Stereotactic Radiotherapy Effective for Low-Grade Gliomas in Children Laurie Barclay, MD Oct. 21, 2003 — Stereotactic radiotherapy is effective for the treatment of low-grade gliomas in children, according to study results presented at the American Society for Therapeutic Radiology and Oncology (ASTRO) annual meeting in Salt Lake City, Utah. "This study demonstrates that stereotactic radiotherapy, a highly conformal type of radiation therapy treating minimal normal brain tissue (we used very tight margins around the tumor) is effective for children with low-grade glial tumors who need radiotherapy, as they have not been successfully treated with either surgery or chemotherapy," lead author Karen J. Marcus, MD, told Medscape. Dr. Marcus is an assistant professor of radiation oncology in pediatrics at the Dana-Farber Cancer Institute in Boston, Massachusetts. From 1992 to 1998, 81 children with progression despite chemotherapy and surgery received stereotactic radiotherapy. Most children had low-grade gliomas: 50 had low-grade astrocytoma, 23 had residual or recurrent craniopharyngioma, four had posterior fossa ependymoma, and four had other histologies. Most children did not require anesthesia for this noninvasive procedure. The authors have collected neurocognitive data on these children and intend to present these findings separately. Of the 50 patients with low-grade astrocytoma, there were 26 boys and 24 girls. Median age was nine years (range, 2-26 years). Five years after treatment, 82% of children had no tumor recurrence, and survival rate was 98%. At eight years, survival was 82%, and 35% had some recurrence, mostly outside the radiation field. Most of the drop-off in survival was due to distant progression. Two of the patients with local progression had histologic evidence of progression to anaplastic astrocytoma three and seven years after radiotherapy. Five patients with primary tumors of the optic system or hypothalamus developed central nervous system dissemination one to 7.4 years after radiation therapy. "There were events after five years, emphasizing the importance of continued follow-up," Dr. Marcus said. "We also show that tumors of the hypothalamic area do have the propensity for dissemination throughout the central nervous system, and this could be an area of future research to explore the biology of these tumors." This study was supported by Dana-Farber with no outside funding, and none of the authors have any pertinent financial disclosures. ASTRO 45th Annual Meeting: Abstract 120. Presented Oct. 21, 2003. Thanks to Medscape.com Childs Nerv Syst 10/06 Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.