliation: Solid Tumor Treatment Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Seilanian Toussi
authors.affiliation: Dept. of Neurosurgery, Shahid Kamiab Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Gholamreza
authors.initials: G
authors.lastname: Bahadorkhan
authors.affiliation: Omid Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Motahare
authors.initials: M
authors.lastname: Bitaghsir
authors.affiliation: Dept. of Radiation Oncology, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mozhgan
authors.initials: M
authors.lastname: Heidari
authors.affiliation: Solid Tumor Treatment Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mitra
authors.initials: M
authors.lastname: Fazl Ersi
authors.affiliation: Solid Tumor Treatment Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Soodabeh
authors.initials: S
authors.lastname: Shahidsales
keywords: Astrocytoma; Non-brain stem; Pediatric