TY - JOUR
T1 - Management of pediatric intracranial low-grade gliomas
T2 - long-term follow-up after radiation therapy
AU - Huynh-Le, Minh Phuong
AU - Walker, Amanda J.
AU - Burger, Peter C.
AU - Jallo, George I.
AU - Cohen, Kenneth J.
AU - Wharam, Moody D.
AU - Terezakis, Stephanie A.
N1 - Publisher Copyright:
© 2016, Springer-Verlag Berlin Heidelberg.
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Introduction: The treatment of pediatric intracranial low-grade gliomas (LGG) generally begins with maximal safe resection. Radiation therapy (RT) and chemotherapy are typically reserved for patients with incomplete resection and/or disease progression. We report long-term treatment outcomes and toxicities in a cohort of pediatric patients with LGG after RT. Methods: Thirty-four patients <21 years old with intracranial LGG who were treated with RT at the Johns Hopkins Hospital were included in this retrospective analysis. Patients were evaluated for overall survival (OS), progression-free survival (PFS), recurrence patterns, and treatment toxicities using descriptive statistics, Kaplan-Meier curves, and Cox proportional hazard regressions. Results: The mean age at diagnosis was 7.9 years (range 1.2–18.3 years) and mean age at RT was 9.8 years (range 3.0–28.9 years). The median follow-up time was 9.8 years after radiation (range 0.8–33.3 years). The estimated 10-year OS and PFS after RT were 92 and 74 %, respectively. Twelve patients had disease progression after RT, and all recurrences were local. Two patients died due to disease progression 2.3 and 9.1 years after RT. One patient had malignant transformation of LGG to high-grade glioma. No significant predictors of PFS were identified on uni- or multivariate analysis. Late effects of LGG and treatment seen were endocrine deficiencies in 16 patients, visual problems in 10 patients, hearing loss in 4 patients, special education requirements for 5 patients, and a vascular injury/demyelination secondary to RT in 1 patient. Conclusion: Our study suggests that the use of radiation in patients with intracranial LGG results in excellent OS and PFS with acceptable toxicity at long-term follow-up.
AB - Introduction: The treatment of pediatric intracranial low-grade gliomas (LGG) generally begins with maximal safe resection. Radiation therapy (RT) and chemotherapy are typically reserved for patients with incomplete resection and/or disease progression. We report long-term treatment outcomes and toxicities in a cohort of pediatric patients with LGG after RT. Methods: Thirty-four patients <21 years old with intracranial LGG who were treated with RT at the Johns Hopkins Hospital were included in this retrospective analysis. Patients were evaluated for overall survival (OS), progression-free survival (PFS), recurrence patterns, and treatment toxicities using descriptive statistics, Kaplan-Meier curves, and Cox proportional hazard regressions. Results: The mean age at diagnosis was 7.9 years (range 1.2–18.3 years) and mean age at RT was 9.8 years (range 3.0–28.9 years). The median follow-up time was 9.8 years after radiation (range 0.8–33.3 years). The estimated 10-year OS and PFS after RT were 92 and 74 %, respectively. Twelve patients had disease progression after RT, and all recurrences were local. Two patients died due to disease progression 2.3 and 9.1 years after RT. One patient had malignant transformation of LGG to high-grade glioma. No significant predictors of PFS were identified on uni- or multivariate analysis. Late effects of LGG and treatment seen were endocrine deficiencies in 16 patients, visual problems in 10 patients, hearing loss in 4 patients, special education requirements for 5 patients, and a vascular injury/demyelination secondary to RT in 1 patient. Conclusion: Our study suggests that the use of radiation in patients with intracranial LGG results in excellent OS and PFS with acceptable toxicity at long-term follow-up.
KW - Low-grade gliomas
KW - Pediatrics
KW - Radiation therapy
KW - Surgery
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U2 - 10.1007/s00381-016-3100-8
DO - 10.1007/s00381-016-3100-8
M3 - Article
C2 - 27179530
AN - SCOPUS:84968593824
SN - 0256-7040
VL - 32
SP - 1425
EP - 1430
JO - Child's Nervous System
JF - Child's Nervous System
IS - 8
ER -