High Grade Gliomas

Abstract

INTRODUCTION: High grade gliomas (HGG) represent approximately 10% of all pediatric central nervous system (CNS) tumors. Despite a variety of therapies, outcomes remain dismal. In contrast to adults with HGG, there is no apparent standard of care (SOC) for the treatment of children with HGG after surgery. We undertook an internet-based survey to better understand what the perceived SOC is for children. 3 years with newly diagnosed HGG. METHODS: An 8 question internet-based survey was e-mailed to 120 physicians who treat children with CNS tumors. Demographic data, including medical specialty, experience and institutional affiliations were collected. Respondents were asked what they consider as SOC for children with newly diagnosed HGG after a maximal surgical resection. RESULTS: The entire survey was completed by 62.5% (75/120) of respondents. 83% (62/75) identified themselves as pediatric oncologists/neuro-oncologists. The remaining were pediatric neurosurgeons, radiation oncologists and neurologists. 65% had .10 years' experience and approximately 84% worked in a large academic or cancer center. More than 70% answered that their affiliated institution sees more than 5 pediatric HGG patients each year. The most commonly answered SOC was to treat patients on any available Phase I or II clinical trial (26.7%). In the absence of a clinical trial, physicians most commonly answered that they personally would treat a newly diagnosed patient with focal radiation plus temozolomide followed by maintenance temozolomide (30.7%).