Treatment options in childhood pontine gliomas
- 6 April 2006
- journal article
- research article
- Published by Springer Science and Business Media LLC in Journal of Neuro-Oncology
- Vol. 79 (3), 281-287
- https://doi.org/10.1007/s11060-006-9133-1
Abstract
Pontine gliomas are the subgroup of brainstem gliomas with the worst prognosis. Controversial treatment approaches are discussed. Data of children with pontine gliomas treated in different prospective multi-center studies who were registered in the HIT-GBM database were pooled and analyzed addressing prognostic factors and the relevance of intensive treatment using contingency tables, Kaplan-Meier curves and Cox regression analyses. From 1983 to 2001, 153 patients (74 males, 79 females, mean age: 8.1 years) with pontine gliomas were registered. Twenty-one tumors were low-grade and 60 were high-grade gliomas (72 undefined histology: 67 no surgery, 5 incomplete data). Sixteen tumors were partially resected, and 125 were irradiated. Ninety children received chemotherapy according to the "HIT-GBM" protocols ("Hirntumor-Glioblastoma multiforme"). The one-year overall survival rate (1YOS) of all patients with pontine glioma was 39.9+/-4.3%. None of the surviving patients had an observation time longer than 3.9 years. Favorable prognostic factors seemed to be age younger than 4 years, low-grade histology and smaller tumor. All three major treatment modalities including resection, irradiation and chemotherapy had prognostic relevance in univariable analysis. Chemotherapy remained beneficial, even if the analysis was restricted to the subgroup of irradiated tumors (1YOS 45.8+/-5.4% vs. 34.4+/-13.5%, P=0.030). Irradiation is an effective element for the treatment of pontine gliomas. Intensive chemotherapy seems to be important in achieving a better OS.Keywords
This publication has 36 references indexed in Scilit:
- Surgical Outcome following Resection of Contrast-Enhanced Pediatric Brainstem GliomasPediatric Neurosurgery, 2003
- Complete Remission of a Diffuse Pontine GliomaNeuropediatrics, 1998
- HIT-GBM: Multizentrische Studie zur Behandlung von Kindern mit malignen GliomenKlinische Padiatrie, 1996
- Pathology of Brain Stem AstrocytomasPediatric Neurosurgery, 1996
- Pediatric Midbrain Tumors: A Benign Subgroup of Brainstem GliomasPediatric Neurosurgery, 1995
- Focal brain-stem astrocytomas causing symptoms of involvement of the facial nerve nucleus: long-term survival in six pediatric casesJournal of Neurosurgery, 1994
- Magnetic Resonance Scans Should Replace Biopsies for the Diagnosis of Diffuse Brain Stem GliomasNeurosurgery, 1993
- Topical Review Article: Brainstem Glioma: I. Pathology, Clinical Features, and TherapyJournal of Child Neurology, 1993
- Focal Midbrain Tumors in ChildrenNeurosurgery, 1992
- Brain Stem Gliomas: A Classification System Based on Magnetic Resonance ImagingPediatric Neurosurgery, 1990