Skip to main content
SpringerLink
Log in

High-grade glioma in children and adolescents: a single-center experience

  • Original Paper
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to report the outcome in children with high-grade astrocytoma outside the brain stem and spinal cord that were treated at a single center.

Materials and methods

The study included 26 patients with anaplastic astrocytoma and 37 patients with glioblastoma; all patients were aged ≤18 years. At initial diagnosis, 18 of the patients with glioblastoma received only temozolomide (TMZ), 14 received other chemotherapies, and 5 did not receive any chemotherapy. Among the patients with anaplastic astrocytoma, 9 received TMZ, 9 received other chemotherapy regimens, and 8 patients did not receive any chemotherapy. The median radiotherapy dose in all patients was 60 Gy.

Results

Median age of the patients was 12.5 years. Median overall survival was 20 months and mean progression-free survival was 4.7–11.3 months (median: 8 months) in all patients. Patients with a Karnofsky performance score (KPS) ≥70 had median overall survival of 32 months, versus 7 months in those with a KPS < 70. Patients aged <15 years had median survival of 38 months, versus 16 months in those aged 15–18 years. Patients with anaplastic astrocytoma that received TMZ, other chemotherapy regimens, and no chemotherapy had median survival of 21 months, 132 months, and 11 months, respectively. Patients with glioblastoma that received TMZ, other chemotherapy regimens, and no chemotherapy had median survival of 32 months, 12 months, and 8 months, respectively.

Conclusion

In the present study, patients with anaplastic astrocytoma treated with chemotherapy protocols other than TMZ had the longest OS; however, in the glioblastoma group, OS was 32 months in those treated with standard TMZ and 12 months in those treated with other protocols (P = 0.493). Although TMZ is less toxic than PCV, it was not shown to be superior.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Baldwin RT, Preston-Martin S (2004) Epidemiology of brain tumors in childhood—a review. Toxicol Appl Pharmacol 199(2):118–131. doi:10.1016/j.taap.2003.12.029

    Article  CAS  PubMed  Google Scholar 

  2. Kleihues P, Louis DN, Scheithauer BW, Rorke LB, Reifenberger G, Burger PC, Cavenee WK (2002) The WHO classification of tumors of the nervous system. J Neuropathol Exp Neurol 61(3):215–225 discussion 226-219

    Article  PubMed  Google Scholar 

  3. Finlay JL, Boyett JM, Yates AJ, Wisoff JH, Milstein JM, Geyer JR, Bertolone SJ, McGuire P, Cherlow JM, Tefft M, et al. (1995) Randomized phase III trial in childhood high-grade astrocytoma comparing vincristine, lomustine, and prednisone with the eight-drugs-in-1-day regimen. Childrens Cancer Group. J Clin Oncol Off J Am Soc Clin Oncol 13(1):112–123

    CAS  Google Scholar 

  4. Sposto R, Ertel IJ, Jenkin RD, Boesel CP, Venes JL, Ortega JA, Evans AE, Wara W, Hammond D (1989) The effectiveness of chemotherapy for treatment of high grade astrocytoma in children: results of a randomized trial: a report from the Childrens Cancer Study Group. J Neuro-Oncol 7(2):165–177

    Article  CAS  Google Scholar 

  5. Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJ, Belanger K, Brandes AA, Marosi C, Bogdahn U, Curschmann J, Janzer RC, Ludwin SK, Gorlia T, Allgeier A, Lacombe D, Cairncross JG, Eisenhauer E, Mirimanoff RO (2005) Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 352(10):987–996. doi:10.1056/NEJMoa043330

    Article  CAS  PubMed  Google Scholar 

  6. Pollack IF, Hamilton RL, Burnham J, Holmes EJ, Finkelstein SD, Sposto R, Yates AJ, Boyett JM, Finlay JL (2002) Impact of proliferation index on outcome in childhood malignant gliomas: results in a multi-institutional cohort. Neurosurgery 50(6):1238–1244 discussion 1244-1235

    PubMed  Google Scholar 

  7. Ansari M, Nasrolahi H, Kani AA, Mohammadianpanah M, Ahmadloo N, Omidvari S, Mosalaei A (2012) Pediatric glioblastoma multiforme: a single-institution experience. Indian J Med Paediatr Oncol Off J Indian Soc Med Paediatr Oncol 33(3):155–160. doi:10.4103/0971-5851.103142

    Article  Google Scholar 

  8. Song KS, Phi JH, Cho BK, Wang KC, Lee JY, Kim DG, Kim IH, Ahn HS, Park SH, Kim SK (2010) Long-term outcomes in children with glioblastoma. J Neurosurg Pediatr 6(2):145–149. doi:10.3171/2010.5.PEDS09558

    Article  PubMed  Google Scholar 

  9. Das KK, Mehrotra A, Nair AP, Kumar S, Srivastava AK, Sahu RN, Kumar R (2012) Pediatric glioblastoma: clinico-radiological profile and factors affecting the outcome. Child’s Nerv Syst ChNS: Off J Int Soc Pediatr Neurosurg 28(12):2055–2062. doi:10.1007/s00381-012-1890-x

    Article  Google Scholar 

  10. Wolff JE, Driever PH, Erdlenbruch B, Kortmann RD, Rutkowski S, Pietsch T, Parker C, Metz MW, Gnekow A, Kramm CM (2010) Intensive chemotherapy improves survival in pediatric high-grade glioma after gross total resection: results of the HIT-GBM-C protocol. Cancer-Am Cancer Soc 116(3):705–712. doi:10.1002/cncr.24730

    Google Scholar 

  11. Sanchez-Herrera F, Castro-Sierra E, Gordillo-Dominguez LF, Vaca-Ruiz MA, Santana-Montero B, Perezpena-Diazconti M, Gonzalez-Carranza V, Torres-Garcia S, Chico-Ponce de Leon F (2009) Glioblastoma multiforme in children: experience at Hospital Infantil de Mexico Federico Gomez. Child’s Nerv Syst ChNS: Off J Int Soc Pediatr Neurosurg 25(5):551–557. doi:10.1007/s00381-008-0780-8

    Article  Google Scholar 

  12. Perkins SM, Rubin JB, Leonard JR, Smyth MD, El Naqa I, Michalski JM, Simpson JR, Limbrick DL, Park TS, Mansur DB (2011) Glioblastoma in children: a single-institution experience. Int J Radiat Oncol Biol Phys 80(4):1117–1121. doi:10.1016/j.ijrobp.2010.03.013

    Article  PubMed  Google Scholar 

  13. Grovas AC, Boyett JM, Lindsley K, Rosenblum M, Yates AJ, Finlay JL (1999) Regimen-related toxicity of myeloablative chemotherapy with BCNU, thiotepa, and etoposide followed by autologous stem cell rescue for children with newly diagnosed glioblastoma multiforme: report from the Children’s Cancer Group. Med Pediatr Oncol 33(2):83–87

    Article  CAS  PubMed  Google Scholar 

  14. Cohen KJ, Pollack IF, Zhou T, Buxton A, Holmes EJ, Burger PC, Brat DJ, Rosenblum MK, Hamilton RL, Lavey RS, Heideman RL (2011) Temozolomide in the treatment of high-grade gliomas in children: a report from the Children’s Oncology Group. Neuro-Oncology 13(3):317–323. doi:10.1093/neuonc/noq191

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. Broniscer A, Chintagumpala M, Fouladi M, Krasin MJ, Kocak M, Bowers DC, Iacono LC, Merchant TE, Stewart CF, Houghton PJ, Kun LE, Ledet D, Gajjar A (2006) Temozolomide after radiotherapy for newly diagnosed high-grade glioma and unfavorable low-grade glioma in children. J Neuro-Oncol 76(3):313–319. doi:10.1007/s11060-005-7409-5

    Article  Google Scholar 

  16. Jung TY, Kim CY, Kim DS, Ra YS, Kim SH, Baek HJ, Choi HS, Kim IA (2012) Prognosis of pediatric high-grade gliomas with temozolomide treatment: a retrospective, multicenter study. Child’s Nerv Syst ChNS: Off J Int Soc Pediatr Neurosurg 28(7):1033–1039. doi:10.1007/s00381-012-1786-9

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, School of Medicine, Hacettepe University, Sihhiye, 06100, Ankara, Turkey

    Gozde Yazici, Faruk Zorlu, Mustafa Cengiz, Gokhan Ozyigit, Gulnihan Eren & Murat Gurkaynak

  2. Department of Preventive Oncology, School of Medicine, Hacettepe University, Ankara, Turkey

    Deniz Yüce

  3. Department of Pediatric Oncology, School of Medicine, Hacettepe University, Ankara, Turkey

    Ali Varan & Canan Akyuz

  4. Department of Neurosurgery, School of Medicine, Hacettepe University, Ankara, Turkey

    Nejat Akalan

Authors
  1. Gozde Yazici
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Faruk Zorlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mustafa Cengiz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gokhan Ozyigit
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gulnihan Eren
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Deniz Yüce
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ali Varan
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Canan Akyuz
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Nejat Akalan
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Murat Gurkaynak
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Faruk Zorlu.

Ethics declarations

Conflict of interest statement

The authors declare there are no actual or potential conflicts of interest—financial or otherwise—relevant to the material presented herein.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yazici, G., Zorlu, F., Cengiz, M. et al. High-grade glioma in children and adolescents: a single-center experience. Childs Nerv Syst 32, 291–297 (2016). https://doi.org/10.1007/s00381-015-2980-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-015-2980-3

Keywords

Search

Navigation