Prognostic Factors in Patients Diagnosed with High Grade Glioma Managed with Radiotherapy: Experience at the Federico Gómez Children's Hospital of Mexico

Abstract

Introduction: High-grade gliomas account for 15-20% of intracranial tumors in the pediatric population, usually with poor prognosis for overall survival. Objective: To identify prognostic factors for overall survival and local control in patients diagnosed with intracranial high-grade gliomas managed with conformal radiotherapy. Patients and methodology: This retrospective study assessed all high-grade glioma-diagnosed patients treated with radiotherapy at the Federico Gómez Children's Hospital over the period [2008][2009][2010][2011][2012][2013] by means of a review of medical records, imaging files, and treatment plans. Results: The analyzed patients (n = 18) had a median age of five years. The most common localization was infratentorial. Histologies found were glioblastoma multiforme and anaplastic astrocytoma. Of the analyzed patients, 44.4% received surgical management owing to the lesion localization and their performance status. All patients received radiotherapy with > 54 Gy total dose with or without chemotherapy. Local control rate was 94.4% and median overall survival was 13 months. With regard to surgical management for gross tumor resection, subtotal tumor resection, and no resection, five-year overall survival was 100, 50, and 36%, respectively (p = 0.04). The patients showed overall survival improvement with radiotherapy total dose > 54 Gy and standard fractioning. Conclusion: In the present study, surgical gross resection and management with standard external beam radiotherapy at doses > 54 Gy were found to be predictive factors for overall survival in pediatric patients diagnosed with intracranial highgrade gliomas. (creativecommons.org/licenses/by-nc-nd/4.0/).