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CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(04): 1144-1150
DOI: 10.4103/ajns.AJNS_101_19
Original Article

Pediatric brainstem gliomas: An institutional experience

Altaf Laghari
0   Department of Neurosurgery, Aga Khan University Hospital Hospital, Karachi
,
Mirza Baig
1   Rudy L. Ruggles Biomedical Research Institute, Danbury, Connecticut
,
Ehsan Bari
0   Department of Neurosurgery, Aga Khan University Hospital Hospital, Karachi
,
Aneela Darbar
0   Department of Neurosurgery, Aga Khan University Hospital Hospital, Karachi
,
Naureen Mushtaq
2   Department of Pediatrics, Aga Khan University Hospital Hospital, Karachi
,
Umm Hani Abdullah
0   Department of Neurosurgery, Aga Khan University Hospital Hospital, Karachi
,
Daniyal Khan
3   Medical College, Aga Khan University Hospital, Karachi
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Objective: The aim of this study was to analyze the clinical profiles and outcomes of pediatric brainstem gliomas treated at our institute. Methodology: We reviewed the files of 18 pediatric age group patients diagnosed with brainstem glioma at our institution. The following variables were recorded: age, sex, duration of symptoms, date of diagnosis, main clinical symptoms, Karnofsky performance status score, magnetic resonance imaging findings, histopathology findings, details of the treatment given, disease progression, and date of mortality/last follow-up. This data were then transferred to SPSS version 23 which was used for further analysis. Results: The mean age of our cohort was 8.6 years (range 3–15). There were 11 (61.1%) males and 7 (38.9%) females. There were 16 (88.9%) patients with diffuse intrinsic pontine gliomas (DIPGs), 1 (5.6%) patients with exophytic medullary gliomas, and 1 (5.6%) patient with midbrain/tectal glioma. Mean overall survival (OS) was 9.7 months. Mean progression-free survival (PFS) was 6.3 months. All patients with DIPG eventually passed away from their disease. Patients with DIPG who received radiotherapy had a longer OS and PFS than those who did not (9.8 and 6 months vs. 3.4 and 2.4 months). Diagnostic latency >1 month was found to have a statistically significant longer progression-free interval. Conclusion: DIPGs in the pediatric population have a poor prognosis. Radiotherapy serves to increase survival time but is not curative.

Key-words:

Pediatric brainstem gliomas - radiotherapy - survival

Financial support and sponsorship

Nil.




Publication History

Article published online:
09 September 2022

© 2019. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Green AL, Kieran MW. Pediatric brainstem gliomas: New understanding leads to potential new treatments for two very different tumors. Curr Oncol Rep 2015;17:436.
  • 2 Upadhyaya SA, Koschmann C, Muraszko K, Venneti S, Garton HJ, Hamstra DA, et al. Brainstem low-grade gliomas in children-excellent outcomes with multimodality therapy. J Child Neurol 2017;32:194-203.
  • 3 Grimm SA, Chamberlain MC. Brainstem glioma: A review. Curr Neurol Neurosci Rep 2013;13:346.
  • 4 Hu X, Fang Y, Hui X, Jv Y, You C. Radiotherapy for diffuse brainstem glioma in children and young adults. Cochrane Database Syst Rev 2016;6:CD010439.
  • 5 Oka H, Utsuki S, Tanizaki Y, Hagiwara H, Miyajima Y, Sato K, et al. Clinicopathological features of human brainstem gliomas. Brain Tumor Pathol 2013;30:1-7.
  • 6 Ramos A, Hilario A, Lagares A, Salvador E, Perez-Nuñez A, Sepulveda J. Brainstem gliomas. Semin Ultrasound CT MR 2013;34:104-12.
  • 7 Sun T, Wan W, Wu Z, Zhang J, Zhang L. Clinical outcomes and natural history of pediatric brainstem tumors: With 33 cases follow-ups. Neurosurg Rev 2013;36:311-9.
  • 8 Hassan H, Pinches A, Picton SV, Phillips RS. Survival rates and prognostic predictors of high grade brain stem gliomas in childhood: A systematic review and meta-analysis. J Neurooncol 2017;135:13-20.
  • 9 Puget S, Beccaria K, Blauwblomme T, Roujeau T, James S, Grill J, et al. Biopsy in a series of 130 pediatric diffuse intrinsic pontine gliomas. Childs Nerv Syst 2015;31:1773-80.
  • 10 Hundsberger T, Tonder M, Hottinger A, Brügge D, Roelcke U, Putora PM, et al. Clinical management and outcome of histologically verified adult brainstem gliomas in Switzerland: A retrospective analysis of 21 patients. J Neurooncol 2014;118:321-8.
  • 11 Reithmeier T, Kuzeawu A, Hentschel B, Loeffler M, Trippel M, Nikkhah G. Retrospective analysis of 104 histologically proven adult brainstem gliomas: Clinical symptoms, therapeutic approaches and prognostic factors. BMC Cancer 2014;14:115.
  • 12 Babu R, Kranz PG, Karikari IO, Friedman AH, Adamson C. Clinical characteristics and treatment of malignant brainstem gliomas in elderly patients. J Clin Neurosci 2013;20:1382-6.
  • 13 Lachi PK, Irrakula M, Ahmed SF, Joseph D, Pamidighantam S, Jagannath Rao Naidu KV. Clinical profile and outcomes in brainstem glioma: An institutional experience. Asian J Neurosurg 2015;10:298-302.
  • 14 Irfan A, Qureshi A. Intracranial space occupying lesions – Review of 386 cases. J Pak Med Assoc 1995;45:319-20.
  • 15 Hanif G, Shafqat S. Morphological pattern and frequency of intracranial tumours in children. J Coll Physicians Surg Pak 2004;14:150-2.
  • 16 Ali M, Ullah W, Jamal B, Alam I, Hussain N. Frequency and pattern of primary pediatric brain tumours: A retrospective study in neurosurgery unit, lady reading hospital Peshawar, Pakistan. KMUJ 2016;8:131-3.
  • 17 Shah SH, Soomro IN, Hussainy AS, Hassan SH. Clinico-morphological pattern of intracranial tumors in children. J Pak Med Assoc 1999;49:63-5.
  • 18 Mathew RK, Rutka JT. Diffuse intrinsic pontine glioma: Clinical features, molecular genetics, and novel targeted therapeutics. J Korean Neurosurg Soc 2018;61:343-51.
  • 19 Vallero SG, Bertin D, Basso ME, Pittana LS, Mussano A, Fagioli F. Diffuse intrinsic pontine glioma in children and adolescents: A single-center experience. Childs Nerv Syst 2014;30:1061-6.
  • 20 Vanan MI, Eisenstat DD. DIPG in children – What can we learn from the past? Front Oncol 2015;5:237.
  • 21 Lundar T, Due-Tønnessen BJ, Egge A, Scheie D, Brandal P, Stensvold E, et al. Neurosurgical treatment of pediatric low-grade midbrain tumors: A single consecutive institutional series of 15 patients. J Neurosurg Pediatr 2014;14:598-603.