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National cancer database analysis of outcomes in pediatric glioblastoma
Meng Liu1,2, Jigisha P Thakkar3, Catherine R Garcia2
1Division of Cancer Biostatistics, University of Kentucky, Lexington, Kentucky.
Insights
Pediatric glioblastoma is aggressive with no standard therapy. Multimodal treatment including surgery, radiation, and chemotherapy improves survival in children, with younger patients showing better outcomes.
Area of Science:
- Pediatric Oncology
- Neuro-oncology
- Cancer Epidemiology
Background:
- Glioblastoma in children presents a significant therapeutic challenge due to its aggressive nature and lack of a standardized treatment protocol.
- Understanding demographic and survival patterns is crucial for improving care for pediatric glioblastoma patients.
Purpose of the Study:
- To analyze demographic characteristics, treatment patterns, and survival outcomes of pediatric glioblastoma patients.
- To identify factors influencing survival in children diagnosed with glioblastoma.
Main Methods:
- Retrospective analysis of 1173 pediatric glioblastoma patients (0-19 years) diagnosed between 1998 and 2011.
- Data sourced from the National Cancer Database, including patient demographics, tumor characteristics, treatment modalities (surgery, radiation, chemotherapy), and survival data.
- Statistical comparisons of survival rates based on age, race, tumor location, and treatment combinations.
Main Results:
- Patients aged ≤5 years demonstrated better 5-year survival compared to older age groups (6-10 and 11-19 years).
- Multimodal therapy (surgery, radiotherapy, chemotherapy) was associated with significantly better outcomes than other treatment combinations.
- Radiotherapy showed a survival benefit for patients aged 11-19 years, but not for those younger than 10 years.
Conclusions:
- Treatment including surgery, radiotherapy, and chemotherapy is associated with improved survival in pediatric glioblastoma.
- Age is a significant prognostic factor, with younger children experiencing better survival.
- Variations in treatment receipt and potential differences in tumor biology may explain observed survival disparities.
Abstract:
Glioblastoma in children is an aggressive disease with no defined standard therapy. We evaluated hospital-based demographic and survival patterns obtained through the National Cancer Database to better characterize children with glioblastoma. Our study identified 1173 patients from 0 to 19 years of age between 1998 and 2011. Comparisons were made among demographics, clinical characteristics, treatment, and survival variables. Fifty-four percent of patients were over 10 years of age. Approximately 80% of patients underwent either partial or complete resection. Adjuvant therapy was used variably, and its use increased with patient age. Forty-eight percent of patients received the combination of surgery, radiation, and chemotherapy, and 4% did not receive any treatment. As expected, patients ≤5 years of age had better 5-year survival than those ages 6-10 (P = 0.01) or 11-19 years (P = 0.0077). Other factors associated with poor survival included black race and central tumor location. Better outcomes were associated with treatment that included surgery, radiotherapy, and chemotherapy compared to any other treatment combinations. Radiotherapy had no impact on survival in the 0 to 10-year-old age group, but was associated with improved survival for patients 11-19 years. We report an extensive demographic and survival analysis of pediatric glioblastoma. The observed differences likely reflect variances in tumor biology and likelihood of treatment receipt. Improved survival was associated with the use of surgery, radiotherapy, and chemotherapy. Radiation therapy was not associated with survival in patients younger than 10 years of age.
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