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Pediatric Brainstem Gliomas: An Institutional Experience
Altaf Ali Laghari1, Mirza Zain Baig2, Ehsan Bari1
1Department of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan.
Insights
Pediatric brainstem gliomas, particularly diffuse intrinsic pontine gliomas (DIPGs), have a poor prognosis. Radiotherapy may extend survival but does not offer a cure for these aggressive pediatric brain tumors.
Area of Science:
- Neuro-oncology
- Pediatric Oncology
- Clinical Neurology
Background:
- Brainstem gliomas are a significant challenge in pediatric neuro-oncology.
- Diffuse intrinsic pontine gliomas (DIPGs) represent the most common and aggressive subtype.
- Understanding clinical profiles and treatment outcomes is crucial for improving patient care.
Purpose of the Study:
- To analyze the clinical characteristics and treatment outcomes of pediatric brainstem gliomas.
- To evaluate the impact of radiotherapy on survival in pediatric DIPG patients.
- To identify factors influencing disease progression and survival.
Main Methods:
- Retrospective review of 18 pediatric patients diagnosed with brainstem glioma.
- Data collection included demographics, clinical symptoms, imaging, histopathology, and treatment details.
- Statistical analysis performed using SPSS version 23.
Main Results:
- The cohort mean age was 8.6 years; 16 patients (88.9%) had DIPGs.
- Mean overall survival (OS) was 9.7 months and mean progression-free survival (PFS) was 6.3 months.
- Radiotherapy improved OS and PFS in DIPG patients; longer diagnostic latency correlated with better PFS.
Conclusions:
- Pediatric DIPGs carry a poor prognosis, with all DIPG patients in this cohort succumbing to the disease.
- Radiotherapy can prolong survival but is not a curative treatment for pediatric brainstem gliomas.
- Early diagnosis and timely intervention may influence progression-free survival.
Objective:
The aim of this study was to analyze the clinical profiles and outcomes of pediatric brainstem gliomas treated at our institute.
Methodology:
We reviewed the files of 18 pediatric age group patients diagnosed with brainstem glioma at our institution. The following variables were recorded: age, sex, duration of symptoms, date of diagnosis, main clinical symptoms, Karnofsky performance status score, magnetic resonance imaging findings, histopathology findings, details of the treatment given, disease progression, and date of mortality/last follow-up. This data were then transferred to SPSS version 23 which was used for further analysis.
Results:
The mean age of our cohort was 8.6 years (range 3-15). There were 11 (61.1%) males and 7 (38.9%) females. There were 16 (88.9%) patients with diffuse intrinsic pontine gliomas (DIPGs), 1 (5.6%) patients with exophytic medullary gliomas, and 1 (5.6%) patient with midbrain/tectal glioma. Mean overall survival (OS) was 9.7 months. Mean progression-free survival (PFS) was 6.3 months. All patients with DIPG eventually passed away from their disease. Patients with DIPG who received radiotherapy had a longer OS and PFS than those who did not (9.8 and 6 months vs. 3.4 and 2.4 months). Diagnostic latency >1 month was found to have a statistically significant longer progression-free interval.
Conclusion:
DIPGs in the pediatric population have a poor prognosis. Radiotherapy serves to increase survival time but is not curative.
