Glioblastoma in children:therapeutic experience from a single center

LI Juan; AI Ruyu; LAI Mingyao; HU Qingjun; SHAN Changguo; CAI Linbo

Abstract：Objective To explore novel approaches to clinical diagnosis and treatment of pediatric GBM by analyzing both clinicopathologic characteristics and treatment-related prognostic factors of pediatric GBM patients.Methods The clinical data of 31 pediatric GBM patients under 18 and admitted to the Oncology Department of Guangdong Sanjiu Neurology Hospital between November 2009 and December 2018 was collected.The clinicopathologic features of these patients were summarized and therapeutic efficacy was assessed.Results A total of 31 pediatric GBM patients under the age of 18 underwent surgery and postoperative chemoradiotherapy,whose age ranged from 0.8 to 18 years old,with the median age of 13.8 years old.There were 19 male and 12 female patients,so the male-to-female ratio was 1.6:1.According to the MRI T1+C phase evaluation of the extent of surgical resection,15 cases received gross total surgical resection,2 cases underwent near-total resection,10 cases experienced partial resection,and 4 cases had biopsies.Postoperatively,27 patients over 3 years old received postoperative radiotherapy,but 4 patients did not.Among the 31 patients,2 were lost to follow-up as of April 1st,2019.The follow-up lasted 4 to 80 months.Thirteen patients died while 16 were still alive.The longest survival time was 80 months while the median survival time was 16.4 months,with the 1-year and 2-year survival rates being 64%and 38%respectively.Analysis of prognostic factors showed that the median survival time of pediatric patients with a surgical resection degree≥90%was 18 months(95%CI:15.9-20 months),compared with 11 months(95%CI:9.9-12 months)for those with a survival resection degree<90%.The difference between the two groups was statistically significant(P=0.027).Multifactorial analysis indicated that the extent of tumor resection was the sole determinant of prognosis.Conclusion The survival rate of pediatric GBM patients remains extremely low.The prognosis of pediatric GBM patients who have undergone gross total or near-total resections is more favorable.