treatment outcomes and prognostic factors in pediatric non-brainstem astrocytoma in north east of iran

background: central nervous system (cns) tumors have accounted for approximately one fourth of all pediatric malignancies. cns tumors have been the most common solid malignancies among the children. in this study, we have evaluated survival and prognostic factors in children with non-brain stem astrocytoma. methods: children with non-brain stem astrocytoma, referring to radiation oncology centers of ghaem and omid hospitals of mashhad, have included in this retrospective study, in years 2000-2010. patients’ demographic data, past medical history, clinical symptoms, extent of tumor resection and treatment modality have recorded. disease-free survival and overall survival have measured using kaplan-meier method. results: we studied 87 patients with male to female ratio of 44/43 (1.02), and median age of 10 yrs (range: 2-15 yrs). tumor grade distribution was as follows: grade i: 20 (23%) subjects; grade ii: 34 (39.1%) subjects; grade iii: 20 (23%) subjects; and grade iv: 13 (14.9%) subjects. the median follow-up duration was 38 months (6 to 110), and 16 months (4 to 100) for patients with low- and high-grade tumors. the 2-year survival rates in grades i-iv were 100%, 84.7%, 60% and 10.8%, respectively. tumor resection less than gross total and non-ambulation have associated with a significantly inferior survival in both groups multivariate analysis, with high- and low-grade tumors. conclusion: for all the cases of the pediatric non-brainstem astrocytoma, tumor grade had dramatic influences on their survival. performing gross total resection was crucial for achieving favorable outcomes in both low-grade and high-grade cases. moreover, according to the results, having major motor deficits has associated with lower survival. keywords: pediatric; non-brain stem; astrocytoma please cite this article as: anvari k, seilanian toussi m, bahadorkhan g, bitaghsir m, heidari m, fazl ersi m, shahidsales s. treatment outcomes and prognostic factors in pediatric non-brainstem astrocytoma in north east of iran. iran j cancer prev. 2014; 7(2):96-100. references central brain tumor registry of the united states. [internet] 2004. [updated 2012 march 23]. available from: http://www.cbtrus.org/2012-npcr-seer/cbtrus_report_2004-2008_3-23-2012.pdf. makino k , nakamura h , yano s , kuratsu j . population-based epidemiological study of                          primary intracranial tumors in childhood. childs nerv syst. 2010; 26(8):1029-34.        shiminski-maher t ,  shields m . pediatric intracranial tumors: diagnosis and management. j pediatr oncol nurs.  1995; 12(4):188-98. jain a ,  sharma mc ,  suri v ,  kale ss ,  mahapatra ak ,  tatke m , et al. spectrum of pediatric brain tumors in india: a multi-institutional study. neurol india.  2011; 59(2):208-11. cohen kj ,  broniscer a ,  glod j . pediatric glial tumors. curr treat options oncol.  2001; 2(6): 529-36. nejat f , el khashab m , rutka jt . initial management of childhood brain tumors: neurosurgical considerations. j child neurol.  2008; 23(10):1136-48. armstrong gt , liu q , yasui y , huang s , ness kk , leisenring w , et al. long-term outcomes among adult survivors of childhood central nervous system malignancies in the childhood cancer survivor study. j natl cancer inst. 2009; 101(13): 946-58. jones c ,  perryman l ,  hargrave d . paediatric and adult malignant glioma: close relatives or distant cousins? nat rev clin oncol.  2012; 9(7): 400-13. burzynski sr . treatments for astrocytic tumors in children: current and emerging strategies. paediatr drugs.  2006; 8(3): 167-78 . hales rk , shokek o , burger pc , paynter np , chaichana kl , quinones-hinojosa a . prognostic factors in pediatric high-grade astrocytoma: the importance of accurate pathologic diagnosis. j neurooncol. 2010; 99(1): 65-71. qaddoumi i , sultan i , gajjar a . outcome and prognostic features in pediatric gliomas: a review of 6212 cases from the surveillance, epidemiology, and end results database. cancer. 2009; 115(24): 5761-70. hales rk , shokek o , burger pc , paynter np , chaichana kl , quiñones-hinojosa a , et al. prognostic factors in pediatric high-grade astrocytoma: the importance of accurate pathologic diagnosis. j neurooncol. 2010; 99(1): 65-71. uche eo , shokunbi mt , malomo ao , akang ee , lagunju i , amanor-boadu sd . pediatric brain tumors in nigeria: clinical profile, management strategies, and outcome. childs nerv syst.  2013 apr 18. [epub ahead of print] karkouri m ,  zafad s ,  khattab m ,  benjaafar n ,  el kacemi h ,  sefiani s , et al. epidemiologic profile of pediatric brain tumors in morocco. childs nerv syst.  2010; 26(8):1021-7. fangusaro j . pediatric high-grade gliomas and diffuse intrinsic pontine gliomas. j child neurol. 2009; 24(11):1409-17.