Pediatric glioblastoma treatment and clinical outcome: An institutional experience.

Abstract

e12513 Background: Pediatric glioblastoma is an aggressive and rare tumor of childhood. It differs from adult glioblastoma both in clinical presentation as well as molecular characteristics. Additionally, unlike adult glioblastoma, management is not standardized. We intended to study the clinical characteristics along with outcome of pediatric glioblastoma patients treated with adjuvant chemoradiation. Methods: We retrospectively evaluated 27 patients with a histopathologic diagnosis of intracranial glioblastoma, treated at our department in the period May 2003 to March 2009. Demographic and disease characteristics in this patient cohort were recorded, and their outcome with adjuvant therapy was analyzed. Results: Median age at presentation was 12 years, (range 7-21 years), with a male: female ratio of 5.25. Most common tumor location was cerebral hemispheres (frontal-8; temporal-7; parietal-7; thalamus-1). Extent of surgery varied from gross total excision (14) to partial excision (13). The chief complaint was seizures in 25.9%. All patients received adjuvant radiotherapy (60 Gray over 6 weeks). 74% patients received concurrent chemotherapy with radiation (temozolomide (75 mg/m2) = 16, carboplatin (AUC 2) = 2, paclitaxel (75 mg/m2) = 2, and 59% patients received post-radiation chemotherapy (temozolomide 150-200 mg/m2 D1-5 q4 weeks for 6 cycles). Median follow up duration was 10 months (range 3-36 months) overall and 11 months (range 6-36 months) for those who received adjuvant temozolomide. At last follow up, 7 patients were disease-free. Eleven patients progressed on therapy, median time to progression being 9 months (range 3-29 months). There were no grade 3/4 adverse events. Conclusions: Pediatric glioblastoma is a rare but aggressive disease. Our study had a median follow-up of 10 months. Concurrent chemoradiation incorporating temozolomide followed by post-radiation temozolomide is a feasible option in pediatric age group as well, with a possibility of better outcomes with standardized therapy and longer follow-up. No significant financial relationships to disclose.