LMI-15: BRAINSTEM GLIOMAS IN CHILDREN AT SRINAGARIND HOSPITAL

The incidence of brainstem gliomas in children represents ∼ 15% of central nervous system tumors. Despite aggressive chemotherapy or radiation the 5-year survival rate ranges between 20-30%. The study is to review then determine prognostic factors for brainstem gliomas. All children diagnosed with brainstem gliomas confirmed by magnetic resonance imaging of the brain at a university hospital in northeastern Thailand between January 2002 and December 2011. 43 cases (M;F ratio= 1.5:1; mean age 7.3 ± 3.4 years) were reviewed. The mean duration of symptoms prior to diagnosis was 1.4 ±1.6 months. The most common initial presentation was gait disturbance, followed by headache and weakness respectively. The most common neurological finding was long tract sign, followed by facial palsy. The most common location was the pons (42/43) and with a diffuse pattern (38/43). Tissue from diagnosis was obtained from 6 patients; pilocystic astrocytoma (1), diffuse astrocytoma (2), anaplastic astrocytoma (2) and glioblastoma multiforme (1). Thirty-seven patients received treatment including cranial irradiation (complete (67%); incomplete 33%), surgery (19) (VP shunt insertion (16), tumor biopsy (6)), and chemotherapy (5). Outcomes of treatment were death (88%) and survived (12%). The median survival time was 6 months and the 5-year survival rate was 10.5%. Progression free survival is 2 months. None of the prognostic factors was significant associated with outcome, including: size, age, duration of symptom, character, pathology, location, or treatment. The outcome of brainstem gliomas remains disappointing despite adequate treatment. The mean survival time and 5-year survival are similar to previous reports.