Clinical management of brain stem glioma

Walker, David; Punt, Jonathan; Sokal, M.

doi:10.1136/adc.80.6.558

Cited by 80 publications

(44 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several studies over the past 4 decades have been aimed at better understanding the dismal outcomes associated with these tumors [5, 7, 8]. Due to the difficulties surrounding its clinical diagnosis, uncertainty about optimal surgical management, and the ineffectiveness of nonsurgical treatment, most reviews of pediatric brainstem tumors are small retrospective analyses or case studies [7, 9-11].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pediatric Brainstem Gliomas: A Retrospective Study of 180 Patients from the SEER Database

et al. 2019

View full text Add to dashboard Cite

Background/Aims: Large population-based studies are needed to assess the epidemiology and survival risk factors associated with pediatric brainstem gliomas. This retrospective study explores factors that may influence survival in this population. Methods: Utilizing the SEER database, the authors retrospectively assessed survival in histologically confirmed brainstem gliomas in patients aged 17 and younger. Survival was described with Kaplan-Meyer curves and multivariate regression analysis. Results: This analysis of 180 cases showed that age (hazard ratio [HR] 1.04, 95% CI 0.96–1.14, p = 0.34), non-white race (HR 1.00, 95% CI 0.35–2.85 p > 0.99), distant or invasive extension of the tumor (HR 0.4, 95% CI 0.08–2.53, p = 0.37), and radiation therapy (HR 1.27, 95% CI 0.52–3.11, p = 0.61) were not associated with decreased survival. High-grade tumor status (HR 8.64, 95% CI 3.49–21.41, p < 0.001) was associated with decreased survival. Partial resection (HR 0.11, 95% CI 0.04–0.30, p < 0.001) and gross-total resection (HR 0.03, 95% CI 0.01–0.14, p < 0.001) were associated with improved survival. Conclusions: High-grade brainstem gliomas have a worse prognosis. Early diagnosis and surgery appear to be associated with improved survival, while the role of radiation is unclear.

show abstract

Section: Introductionmentioning

confidence: 99%

“…An estimated 90% of these tumors are glial tumors, and constitute only 10% of all pediatric brain tumors [2-5]. According to the most recent Central Brain Tumor Registry of the United States (CBTRUS) report, 4.2% of all gliomas are localized to the brainstem [6].…”

Section: Introductionmentioning

confidence: 99%

Pediatric Brainstem Gliomas: A Retrospective Study of 180 Patients from the SEER Database

et al. 2019

View full text Add to dashboard Cite

show abstract

“…This corresponds to 150–300 annual cases in the United States [1, 2]. There is an equal predilection for males and females, and these tumors are typically diagnosed between ages 7 and 9 [3, 4].…”

Section: Introductionmentioning

confidence: 99%

Brainstem Tumors: Where Are We Today?

Recinos

Sciubba

Jallo³

2007

Pediatr Neurosurg

View full text Add to dashboard Cite

Brainstem tumors comprise 10–20% of all pediatric central nervous system tumors. The management of these tumors has evolved dramatically in the past century. Once considered uniformly fatal, it is now known that brainstem tumors have distinguishing characteristics and do not behave identically. The focality and location of the lesion is determined from the clinical history, presentation, and associated imaging. Based on these findings, it is possible to predict the behavior of the tumor and choose an appropriate intervention. Focal lesions have a good prognosis and are treated operatively while diffuse lesions have a poor prognosis and are managed medically. This article reviews the current classification of brainstem tumors, current management options and future directions for the treatment of these rare tumors.

show abstract

“…In the US alone, there are ~ 200-300 cases annually, of which 60-75% are classified as diffuse intrinsic brainstem tumors. 33,113 Children with these infiltrating fibrillary astrocytomas often present with progressive symptoms such as ataxia and multiple deficits of the cranial nerves, long tracts, and cerebellum. The mean age at diagnosis is 7-9 years, and there is no age or sex predilection.…”

mentioning

confidence: 99%

Treatment of diffuse intrinsic brainstem gliomas: failed approaches and future strategies

Frazier¹,

Lee²,

Thomale

et al. 2009

PED

128

107

View full text Add to dashboard Cite

Diffuse intrinsic pontine gliomas constitute ~ 60–75% of tumors found within the pediatric brainstem. These malignant lesions present with rapidly progressive symptoms such as cranial nerve, long tract, or cerebellar dysfunctions. Magnetic resonance imaging is usually sufficient to establish the diagnosis and obviates the need for surgical biopsy in most cases. The prognosis of the disease is dismal, and the median survival is < 12 months. Resection is not a viable option. Standard therapy involves radiotherapy, which produces transient neurological improvement with a progression-free survival benefit, but provides no improvement in overall survival. Clinical trials have been conducted to assess the efficacy of chemotherapeutic and biological agents in the treatment of diffuse pontine gliomas. In this review, the authors discuss recent studies in which systemic therapy was administered prior to, concomitantly with, or after radiotherapy. For future perspective, the discussion includes a rationale for stereotactic biopsies as well as possible therapeutic options of local chemotherapy in these lesions.

show abstract

Clinical management of brain stem glioma

Cited by 80 publications

References 60 publications

Pediatric Brainstem Gliomas: A Retrospective Study of 180 Patients from the SEER Database

Pediatric Brainstem Gliomas: A Retrospective Study of 180 Patients from the SEER Database

Brainstem Tumors: Where Are We Today?

Treatment of diffuse intrinsic brainstem gliomas: failed approaches and future strategies

Contact Info

Product

Resources

About