Abstract
Introduction: The purpose of this review was to analyze outcomes for pediatric patients treated for more common (non-low grade glioma) primary central nervous system (CNS) tumors at a Regional (tertiary) Cancer Center. Comparison to reported results from other regional centres and results from the contemporary literature were made.
Material and methods: The records of pediatric patients treated with radiotherapy at the London Regional Cancer Center (LRCC) for more common (non-low grade glioma) primary CNS tumors between 1980 and 2001 were reviewed. Details regarding tumor presentation, treatment and outcome were analyzed.
Results: Eighty-eight patients were eligible for the review. Twenty-nine patients with malignant glioma, 37 patients with medulloblastoma or primitive neuroectodermal tumor (PNET), 15 patients with brainstem glioma, 4 with ependymoma and 3 with germ cell tumors were treated during this time period. Average follow-up for the group was 5 years (range 4 months to 19 years). Five-year overall, progression free and cause specific survival were 45, 42 and 50%, respectively. For patients with malignant glioma median progression free and overall survival was 20 and 29 months. For patients with brainstem glioma median progression free and overall survival was 9 and 13 months. For medulloblastoma, 5-year progression free, and overall survival was 60 and 59%.
Conclusions: Results of this retrospective review of pediatric patients treated at a regional cancer center for primary CNS tumors (other than low grade glioma) were comparable to contemporary results reported by other Canadian centers and North American co-operative group trials.
Similar content being viewed by others
References
Pollack IF: Brain tumors in children. NEJM 331: 1500–1507, 1994
Albright AL, Sposto R, Holmes E et al.: Correlation of neurosurgical subspecialization with outcomes in children with malignant brain tumors. Neurosurgery 47: 879–885; discussion 885–877, 2000
Danjoux CE, Jenkin RD, Mclaughlin JR et al.: Childhood medulloblastoma in Ontario, 1977–1987: population based results. Med Ped Oncol 26: 1–9, 1996
Fisher BJ, Bauman GS, Leighton CC et al.: Low-grade gliomas in children: tumor volume response to radiation. J Neurosurg 88: 969–974, 1998
Fisher BJ, Leighton CC, Vujovic O et al.: Results of a policy of surveillance alone after surgical management of pediatric low grade gliomas. Int J Rad Oncol Biol Phys 51: 704–710, 2001
Gaspar L, Dawson DJ, Tilley-Gulliford SA et al.: Medulloblastoma: long-term follow-up of patients treated with electron irradiation of the spinal field. Radiology 180: 867–870, 1991
Hayter CR, Payne D, Ege GN: Radiation oncology in Canada 1895–1995. Int J Radiat Oncol Biol Phys 36: 487–496, 1996
Jenkin RD: Long-term survival of children with brain tumors. Oncology (Huntington) 10: 715–719, 1996
Pollack IF: The role of surgery in pediatric gliomas. J Neuro-Oncology 42: 271–288, 1999
Krischer JP, Ragab AH, Kun L et al.: Nitrogen mustard, vincristine, procarbazine, and prednisone as adjuvant chemotherapy in the treatment of medulloblastoma. A Pediatric Oncology Group study. J Neurosurg 74: 905–909, 1991
Sposto R EI, Jenkin RDT et al.: The effectiveness of chemotherapy for treatment of high grade astrocytoma in children: results of a randomized trial. A report from the children's cancer study group. J Neuroonc 7: 165, 1989
Tait DM T-JH, Bloom HJG, Lemerle J, Morris-Jones P: Adjuvant chemotherapy for medulloblastoma: the first multi-centre control trial of the international society of pediatric oncology (SIOP I). Eur J Cancer 26: 461–469, 1990
Griffin P, Cockerill R, Deber R: Potential impact of population-based funding on delivery of pediatric services. Annals (RCPSC) 272a: 2001
Saettler EB, Temple WJ: The surgeon as a prognostic factor in the management of pancreatic cancer. Surg Oncol Clin N Am 9(Part viii): 133–142, 2000
Cohn RJ, Goodenough B, Foreman T et al.: Hidden financial costs in treatment for childhood cancer: an Australian study of lifestyle implications for families absorbing out-of-pocket expenses. J Pediatr Hematol Oncol 25: 854–863, 2003
Yantzi N, Rosenberg MW, Burke SO et al.: The impacts of distance to hospital on families with a child with a chronic condition. Soc Sci Med 52: 1777–1791, 2001
Finlay JL, Boyett JM, Yaters AJ et al.: Randomized phase III trial in childhood high-grade astrocytoma comparing vincristine, lomustine, and prednisone with the eight-drugs-in-1-day regimen. J Clin Oncol 13: 112–123, 1995
Mandell LR, Kadota R, Freeman C et al.: There is no role for hyperfractionated radiotherapy in the management of children with newly diagnosed diffuse intrinsic brainstem tumors: results of a pediatric oncology group phase III trial comparing conventional vs. hyperfractionated radiotherapy. Int J Rad Oncol Biol Phys 43: 959–964, 1999
Evans AE, Jenkin RD, Sposto R et al.: The treatment of medulloblastoma. Results of a prospective trial of irradiation with and without adjuvant CCNU, VCR, and prednisone. J Neurosurg 72: 572–582, 1990
Kortmann RD, Kuhl J, Timmermann B et al.: Postoperative neoadjuvant chemotherapy before radiotherapy as compared to immediate radiotherapy followed by maintenance chemotherapy in the treatment of medulloblastoma in childhood: results of the German prospective randomized trial HIT '91. Int J Radiat Oncol Biol Phys 46: 269–279, 2000
Zeltzer PM BJ, Finlay J et al.: Prognostic factors for survivial differ in high-risk infra-and supratentorial primitive neuroectodermal tumors. Pediatric Neurosurg 19: 333, 1993
Modha A, Vassilyadi M, Kuehn GA et al.: Medulloblastoma in children — the Ottawa experience. Childs Nerv Syst 16: 341–350, 2000
Anderson NE: Late complications in childhood central nervous system tumour survivors. Curr Opin Neurol 16: 677–683, 2003
Packer RJ, Gurney JG, Punyko JA et al.: Long-term neurologic and neurosensory sequelae in adult survivors of a childhood brain tumor: childhood cancer survivor study. J Clin Oncol 21: 3255–3261, 2003
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Bauman, G., Fisher, B., Cairney, E. et al. Radiotherapy for Pediatric Central Nervous System Tumors: A Regional Cancer Centre Experience. J Neurooncol 68, 285–294 (2004). https://doi.org/10.1023/B:NEON.0000033386.38403.3b
Issue Date:
DOI: https://doi.org/10.1023/B:NEON.0000033386.38403.3b