QUALITY OF SURVIVAL AMONG CHILDREN TREATED FOR BRAIN-STEM GLIOMA

In order to describe the status of long-term survivors of brain stem g lioma, neuropsychological and behavioral measures were obtained a medi an of 2.5 (range 1.5-5.6) years after diagnosis from 16 survivors of 5 1 consecutively diagnosed children with brain stem glioma between 1983 and 1991. Among 11 children with dorsally exophytic tumors, 7 were tr eated with surgery alone (SRG) and 4 received conventionally fractiona ted local cranial radiation therapy (CFRT; 54-56 Gy) to the brain stem following surgery, 3 of these because of recurrent disease. Five othe rs with diffusely infiltrative brain stem tumors received hyperfractio nated radiation therapy (HFRT; 70.2 Gy) to the brain stem; 4 following biopsy or limited resection and 1 without prior surgery. IQs of child ren in the CFRT (mean 89, SD 24.4) and HFRT (mean 85, SD 12.7) groups were not significantly different. Children in the SRG group had signif icantly higher IQs (mean 100, SD 11.0) and fewer neurologic deficits t han those who had received CFRT or HFRT. However, after statistically controlling for severity of neurologic deficits, treatment had no effe ct on IQ. The severity of residual neurologic deficits accounted for 4 2% of the variance in IQ scores; children with fewer neurologic proble ms scored higher. Additional studies are required to evaluate the pote ntial neuropsychological benefits of equivalent total doses of HFRT co mpared to CFRT.