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Background: The current study aimed to determine the overall survival (OS) rates of patients diagnosed with pediatric gliomas in Brazil, accounting for the influence of age, treatment modalities, and tumor site, using a population-based national database. Materials and methods: Patients diagnosed with pediatric gliomas of central nervous system (CNS) from 1999-2020 were identified from The Fundação Oncocentro de São Paulo public database. The Kaplan-Meier and the log-rank test were used for survival analysis. Results: A total of 1296 patients were included. The most common histologic tumor types were glioblastomas (38.27%; n = 496), pilocytic astrocytoma (32.87%; n = 426), and astrocytoma grade II (20.76%; n = 269). A total of 379 (29.24%) had brainstem tumors. The mean follow-up was 135 months [95% confidence interval (CI) 128-142\. The 1-year, 3-year 5-year OS for pilocytic astrocytoma were 93.72%, 89.98%, and 88.97%; for grade II gliomas, 80.36%, 71.89%, and 68.60%; for grade III gliomas, 53.72%; 31.87%, and 28.33%; and for glioblastoma, 52.90%, 28.76%, 25.20%, respectively. Brainstem tumors had the worse OS compared to no brainstem tumors (p = 0.001). For high-grade glioma (grade III/IV), excluding brainstem tumors (n = 570), young patients had greater median OS (0 to 3 years:22 months; 4 to 18 years:13 months; p = 0.005). Regarding the treatment modalities, combined treatments were associated with higher median survival compared to less intensive therapy (surgery: 11 months; surgery and chemotherapy: 16 months; surgery, radiotherapy, and chemotherapy: 20 months; p = 0.005). Conclusion: In our cohort, low-grade gliomas had favorable prognoses and outcomes. Patients diagnosed with glioblastomas and brainstem gliomas had the worst OS. For high-grade gliomas, undergoing treatment de-intensification in the Brazilian pediatric population is associated with worse survival.
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INTRODUCCION: Los avances científicos han logrado aumentar la cantidad de pacientes pediátricos que sobreviven a enfermedades oncológicas. En general, para los niños que padecen tumores del sistema nervioso central, esta sobrevida viene acompañada de efectos adversos secundarios, tales como déficits cognitivos.OBJETIVO: Evaluar las funciones cognitivas y la calidad de vida en niños con tumores cerebrales infratentoriales y supratentoriales.METODOS: Se realizó un estudio analítico observacional. La muestra total estuvo conformada por 51 sujetos. Se utilizaron los siguientes instrumentos de medición: Escala de Inteligencia de Wechsler para niños IV, Sistema de Evaluación Cognitiva; Test de Memoria y Aprendizaje; Escala Graffar y Peds Quality of Life 4.0.RESULTADOS: La comparación de los resultados no arrojó diferencias significativas entre localizaciones tumorales infratentoriales y supratentoriales. La totalidad de los pacientes evaluados en un período de post-tratamiento oncológico presentó un descenso similar y significativo en todas las áreas estudiadas, en relación con lo esperado para la población general. Las funciones cognitivas que evidenciaron mayor compromiso fueron la velocidad de procesamiento y la capacidad atencional (principalmente en tareas de planificación). Los resultados observados pusieron de manifiesto estos déficits, así como un alto compromiso de la calidad de vida escolar.CONCLUSIONES: El trabajo se presenta como un estudio preliminar. A partir de él se podría definir la tendencia general del estado neurocognitivo, analizar su impacto en la calidad de vida de la población estudiada y plantear interrogantes dirigidos a futuras investigaciones.
INTRODUCTION: Due to scientific advances, there is a growing number of pediatric patients surviving cancer. In general, for children who suffer from central nervous system tumors, this survival is associated with secondary adverse effects, such as cognitive deficits.OBJECTIVE: To assess cognitive functions and quality of life in children with infratentorial and supratentorial brain tumors.METHODS: An analytical observational study was conducted. The total sample consisted of 51 subjects. Following measurement instruments were used: Wechsler Intelligence Scale for Children, Fourth Edition (WISC IV), Cognitive Assessment System (CAS), Test of Memory and Learning (TOMAL), Graffar Scale and Peds Quality of Life 4.0.RESULTS: The comparisons of the results did not show significant differences between infratentorial and supratentorial tumor location. All patients that were evaluated in the post-cancer treatment period revealed a similar significant impairment in all the areas studied, when compared with the level expected in the general population. The most severely affected cognitive functions were processing speed and attention span, mainly on planning tasks. The findings also showed that quality of life at school is severely affected in these children.CONCLUSIONS: This is a preliminary study whose results may define a general trend of neurocognitive status, analyzing its impact on the quality of life of the study population and posing useful questions for the future research.
Assuntos
Criança , Qualidade de Vida , Neoplasias Encefálicas , Neoplasias Infratentoriais , Neoplasias Supratentoriais , Criança , Transtornos Cognitivos , Argentina , Saúde PúblicaRESUMO
INTRODUCCION: Los avances científicos han logrado aumentar la cantidad de pacientes pediátricos que sobreviven a enfermedades oncológicas. En general, para los niños que padecen tumores del sistema nervioso central, esta sobrevida viene acompañada de efectos adversos secundarios, tales como déficits cognitivos.OBJETIVO: Evaluar las funciones cognitivas y la calidad de vida en niños con tumores cerebrales infratentoriales y supratentoriales.METODOS: Se realizó un estudio analítico observacional. La muestra total estuvo conformada por 51 sujetos. Se utilizaron los siguientes instrumentos de medición: Escala de Inteligencia de Wechsler para niños IV, Sistema de Evaluación Cognitiva; Test de Memoria y Aprendizaje; Escala Graffar y Peds Quality of Life 4.0.RESULTADOS: La comparación de los resultados no arrojó diferencias significativas entre localizaciones tumorales infratentoriales y supratentoriales. La totalidad de los pacientes evaluados en un período de post-tratamiento oncológico presentó un descenso similar y significativo en todas las áreas estudiadas, en relación con lo esperado para la población general. Las funciones cognitivas que evidenciaron mayor compromiso fueron la velocidad de procesamiento y la capacidad atencional (principalmente en tareas de planificación). Los resultados observados pusieron de manifiesto estos déficits, así como un alto compromiso de la calidad de vida escolar.CONCLUSIONES: El trabajo se presenta como un estudio preliminar. A partir de él se podría definir la tendencia general del estado neurocognitivo, analizar su impacto en la calidad de vida de la población estudiada y plantear interrogantes dirigidos a futuras investigaciones.
INTRODUCTION: Due to scientific advances, there is a growing number of pediatric patients surviving cancer. In general, for children who suffer from central nervous system tumors, this survival is associated with secondary adverse effects, such as cognitive deficits.OBJECTIVE: To assess cognitive functions and quality of life in children with infratentorial and supratentorial brain tumors.METHODS: An analytical observational study was conducted. The total sample consisted of 51 subjects. Following measurement instruments were used: Wechsler Intelligence Scale for Children, Fourth Edition (WISC IV), Cognitive Assessment System (CAS), Test of Memory and Learning (TOMAL), Graffar Scale and Peds Quality of Life 4.0.RESULTS: The comparisons of the results did not show significant differences between infratentorial and supratentorial tumor location. All patients that were evaluated in the post-cancer treatment period revealed a similar significant impairment in all the areas studied, when compared with the level expected in the general population. The most severely affected cognitive functions were processing speed and attention span, mainly on planning tasks. The findings also showed that quality of life at school is severely affected in these children.CONCLUSIONS: This is a preliminary study whose results may define a general trend of neurocognitive status, analyzing its impact on the quality of life of the study population and posing useful questions for the future research.