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- Title
Long-term outcome of centrally located low-grade glioma in children.
- Authors
Terashima, Keita; Chow, Kevin; Jones, Jeremy; Ahern, Charlotte; Jo, Eunji; Ellezam, Benjamin; Paulino, Arnold C.; Okcu, M. Fatih; Su, Jack; Adesina, Adekunle; Mahajan, Anita; Dauser, Robert; Whitehead, William; Lau, Ching; Chintagumpala, Murali
- Abstract
BACKGROUND Optimal management of children with centrally located low-grade glioma (LGG) is unclear. Initial interventions in most children are chemotherapy in younger and radiation therapy (RT) in older children. A better understanding of the inherent risk factors along with the effects of interventions on long-term outcome can lead to reassessment of the current approaches to minimize long-term morbidity. METHODS To reassess the current treatment strategies of centrally located LGG, we compared the long-term survival and morbidity of different treatment regimens. Medical records of patients primarily treated at Texas Children's Cancer and Hematology Centers between 1987 and 2008 were reviewed. RESULTS Forty-seven patients with a median follow-up of 79 months were included in the analysis. The 5-year overall survival and progression-free survival (PFS) for all patients were 96% and 53%, respectively. The 5-year PFS for those treated initially with RT (12 patients; median age, 11 years [range, 3-15 years]) and with chemotherapy (28 patients; median age, 2 years [range 0-8 years]) were 76% and 37%, respectively (log-rank test P = .02). Among children who progressed after chemotherapy, the 5-year PFS after salvage RT was 55%. Patients diagnosed at a younger age (<5 years) were more likely to experience endocrine abnormalities (Fisher exact test; P<.00001). CONCLUSIONS Effective and durable tumor control was obtained with RT as initial treatment. In younger patients, chemotherapy can delay the use of RT; however, frequent progression and long-term morbidity are common. More effective and less toxic therapies are required in these patients, the majority of whom are long-term survivors. Cancer 2013;119:2630-2638. © 2013 American Cancer Society.
- Subjects
GLIOMAS; JUVENILE diseases; CANCER chemotherapy; CANCER risk factors; DISEASE progression; PATIENTS
- Publication
Cancer (0008543X), 2013, Vol 119, Issue 14, p2630
- ISSN
0008-543X
- Publication type
Article
- DOI
10.1002/cncr.28110