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Long-term survival in children under 3 years of age with low-grade astrocytoma
Roberto Rivera-Luna1, Marta Zapata-Tarrés, Aurora Medina-Sansón
1Division of Hem/Oncology and Radiotherapy, National Institute of Pediatrics [Instituto Nacional de Pediatría], Insurgentes Sur no. 3700-C, Mexico City, D F, 04530, México. riveraluna@infosel.net.mx
Insights
This study analyzed low-grade astrocytoma in young children, finding supratentorial presentation a favorable sign. Treatments like radiotherapy and chemotherapy did not significantly impact disease-free survival (DFS).
Area of Science:
- Pediatric Oncology
- Neuro-oncology
- Clinical Research
Background:
- Low-grade astrocytoma is a common brain tumor in young children.
- Understanding prognostic factors and treatment outcomes is crucial for this population.
Purpose of the Study:
- To analyze clinical features and disease-free survival (DFS) in children under 3 years old with low-grade astrocytoma.
- To identify prognostic indicators for this specific pediatric patient group.
Main Methods:
- Retrospective analysis of 43 children diagnosed with low-grade astrocytoma between 1980-2004.
- Evaluation of tumor types (pilocytic, diffuse, mixed), surgical resection extent, and adjuvant therapies (radiotherapy, chemotherapy).
- Assessment of disease-free survival (DFS) based on tumor location and treatment modalities.
Main Results:
- Supratentorial tumor presentation was associated with a significantly better DFS (60% at 250 months) compared to infratentorial presentation (22% at 120 months).
- Overall DFS was 50% at 250 months for the entire cohort.
- Incomplete surgical resection was more common (72.1%) than complete resection (27.9%).
Conclusions:
- Supratentorial location is the sole favorable prognostic factor identified in this cohort.
- Adjuvant radiotherapy and chemotherapy did not demonstrate a significant impact on altering the disease-free survival outcomes.
Objective:
The purpose of this study is to analyze clinical aspects and disease-free survival (DFS) in children less than 3 years of age diagnosed with low-grade astrocytoma.
Methods:
In a period of 24 years (1980-2004), a total of 43 (5.4%) children were registered with these characteristics. Twenty-three patients had pilocytic astrocytoma, 18 diffused, and 2 mixed. Thirty-one (72.1%) children had incomplete surgical tumor resection and 12 (27.9%) had a complete tumor resection. Twelve (27.9%) patients had cranial radiotherapy and 17 (39.5%) received chemotherapy. Overall survival was recorded in 23 (53%). DFS was 50% at 250 months of follow-up for the whole group. DFS for the supratentorial group was 60% at 250 months, whereas, for the infratentorial, it was 22% at 120 months (p = 0.008).
Conclusion:
The only favorable prognostic pattern was the supratentorial presentation. Radiotherapy and chemotherapy did not alter the outcome.
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