title: High-grade glioma in children and adolescents: a single-center experience.
abstract: OBJECTIVE
  The aim of this study was to report the outcome in children with high-grade astrocytoma outside the brain stem and spinal cord that were treated at a single center.
  
  
  METHODS
  The study included 26 patients with anaplastic astrocytoma and 37 patients with glioblastoma; all patients were aged ≤18 years. At initial diagnosis, 18 of the patients with glioblastoma received only temozolomide (TMZ), 14 received other chemotherapies, and 5 did not receive any chemotherapy. Among the patients with anaplastic astrocytoma, 9 received TMZ, 9 received other chemotherapy regimens, and 8 patients did not receive any chemotherapy. The median radiotherapy dose in all patients was 60 Gy.
  
  
  RESULTS
  Median age of the patients was 12.5 years. Median overall survival was 20 months and mean progression-free survival was 4.7-11.3 months (median: 8 months) in all patients. Patients with a Karnofsky performance score (KPS) ≥70 had median overall survival of 32 months, versus 7 months in those with a KPS < 70. Patients aged <15 years had median survival of 38 months, versus 16 months in those aged 15-18 years. Patients with anaplastic astrocytoma that received TMZ, other chemotherapy regimens, and no chemotherapy had median survival of 21 months, 132 months, and 11 months, respectively. Patients with glioblastoma that received TMZ, other chemotherapy regimens, and no chemotherapy had median survival of 32 months, 12 months, and 8 months, respectively.
  
  
  CONCLUSIONS
  In the present study, patients with anaplastic astrocytoma treated with chemotherapy protocols other than TMZ had the longest OS; however, in the glioblastoma group, OS was 32 months in those treated with standard TMZ and 12 months in those treated with other protocols (P = 0.493). Although TMZ is less toxic than PCV, it was not shown to be superior.
authors.affiliation: Department of Radiation Oncology, School of Medicine, Hacettepe University, Sihhiye, 06100, Ankara, Turkey.
authors.forename: Gozde
authors.initials: G
authors.lastname: Yazici
authors.affiliation: Department of Radiation Oncology, School of Medicine, Hacettepe University, Sihhiye, 06100, Ankara, Turkey. yazicig@gmail.com.
authors.forename: Faruk
authors.initials: F
authors.lastname: Zorlu
authors.affiliation: Department of Radiation Oncology, School of Medicine, Hacettepe University, Sihhiye, 06100, Ankara, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cengiz
authors.affiliation: Department of Radiation Oncology, School of Medicine, Hacettepe University, Sihhiye, 06100, Ankara, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Ozyigit
authors.affiliation: Department of Radiation Oncology, School of Medicine, Hacettepe University, Sihhiye, 06100, Ankara, Turkey.
authors.forename: Gulnihan
authors.initials: G
authors.lastname: Eren
authors.affiliation: Department of Preventive Oncology, School of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Deniz
authors.initials: D
authors.lastname: Yüce
authors.affiliation: Department of Pediatric Oncology, School of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Varan
authors.affiliation: Department of Pediatric Oncology, School of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Canan
authors.initials: C
authors.lastname: Akyuz
authors.affiliation: Department of Neurosurgery, School of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Nejat
authors.initials: N
authors.lastname: Akalan
authors.affiliation: Department of Radiation Oncology, School of Medicine, Hacettepe University, Sihhiye, 06100, Ankara, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Gurkaynak
mesh_terms: D000293:Adolescent; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001254:Astrocytoma / Q000628:therapy*; D001932:Brain Neoplasms / Q000628:therapy*; D002648:Child; D003131:Combined Modality Therapy; D003606:Dacarbazine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D005909:Glioblastoma / Q000628:therapy*; D006801:Humans; D017567:Karnofsky Performance Status; D008130:Lomustine / Q000627:therapeutic use; D008297:Male; D019635:Neurosurgical Procedures; D011344:Procarbazine / Q000627:therapeutic use; D011379:Prognosis; D016016:Proportional Hazards Models; D011878:Radiotherapy; D012189:Retrospective Studies; D015996:Survival Rate; D000077204:Temozolomide; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D018906:Antineoplastic Agents, Alkylating; D011344:Procarbazine; D014750:Vincristine; D008130:Lomustine; D003606:Dacarbazine; D000077204:Temozolomide
keywords: Anaplastic astrocytoma; Children; Glioblastoma; High-grade glioma; Temozolomide