EPI-05: CHILDREN WITH MEDULLOBLASTOMA AND HIGH-GRADE GLIOMA: RACIAL/ETHNIC AND SOCIOECONOMIC DISPARITIES IN SURVIVAL OUTCOME

BACKGROUND: Disparities within pediatric neuro-oncology outcomes are not well studied. We examined racial/ethnic differences in survival outcomes for pediatric medulloblastoma and high-grade glioma, and how they are affected by neighborhood socioeconomic characteristics. METHODS: We collected data on all California children (age ≤ 19 years) with a first diagnosis of high-grade glioma or medulloblastoma between 1988 and 2012. Primary outcome measure was overall survival (OS). Cox regression covariates included gender, age, surgery, radiation, and chemotherapy status, race/ethnicity, neighborhood socioeconomic status (SES), insurance status, and treatment at NCI cancer center. RESULTS: 238 medulloblastoma patients and 371 high-grade glioma (279 non-brainstem, 92 brainstem) patients were identified. Using Cox regression analysis, medulloblastoma patients with public health insurance had worse outcome (public/medicaid vs private: hazard ratio [HR] = 1.55; 95% confidence interval [CI] = 1.10 to 2.17). Hispanic non-brainstem high-grade glioma patients had worse outcome (Hispanic vs white: HR = 1.55; 95% CI = 1.14 to 2.10). Non-Hispanic black and Asian/Pacific Islander brainstem high-grade glioma patients had worse outcome than their white counterparts (HR = 2.50; 95% CI = 1.07 to 5.85 and HR = 2.71; 95% CI = 1.15 to 6.37 respectively). CONCLUSIONS: Our population-based studies are the first to examine racial/ethnic differences in survival for pediatric medulloblastoma and high-grade glioma while adjusting for socioeconomic and neighborhood characteristics. Alarmingly, medulloblastoma patients with public health insurance fared worse regardless of treatment and demographics. Racial disparities were found for pediatric high-grade glioma even after adjusting for socioeconomic factors. Future research needs to uncover remediable reasons.