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Long-term outcomes in children with glioblastoma
Kyung Sun Song1, Ji Hoon Phi, Byung-Kyu Cho
1Division of Pediatric Neurosurgery, Seoul National University Hospital, College of Medicine, Seoul, Republic of Korea.
Insights
Pediatric glioblastoma outcomes are better than in adults. Complete tumor resection and chemoradiation therapy improve survival for children with this rare brain cancer.
Area of Science:
- Pediatric neuro-oncology
- Brain tumor research
- Clinical outcome studies
Background:
- Glioblastoma is the most common primary malignant brain tumor.
- Pediatric glioblastoma is rare, with limited data on clinical outcomes.
- Understanding long-term outcomes is crucial for improving pediatric cancer care.
Purpose of the Study:
- To evaluate the long-term clinical outcome of pediatric glioblastoma.
- To identify factors influencing survival in children with glioblastoma.
Main Methods:
- Retrospective review of 27 children diagnosed with glioblastoma between 1985 and 2007.
- Analysis of surgical resection extent, radiation therapy, and chemotherapy regimens.
- Assessment of overall survival (OS) and progression-free survival (PFS).
Main Results:
- Median OS was 43 months; median PFS was 12 months.
- 5-year OS rate was 40%.
- Tumor location and extent of surgical removal significantly impacted OS (p < 0.017 and p < 0.0001, respectively).
Conclusions:
- Pediatric glioblastoma prognosis is more favorable than in adults.
- Radical tumor resection followed by concurrent chemoradiation therapy is recommended.
- Further research into optimal treatment strategies for pediatric glioblastoma is warranted.
Object:
Glioblastoma is the most common primary malignant brain tumor; however, glioblastoma in children is less common than in adults, and little is known about its clinical outcome in children. The authors evaluated the long-term outcome of glioblastoma in children.
Methods:
Twenty-seven children were confirmed to have harbored a glioblastoma between 1985 and 2007. The clinical features and treatment outcomes were reviewed retrospectively. All patients underwent resection; complete resection was performed in 12 patients (44%), subtotal resection in 12 patients (44%), and biopsy in 3 patients (11%). Twenty-four patients (89%) had radiation therapy, and 14 (52%) patients received chemotherapy plus radiation therapy. Among the latter, 5 patients had radiation therapy concurrent with temozolomide chemotherapy. Four patients with small-size recurrent glioblastoma received stereotactic radiosurgery.
Results:
The median overall survival (OS) was 43 months, and the median progression-free survival was 12 months. The OS rate was 67% at 1 year, 52% at 2 years, and 40% at 5 years. The median OS was significantly associated with tumor location (52 months for superficially located tumors vs 7 months for deeply located tumors; p = 0.017) and extent of removal (106 months for completely resected tumors vs 11 months for incompletely resected tumors; p < 0.0001).
Conclusions:
The prognosis of glioblastoma is better in children than in adults. Radical resection followed by concurrent chemoradiation therapy may be the initial treatment of choice.
