A Tale of Two Trachs: Implications of Tracheostomy in Two Patients with Diffuse Intrinsic Pontine Glioma

Mark, Melissa; Nee, Krista; Mushrif, Sujata

doi:10.1542/peds.141.1ma4.375

Cited by 1 publication

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“…There are controversial opinions regarding the use of tracheostomy to manage the airway in patients with DIPG. 41 As previously described, seven patients underwent tracheostomies as part of their The use of steroids as part of the initial treatment was documented in 40 patients, indicating that not all health centers use steroids as part of their treatment, as it has been documented that side effects can occur, and the health benefits and risks remain controversial. 42 The standard of care advocates for the use of radiotherapy, and not all health institutions have the required infrastructure, anesthesia, and ambulance included; however, 76 patients in our cohort underwent radiotherapy.…”

Section: Discussionmentioning

confidence: 87%

Diffuse intrinsic pontine gliomas: First registry effort in Mexico

Robles‐Castro,

Niembro‐Zúñiga,

Ortiz‐Azpilcueta

et al. 2023

Pediatric Blood & Cancer

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Introduction Brainstem tumors comprise 10.9% of all brain tumors, and pediatric diffuse intrinsic pontine gliomas (DIPG) have a fatal prognosis. Some countries have developed national and international register databases to characterize their populations to aid clinical and public policy decisions. This study provides information regarding the clinical characteristics of a retrospective cohort of children with DIPG in México from 2001 to 2021, and assesses the proposed prognostic factors previously described for survival outcome. Methods Health institutions from Mexico were invited to contribute to a retrospective electronic registry of patients with DIPG based on the International DIPG Registry. Fisher's exact test was used to compare long‐ and short‐term survivors. Overall survival was estimated using the Kaplan–Meier method. Differences between survival curves were evaluated using the log‐rank test and Cox proportional hazard regression analysis. Results Total 110 patients were included. The median age of the patients at diagnosis was 7 years. Sixty patients (54.5%) presented with symptoms in less than 6 months; the most frequent symptom was ataxia (56.4%). Ninety patients received treatment (81.8%), the overall survival at 4 years was 11.4%, and 16 patients (14.5%) were admitted for palliative end‐of‐life care. We found no significant survival differences for any of the prognostic factors. Conclusion This study highlights the need to develop strategies to standardize healthcare processes and enhance the quality of care to improve clinical diagnosis in Mexico. We also observed a barrier to the acceptance of palliative end‐of‐life care in the family and medical teams.

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Section: Discussionmentioning

confidence: 87%