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Primary pediatric brain tumours in Barbados: 10-year analysis (1978-1988)
P M Lashley1, H Clarke, E Y Archer
1Department of Surgery, Queen Elizabeth Hospital, Bridgetown, Barbados.
Insights
This study reviewed pediatric brain tumors in children aged 6 months to 17 years, finding a high mortality rate. Outcomes varied by tumor type, with pituitary and cerebral tumors showing 100% survival.
Area of Science:
- Pediatric Oncology
- Neuro-oncology
- Clinical Epidemiology
Background:
- Pediatric brain tumors represent a significant health challenge globally.
- Understanding tumor distribution and outcomes is crucial for improving patient care.
- Limited data exists comparing pediatric brain tumor series from different regions.
Purpose of the Study:
- To analyze the characteristics of pediatric brain tumors in a specific cohort.
- To compare findings with international data from developed countries.
- To review tumor types, clinical presentations, and treatment outcomes.
Main Methods:
- Retrospective review of case notes for 29 children (6 months–17 years) treated between 1978–1988.
- Analysis of tumor location (posterior fossa vs. supratentorial), histological type, and presenting symptoms.
- Evaluation of surgical and radiation therapy approaches and patient outcomes.
Main Results:
- Posterior fossa tumors accounted for 52% of cases, supratentorial tumors for 48%.
- Common posterior fossa tumors included medulloblastomas and astrocytomas; supratentorial tumors included astrocytomas and craniopharyngiomas.
- Overall mortality was 48%, with higher survival rates for pituitary and cerebral tumors (100%) compared to cerebellar astrocytomas (67%).
Conclusions:
- Pediatric brain tumors in this series presented with symptoms of raised intracranial pressure, ataxia, seizures, and cranial nerve deficits.
- Surgical resection was the primary treatment, with radiation therapy used for brain stem tumors.
- Significant mortality highlights the need for improved therapeutic strategies and further research into long-term outcomes.
Abstract:
The case notes of 29 children ranging in age between 6 months and 17 years were reviewed for the period 1978-88. This study was done to determine if there were any differences when compared with other series in the developed countries. In addition, the distribution, tumour type, clinical presentations, and outcome were reviewed. Of the 29 tumours, 15 tumours were confined to the posterior fossa (52 per cent), and tumours were located supratentorially (48 per cent). Of the 15 tumours in the posterior fossa, five were medulloblastomas, four brain stem astrocytomas, and six cerebellar astrocytomas. The supra-tentorial tumours included, five astrocytomas, two pituitary tumours, two cranio-pharyngiomas, one hypothalamic glioma, and four intraventricular tumours. Clinical presentation was confined to symptoms and signs related to raised intracranial pressure, ataxia, seizures, and cranial nerve involvement. All the tumours were resected surgically except for the brain stem tumours, which were treated in most cases with radiation therapy. The overall mortality was 48 per cent (14 patients died). We were unable to comment on long-term survival except for a 100 per cent survival in patients with pituitary and cerebral tumours, and 67 per cent in patients with cerebellar astrocytomas.