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Radiation therapy in paediatric gliomas: our institutional experience
Daya N Sharma1, Shikha G Goyal, Sandeep Muzumder
1Department of Raidation Oncology, All India Institute of Medical Science, New Delhi, India. sharmadn@hotmail.com
Insights
Radiation therapy (RT) is effective for pediatric glioma patients. Surgical decompression and non-brainstem tumors improved event-free survival (EFS), while chemotherapy showed no significant benefit.
Area of Science:
- Pediatric Oncology
- Radiation Oncology
- Neuro-oncology
Background:
- Retrospective analysis of pediatric glioma patients treated with radiation therapy (RT).
- Focus on clinical outcomes and survival rates.
- Data collected from 2004-2007.
Purpose of the Study:
- To analyze the clinical outcome of pediatric glioma patients treated with RT.
- Evaluate factors influencing event-free survival (EFS).
- Assess the role of surgery, tumor location, and chemotherapy.
Main Methods:
- Retrospective review of 70 pediatric glioma patients (<18 years) who received RT.
- Analysis of demographic, clinical, treatment, and RT details.
- Calculation of 3-year EFS and median EFS period.
Main Results:
- Overall 3-year EFS rate was 44% with a median EFS of 18 months.
- Surgical decompression (58% EFS) and non-brainstem gliomas (56% EFS) showed significantly better outcomes.
- Brainstem gliomas (28% EFS) and no surgery (25% EFS) had poorer outcomes.
- Chemotherapy did not demonstrate a statistically significant survival benefit.
Conclusions:
- Radiation therapy (RT) is an effective treatment for pediatric gliomas.
- Early RT for incompletely resected low-grade gliomas warrants further investigation.
- Chemotherapy results in high-grade and brainstem gliomas are promising.
Background And Purpose:
The aim of our retrospective study was to analyze the clinical outcome of paediatric glioma patients treated with radiation therapy (RT) in our institution.
Material And Methods:
We retrieved the case records of all children with gliomas (age < 18 years) who received RT in our department between 2004 and 2007. We analyzed the information regarding patients' demography, clinical details, treatment given, RT details, and survival. The event-free survival (EFS), the period from the date of completion of RT to the date of the event, i.e. death/recurrence, was calculated with respect to age, sex, location of tumour (brainstem vs. non-brainstem), histopathology (low grade vs. high grade), extent of surgical resection, dose and duration of RT, and use of chemotherapy.
Results:
A total of 70 children with glioma received RT during the above-mentioned period. The 3-year EFS rate for all patients was 44% and the median EFS period was 18 months. The 3-year EFS in patients who underwent surgical decompression and no surgery was 58% and 25%, respectively (p < 0.05). Patients with brainstem lesions had statistically significantly lower 3-year EFS to non-brainstem gliomas (28% vs. 56%, p < 0.01). Chemotherapy use showed no statistically significant trend towards better survival.
Conclusions:
RT is an effective modality of treatment in paediatric glioma patients in our setup. Early use of RT in incompletely resected low-grade gliomas is worth revisit-ing. Results of chemotherapy in high-grade glioma and brainstem gliomas are encouraging.
