Building a Neuro-Oncology Program and Epidemiological Profiling of Pediatric Brain Tumors in a Tertiary Cancer Care Center in India (original) (raw)
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The management of pediatric brain tumors in a tertiary center
Medical oncology and tumor pharmacotherapy, 1992
Between January 1982 and January 1990, 120 newly diagnosed pediatric patients were treated at The Chaim Sheba Medical Center. Sixty three (52.5%) tumors arose in the posterior fossa and 57 (47.5%) appeared supratentorially. A wide variety of histologic subtypes was seen, each requiring tumor-specific treatment. The modern imaging techniques-CT and MRI-offered better planning of operation, treatment and follow up. All children with highly malignant tumors were treated with combination chemotherapy besides the 'conventional radiotherapy'. Since 1987 the "eight in one day" protocol has been used extensively pre- and post-irradiation. Five-year survival, varied significantly according to tumor type, location and stage. The average delay from presentation of symptoms to diagnosis was 6 months. A multidisciplinary approach has been used in the treatment, rehabilitation and follow-up of these children. In this study, the results of treatment are presented and the role of ...
Treatment of CNS neoplasms in childhood by the pediatric oncology group
Brain and Development, 1989
The incidence of brain tumors in children under 15 years of age in the United States is 2.4/100,000. Based upon a US population of approximately 60 million black and white children, there are only 1,200-1,500 newly diagnosed cases of CNS neoplasia diagnosed in children each year in the US. These relatively small numbers, the large geographic dispersion, and the multitude of histologic types, make it unlikely that all but a few medical centers can develop a large experience with this diverse group of tumors. The Brain Tumor Committee (BTC) of the Pediatric Oncology Group was formed, in part, to address this problem. Each of the four goals of the BTC will be addressed separately. A justification for the rationale for each goal is given, following which there is a discussion of how each goal is being met.
Diagnosis and Treatment of Pediatric Brain Tumors
Acta medica academica, 2020
OBJECTIVE Tumors of the brain and spine make up about 20% of all childhood cancers; they are the second most common form of childhood cancer after leukemia. Brain tumors are the most common solid tumor in children. Symptoms depend on a variety of factors, including location of the tumor, age of child, and rate of tumor growth. The aim of study was to present our experience with the diagnosis and treatment of brain tumors in children. PATIENTS AND METHODS The aim of this study is to analyze clinicopathological characteristics, treatments, complications, and outcomes in children with brain tumors. This study is a retrospective analysis of 27 consecutive patients younger than 16 years and hospitalized for surgical treatment of brain tumors. Intracranial hypertension, neurological status, radiological computerized tomography (CT) or magnetic resonance imaging (MRI) findings, tumor localization, type of resection, hydrocephalus treatment, histopathology, complications, and outcome were a...
Profile and management of pediatric brain tumors: A single-center experience
Journal of Pharmacy & Pharmacognosy Research, 2021
Context: Pediatric brain tumors are the most common solid tumors and the leading cause of death among children worldwide. Although there are some published studies from many countries regarding the pathological model of pediatric brain tumors, comprehensive clinical pathology studies conducted at Vietnam are still lacking. Aims: To explore the clinical and histopathological features of pediatric brain tumors at a central hospital in Vietnam. Methods: This study used a retrospective epidemiological approach. Children aged <17 years were selected according to their profiles registered in our department during 2016-2020 when they were diagnosed with primary brain tumors. Data of patients' age, sex, clinical features, and histology were collected. The 2016 World Health Organization classification of tumors was adopted. Results: A total of 34 patients with brain tumors were identified, with a males/females ratio of 2.8/1. Patients’ age ranged from 3 months to 16 years, with a median age of 6 years. The most common presentation of brain tumor in our series was headache (47.1%). According to the location of involvement, 51.5% of the tumors were in supratentorial region. Moreover, astrocytes (55.9%) were the most common type of pediatric brain tumors. Surgery was the main treatment, and chemotherapy was administered to 14.7% of patients. Conclusions: This study addresses the issue of sensitivity but not that of specificity of clinical features to the presence of an underlying brain tumor. Histopathology analysis is necessary to develop further treatment after neurosurgery.
Intracranial tumors in children: a 10-year review from a single tertiary health-care center
Child's Nervous System, 2019
Objective Brain tumors are the second most common pediatric malignancy and the most common cause of cancer-related mortality and morbidities. Major advances in terms of surgery, radiation, and chemotherapy have led to better outcomes in developed countries. Delayed diagnosis, advanced disease at presentation, late referrals, nosocomial infections, delays to radiotherapy, and poor support services are the major reasons for poorer outcomes in developing countries. Little is known about the profile of brain tumors in Pakistan. This study aims to evaluate the epidemiology, management, and clinical outcomes of children with brain tumors in Pakistan in a single tertiary care center. Methods/materials All children (0-16 years) with primary CNS tumors from 2004 to 2014 at Aga Khan University Hospital were reviewed retrospectively for clinical data, demographics, radiological findings, management, and outcome. Results One hundred seventy-five children were included in the study. Male to female ratio was 1.4:1. Most of the patients were in 5-10 years age group (38.9%). Most common presenting complains were headache 115 (65.7%) and vomiting 100 (57.1%). Predominant site was infratentorial 93 (53%). Glial tumors were 105 (60%) followed by embryonal 40(22.9%), craniopharyngiomas 25 (14.3%), and germ cell 1 (0.6%). Astrocytomas (25.7%) were the most common glial tumors while medulloblastoma (15.4%) was the most common embryonal tumor. Majority of the patients underwent surgical resection (78.8%). Radiation was given to 47 (26.8%) patients. A half of the patients, 89 (50%), were lost to follow-up. Forty-two (24%) patients expired, 20 (11.4%) are alive with residual disease while 15 patients (8.5%) were cured with no evidence of recurrence and regular follow-ups. Conclusion This is the only study from Pakistan showing demographics of the childhood brain tumors. Significant improvement needs to be made for timely diagnosis, early referrals, and collaborated team efforts with multidisciplinary tumor board to improve outcome.
National Journal of Medical Research, 2020
Background: Pediatric brain tumours are the most common solid tumours in children and comprise approximately 20-25% of all pediatric malignancies worldwide. Aims: There is no data about the epidemiological profile of primary brain tumours in pediatric age group from the North-East India. The main aim of the study was to assess the epidemiological profile of pediatric brain tumours in children of the North-Eastern region of India and their patterns of care. Materials and Methods: In this analysis, data regarding age, sex, community, site of the tumour, clinical features, histology, geographical distribution and treatment delivered were collected from hospital cancer registry. Results: A total of 115 cases of pediatric primary brain tumours from age 0-18 years from 2012-2017 were identified and included in this study. According to this study, males (61.7%) slightly outnumbered females (38.3%) with a male: female ratio of 1.61:1 and incidence was most common in the 6-12 years age group. When divided according to anatomical site, primary brain tumours were found to be most common in cerebellum (44.35%) followed by cerebrum (36.26%). Infratentorial tumours (53%) were more than supratentorial tumours (47%). Histologically, the most common variety was found to be Medulloblastoma (34.8%) followed by Astocytomas (26.95%). Patients were mostly seen to belong to Middle Assam region (38.2%). Among the communities, Hindus (61.74%) were most commonly found to have primary pediatric brain tumours. Around 96% of the patients were offered to take radiotherapy out of which only 67% took radiotherapy, 2.6% defaulted treatment(drop outs) and 27% didn’t turn up for treatment. 4.35% of the patients took other modalities of treatment. Conclusion: Multimodality management including surgery, radiotherapy and chemotherapy remains the cornerstone in the management of pediatric brain tumours.
Pediatric brain tumor care in a Sub-Saharan setting: current poise of a precariously loaded dice
British Journal of Neurosurgery, 2020
Objective: To evaluate the current status of pediatric brain tumor (PBT) care and identify determinants and profiles of survival and school attendance Methods: An 8-year institution-based prospective longitudinal study. All cases investigated with neuroimaging and treated were enrolled. Data was analyzed with SPSS (Inc) Chicago IL, USA version 23. Chi Square test, One-way ANOVA and confidence limits were used to evaluate associations at the 95% level of significance. Ethical approval for our study was obtained Health Research Ethics Committee of our hospital. Results: Among 103 patients enrolled, 92 satisfied our study criteria. There were 45 males and 39 females, M: F ¼ 0.8. The mean age was 9.5 ± 2.1 years 95%CI with a range of 7 months to 16 years. The most common symptom was headache for supratentorial lesions (73%) and gait disturbance (80.2%) for infratentorial lesions. More tumors were supratentorial in location 51 (55.4%), 35 (38.1%) were infratentorial and 6 (6.5%) were transtentorial. Craniopharyngiomas (n ¼ 23), medulloblastomas (n ¼ 22) and astrocytomas (n ¼ 15) were the most common tumors. Hemoglobin genotype (AA and AS) had some influence on tumor phenotype FT, P ¼ 0.033. 76 cases were microsurgically resected while 16 patients were treated with radiotherapy alone. The 30-day mortality for operated cases is 7.2 ± 0.7%. Overall 1-year and 5-year survival was 66.7 and 52.3%, respectively. School attendance, performance and outcome varied among treatment subgroups. Conclusion: Survival profile in this series suggests some improvement in comparison to previous studies from our region, Hemoglobin genotype profiles may signature paediatric brain tumor phenotypes in our setting.
Changes in the Approach to Central Nervous System Tumors in Childhood
Pediatric Clinics of North America, 1992
The number of children who survive brain tumors has increased over the past 20 years because of advances in surgery, radiation, and possibly chemotherapy. Previously, minimal concern existed about possible adverse effects of these types of therapies because the number of long-term survivors was so limited. Today, 50% of children with all types of brain tumors may be expected to survive 5 years. The goals of neuro-oncology have broadened to include not only improved survival rates but also improved quality of life. In this article, we discuss both of these areas: (1) changes in therapy that have impacted survival rates and (2) changes in therapy as a consequence of complications of treatment. CHANGES IN THERAPY THAT HAVE IMPACTED ON SURVIVAL RATES Two tumors in which changes in therapy have impacted on survival rates are medulloblastomas and brain-stem gliomas. Perhaps the most remarkable improvement in survival has been in those children with medulloblastomas. Medulloblastomas Medulloblastomas represent 20% to 30% of all childhood brain tumors. Survival rates of children with these tumors have changed dramatically over the last 60 years. In 1930, Cushing reported that 1 of 61 children operated for
PLOS ONE, 2021
ObjectiveThis study aimed to evaluate the characteristics of children with primary brain tumors, the effectiveness of treatment modalities, and to detect factors related to the outcome.MethodsA detailed analysis was performed on a series of 173 pediatric patients treated in a Serbian referral oncology institution between 2007 and 2016, based on their clinical, histological, treatment, and follow-up data.ResultsMean survival time of all children was 94.5months. 2-, 5- and 10-year overall survival probabilities were 68.8%, 59.4%, and 52.8%, respectively. Patients with supratentorial tumors had longer survival than patients with infratentorial tumors and patients with tumors in both compartments (p = 0.011). Children with the unknown histopathology (brainstem glioma) and high-grade glioma had a shorter life than embryonal tumors, ependymoma, and low-grade glioma (p<0.001). Survival of the children who underwent gross total resection was longer than the children in whom lesser degree...
The results of treatment of primary brain tumors in children
Acta chirurgica iugoslavica, 2012
During the period of 2009-2011 in UCH in Belgrade, we treated 22 patients with brain tumors. Treatment included the diagnosis and therapy that included surgery and postoperative neuroradiological follow-up of all patients regardless of whether radiotherapy was conducted with or without chemotherapy. The most frequent were low grade astrocytomas and medulloblastomas. Patients with supratentorial localization of tumor had significantly smaller neurological sequelae compared with patients with infratentorial as well as patients diagnosed with low grade astrocytomas of any localization. From 10 patients with supratentorial localization,7 of them had no neurological deficit, while from 11 patients with infratentorial localization, 3 of them were without deficit. Patients with histological diagnosis of low grade astrocytoma of any localization had less neurological deficits compared with other tumors. From 7 low grade astrocytoma in 5 of them there was no neurological deficit, while only ...