Contemporary management of adult and pediatric brain stem gliomas. 1993

M J Guiney, and J G Smith, and P Hughes, and C Yang, and K Narayan
Department of Radiation Oncology, Peter MacCallum Cancer Institute, Melbourne, Australia.

The aim of this study was to analyze the survival of a series of patients diagnosed as having brain stem tumors by computerized tomography scan, magnetic resonance imaging and/or biopsy and treated with megavoltage irradiation. Fifty-three patients presenting to the Peter MacCallum Cancer Institute with a diagnosis of brain stem tumor from January 1980 to July 1989 were reviewed. There were 32 pediatric (age < or = 16) and 21 adult patients. The median age at presentation was 12 years (range 2-73 years). Eighteen patients had biopsy proof of glioma, the rest were diagnosed on the basis of CT and/or MRI appearance. Eighty-seven percent of patients received 44-55 Gy in 1.67-2.25 Gy fractions to the brain stem. Seventy-seven percent of patients showed improvement following treatment, 6% were stable, 11% progressed, and 6% were not evaluable. The estimated median survival from presentation for all patients was 34 months with 49% surviving at 3 years. The estimated median time to progression was 19 months with 34% not progressed at 3 years. There was no significant survival difference between patients with biopsy-proven glioma and those patients where the diagnosis was made radiologically. Survival was not significantly affected by age-group or sex. Patients with symptoms for more than 9 months prior to presentation had significantly longer survival than those with shorter duration of symptoms (p = 0.002). This paper presents the survival of patients with brain stem tumors diagnosed and treated by contemporary radiological and radiotherapeutic techniques.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011882 Radiotherapy, High-Energy Radiotherapy using high-energy (megavolt or higher) ionizing radiation. Types of radiation include gamma rays, produced by a radioisotope within a teletherapy unit; x-rays, electrons, protons, alpha particles (helium ions) and heavy charged ions, produced by particle acceleration; and neutrons and pi-mesons (pions), produced as secondary particles following bombardment of a target with a primary particle. Megavolt Radiotherapy,High-Energy Radiotherapy,Radiotherapy, Megavolt,High Energy Radiotherapy,Radiotherapy, High Energy
D001932 Brain Neoplasms Neoplasms of the intracranial components of the central nervous system, including the cerebral hemispheres, basal ganglia, hypothalamus, thalamus, brain stem, and cerebellum. Brain neoplasms are subdivided into primary (originating from brain tissue) and secondary (i.e., metastatic) forms. Primary neoplasms are subdivided into benign and malignant forms. In general, brain tumors may also be classified by age of onset, histologic type, or presenting location in the brain. Brain Cancer,Brain Metastases,Brain Tumors,Cancer of Brain,Malignant Primary Brain Tumors,Neoplasms, Intracranial,Benign Neoplasms, Brain,Brain Neoplasm, Primary,Brain Neoplasms, Benign,Brain Neoplasms, Malignant,Brain Neoplasms, Malignant, Primary,Brain Neoplasms, Primary Malignant,Brain Tumor, Primary,Brain Tumor, Recurrent,Cancer of the Brain,Intracranial Neoplasms,Malignant Neoplasms, Brain,Malignant Primary Brain Neoplasms,Neoplasms, Brain,Neoplasms, Brain, Benign,Neoplasms, Brain, Malignant,Neoplasms, Brain, Primary,Primary Brain Neoplasms,Primary Malignant Brain Neoplasms,Primary Malignant Brain Tumors,Benign Brain Neoplasm,Benign Brain Neoplasms,Benign Neoplasm, Brain,Brain Benign Neoplasm,Brain Benign Neoplasms,Brain Cancers,Brain Malignant Neoplasm,Brain Malignant Neoplasms,Brain Metastase,Brain Neoplasm,Brain Neoplasm, Benign,Brain Neoplasm, Malignant,Brain Neoplasms, Primary,Brain Tumor,Brain Tumors, Recurrent,Cancer, Brain,Intracranial Neoplasm,Malignant Brain Neoplasm,Malignant Brain Neoplasms,Malignant Neoplasm, Brain,Neoplasm, Brain,Neoplasm, Intracranial,Primary Brain Neoplasm,Primary Brain Tumor,Primary Brain Tumors,Recurrent Brain Tumor,Recurrent Brain Tumors,Tumor, Brain
D001933 Brain Stem The part of the brain that connects the CEREBRAL HEMISPHERES with the SPINAL CORD. It consists of the MESENCEPHALON; PONS; and MEDULLA OBLONGATA. Brainstem,Truncus Cerebri,Brain Stems,Brainstems,Cerebri, Truncus,Cerebrus, Truncus,Truncus Cerebrus
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D005260 Female Females
D005910 Glioma Benign and malignant central nervous system neoplasms derived from glial cells (i.e., astrocytes, oligodendrocytes, and ependymocytes). Astrocytes may give rise to astrocytomas (ASTROCYTOMA) or glioblastoma multiforme (see GLIOBLASTOMA). Oligodendrocytes give rise to oligodendrogliomas (OLIGODENDROGLIOMA) and ependymocytes may undergo transformation to become EPENDYMOMA; CHOROID PLEXUS NEOPLASMS; or colloid cysts of the third ventricle. (From Escourolle et al., Manual of Basic Neuropathology, 2nd ed, p21) Glial Cell Tumors,Malignant Glioma,Mixed Glioma,Glial Cell Tumor,Glioma, Malignant,Glioma, Mixed,Gliomas,Gliomas, Malignant,Gliomas, Mixed,Malignant Gliomas,Mixed Gliomas,Tumor, Glial Cell,Tumors, Glial Cell
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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