title: Pediatric glioblastoma: a single institution experience.
abstract: OBJECTIVE
  The aim of this study was to evaluate characteristics of childhood glioblastoma multiforme, effectiveness of treatment modalities, and detect factors related to outcome.
  
  
  METHODS
  A detailed analysis was performed on a series of 15 patients treated between 2000 and 2013, based on their clinical, radiologic, pathologic, treatment, and follow-up data.
  
  
  RESULTS
  Median survival time of children with glioblastoma was 13.5 months. One- and 2-year overall survival probabilities were 66.7 and 20 %, respectively. There were no significant differences in survival based on patients' gender, age, disease presentation with or without epileptic seizures, signs/symptoms of increased intracranial pressure, or tumor location. The presence of neurological deficit initially, as well as prior to radiotherapy, which was quantified by neurologic function score (NFS), had an impact on overall survival. Children with NFS 0 lived longer compared to others (p = 0.001). Survival of children that underwent gross total resection was longer than that of children that underwent subtotal resection (p = 0.030). Mean survival time of children with gross total resection was 73.5 months, compared to 13 months in children with subtotal resection. There was no significant correlation between outcome and type of radiotherapy. In four patients with gigantocellular glioblastoma, we found no evidence of a better prognosis. Two long-term survivors were recorded. Both of them underwent gross total resection and were assigned a NFS 0.
  
  
  CONCLUSIONS
  Gross total resection is essential for longer overall survival among pediatric patients with glioblastoma and offers a possibility for long-term survival. Severity of neurologic symptoms quantified by NFS can be considered as a potential predictor of outcome.
authors.affiliation: Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000, Belgrade, Serbia. marina.nikitovic@ncrc.ac.rs.|Institute for Oncology and Radiology of Serbia, Clinic for Radiation Oncology, Pasterova 14, 11000, Belgrade, Serbia. marina.nikitovic@ncrc.ac.rs.
authors.forename: Marina
authors.identifier: http://orcid.org/0000-0001-7272-9587
authors.initials: M
authors.lastname: Nikitović
authors.affiliation: Institute for Oncology and Radiology of Serbia, Clinic for Radiation Oncology, Pasterova 14, 11000, Belgrade, Serbia.
authors.forename: Dragana
authors.initials: D
authors.lastname: Stanić
authors.affiliation: Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000, Belgrade, Serbia.|Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Visegradska 26, 11000, Belgrade, Serbia.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Pekmezović
authors.affiliation: Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000, Belgrade, Serbia.|Institute of Pathology, Faculty of Medicine, University of Belgrade, Pasterova 1, 11000, Belgrade, Serbia.
authors.forename: Milica Skender
authors.initials: MS
authors.lastname: Gazibara
authors.affiliation: Institute for Oncology and Radiology of Serbia, Clinic for Radiation Oncology, Pasterova 14, 11000, Belgrade, Serbia.|Institute for Oncology and Radiology of Serbia, Clinic for Pediatric Oncology, Pasterova 14, 11000, Belgrade, Serbia.
authors.forename: Jelena
authors.initials: J
authors.lastname: Bokun
authors.affiliation: Institute for Oncology and Radiology of Serbia, Clinic for Pediatric Oncology, Pasterova 14, 11000, Belgrade, Serbia.
authors.forename: Lejla
authors.initials: L
authors.lastname: Paripović
authors.affiliation: Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000, Belgrade, Serbia.|Clinic of Neurosurgery, Clinical Center of Serbia, Koste Todorovica 4, 11000, Belgrade, Serbia.
authors.forename: Danica
authors.initials: D
authors.lastname: Grujičić
authors.affiliation: Institute for Oncology and Radiology of Serbia, Clinic for Radiation Oncology, Pasterova 14, 11000, Belgrade, Serbia.
authors.forename: Milan
authors.initials: M
authors.lastname: Sarić
authors.affiliation: Institute for Oncology and Radiology of Serbia, Clinic for Radiation Oncology, Pasterova 14, 11000, Belgrade, Serbia.
authors.forename: Ivana
authors.initials: I
authors.lastname: Mišković
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005909:Glioblastoma / Q000401:mortality / Q000473:pathology / Q000628:therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Brain tumors; Children; Glioblastoma multiforme; Treatment