Purpose

We describe large-scale demographic, initial treatment, and outcomes data for pediatric grade II gliomas included in the National Cancer Database from 2004 to 2014.

Methods

Our cohort included cases less than 21 years of age with pathology-confirmed disease. Logistic regressions were used to evaluate the use of chemotherapy (CT) and radiation therapy (RT). Overall survival (OS) rates were determined using Kaplan-Meier estimates and the log-rank test.

Results

We identified 803 cases with astrocytoma (56.2%), oligodendroglioma (26.0%), and mixed glioma/glioma NOS (17.8%) histologies. Most cases underwent surgical resection (n = 661). Whereas cases 16 to 21 years of age were more likely than cases 0 to 5 years to receive RT (OR = 7.38, 95% CI 3.58–15.21, p < 0.001), they were less likely to receive CT (OR = 0.34, 95% CI 0.22–0.52, p < 0.001). The 5-year OS rates for all cases, cases that underwent surgical resection, and cases managed with biopsy were 87.5%, 92.7%, and 63.6%, respectively.

Conclusion

In one of the largest series of pediatric grade II gliomas, astrocytoma was the most common histology. Patterns of care and OS outcomes were similar to grade I gliomas, with surgical resection being the most common initial treatment and associated with a favorable rate of OS. Younger patients were more likely to receive post-operative CT and the use of RT increased with age.

中文翻译：

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新诊断为 II 级胶质瘤的儿科患者的护理模式

目的

我们描述了 2004 年至 2014 年国家癌症数据库中儿童 II 级胶质瘤的大规模人口统计学、初始治疗和结果数据。

方法

我们的队列包括小于 21 岁的病理确诊病例。使用逻辑回归来评估化学疗法 (CT) 和放射疗法 (RT) 的使用。使用 Kaplan-Meier 估计和对数秩检验确定总生存 (OS) 率。

结果

我们确定了 803 例患有星形细胞瘤 (56.2%)、少突胶质细胞瘤 (26.0%) 和混合神经胶质瘤/神经胶质瘤 NOS (17.8%) 组织学的病例。大多数病例接受了手术切除（n = 661）。虽然 16 至 21 岁的病例比 0 至 5 岁的病例更有可能接受 RT（OR = 7.38，95% CI 3.58–15.21，p < 0.001），但他们接受 CT 的可能性较小（OR = 0.34, 95 % CI 0.22–0.52，p < 0.001）。所有病例、手术切除病例和活检病例的 5 年 OS 率分别为 87.5%、92.7% 和 63.6%。

结论

在最大的儿科 II 级胶质瘤系列之一中，星形细胞瘤是最常见的组织学类型。护理模式和 OS 结果与 I 级神经胶质瘤相似，手术切除是最常见的初始治疗，并与有利的 OS 率相关。年轻患者更可能接受术后 CT，RT 的使用随着年龄的增长而增加。