Prognosis of pediatric high-grade gliomas with temozolomide treatment: a retrospective, multicenter study

Jung, Tae Young; Kim, Chae Yong; Kim, Do Kyung; Shin, Young; Kim, Seong Ho; Baek, Hee Jo; Choi, Hyoung Soo; Kim, In Ah

doi:10.1007/s00381-012-1786-9

Cited by 10 publications

(7 citation statements)

References 21 publications

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“…There was a slightly better result in those patients receiving temozolomide in conjunction with radiotherapy, but this finding could not be confirmed on multivariate analysis. There are also some clinical trials emphasizing minimal or no benefit of temozolomide over conventional treatment in the pediatric group (10,22,25). Based on these, in this age group, a patient specific-discretion is warranted in balancing the risk of tumor growth with the benefits and complications of radiotherapy.…”

Section: █ Discussionmentioning

confidence: 99%

Is the knowledge pertained to adult glioblastomas enough for pediatric cases? prognostic factors in childhood

Bilginer¹,

Hanalıoğlu²,

Türk³

et al. 2015

Turkish Neurosurgery

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There is a paucity of information in the literature about agespecific histopathological and molecular biology. This is also true for prognostic factors and therapeutic strategies regarding pediatric glioblastoma. The current understanding is therefore majorly based on adult data.The incidence and spectrum of pediatric CNS tumors have been addressed in several studies in the literature. Despite geographical differences, the incidence of glioblastoma was updated to 7-12 % of all pediatric brain tumors (12,30). (8,21). This predominance is responsible for the general perception regarding GBM as a "tumor of the elderly". Indeed, pediatric cases are rare, accounting for 3-6 % of all glioblastomas. The incidence may be responsible for the underestimation of this devastating pathology in childhood.AIM: Pediatric glioblastoma (GBM) is still a topic obscurity. The aim of this study was to explore clinical, radiological and pathological features, and prognostic factors affecting the outcomes. MATERIAL and METhODS:We retrospectively reviewed our database for prognostic factors for 42 consecutive pediatric patients with histologically proven GBM treated in our hospital. RESuLTS:The study reached at 20 boys and 22 girls, with a mean age of 10.2 years. Almost all patients (97.6%) had supratentorial tumors; lobar/hemispheric (68.3%), thalamic (26.8%) and suprasellar-hypothalamic region (4.8%). Total of 11/42 children had seeding metastases (mean 11.5 months) either preoperatively or postoperatively. Gross total resection (GTR) was achieved in 13 patients (30.9%) in the first surgery. Perioperative mortality and morbidity rates were 4.7% and 19%, respectively. Patients were followed for an average of 18.1 months. The median progression-free and overall survivals were 7.0 (95% CI: 5.9-8.0) and 11.0 (95% CI: 8.9-13.1) months, respectively. 1-year, 2-year and 5-year progression-free survival and overall survivals were 30.9% vs. 50.0%, 11.9% vs. 19.0%, 4.8% vs. 9.5%; respectively.COnCLuSIOn: Gross total resection should be safely attempted in pediatric GBM. In addition, a thorough and frequent radiological evaluation of the entire neuraxis for seeding metastases is recommended both at diagnosis and follow-ups.

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Section: █ Discussionmentioning

confidence: 99%

Is the knowledge pertained to adult glioblastomas enough for pediatric cases? prognostic factors in childhood

Bilginer¹,

Hanalıoğlu²,

Türk³

et al. 2015

Turkish Neurosurgery

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“…We found that postoperative CCRT is an effective way to prolong the survival time and delay the recurrence for psGBM patients. Although current studies have found many differences between childhood and adult GBM, but the effect of the same treatment in adults and children is not consistent, however, many new treatment options are still in active investigation [3,11,14]. Nowadays, electric eld therapy is being hotly debated, it is an emerging treatment that can extend the life span of several months, it is also noninvasive and has little effect on children's growth and development.…”

Section: Discussionmentioning

confidence: 99%

Pediatric supratentorial glioblastoma: Experience at a Single Center in the past 6-year

Jiao¹,

Wang²,

Liu³

et al. 2021

Preprint

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OBJECTIVE: Pediatric supratentorial glioblastoma (psGBM) is rare tumor of the central nervous system, the prognosis of it remains controversial due to their rarity. The aim of this study was to evaluate characteristics of pediatric supratentorial glioblastoma, effectiveness of modern treatment modalities, and detect factors related to prognosisMETHODS: Twenty-eight children under 18 years old were pathologically diagnosed with supratentorial glioblastoma at The First Aﬃliated Hospital of Zhengzhou University between 2014 and 2020.Epidemiological characteristics, clinical features, imaging features, functional outcomes, overall survival, progression-free survival according to multimodal treatments were reviewed retrospectively.RESULTS: Median survival time of children with supratentorial glioblastoma was 11 months and median progression-free survival was 7 months. Half-, one-year and two-year overall survival probabilities were 64.3%,42.9% and 14.3%, respectively. Half-, one-year and two-year progression-free survival probabilities were 53.6%,21.4% and 9.5%, respectively. Extent of resection(p=0.011) and postoperative concurrent chemoradiotherapy (p=0.032) are independent factors of prognosis while gender, age, initial symptom, tumor side, enhancement character, preoperative KPS and with or without cystoid variation and necrosis are not. Three patients lived longer than 2 years, one patient was alive at 46 months after diagnosis and no evidence of recurrence was found.CONCLUSION: Prognosis of pediatric supratentorial glioblastoma remains poor, and its prognosis may not be better than adult’s. Preoperative KPS score is a risk factor, but isn’t an independent risk factor. Concurrent chemoradiotherapy and gross total resection are the main methods to prolong life span.

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“…However, this correlation has not been replicated in paediatric HGG 1. Temozolomide has been used in children with estimated response rates of 12%–20%4 but with increased side effects, thrombocytopaenia being the most common. Retrospective analyses of temozolomide in paediatric HGG have not shown definite benefit, although randomised trials are lacking 2 4…”

Section: Discussionmentioning

confidence: 99%

Atypical anaplastic astrocytoma with unique molecular features and diffuse leptomeningeal spread in a child with long-term survival

et al. 2019

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Paediatric high-grade gliomas, including glioblastoma and anaplastic astrocytoma, make up 8%–12% of paediatric central nervous system tumours 1 and have poor prognosis, with 2-year survival less than 30% 2 and overall survival less than 10%. The only known prognostic factors in this population include extent of resection and tumour histological grade. We present the case of a 9-year-old boy with disseminated anaplastic astrocytoma treated with subtotal resection, craniospinal radiation and temozolomide, with 8-year survival despite metastatic disease at presentation and subtotal resection. Next generation cancer gene panel sequencing revealed an usual pattern of 12 amplifications and four mutations not previously described.

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Prognosis of pediatric high-grade gliomas with temozolomide treatment: a retrospective, multicenter study

Abstract: Initial or recurrent TMZ treatment in pediatric HGGs was safe and tolerable. Initial treatment showed improved PFS compared to recurrent treatment, and both showed similar OS.

Cited by 10 publications

References 21 publications

Is the knowledge pertained to adult glioblastomas enough for pediatric cases? prognostic factors in childhood

Is the knowledge pertained to adult glioblastomas enough for pediatric cases? prognostic factors in childhood

Pediatric supratentorial glioblastoma: Experience at a Single Center in the past 6-year

Atypical anaplastic astrocytoma with unique molecular features and diffuse leptomeningeal spread in a child with long-term survival

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