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A multi-institutional experience in pediatric high-grade glioma
Steve Walston1, Daniel A Hamstra2, Kevin Oh3
1Department of Radiation Oncology, The Ohio State University Wexner Medical Center , Columbus, OH , USA.
Frontiers in Oncology
|March 6, 2015
Summary
Complete tumor resection and adjuvant chemotherapy significantly improve survival for pediatric high-grade gliomas. For high-risk cases, intensified treatment with temozolomide and chemoradiation offers better outcomes.
Area of Science:
- Pediatric neuro-oncology
- Neurosurgery
- Radiation oncology
Background:
- Pediatric high-grade gliomas (pHGGs) are rare central nervous system tumors with poor prognoses.
- Current management strategies for pHGGs are not fully established, necessitating further research into prognostic factors.
Purpose of the Study:
- To investigate the association between clinical, pathological, and treatment characteristics and outcomes in pediatric high-grade gliomas.
- To identify factors influencing progression-free survival (PFS) and overall survival (OS) in this patient population.
Main Methods:
- A multi-institutional retrospective study included 51 patients diagnosed with pHGGs between 1984 and 2008.
- Statistical analyses, including log-rank and Cox proportional hazard modeling, were employed to assess PFS and OS in various patient subgroups.
Main Results:
- Complete tumor resection and grade III histology were associated with improved PFS and OS.
- Temozolomide use and chemotherapy following chemoradiation (CRT) correlated with better PFS, while seizures at presentation predicted better OS.
- Multivariate analysis confirmed complete resection and post-radiotherapy chemotherapy as independent predictors of improved PFS and OS.
Conclusions:
- Total resection and adjuvant chemotherapy to radiation or CRT are strongly linked to improved PFS and OS in pediatric high-grade gliomas.
- For incompletely resected, high-risk patients, intensified treatment including temozolomide, concurrent CRT, adjuvant chemotherapy, and higher radiation doses showed improved outcomes.
