Abstract

PURPOSE
We analyzed the usefulness of initial or recurrent treatment of temozolomide (TMZ) in pediatric high-grade gliomas (HGGs).
METHODS
Between 2002 and 2010, we performed surgery on 35 patients with 17 glioblastomas, 14 anaplastic astrocytomas, 3 anaplastic oligodendrogliomas, and 1 anaplastic oligoastrocytoma. The male-to-female ratio was 21:14, and the median age was 13 years (range, 3-18 years). The mean follow-up period was 15.9 (± 1.8) months. As the TMZ treatment, 22 patients received the initial treatment and 13 patients at recurrence. We analyzed the prognostic significance of TMZ treatment, tumor location, extent of removal, pathology, and recurrence pattern.
RESULTS
The median progression-free survival (PFS) and overall survival (OS) were 9.7 (± 1.4) and 17.8 (± 2.5) months, respectively. Based on univariate analysis, the median PFS was 9.9 (± 1.6) months in the tumors located in the cerebral hemisphere and 5.6 (± 1.3) months in the diencephalon (p = 0.03). Median PFS was 12.5 (± 1.7) months in the initial treatment and 6.8 (±0.8) months in the recurrent treatment (p = 0.03). The median OS was 14.9 (± 2.3) months in glioblastomas and 24.4 (± 4.1) months in tumors with an anaplastic pathology (p = 0.01). The median OS was 12.1 (± 3.7) months in patients with cerebrospinal fluid (CSF) dissemination and 18.2 (± 2.9) months in patients without CSF dissemination (p = 0.02). Grades 3 and 4 treatment-related toxicity occurred in 7.7-9 % of the patients.
CONCLUSIONS
Initial or recurrent TMZ treatment in pediatric HGGs was safe and tolerable. Initial treatment showed improved PFS compared to recurrent treatment, and both showed similar OS.

Links

Publisher Full Text

Authors

Jung TY, Kim CY, Kim DS, Ra YS, Kim SH, Baek HJ, Choi HS, Kim IA

Institution

Department of Neurosurgery, Chonnam National University Hwasun Hospital and Chonnam National University Medical School, Gwangju, South Korea.

Source

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery 28:7 2012 Jul pg 1033-9

MeSH

Adolescent
Antineoplastic Agents, Alkylating
Brain Neoplasms
Child
Child, Preschool
Dacarbazine
Female
Follow-Up Studies
Glioma
Humans
Male
Prognosis
Proportional Hazards Models
Retrospective Studies
Survival Analysis
Treatment Outcome

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

22576807