Supratentorial malignant gliomas of childhood

Results of treatment with radiation therapy and chemotherapy

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✓ Twenty-seven patients aged 1 to 18 years harboring supratentorial (20 in the cerebrum and seven in the thalamus) malignant gliomas were treated between 1975 and 1982. There were four glioblastomas multiforme, 14 anaplastic astrocytomas, and nine malignant gliomas. All patients had a subtotal resection or biopsy as the initial procedure and received postoperative radiation therapy (RT). Fifteen of 27 patients were treated by RT alone; 14 had tumor progression with a median time to tumor progression (MTP) of 65 weeks. Twelve patients were treated with chemotherapy as an adjuvant to RT; only seven had tumor recurrence, with an MTP of 130 weeks. Of the 21 patients with recurrent tumors in both groups, 18 were treated with chemotherapy alone, or chemotherapy with a second surgical procedure or second course of RT.

For all histological grades of tumor, the MTP for first recurrence was 75 weeks and the median survival time was 180 weeks. Age at initial diagnosis was found to be a statistically significant prognostic factor, with patients younger than 10 years of age surviving longer than patients aged over 10 years (p = 0.02).

Article Information

Address reprint requests to: Michael S. B. Edwards, M.D., c/o The Editorial Office, Department of Neurological Surgery, 350 Parnassus Avenue, Suite 807, San Francisco, California 94117.

© AANS, except where prohibited by US copyright law.

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Figures

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    Kaplan-Meier representation of the probability of freedom from initial tumor progression between the radiation therapy (RT) group and the adjuvant chemotherapy group. The numbers in parentheses are the censored patients who have not failed/total patients in the group.

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    Kaplan-Meier representation of the probability of freedom from initial tumor recurrence and survival for the total 27 patients in this study. The numbers in parentheses are the censored patients who have not failed/total patients in the study.

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    Scattergram demonstration of the relationship between age at diagnosis of supratentorial glioma and survival time.

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