LGG-15. REQUIREMENT OF ADJUVANT TREATMENT IN CHILDHOOD LOW GRADE GLIOMAS (LGG) OF THE SPINAL CORD: EXPERIENCES FROM THE GERMAN LGG STUDY GROUP. Issue 2 (22nd June 2018)

• Record Type: Journal Article
• Authors: Perwein, Thomas; Benesch, Martin; Kandels, Daniela; Pietsch, Torsten; Timmermann, Beate; Bison, Brigitte; Warmuth-Metz, Monika; Gnekow, Astrid Katharina
• Is Part Of: Neuro-oncology. Volume 20:Issue 2(2018)supplement 2
• Page Start: i107
• Page End: i107
• Publication Date: 2018-06-22
• Subjects: Brain Neoplasms -- Periodicals; Brain -- Tumors -- Periodicals; Brain -- Cancer -- Periodicals; Nervous system -- Cancer -- Periodicals; 616.99481
• DOI: 10.1093/neuonc/noy059.357
• Languages: English
• ISSNs: 1522-8517

Abstract

Abstract: PURPOSE: To evaluate the risk of progression and the proportion of patients with childhood spinal cord LGG requiring multiple treatments. METHODS: Clinical data-sets of 117 pediatric patients (male, n=74; median age 8 [range, 0.7-16.2] years) registered in the prospective multicenter trials HIT-LGG-1996 (n=36), SIOP-LGG-2004 (n=56) and the subsequent LGG-Interim registry (n=25) were analyzed (median follow-up 6.6 years). RESULTS: 107 patients were observed following complete (n=22) or partial resection (n=73), biopsy (n=20), or radiologic diagnosis only (n=2). 10 patients received initial chemotherapy (n=8) or irradiation (n=2). 60 of 107 initially observed patients (56%) developed radiological/clinical progressive disease. Median time to progression was 7 months (range, 0.1-11 years) after diagnosis. 10-year event-free survival (EFS) of the entire cohort was 33.5 ± 5.5%. Overall, 43 patients underwent 2-4 surgical interventions and 42 patients (36%) required adjuvant treatment (chemotherapy, n=21; radiotherapy, n=11; multimodal treatment, n=10). 10-year PFS after chemo- and radiotherapy was 37.7 ± 9.7% and 59.5 ± 16.2%, respectively. Disease control (median, 5.1 years) was achieved in 70 patients (67%) after one (n=52) or repeated (n=18) resections, in 12/21 after chemotherapy, 11/11 after irradiation and 5/10 patients with multimodal treatment. 10-year overall survival (OS) was 92.7 ± 2.8%. Patients with dissemination (n=16) had inferior OS and EFS, while age ≥11 years and complete resection were favorable factors for EFS. CONCLUSIONS: The majority of children with spinal LGG experience progressive disease, even after years, and more than a third require repeated resections and/or adjuvant treatment. Despite frequent progression following adjuvant chemo-/radiotherapy, long-term disease control is achieved even in cases with multiple progressions.