title: Survival with concurrent temozolomide and radiotherapy in pediatric brainstem glioma with relation to the tumor volume.
abstract: BACKGROUND
  Brainstem gliomas account for approximately 25% of all posterior fossa tumors. In pediatric age group, it constitutes about 10% of all brain tumors. Brainstem glioma is an aggressive and lethal type of malignancy with poor outcome despite all treatments.
  
  
  OBJECTIVE
  We studied the incidence and treatment outcome in pediatric patients with brainstem glioma depending on their tumor volume presenting in our institution in last 5 years. Brain tumors comprised 2.95% of all cancers and brainstem gliomas were 8% of all brain tumors.
  
  
  METHODS
  Nine pediatric patients were included in this analysis, who were treated with localized external radiotherapy 54-59.4 Gy along with temozolomide 75 mg/m(2) during the whole course of radiotherapy.
  
  
  RESULTS
  The median survival in all these patients was 20 months and the overall 2 years survival is 44.4% (4/9). The median survival of patients with primary disease volume <40cc is 26 months whereas when the volume is more than 40cc the median survival is 13.5 months as calculated by Chi-square test.
  
  
  CONCLUSIONS
  As this study includes a small number of patients with unknown histology and treated on the basis of magnetic resonance imaging findings, no definite opinion can be given as some patients may have a low-grade tumor. More studies are required to establish the relation of size of the tumor with survival.
authors.affiliation: Department of Paediatrics, Sri Aurobindo Medical College and PG Institute, Indore, Madhya Pradesh, India.
authors.forename: Shachi Jain
authors.initials: SJ
authors.lastname: Taran
authors.affiliation: Department of Medical Oncology, Sri Aurobindo Medical College and PG Institute, Indore, Madhya Pradesh, India.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Taran
authors.affiliation: Department of Radiation Oncology, Sri Aurobindo Medical College and PG Institute, Indore, Madhya Pradesh, India.
authors.forename: Manika
authors.initials: M
authors.lastname: Batra
authors.affiliation: Department of Radiation Oncology, Sri Aurobindo Medical College and PG Institute, Indore, Madhya Pradesh, India.
authors.forename: Deah Deepak
authors.initials: DD
authors.lastname: Ladia
authors.affiliation: Department of Radiation Oncology, Sri Aurobindo Medical College and PG Institute, Indore, Madhya Pradesh, India.
authors.forename: Virendra
authors.initials: V
authors.lastname: Bhandari
keywords: Brainstem glioma; pediatric; tumor volume