Selection of a management strategy for pediatric brainstem tumors

Journal Article · Sun Jan 01 00:00:00 EST 1989 · Med. Pediatr. Oncol.; (United States)

DOI:https://doi.org/10.1002/mpo.2950170209· OSTI ID:6025826

Halperin, E C; Wehn, S M; Scott, J W; Djang, W; Oakes, W J; Friedman, H S

Brainstem tumors arise in portions of the rhombencephalon and mesencephalon. Some authorities include diencephalic tumors in this group. We have reviewed our clinical experience of 69 children (less than 21 years of age) with brainstem tumors evaluated and treated at Duke University Medical Center (DUMC) from 1960 to 1986. There were 19 patients with group 1 tumors (thalamus, third ventricle region, or midbrain) and 50 with group II tumors (pons, medulla oblongata). The common presenting signs and symptoms were ataxia, headache, motor loss, and cranial nerve palsies. The most commonly employed diagnostic imaging studies were air examinations and CT. Preradiotherapy confirmation of malignancy was obtained in five group I patients (astrocytoma, 4; germinoma, 1) and 8 group II patients (astrocytoma, 3; anaplastic astrocytoma, 2; glioblastoma multiforme, 3). All patients received radiotherapy. The 5-year survival rate for the entire population was 40%. The survival rate for group I patients was significantly better than that observed for group II patients. In the 50 group II patients neither patient sex nor age nor presence of cranial nerve palsies nor pretreatment CT scan findings nor field size influenced survival. A long duration of symptoms positively influenced survival. The vast majority of tumor recurrences were within the radiation field. Half of the patients had either stable or improved Karnofsky status 6 months following completion of irradiation. The management strategy for childhood brainstem tumors is discussed.

• Research Organization: Duke Univ. Medical Center, Durham, NC (USA)
• OSTI ID: 6025826
• Journal Information: Med. Pediatr. Oncol.; (United States), Vol. 17:2
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BRAIN
NEOPLASMS
RADIOTHERAPY
BIOPSY
CHILDREN
COMPUTERIZED TOMOGRAPHY
DIAGNOSIS
PATIENTS
PROBABILITY
RADIATION DOSES
SURVIVAL CURVES
SYMPTOMS
AGE GROUPS
BODY
CENTRAL NERVOUS SYSTEM
DIAGNOSTIC TECHNIQUES
DISEASES
DOSES
MEDICINE
NERVOUS SYSTEM
NUCLEAR MEDICINE
ORGANS
RADIOLOGY
THERAPY
TOMOGRAPHY
550603* - Medicine- External Radiation in Therapy- (1980-)
550602 - Medicine- External Radiation in Diagnostics- (1980-)