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Pediatric brain stem gliomas

P Littman, P Jarrett, L T Bilaniuk

    Cancer
    |June 1, 1980
    PubMed
    Summary
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    Pediatric brain stem gliomas treated with radiation therapy show a 30% five-year survival rate. Well-differentiated gliomas had better outcomes, highlighting the importance of accurate diagnosis and localized radiation therapy.

    Area of Science:

    • Pediatric Oncology
    • Neuro-oncology
    • Radiation Oncology

    Background:

    • Brain stem gliomas are rare and aggressive tumors in children.
    • Historical treatment data from 1964-1978 provides insights into outcomes.
    • Advances in diagnostic imaging like CT have evolved treatment planning.

    Purpose of the Study:

    • To review treatment outcomes for pediatric brain stem gliomas.
    • To evaluate the efficacy of radiation therapy in this patient cohort.
    • To establish optimal radiation doses and target definition for brain stem gliomas.

    Main Methods:

    • Retrospective review of 62 pediatric patients diagnosed between 1964 and 1978.
    • Analysis of surgical interventions, pathological diagnoses, and radiation therapy details.

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  • Actuarial survival analysis and correlation with tumor grade and treatment parameters.

    • Main Results:

    • Overall five-year actuarial survival was 30%.
    • Patients with well-differentiated gliomas had a 55% five-year survival, while malignant gliomas had <16 months survival.
    • No dose-response relationship was observed for radiation therapy.

    Conclusions:

    • Localized radiation therapy of 5000-5500 rads to the tumor area is recommended.
    • Computed tomography (CT) is crucial for diagnosis, follow-up, and radiation therapy portal design.
    • Tumor differentiation significantly impacts prognosis in pediatric brain stem gliomas.