title: Radiotherapy for brainstem gliomas in children and adults: A single-institution experience and literature review.
abstract: OBJECTIVE
  To evaluate the treatment results of radiotherapy (RT) in children and adults with brainstem gliomas (BSGs) and review the previous literature.
  
  
  METHODS
  Thirty patients (14 children, 16 adults) with BSG treated using RT were retrospectively evaluated. The median ages of the children and adults were 8 years (range: 2-16 years) and 49 years (range: 19-75 years), respectively. A histological diagnosis was obtained in 11 patients. The median total radiation dose was 56 Gy (range: 50-70 Gy) with a single fraction size of 1.8-2.0 Gy. Temozolomide was administered concurrently with RT in 14 patients.
  
  
  RESULTS
  Tumor progression after RT occurred in 26 patients (14 children and 12 adults). Four adults survived without tumor progression. The median survival times for children and adults were 8.5 and 39 months, respectively. The 1-, 2- and 3-year overall survival rates for children/adults were 29%/75%, 14%/68% and 0%/53%, respectively (P = 0.001), and the 1-, 2- and 3-year progression-free survival rates for children/adults were 14%/69%, 0%/49% and 0%/35%, respectively (P < 0.001). Grade 3 or higher acute and late toxicities did not occur.
  
  
  CONCLUSIONS
  In this study, the prognosis of children with BSGs was considerably poorer than that of adults, and our results are consistent with those of previous studies. Efforts should be made to improve the survival outcomes of patients with BSGs, especially children.
authors.affiliation: Division of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Yoshida
authors.affiliation: Division of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Nor Shazrina
authors.initials: NS
authors.lastname: Sulaiman
authors.affiliation: Division of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Miyawaki
authors.affiliation: Division of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ejima
authors.affiliation: Department of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Kobe, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Nishimura
authors.affiliation: Division of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Takeaki
authors.initials: T
authors.lastname: Ishihara
authors.affiliation: Division of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Matsuo
authors.affiliation: Division of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Nishikawa
authors.affiliation: Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Sasayama
authors.affiliation: Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Hayakawa
authors.affiliation: Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Kohmura
authors.affiliation: Division of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Ryohei
authors.initials: R
authors.lastname: Sasaki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D020295:Brain Stem Neoplasms / Q000532:radiotherapy*; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D005910:Glioma / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult
keywords: brainstem glioma; children/adults; radiotherapy