Long-term outcome of centrally located low-grade glioma in children

Keita Terashima, Kevin Chow, Jeremy Jones, Charlotte Ahern, Eunji Jo, Benjamin Ellezam, Arnold C. Paulino, M. Fatih Okcu, Jack Su, Adekunle Adesina, Anita Mahajan, Robert Dauser, William Whitehead, Ching Lau, Murali Chintagumpala

Research output: Contribution to journalArticle

24 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)2630-2638
Number of pages9
JournalCancer
Volume119
Issue number14
DOIs
StatePublished - Jul 15 2013

Keywords

  • BRAF-KIAA1549 fusion protein
  • chemotherapy
  • childhood cerebral astrocytoma
  • childhood optic nerve glioma
  • hypothalamic-chiasmatic neoplasms
  • long-term effects
  • pilocytic astrocytoma
  • radiotherapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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