Table 2.
Surgery at diagnosis |
Extent of resection |
Age at diagnosis in years |
Tumor location | Histology | BRAF alteration | Neurologic deficits at presentation |
Hydrocephalus/ VP shunt |
Adjuvant therapy |
Progression/ PFS |
Salvage therapy |
Disease outcome |
Follow-up, (in years) |
Sequelae | Clinical outcome (compared with status at diagnosis) |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Yes, n = 22 | GTR = 4 | 6 | Cervicomedullary, DE | Ganglioglioma | Inadequate | - R hemiparesis - Ataxia |
No/no | None | No | – | NED | 11 | Right hemiparesis | No change |
16 | Pontomedullary, DE | PA | NA | - Ataxia | Yes/yes | None | No | – | NED | 3 | -Tracheostomy - Multiple cranial nerve palsy - Ataxia - G tube dependent |
Worse | ||
5 | Pontomedullary, DE | PA | Negative | - Dysphagia - FTT |
Yes/no | None | No | – | NED | 9 | None | Better | ||
1.8 | Medullary, DE | PA | Negative | - Abnormal tongue movements -FTT | Yes/no | None | No | – | NED | 12 | Hemiatrophy and fasciculation of tongue | Better | ||
NTR = 6 | 5 | Pontine, focal | PA | NA | - Right sensorineural hearing loss | No/no | None | Yes/3 mo | CT VCR/carboplatin |
NED | 2.5 | - U/L deafness - Right facial nerve paresis |
Worse | |
1.6 | Cervicomedullary, DE | PA | Inadequate | - Dysphagia -FTT - Quadriparesis |
Yes/no | None | Yes/4 mo | Resection + CT VCR/carboplatin |
NED | 18 | Central sleep apnea | Better | ||
0.8 | Cervicomedullary, DE | PA | Inadequate | - Torticollis - R sixth nerve palsy -RUE monoparesis |
No/no | None | No | – | SD | 10 | None | Better | ||
6 | Pontomedullary, DE | PA | Inadequate | - L sixth nerve palsy - L hearing loss - L seventh nerve palsy - L hemiparesis |
Yes/no | None | No | – | SD | 12 | - L seventh nerve palsy - L sensorineural hearing loss - L hemiparesis |
No change | ||
5.5 | Pontomedullary, DE | Ganglioglioma | KIAA1549- BRAF | - Dysphagia | No/no | None | No | – | SD | 6 | None | Better | ||
2 | Midbrain tegmentum | PA | KIAA 1549- BRAF | - L hemiparesis | No/no | None | Yes/4 mo | CT VCR/carboplatin |
NED | 1.6 | None | Better | ||
STR = 7 | 2 | Midbrain tegmentum, LE | PA | NA | - Dysphagia - Diplopia - Ataxia - FTT |
Yes/yes | None | Yes/15 mo | CT TPCV |
SD | 10.5 | - Dysphagia - Left hemiparesis |
Worse | |
STR = 7 | 16 | Cervicomedullary, DE | PA | Inadequate | - None | No/no | None | No | – | SD | 2 | None | No change | |
11 | Pontine, focal DE | PA | Negative | - None | Yes/no | None | Yes/16 y | Resection +RT | SD | 17 | None | No change | ||
4.25 | Cervicomedullary, DE | PA | NA | - Apnea - Ataxia - Dysphagia - Right hemiparesis |
No/no | None | Yes/6 mo | CT VCR/carboplatin |
SD | 14.5 | - Sleep apnea - Bulbar dysfunction - Right hemiparesis - Tracheostomy - G tube dependent |
Worse | ||
16 | Pontomedullary, DE | PA | Inadequate | None | Yes/no | RT | No | – | SD | 15 | Mild ataxia | Worse | ||
5 | Pontomedullary, LE | PA | KIAA 1549- BRAF | - None | Yes/no | CT TPCV |
No | – | NED | 2 | None | No change | ||
8 | Cervicomedullary, DE | Mixed OA | NA | - Obstructive sleep apnea - Stridor |
No/no | RT | No | – | SD | 8 | Obstructive sleep apnea | No change | ||
PR = 2 | 14 | Pontine, focal | Grade II Astro | Inadequate | - R seventh nerve palsy - B/L abductor palsy |
No/no | CT TMZ |
No | – | SD | 7 | - R seventh nerve palsy - B/L abductor palsy |
No change | |
0.3 | Pontomedullary, DE | Mixed OA | NA | - Dysphagia - FTT |
Yes/yes | CT VCR/carboplatin |
Yes/3 y | RT | SD | 13 | - Central sleep apnea - T racheostomy |
Worse | ||
Biopsy = 3 | 11 | Midbrain tegmentum, DE | Grade II Astro | NA | - Dysphagia - B/L ptosis - Ataxia - Dysarthria |
Yes/no | RT+CT TPCV |
No | – | SD | 6 | None | Better | |
13 | Midbrain tegmentum | PA | KIAA 1549- BRAF | - Ataxia - Right hemiparesis |
Yes/yes | RT | No | – | SD | 13 | Right hemiparesis | Better | ||
8 | Midbrain | Grade II Astro | NA | -Left hemiparesis | No/no | RT | No | – | SD | 4 | None | Better | ||
None, n = 3 | 11 | Medullary, DE | NA | - None | No/no | None | No | – | SD | 2 | None | No change | ||
14 | Midbrain tegmentum | PA | Inadequate | -Left hemiparesis - Right third nerve paresis | Yes/yes | RT+ 1 cycle CT VCR/carboplatin | Yes/3 mo after RT, during CT | Resection after failure of RT and CT | NED | 5.5 | - Left hemiparesis - Right third nerve paresis |
No change | ||
7 | Medullary, DE | NA | - Hyponasal speech | Yes/yes | RT | No | – | SD | 15 | Hyponasal speech | No change |
Abbreviations: CCNU, lomustine; CT, chemotherapy; DE, dorsally exophytic; FTT, failure to thrive; GTR, gross total resection; LE, laterally exophytic; NA, not available; NED, no evidence of disease; NTR, near total resection; OA, oligoastrocytoma; PA, pilocytic astrocytoma; PFS, progression-free survival; PR, partial resection; RT, radiotherapy; SD, stable disease; STR, subtotal resection; TMZ, temozolomide; TPCV, thioguanine, procarbazine, lomustine, vincristine