Clinical Outcomes of Radiation Therapy for Brain Stem Glioma

IF 6.4 1区医学 Q1 ONCOLOGY

International Journal of Radiation Oncology Biology Physics Pub Date : 2025-02-03 DOI:10.1016/j.ijrobp.2024.11.059

K. Pyone , T. Tun , L. Myint , T. Hnin , A. Khaing

{"title":"Clinical Outcomes of Radiation Therapy for Brain Stem Glioma","authors":"K. Pyone , T. Tun , L. Myint , T. Hnin , A. Khaing","doi":"10.1016/j.ijrobp.2024.11.059","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>Brain Stem Gliomas are up to 20% of all brain tumors in children and unusual in adults. Radiotherapy is mainstay of treatment. Surgery for brain stem glioma is difficult because of anatomical location. This study was performed to evaluate the clinical outcomes of radiotherapy in brain stem glioma.</div></div><div><h3>Methods</h3><div>Retrospective analysis of brain stem glioma patients treated with radiation therapy (54 Gy/ 30 fractions of IMRT or 3D CRT) with or without surgery or chemotherapy or other agents in Yangon General Hospital, Myanmar.</div></div><div><h3>Results</h3><div>Twenty-four patients (median age 11.8 years) were treated between 2016 and 2020. Male to female ratio was 2:3. Surgical approach (Biopsy and partial removal) was done in 16 patients. Histology revealed that anaplastic ependymoma in 2 patients, low-grade astrocytoma in 2 patients, anaplastic astrocytoma in 8 patients, glioblastoma in 4 patients and remaining 8 patients had no histological diagnosis. Radiotherapy (dose-54Gy/ 30 fractions) was given with the technique of IMRT or 3D CRT. At the time of follow-up, 8 patients had local recurrence, 10 patients died of due to disease and recurrence, 14 patients were alive. Among alive patients, 2 patients were treated with chemotherapy and 12 patients with temozolomide for 12 cycles. Patients who received temozolomide got improvement in performance status and reduced clinical symptoms; among them, 6 patients had more than 50% objective tumor response in radiological findings for follow-up 3-6 months after radiotherapy. The 3-years overall survival (OS) rate was 58.3% and 3 years Event-free Survival (EFS) rate was 50%. The medium survival time was 14 months. There is no Grade 3 or greater acute and late toxicities.</div></div><div><h3>Conclusion</h3><div>As the LMIC country with limited resources, our results of radiotherapy followed by temozolomide in brain stem gliomas have optimal outcomes. However, prospective studies of this select group of patients with larger number and longer follow-up is required.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Pages e16-e17"},"PeriodicalIF":6.4000,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Radiation Oncology Biology Physics","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0360301624036332","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives

Brain Stem Gliomas are up to 20% of all brain tumors in children and unusual in adults. Radiotherapy is mainstay of treatment. Surgery for brain stem glioma is difficult because of anatomical location. This study was performed to evaluate the clinical outcomes of radiotherapy in brain stem glioma.

Methods

Retrospective analysis of brain stem glioma patients treated with radiation therapy (54 Gy/ 30 fractions of IMRT or 3D CRT) with or without surgery or chemotherapy or other agents in Yangon General Hospital, Myanmar.

Results

Twenty-four patients (median age 11.8 years) were treated between 2016 and 2020. Male to female ratio was 2:3. Surgical approach (Biopsy and partial removal) was done in 16 patients. Histology revealed that anaplastic ependymoma in 2 patients, low-grade astrocytoma in 2 patients, anaplastic astrocytoma in 8 patients, glioblastoma in 4 patients and remaining 8 patients had no histological diagnosis. Radiotherapy (dose-54Gy/ 30 fractions) was given with the technique of IMRT or 3D CRT. At the time of follow-up, 8 patients had local recurrence, 10 patients died of due to disease and recurrence, 14 patients were alive. Among alive patients, 2 patients were treated with chemotherapy and 12 patients with temozolomide for 12 cycles. Patients who received temozolomide got improvement in performance status and reduced clinical symptoms; among them, 6 patients had more than 50% objective tumor response in radiological findings for follow-up 3-6 months after radiotherapy. The 3-years overall survival (OS) rate was 58.3% and 3 years Event-free Survival (EFS) rate was 50%. The medium survival time was 14 months. There is no Grade 3 or greater acute and late toxicities.

Conclusion

As the LMIC country with limited resources, our results of radiotherapy followed by temozolomide in brain stem gliomas have optimal outcomes. However, prospective studies of this select group of patients with larger number and longer follow-up is required.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

International Journal of Radiation Oncology Biology Physics 医学-核医学

CiteScore

11.00

自引率

7.10%

发文量

2538

审稿时长

6.6 weeks

期刊介绍： International Journal of Radiation Oncology • Biology • Physics (IJROBP), known in the field as the Red Journal, publishes original laboratory and clinical investigations related to radiation oncology, radiation biology, medical physics, and both education and health policy as it relates to the field. This journal has a particular interest in original contributions of the following types: prospective clinical trials, outcomes research, and large database interrogation. In addition, it seeks reports of high-impact innovations in single or combined modality treatment, tumor sensitization, normal tissue protection (including both precision avoidance and pharmacologic means), brachytherapy, particle irradiation, and cancer imaging. Technical advances related to dosimetry and conformal radiation treatment planning are of interest, as are basic science studies investigating tumor physiology and the molecular biology underlying cancer and normal tissue radiation response.