Treatment burden and long-term health deficits of patients with low-grade gliomas or glioneuronal tumors diagnosed during the first year of life

被引:22
作者
Liu, Anthony P. Y. [1 ]
Hastings, Camden [2 ]
Wu, Shengjie [3 ]
Bass, Johnnie K. [4 ]
Heitzer, Andrew M. [5 ]
Ashford, Jason [5 ]
Vestal, Robert [6 ]
Hoehn, Mary E. [6 ,7 ]
Ghazwani, Yahya [1 ]
Acharya, Sahaja [8 ]
Conklin, Heather M. [5 ]
Boop, Frederick [7 ,9 ,10 ,11 ]
Merchant, Thomas E. [8 ]
Gajjar, Amar [1 ]
Qaddoumi, Ibrahim [1 ]
机构
[1] St Jude Childrens Res Hosp, Dept Oncol, 262 Danny Thomas Pl,MS 260, Memphis, TN 38105 USA
[2] St Jude Childrens Res Hosp, Pediat Oncol Educ Program, Memphis, TN 38105 USA
[3] St Jude Childrens Res Hosp, Dept Biostat, Memphis, TN 38105 USA
[4] St Jude Childrens Res Hosp, Rehabil Serv, Memphis, TN 38105 USA
[5] St Jude Childrens Res Hosp, Dept Psychol, Memphis, TN 38105 USA
[6] Univ Tennessee, Hlth Sci Ctr, Dept Ophthalmol, Memphis, TN USA
[7] St Jude Childrens Res Hosp, Dept Surg, Memphis, TN 38105 USA
[8] St Jude Childrens Res Hosp, Dept Radiat Oncol, Memphis, TN 38105 USA
[9] Univ Tennessee, Hlth Sci Ctr, Dept Neurosurg, Memphis, TN USA
[10] Le Bonheur Childrens Hosp, Le Bonheur Neurosci Inst, Memphis, TN USA
[11] Semmes Murphey Clin, Memphis, TN USA
关键词
infant; low-grade glioma; morbidities; prognostic factors; treatment burden; CONFORMAL RADIATION-THERAPY; CENTRAL-NERVOUS-SYSTEM; OPTIC PATHWAY GLIOMA; BRAIN-TUMORS; CHILDHOOD-CANCER; ADULT SURVIVORS; NEUROCOGNITIVE STATUS; PEDIATRIC-PATIENTS; LESS-THAN; CHILDREN;
D O I
10.1002/cncr.31918
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BackgroundLow-grade gliomas (LGGs) and low-grade glioneuronal tumors (LGGNTs) diagnosed during the first year of life carry unique clinical characteristics and challenges in management. However, data on the treatment burden, outcomes, and morbidities are lacking. MethodsA retrospective study of LGGs and LGGNTs diagnosed in patients younger than 12 months at St. Jude Children's Research Hospital (1986-2015) was conducted. Results For the 51 patients (including 31 males), the mean age at diagnosis was 6.47 months (range, 0.17-11.76 months), and the mean follow-up period was 11.8 years (range, 0.21-29.19 years). Tumor locations were hypothalamic/optic pathway (61%), hemispheric (12%), brainstem (12%), cerebellar (8%), and spinal (8%). There were 41 patients with histological diagnoses: 28 had World Health Organization grade 1 tumors, 6 had grade 2 tumors, and 7 had an LGG/LGGNT not definitively graded. Forty-one patients required an active intervention at diagnosis. Throughout their treatment course, 41 patients eventually underwent tumor-directed surgeries (median, 2 surgeries; range, 1-6), 39 received chemotherapy (median, 2 regimens; range, 1-13), and 21 received radiotherapy. Forty patients experienced disease progression (median, 2 progressions; range, 1-18). Ten patients died of progression (n = 5), malignant transformation (n = 2), a second cancer (n = 2), or a shunt infection (n = 1). The 10-year overall survival, progression-free survival, and radiation-free survival rates were 85% +/- 5.3%, 16.9% +/- 5.3%, and 51.2% +/- 7.5%, respectively. Forty-nine patients experienced health deficits (eg, endocrinopathies, obesity, seizures, visual/hearing impairments, neurocognitive impairments, and cerebrovascular disease). Predictors of progression and toxicities were defined. Conclusions Infantile LGG/LGGNT is a chronic, progressive disease universally associated with long-term morbidities and requires multidisciplinary intervention.
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收藏
页码:1163 / 1175
页数:13
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