Author/Authors :
Nair Manjusha نويسنده Division of Pediatric Oncology, Regional Cancer Centre, Trivandrum, India , Raghavan Rajeev Kavalakara نويسنده Department of Radiotherapy, Regional Cancer Centre, Trivandrum, India , Parukkutty Kusumakumary نويسنده Division of Pediatric Oncology, Regional Cancer Centre, Trivandrum, India , Prahladan Anil نويسنده Department of Imageology, Regional Cancer Centre, Trivandrum, India , Mathews Anita نويسنده Division of Pathology, Regional Cancer Centre, Trivandrum, India
Abstract :
Background: Treatment of childhood brain tumours requires coordinated efforts
by multiple specialities - neurosurgery, neuroradiology, neuropathology, oncology,
and radiotherapy. The outcome is worse in developing countries compared to
developed countries because of deficiencies in proper registry, failure of timely
diagnosis, lack of availability and co-ordination of multiple specialists required for
comprehensive management and high abandonment rates.
Method: The pediatric neuro-oncology program was initiated in collaboration with
the neighbouring neurosurgery institution as a step towards improving care for
pediatric brain tumor patients in our hospital. Epidemiology, treatment and followup
of brain tumours in children aged 1-14 years attending the pediatric oncology
department were studied. Patients received multimodality treatment with surgery,
radiotherapy and chemotherapy by specialists in both centres. The study period
was from January 2008 to December 2012.
Results: There were 375 pediatric brain tumour patients during the study period.
166 patients (44.2%) had supratentorial tumors and 209 (55.73%) had infratentorial
tumors. 42.6% of tumours were high-grade and 53.6% were low grade. The
commonest histopathological tumour type was astrocytoma (48.8%) followed by
medullobastoma (24.5%). 287 (76.5%) patients underwent surgery, 216 (57.6%)
patients received radiotherapy, 97 (25.8%) patients received chemotherapy and 94
(25%) required follow-up only. Patient follow-up rates improved from 37.2% to 82.6%
and treatment abandonment decreased from 35.8% to 14.8% over these years.
Conclusions: Impact of the pediatric neuro-oncology program in our hospital has
made it possible to provide comprehensive multidisciplinary treatment in a co-ordinated
manner, describe the epidemiology of pediatric brain tumors, reduce treatment
abandonment, and improve the follow-up of pediatric brain tumour patients.
