RT-32 CLINICAL PROFILE AND OUTCOMES IN BRAINSTEM GLIOMA. AN INSTITUTIONAL EXPERIENCE

BACKGROUND AND PURPOSE: The aim of our retrospective study was to analyze the clinical outcomes of brain stem glioma treated with radiation therapy (RT) in our institution. MATERIAL AND METHODS: Records of 48 patients with brainstem glioma treated between January 2007 and January 2013 were reviewed. Demographic variables, clinical variables, radiological findings and treatment details with respect to age, sex, location of tumor ( pontine Vs non pontine ), signs and symptoms, RT dose, follow up period and outcomes were recorded. Patients were subdivided into two groups based on their age, age = 15 yrs (group II). RESULTS: The median age at diagnosis was 10 years (range 4-50). Male to female ratio was 11:10. Of the 48 cases analyzed, 27 patients (56%) were in group I and 21 (44%) were in group II. At initial presentation 62% had features of raised intracranial tension, 71% had cranial nerve defects and 57% had cerebellar signs. Radiologically, 90.5% had involvement of pons. 10 (21%) patients received RT dose >60 Gy and 38 (79 %) patients received RT dose of 54-60 Gy. Median overall survival was 7months (range 3 - 44 months). The median age at diagnosis for group I and II was 6.5 and 32 years respectively. At initial presentation, 67% in group I and 56% patients in group II had features of raised intracranial tension, 67% in group I and 78% in group II had cranial nerve defects, 83% patients group I and 100% group II had involvement of pons. Median overall survival in group I and group II was 4 months and 10 months respectively (p = 0.042). CONCLUSIONS: Brain stem glioma in pediatric age group is associated with worse outcomes than in adults.