Glioblastoma in childhood – Treatment and outcome of 7 patients

Objective: While glioblastoma is very common in adults and is the most common primary malignant brain tumour in this age group, it remains a rare diagnosis in children. Postoperative treatment of glioblastoma in adults is well standardized, but in children the treatment is under constant discussion and follows different types of study protocols (HIT-GBM A-D). Methods: Treatment and outcome of 7 consecutive paediatric patients were retrospectively evaluated in order to determine the clinical course, median progression-free survival and overall survival. Results: 7 patients were diagnosed and treated between 2000 and 2010. The median age was 9 years, all patients were under 16. All but one of the patients underwent open surgery; complete resection was performed in 2 cases, subtotal resection in 4 cases. One patient underwent stereotactic biopsy due to the depth of the lesion. Combined radio-chemotherapy was performed in all cases, using the HIT-GBM-C and -D and the HIT 2000 protocols as first-line therapy as well as Topotecan and Temozolomide as second-line chemotherapy for recurrent disease. Median survival in this cohort was 16 months. The progression-free survival was 3 months. Local tumour-recurrences were apparent in all cases. Median survival and progression-free survival in this small cohort did not correlate with extent of resection, depth of the lesion or the adjuvant regimen. Conclusions: Survival of children with glioblastoma is being described as far better than in adults. Although we followed the common study protocols, we cannot confirm these results in this cohort, most probably due to the low case number.