Original contribution
Quality of long-term survival following irradiation for intracranial tumors in children under the age of two

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Abstract

Thirty-eight children aged two and under who received radiotherapy alone or post-operatively for primary intracranial tumors from 1957 to 1974 were retrospectively studied for survival rate, late radiation sequelae, and quality of survival. There were 24 deaths, all attributed to the primary disease or its complications. The five, ten, and fifteen year absolute survival rates were 50 %, 39 %, and 38 % respectively, with posterior fossa tumors faring best. The 14 survivors, aged 6 to 2112 years, were evaluated fore physical, neurologic, endocrinologic, and psychologic abnormalities. Eight were found to have minimal or no abnormal neurologic findings, 11 were within the educable range on formal intelligence testing, and 12 had Karnofsky performance scores of 70 or better. There was little clinical evidence of severe endocrinologic dysfunction except for short stature in three. patients correlated with a dose of greater than 3600 rad to the hypothalamic-pituitary region. The patients were assigned to a proposed “Composite Quality of Survival Scale”(CQS) graded 1 to 5 based upon their overall quality of life evaluation. Eight of the patients were rated Grade 3 or better, with three patients essentially normal in most respects. We conclude that the data justify the continued use of radiotherapy in the treatment of very young children with brain tumors. However, there is the obvious need for further optimization of radiotherapy factors (time, dose, volume) in order to minimize the potential late effects of radiation to the central nervous system.

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    Presented at the Annual Meeting of the American Society of Therapeutic Radiologists in Dallas, Texas on October 22, 1980.

    Resident in Radiation Oncology, Dept. of Radiology.

    Professor of Radiology & Director of Radiation Oncology Division, Dept. of Radiology.

    §

    Dept. of Psychology, Neurological Institute.

    ∗∗

    Associate Professor of Clinical Pediatrics.

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