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Late sequela after treatment of childhood low-grade gliomas: a retrospective analysis of 69 long-term survivors treated between 1983 and 2003

  • Martin BeneschEmail author
  • Herwig Lackner
  • Petra Sovinz
  • Elisabeth Suppan
  • Wolfgang Schwinger
  • Hans-Georg Eder
  • Hans Jürgen Dornbusch
  • Andrea Moser
  • Karin Triebl-Roth
  • Christian Urban
Clinical–patient studies

Summary

The aim of the present study was to evaluate the spectrum of late effects in a large cohort of pediatric patients with low-grade gliomas (WHO grade I and II) during an observation period of 20 years. Eighty-seven patients with low-grade gliomas grouped according to tumor location (cerebellum: n=28; cerebral hemispheres: n=21; central midline: n=15; brainstem: n=12; tectum: n=5; other locations: n=6) were evaluated for tumor- and/or treatment-related late effects by analysis of medical and computer records, and personal interviews. Seventy patients underwent neurosurgery, 29 patients received additional radiotherapy and 20 additional chemotherapy. Median follow-up of survivors is 96 months with an overall survival of 79% (cerebellum: 89%; cerebral hemispheres: 95%; central midline: 80%; brainstem: 25%; tectum: 100%; other locations: 66%). Chronic medical problems (mild ataxia to multiple severe neuroendocrine deficits) are observed in 100% of patients with brainstem/central midline tumors and in 40–50% of patients with low-grade gliomas of other locations. Endocrine deficiencies were observed in 15/17 (88%) of long-term survivors who received radiotherapy. In contrast, none of the patients who underwent surgery only had endocrine deficiencies. Seven long-term survivors (10.1%) are severely disabled with permanent need of medical help. Tumor- and treatment-related late effects are common in patients with low-grade gliomas with the most severe occurring in patients with brainstem or central midline tumors. As long-term survival is excellent in patients with low-grade gliomas except for tumors located in the brainstem, future treatment studies should focus on avoiding long-term late effects.

Keywords

children late effects low-grade gliomas outcome treatment 

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Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Martin Benesch
    • 1
    • 4
    Email author
  • Herwig Lackner
    • 1
  • Petra Sovinz
    • 1
  • Elisabeth Suppan
    • 2
  • Wolfgang Schwinger
    • 1
  • Hans-Georg Eder
    • 3
  • Hans Jürgen Dornbusch
    • 1
  • Andrea Moser
    • 1
  • Karin Triebl-Roth
    • 1
  • Christian Urban
    • 1
  1. 1.Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent MedicineMedical University of GrazGrazAustria
  2. 2.Division of General Pediatrics, Department of Pediatrics and Adolescent MedicineMedical University of GrazGrazAustria
  3. 3.Department of NeurosurgeryMedical University of Graz GrazAustria
  4. 4.Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent MedicineMedical University of GrazGrazAustria

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