LMI-12: CLINICAL PROFILE, MANAGEMENT AND OUTCOME OF PEDIATRIC BRAIN TUMOR IN A TERTIARY CARE ONCOLOGY CENTER IN NEPAL: REPORT FROM A DEVELOPING COUNTRY

OBJECTIVE: Multi disciplinary pediatric neuro-oncology is still in nascent stage in developing countries. This study was done to determine clinico-pathological profile and treatment of pediatric brain tumor patients treated in a tertiary oncology center in Nepal. METHODS: A retrospective review of all cases treated in our unit from 2011-2014 was done. We report clinical-pathological status and treatment of patients treated in our center after conformal radiotherapy was initiated. RESULTS: Twenty-four patients were identified and treated at BPKMCH. Median age at diagnosis was 9 years (4-17years) and sex distribution was male 18(75%) and female 6(25%). Site was supratentorial in 8(33%) and infratentorial in 15(33%) patients. Medulloblastoma was most common tumor histology in 6(25%) patients followed by brainstem glioma in 5(21%),ependymoma in 4(16%), glioblastoma-2,craniopharyngioma-2 and others 5 .Two patients refused further treatment after diagnosis while 4 patients had incomplete treatment (no adjuvant treatment after surgery). All patients with medulloblastoma underwent surgery and cranio-spinal radiotherapy using CT scan based 3D conformal technique. Four of those patients received adjuvant chemotherapy. Brainstem glioma patients were treated with primary radiotherapy without surgery/biopsy. Other histology underwent surgery and post operative radiotherapy with 3D conformal radiotherapy technique. Ten patients are in follow up since 12.6 to 30.3 months. CONCLUSION: Providing multi disciplinary pediatric brain tumor service is a difficult task in resource-poor setting. High morbidity and incomplete treatment rate (25%) with our present treatment calls for improvement in management including better supportive care for better adherence to treatment.