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Irradiation of primary thalamic and brainstem tumors in a pediatric population. A 33-year experience
P W Grigsby1, P R Thomas, H G Schwartz
1Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, Missouri.
Insights
This study analyzed 70 pediatric brain tumor patients, finding that total radiation dose and patient race significantly impacted survival. Other factors like age and sex did not show prognostic significance.
Area of Science:
- Pediatric Oncology
- Neuro-oncology
- Radiation Oncology
Background:
- Primary neoplasms of the thalamus, hypothalamus, and brainstem are rare in pediatric patients.
- Treatment often involves surgery and radiotherapy, but prognostic factors require further elucidation.
Purpose of the Study:
- To identify prognostic factors influencing survival in pediatric patients with thalamic, hypothalamic, and brainstem neoplasms.
- To evaluate the impact of various clinical and treatment-related factors on patient outcomes.
Main Methods:
- Retrospective analysis of 70 pediatric patients treated between 1950 and 1983.
- Involved assessment of survival rates and statistical analysis of prognostic factors using univariate and multivariate models.
Main Results:
- Overall 5- and 10-year survival rates were 34.9% and 32.7%, respectively.
- Univariate analysis identified primary site, extent of surgery, race, cranial nerve paresis, and radiation dose as significant prognostic factors.
- Multivariate analysis confirmed that only total radiation dose and race were of independent prognostic significance.
Conclusions:
- Total radiation dose and patient race are critical prognostic indicators for pediatric thalamic, hypothalamic, and brainstem neoplasms.
- Findings underscore the importance of considering these factors in treatment planning and patient management.
Abstract:
A retrospective analysis of 70 pediatric patients (less than 16 years of age) with histologically proven or presumed primary neoplasms of the thalamus, hypothalamus, and brainstem, treated with combined surgery and postoperative radiotherapy or radiotherapy alone at the Washington University Medical Center from January 1950 through December 1983, is reported. Overall survival for all patients at 5 and 10 years was 34.9% and 32.7%, respectively. Follow-up of the 22 surviving patients ranged from 3.0 to 20.0 years (median, 10.6 years). Statistical analysis of multiple prognostic factors was performed. Prognostic factors found by single variate analysis to significantly influence survival were primary site of disease, extent of surgery, race, cranial nerve paresis at diagnosis, and dose of radiation. Factors evaluated but found to be insignificant were age at diagnosis, duration of symptoms before diagnosis, sex, and volume irradiated. Multivariate analysis revealed that only total radiation dose and race were of prognostic significance.
