P11.04 A single center experience in pediatric high grade gliomas (a retrospective observational study)

Abstract

Abstract Introduction: Pediatric high grade glioma is an uncommon type of Pediatric central nervous system (CNS) tumors as it represents only 8-12 % of these tumors. These tumors still represent challenges in their treatment. Survival rates are higher in Pediatric tumors than in adults, which can be partially explained by more chemotherapy protocols or difference in the tumor biology. In 2005 the introduction of temozolamide change the way of practice in treatment of these tumors in adult patients. But no data was available for Pediatric tumors at that time. The use of temozolamide in pediatric gliomas has different results in studies and still it is not a standard of care in pediatric patients. Materials and Methods: We perform a retrospective analysis for Pediatric high grade glioma patients. We collect all data of Patients aged less than 18 years old having high grade glioma, from the period of 2010-2016 in Assuit university, and Comparing the results of patients received temozolamide with radiotherapy and adjuvant temozolamide to patients received radiotherapy alone or with other lines of chemotherapy and we analyze prognostic factors and results of the treatment. Results: 22 Patients with high grade glioma was found from the period of 2010 till 2016, and were surgically operated at Assiut university hospital, and was diagnosed pathologically as glioblastoma multiform. The median age was 9 years (range 3.5-17). The male-to-female ratio was 2:1. 16 patients have near total resection and 6 of them have only biopsy. All the patients received radiation therapy 6000 CGy over 30 setting for 6 weeks.10 patients received temozolamide concomitant with radiotherapy followed by adjuvant temozolamide and 2 patients received radiotherapy alone and the remaining 10 patients received cisplatin, vepside and vencristine as adjuvant treatment after radiotherapy. At 3 years median progression free survival (PFS) to all patients was 11.91 months (95% CI 9.35-14.46) and overall survival (OS) was 17.55 months (95% CI 14.15 -20.94). The patients receiving Temozolamide had better PFS 15.40 months (95% CI 12.48-18.32) and OS 21.20 months (95% CI 18.09-24.31) than the other patients receiving other adjuvant treatment were their PFS 9 months (95% CI 5.55- 12.45) and OS 14.50 months (95% CI 9.02-19.98). Subtotal resection of the tumor and temozolamide treatment was found to be a statistically significant prognostic factor in both univariate and multivariate analysis (P value<0.05).Conclusions: High grade glioma is an aggressive uncommon pediatric tumor. In our analysis optimal surgical resection and use temozolamide were found to be significant prognostic factors. Further prospective studies and more patients number are needed to confirm these results.