Prognosis of pediatric high-grade gliomas with temozolomide treatment: a retrospective, multicenter study

Title
Prognosis of pediatric high-grade gliomas with temozolomide treatment: a retrospective, multicenter study
Author(s)
김성호정태영[정태영]김재영[김재영]김동석[김동석]나영신[나영신]백희조[백희조]최형수[최형수]김인아[김인아]
Keywords
GLIOBLASTOMA MULTIFORME; MALIGNANT ASTROCYTOMA; BRAIN-TUMORS; CHILDHOOD; CHILDREN; RESECTION; SURVIVAL; THERAPY; TRIAL
Issue Date
201207
Publisher
SPRINGER
Citation
CHILDS NERVOUS SYSTEM, v.28, no.7, pp.1033 - 1039
Abstract
We analyzed the usefulness of initial or recurrent treatment of temozolomide (TMZ) in pediatric high-grade gliomas (HGGs). Between 2002 and 2010, we performed surgery on 35 patients with 17 glioblastomas, 14 anaplastic astrocytomas, 3 anaplastic oligodendrogliomas, and 1 anaplastic oligoastrocytoma. The male-to-female ratio was 21:14, and the median age was 13 years (range, 3-18 years). The mean follow-up period was 15.9 (+/- 1.8) months. As the TMZ treatment, 22 patients received the initial treatment and 13 patients at recurrence. We analyzed the prognostic significance of TMZ treatment, tumor location, extent of removal, pathology, and recurrence pattern. The median progression-free survival (PFS) and overall survival (OS) were 9.7 (+/- 1.4) and 17.8 (+/- 2.5) months, respectively. Based on univariate analysis, the median PFS was 9.9 (+/- 1.6) months in the tumors located in the cerebral hemisphere and 5.6 (+/- 1.3) months in the diencephalon (p = 0.03). Median PFS was 12.5 (+/- 1.7) months in the initial treatment and 6.8 (+/- 0.8) months in the recurrent treatment (p = 0.03). The median OS was 14.9 (+/- 2.3) months in glioblastomas and 24.4 (+/- 4.1) months in tumors with an anaplastic pathology (p = 0.01). The median OS was 12.1 (+/- 3.7) months in patients with cerebrospinal fluid (CSF) dissemination and 18.2 (+/- 2.9) months in patients without CSF dissemination (p = 0.02). Grades 3 and 4 treatment-related toxicity occurred in 7.7-9 % of the patients. Initial or recurrent TMZ treatment in pediatric HGGs was safe and tolerable. Initial treatment showed improved PFS compared to recurrent treatment, and both showed similar OS.
URI
http://hdl.handle.net/YU.REPOSITORY/27639http://dx.doi.org/10.1007/s00381-012-1786-9
ISSN
0256-7040
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의과대학 > 신경외과학교실 > Articles
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