title: Clinicopathological features and treatment outcomes of brain stem gliomas in Saudi population.
abstract: OBJECTIVE
  To analyze experiences to identify treatment outcomes and prognostic factors in a Saudi population.
  
  
  METHODS
  Medical records of patients with brainstem gliomas treated from July 2001 to December 2012 were reviewed to identify treatment outcomes of surgery, radiation therapy and chemotherapy and associated prognostic factors in a Saudi population.
  
  
  RESULTS
  We analyzed 49 brain stem glioma (BSG) patients from July 2001 to December 2012; 31 of them were males (63.3%) with a median age of 12.6 years (range: 8-64 mo). Twenty-two patients (44.9%) had diffuse intrinsic pontine gliomas (DIPG) and 15 (30.6%) presented with focal/tectal BSG. Histopathology was available in 30 patients (61.2%). Median survival time for the whole cohort was 1.5 years. One and two year OS rates were 51.1% and 41.9% respectively. Two year OS rates for focal/tectal, dorsally exophytic, cervicomedullary and DIPG tumors were 60%, 33.3%, 33.3% and 13.6% respectively (P < 0.0001). Significant prognostic factors related to OS were age at diagnosis (worse for > 18 years) P = 0.01, KPS < 70 P = 0.02, duration of symptoms (< 60 d) P = 0.002, histology (better for favorable) P = 0.002, surgery (maximal resection) P = 0.002, and concurrent chemotherapy with radiation therapy in DIPG (better if given) P = 0.01.
  
  
  CONCLUSIONS
  BSG, especially the DIPG subgroup, had a dismal prognosis, needing more aggressive neurosurgical, radiation and chemotherapy techniques, while focal and tectal tumors were found to have a better prognosis.
authors.affiliation: Yasser Bayoumi, Consultant Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh-59046, Saudi Arabia.
authors.forename: Yasser
authors.initials: Y
authors.lastname: Bayoumi
authors.affiliation: Yasser Bayoumi, Consultant Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh-59046, Saudi Arabia.
authors.forename: Abdulrahman J
authors.initials: AJ
authors.lastname: Sabbagh
authors.affiliation: Yasser Bayoumi, Consultant Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh-59046, Saudi Arabia.
authors.forename: Reham
authors.initials: R
authors.lastname: Mohamed
authors.affiliation: Yasser Bayoumi, Consultant Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh-59046, Saudi Arabia.
authors.forename: Usama M
authors.initials: UM
authors.lastname: ElShokhaiby
authors.affiliation: Yasser Bayoumi, Consultant Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh-59046, Saudi Arabia.
authors.forename: Ahmed Marzouk
authors.initials: AM
authors.lastname: Maklad
authors.affiliation: Yasser Bayoumi, Consultant Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh-59046, Saudi Arabia.
authors.forename: Mutahir A
authors.initials: MA
authors.lastname: Tunio
authors.affiliation: Yasser Bayoumi, Consultant Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh-59046, Saudi Arabia.
authors.forename: Ali Abdullah O
authors.initials: AA
authors.lastname: Balbaid
keywords: Adults; Brain stem glioma; Children; Saudi Arabia; Treatment outcomes