The results of radiotherapy for brainstem tumors

Objective: This analysis was performed to examine the outcome of adult and pediatric patients with brainstem tumors. Methods and materials: Forty pati ents with brainstem glioma were evaluated retrospectively. Included were 24 females and 16 males ranging in age from 3 to 81. years (median, 29.5 year s). These patients were treated with various combinations of surgery, chemo therapy, and radiotherapy (RT). The length of follow-up in survivors ranged from 0.6 to 20 years (median: 3.2 years, mean: 6 years). Survival rates we re calculated with the Kaplan Meier method and differences between survival curves were calculated using the log-rank test. Results: The overall 2 and 5-year survival rates were 44% and 34%,respectively. The median survival t ime was 19 months. The 5-year survival rate was 54% for patients with tumor s outside the pens compared to 21% for those with tumors involving the pens (p = 0.04). The 5-year survival rate was 59% for patients with exophytic t umors as compared to 23% for those with intrinsic tumors (p = 0.05). Patien ts undergoing subtotal resection had a 5-year survival rate of 53% compared to 28% for those having only a biopsy or no surgical intervention (p = 0.0 4). None of the other potential prognostic or treatment related factors eva luated [patient age, tumor grade, tumor histology, radiotherapy parameters (including BID fractionation, 3-D treatment planning, or the use of doses > 55 Gy), or the administration of adjuvant chemotherapy] evaluated were ass ociated with patient survival. Conclusions: Brainstem gliomas generally occ ur in younger individuals. The survival rates were better for patients with exophytic tumors, those involving sites other than the pens, and tumors am enable to subtotal resection. Improvements in the outcome of patients with brainstem gliomas will require new therapeutic approaches.