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Clinical Features, Treatment and Outcome of Childhood Glial Tumors
Buket Kara1, Kubra Ertan, Pinar Karabagli
1Selcuk University, Faculty of Medicine, Department of Pediatric Hematology and Oncology, Konya, Turkey.
Insights
Pediatric glial tumors, including astrocytoma and ependymoma, show varied survival rates based on grade and location. High-grade astrocytomas in children have poor treatment outcomes, necessitating novel therapeutic strategies.
Area of Science:
- Pediatric neuro-oncology
- Cancer research
- Clinical neurology
Background:
- Glial tumors are a significant cause of brain tumors in children.
- Understanding their clinical features, treatment, and outcomes is crucial for improving patient care.
Purpose of the Study:
- To evaluate the clinical characteristics, treatment modalities, and survival outcomes of pediatric glial tumors.
- To identify factors influencing prognosis in this patient population.
Main Methods:
- Retrospective review of medical records for pediatric patients diagnosed with glial tumors between 2006 and 2020.
- Data collection included demographics, clinical presentation, treatment, and outcomes.
Main Results:
- Glial tumors comprised 40.6% of pediatric brain tumors (73/180).
- Astrocytomas and ependymomas showed significant age distribution differences (median ages 8.7 vs. 3 years).
- Common symptoms included headaches, gait abnormalities, and vomiting. Five-year overall survival rates varied by tumor grade (42% overall, 0% for Grade IV) and location (25.6% supratentorial, 63.6% infratentorial). Tumor resection and grade significantly impacted prognosis.
Conclusions:
- Current treatment outcomes for high-grade pediatric astrocytomas are unsatisfactory.
- There is a critical need for innovative treatment strategies incorporating molecular features and multidisciplinary care approaches for pediatric glial tumors.
Aim:
To evaluate the clinical features, treatment approaches, and outcomes of glial tumors in children.
Material And Methods:
Files (2006 to 2020) of children diagnosed with glial tumors and followed-up were reviewed retrospectively. Information regarding demographic and clinical characteristics, treatment approaches, and outcomes were retrieved from the patients? files.
Results:
Of the total of 180 pediatric patients diagnosed with brain tumors, 73 (40.6%) had glial tumors. The children with astrocytoma were in the age range of 2?18 years (median age: 8.7 years), while the ages of children with ependymoma ranged from three months to 10 years (median age: 3 years). This difference was statistically significant (p < 0.0001). The male to female ratio was 1.6. The most common symptoms or signs were headaches (n=34, 46.6%), abnormal gait or coordination (n=22, 30.2%), vomiting (n=21, 28.8%), and cranial nerve palsies (n=20, 27.4%). The pathological diagnoses were astrocytomas (n=53, 72.6%), oligodendroglial tumors (n=2, 2.7%), ependymoma (n=15, 20.7%), and other glial tumors (n=3, 4.1%). The most common tumor location was supratentorial (n=42, 57.5%), while midline glioma was detected in seven patients. The 5-year overall survival (OS) rate of all glial tumors, astrocytoma, and ependymoma was 42%, 40%, and 55%, respectively. The 5-year OS rate of the tumor Grade I, II, III, and IV was 77.2%, 45%, 32%, and 0%, respectively (p < 0.0001). The 5-year OS rate of supratentorial, infratentorial, and spinal tumors was 25.6%, 63.6%, and 50%, respectively (p=0.021). In Cox regression analysis, it was found that the tumor resection and grade had an effect on the tumor prognosis.
Conclusion:
Treatment results are not satisfactory in high-grade astrocytomas. There is a need for new treatment approaches that would take cognizance of molecular features and adopt multidisciplinary approaches.
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