Complexity in the Management of Brainstem Gliomas: Our Experience

Abstract

Background: Brainstem gliomas (BSGs) constitutes 10% of pediatric and 2% of adult brain tumors. Overall management of BSGs is complex due to lack of biopsy, location of the tumor making it inoperable and dosimetric constraints in RT delivery. We did a retrospective analysis on clinical outcomes of BSGs in our institute. Case Series: Seven cases of BSGs (5 adults and 2 pediatric) were included. Most common presenting symptom was weakness of limbs. Magnetic Resonance Imaging was the sole imaging modality. Biopsy was feasible in two patients. Median RT dose was 50 Gy. Two patients received concurrent temozolamide and one patient received adjuvant temozolamide. Median overall survival was 7.9 months. In our cohort adults had better survival than children. Conclusion: BSGs are distinct group of brain tumors. In most of the cases biopsy is not feasible and MRI is the current standard diagnostic imaging modality. Radiotherapy is the standard treatment options for BSGs.