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. 2018 Apr;7(4):1151-1159.
doi: 10.1002/cam4.1404. Epub 2018 Mar 13.

National cancer database analysis of outcomes in pediatric glioblastoma

Meng Liu  1   2 , Jigisha P Thakkar  3 , Catherine R Garcia  2 , Therese A Dolecek  4 , Lars M Wagner  2   5   6 , Emily Van Meter Dressler  7 , John L Villano  2   3   6   8
Affiliations

National cancer database analysis of outcomes in pediatric glioblastoma

Meng Liu et al. Cancer Med. 2018 Apr.

Abstract

Glioblastoma in children is an aggressive disease with no defined standard therapy. We evaluated hospital-based demographic and survival patterns obtained through the National Cancer Database to better characterize children with glioblastoma. Our study identified 1173 patients from 0 to 19 years of age between 1998 and 2011. Comparisons were made among demographics, clinical characteristics, treatment, and survival variables. Fifty-four percent of patients were over 10 years of age. Approximately 80% of patients underwent either partial or complete resection. Adjuvant therapy was used variably, and its use increased with patient age. Forty-eight percent of patients received the combination of surgery, radiation, and chemotherapy, and 4% did not receive any treatment. As expected, patients ≤5 years of age had better 5-year survival than those ages 6-10 (P = 0.01) or 11-19 years (P = 0.0077). Other factors associated with poor survival included black race and central tumor location. Better outcomes were associated with treatment that included surgery, radiotherapy, and chemotherapy compared to any other treatment combinations. Radiotherapy had no impact on survival in the 0 to 10-year-old age group, but was associated with improved survival for patients 11-19 years. We report an extensive demographic and survival analysis of pediatric glioblastoma. The observed differences likely reflect variances in tumor biology and likelihood of treatment receipt. Improved survival was associated with the use of surgery, radiotherapy, and chemotherapy. Radiation therapy was not associated with survival in patients younger than 10 years of age.

Keywords: Outcomes; pediatric glioblastoma; survival; treatment.

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Figures

Figure 1
Figure 1
Receipt of treatment combination in different pediatric age groups from NCDB, 1998–2011. X‐axis: percentage of pediatric glioblastoma cases from NCDB, 1998–2011. Y‐axis: different treatment combinations received. Abbreviations: RT, radiation; CT, Chemotherapy.
Figure 2
Figure 2
Kaplan–Meier survival by years of diagnosis 1998–2001 and 2002–2006. X‐axis: time in years. Y‐axis: survival probability.
Figure 3
Figure 3
Kaplan–Meier survival by receipt of treatment in pediatric glioblastoma from 1998 to 2006. X‐axis: time in years. Y‐axis: survival probability. Abbreviations: RT, radiation; CT, chemotherapy; S, surgery.
Figure 4
Figure 4
Kaplan–Meier survival in patients receiving radiation in the 0 to 5‐, 5 to 10‐, and 11 to 19‐year‐old age groups from 1998 to 2006. X‐axis: time in years. Y‐axis: survival probability. (A) Kaplan–Meier survival in all pediatric patients receiving radiation. (B) Kaplan–Meier survival in the 0 to 5‐year‐old age group. (C) Kaplan–Meier survival in the 6 to 10‐year‐old age group. (D) Kaplan–Meier survival in the 11 to 19‐year‐old age group.
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