Brainstem Low-Grade Gliomas in Children-Excellent Outcomes With Multimodality Therapy

作者：Upadhyaya Santhosh A^*; Koschmann Carl; Muraszko Karin; Venneti Sriram; Garton Hugh J; Hamstra Daniel A; Maher Cormac O; Betz Bryan L; Brown Noah A; Wahl Daniel; Weigelin Helmut C; DuRoss Kathleen E; Leonard Annette S; Robertson Patricia L

来源：Journal of Child Neurology, 2017, 32(2): 194-203.

DOI：10.1177/0883073816675547

• brainstem tumors
• low-grade glioma
• progressive tumors
• chemotherapy
• overall survival

Safe maximal surgical resection is the initial treatment of choice for pediatric brainstem low-grade gliomas. Optimal therapy for incompletely resected tumors or that progress after surgery is uncertain. We reviewed the clinical characteristics, therapy, and outcomes of all children with nontectal brainstem low-grade gliomas treated at the University of Michigan between 1993 and 2013. Median age at diagnosis was 6 years; histology was confirmed in 23 of 25 tumors, 64% were pilocytic astrocytoma. Nineteen patients underwent initial tumor resection; 14/19 received no upfront adjuvant therapy. Eight patients in the study had progressive disease; 5 initially resected tumors received chemotherapy at tumor relapse, all with partial or complete radiographic responses. Ten-year progression-free survival is 71% and overall survival, 100%. This single-institution retrospective study demonstrates excellent survival rates for children with brainstem low-grade gliomas. The efficacy of the well-tolerated chemotherapy in this series supports its role in the treatment of unresectable or progressive brainstem low-grade gliomas.

• 出版日期2017-2