Jul 1, 1985

Pediatric brain stem tumors: patterns of treatment failure and their implications for radiotherapy

International Journal of Radiation Oncology, Biology, Physics
E C Halperin

Abstract

There have been conflicting opinions regarding the correct volume to be used in radiotherapy fields for brain stem tumors of childhood. Whereas many clinicians recommend limited fields designed to cover the tumor volume with a margin, some have advocated whole brain radiotherapy. Using our clinical experience at Duke University Medical Center, we have made an attempt to determine the proper irradiation volume in this group of tumors. We have evaluated 38 patients with brain stem tumors in children less than 18 years of age. The most common presenting symptoms were headache, ataxia, and hemiparesis. Thirteen patients had a histologic diagnosis made prior to treatment or post-mortem. All had either an anaplastic astrocytoma or a glioblastoma multiforme. Tumors were located in the thalamus, hypothalamus, or midbrain in 9 patients and in the pons or medulla oblongata in the remaining 29 patients. All patients received a course of radiotherapy. The mean minimum tumor dose was 52.6 +/- 5 Gy given at 1.7 to 2.0 Gy/fraction. Twenty-three patients received radiation to a limited field and 14 received whole brain irradiation. In one patient, the field size could not be ascertained. The five year survival of the total group was 39%. The s...Continue Reading

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Citations

Mentioned in this Paper

Glioblastoma Multiforme
Neoplasm Recurrence, Local
Ataxia as Late Effect of Cerebrovascular Disease
Entire Medulla Oblongata
Mixed Oligoastrocytoma
Anaplastic Astrocytoma
Neoplasms
Entire Midbrain
Pontine Structure
Recurrence (Disease Attribute)

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