BRAIN-TUMORS IN CHILDREN - LONG-TERM SURVIVAL AFTER RADIATION TREATMENT

Purpose: To determine the cause of death in children who survive more than 5 years after radiation treatment of a brain tumor. Methods and M aterial: Nine hundred and twelve consecutive children with a primary b rain tumor irradiated at the Princess Margaret Hospital or Toronto-Bay view Regional Cancer Center from 1958 to 1991, were evaluated for long -term outcome. Results: Overall 10- and 20-year survival rates were 44 % and 37%. Subsequent survival of 377 5-year survivors was, at an addi tional 10 and 20 years, 78% and 67%. Most (83%) deaths that occurred m ore than 5 years from diagnosis were a result of relapse of the origin al tumor. The 10-year survival rate subsequent to relapse was 9% when the first relapse occurred less than one year from diagnosis, 17% for 1-2 years, and 31% when the time to relapse was 3 years or greater. Th e cumulative actuarial incidence of, and death from, second malignant tumors at 30 years from diagnosis was 18% and 13%, respectively. Concl usions: Death later than 5 years from diagnosis of a brain tumor in ch ildren is common and is usually due to progressive disease in slowly e volving low grade tumors. Death from a second malignant tumor becomes more frequent than death from the original tumor after 15 years from d iagnosis.