Neurological Surgery No Shinkei Geka Volume 19, Issue 2 (February 1991)

Evaluation of Radiation Therapy for Pediatric Brain Stem Glioma by Computed Tomography:CT findings and tumor response to radiotherapy Shichi MORI 1 , Ryuichi TANAKA 1 , Norio TAKEDA 1 , Seiichi YOSHIDA 1 1Department of Neuro-surgery, Brain Research Institute, Niigata University, Niigata, Japan Keyword: Brain stem glioma , Children , Radiotherapy , CT pp.129-135
Published Date 1991/2/10
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The effects of radiation therapy on 29 brain stem gliomas in childhood were evaluated by computed to-mography (CT). The patients received radiation of 2 Gy/day as a single fraction, 5 day a week with a total dose of 40 to 60 Gy. Initial CT findings of brain stem gliomas were divided into two types : diffuse and loca-lized. Of 29 children, 5 had localized and 24 had diffuse tumor. Histological diagnoses were available for 18 pa-tients, 4 with localized and 14 with diffuse tumor. All of the localized tumors were astrocytomas and diffuse tumors included 13 anaplastic gliomas (glioblastomas), 3 anaplastic astrocytomas, and one astrocytoma. Complete response or partial response to radiation therapy was observed on CT in 100% (5/5) of the localized tumors and 46% (11/13) of the diffuse tumors at the first evaluation.

Contrary to expectation, low-grade gliomas re-sponded much better to radiation therapy than high-grade gliomas. The response rates were 80% (4/5) in astrocytoma, 67% (2/3) in anaplastic astrocytoma, and 38% (5/13) in anaplastic glioma.

In the follow-up CT after radiation therapy, a de-layed effect was observed in only one of the 24 diffusetumors. Nine of 10 children who had a re-irradiation following the recurrence experienced very little benefit.

None of the patients with localized tumors have shown evidence of tumor progression or recurrence, and the quality of their life has been excellent. On the other hand, all of the patients with diffuse tumor died within 20 months after initial treatment.

The results of this study suggest that radiation ther-apy is beneficial for localized tumors but not for diffuse tumors, and new treatments need to be developed for diffuse tumors.

Copyright © 1991, Igaku-Shoin Ltd. All rights reserved.


Neurological Surgery 脳神経外科
19巻2号 (1991年2月)
電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院