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Pediatric astrocytomas. The Louisville experience: 1978-1988
1Department of Radiation Oncology, Kosair Children's Hospital, University of Louisville, Kentucky.
American Journal of Clinical Oncology
|December 1, 1994
Summary
Pediatric astrocytoma radiotherapy shows excellent local control for low-grade tumors. Higher grade astrocytomas need further study, as tumor grade significantly impacts overall survival in pediatric patients.
Area of Science:
- Pediatric Oncology
- Radiation Oncology
- Neuro-oncology
Background:
- Astrocytomas are common pediatric brain tumors.
- Treatment outcomes vary significantly based on tumor grade and extent of resection.
- Radiotherapy is a key modality in managing pediatric astrocytomas.
Purpose of the Study:
- To retrospectively analyze pediatric astrocytoma cases treated between 1978-1988.
- To evaluate prognostic indicators including grade, age, T-stage, tumor location, and extent of resection.
- To assess the impact of radiotherapy on overall survival in pediatric astrocytoma patients.
Main Methods:
- Retrospective analysis of 17 pediatric astrocytoma patients (grades I-IV).
- Patients received external beam radiotherapy (4- or 6-MV photons) with doses ranging from 41.4 to 66 Gy.
- Prognostic factors including tumor grade, age, T-stage, location, and resection extent were analyzed.
Main Results:
- Overall survival at 140 months was 63%.
- Low-grade (I & II) astrocytomas showed 82% survival (NED), while higher grades had poorer outcomes.
- Tumor grade was the only statistically significant prognostic indicator (p < .03) for overall survival.
Conclusions:
- Postoperative radiotherapy is effective for local control in low-grade pediatric astrocytomas.
- Higher-grade pediatric astrocytomas necessitate further research to improve survival and local control.
- Tumor grade is a critical prognostic factor for overall survival in pediatric astrocytoma.