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Treatment options in childhood pontine gliomas

  • Clinical Study
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Summary

Background

Pontine gliomas are the subgroup of brainstem gliomas with the worst prognosis. Controversial treatment approaches are discussed.

Patients and methods

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.

Results

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).

Conclusion

Irradiation is an effective element for the treatment of pontine gliomas. Intensive chemotherapy seems to be important in achieving a better OS.

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Acknowledgements

We thank the participants of the various studies for submitting the data and Norman Jaffe for helpful discussions and correcting the manuscript. Supported by the Deutsche Kinderkrebsstiftung, Germany.

Author information

Authors and Affiliations

  1. Department of Pediatric Oncology, Krankenhaus der Barmherzigen Brüder Klinik St. Hedwig, Regensburg, Germany

    Sabine Wagner & Ove Peters

  2. Department of Neuroradiology, Universitätskliniken, Würzburg, Germany

    Monika Warmuth-Metz

  3. Institute of Medical Biostatistics, Epidemiology and Informatics, University of Mainz, Mainz, Germany

    Angela Emser

  4. Department of Pediatrics, Klinikum Augsburg, Augsburg, Germany

    Astrid-K. Gnekow

  5. Department of Pediatric Oncology, University of Münster, Münster, Germany

    Ronald Sträter

  6. Department of Pediatrics, Universitätskinderklinik, Würzburg, Germany

    Stefan Rutkowski

  7. Department of Pediatrics, Krankenanstalten Gilead, Bielefeld, Germany

    Norbert Jorch

  8. Department of Pediatric Oncology, University of Hannover, Hannover, Germany

    Hans-J. Schmid

  9. Department of Pediatric Oncology, University of Köln, Köln, Germany

    Frank Berthold

  10. Department of Pediatric Oncology, University of Saarland, Homburg, Germany

    Norbert Graf

  11. Department of Radiotherpay, University of Leipzig, Leipzig, Germany

    Rolf-D. Kortmann

  12. Institut für Neuropathologie der Universität, Bonn, Germany

    Thorsten Pietsch

  13. Department of Neurosurgery, University of Würzburg, Würzburg, Germany

    Norbert Sörensen

  14. Deparment of Pediatrics, MDAnderson Cancer Center, Houston, TX, USA

    Johannes E.A. Wolff

  15. University of Regensburg, Regensburg, Germany

    Sabine Wagner, Ove Peters & Johannes E.A. Wolff

  16. Department of Pediatric Oncology, Krankenhaus der Barmherzigen Brüder Klinik St. Hedwig, Steinmetzstr. 1-3, D-93049, Regensburg, Germany

    Sabine Wagner

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  1. Sabine Wagner
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Correspondence to Sabine Wagner.

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Wagner, S., Warmuth-Metz, M., Emser, A. et al. Treatment options in childhood pontine gliomas. J Neurooncol 79, 281–287 (2006). https://doi.org/10.1007/s11060-006-9133-1

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  • DOI: https://doi.org/10.1007/s11060-006-9133-1

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