(P125) Glioblastoma Multiforme Outcome Comparison Between Pediatrics and Adults: Is There a Difference?

Publication
Article
OncologyOncology Vol 29 No 4_Suppl_1
Volume 29
Issue 4_Suppl_1

This is the first report to directly compare pediatric and adult patients with GBM. Pediatric patients had significantly superior OS and CSS when compared with adults, and these differences remained significant over time and on multivariate analysis. The underlying cause of these survival differences between pediatrics and adults requires exploration, with attention to molecular biological tumor differences.

Dayssy A. Diaz, MD, Duran Mitchell, Isildinha Reis, PhD, Joseph Panoff, MD; Department of Radiation Oncology, Division of Biostatistics, Department of Public Health Sciences, University of Miami

PURPOSE: There is a paucity of data regarding the clinical outcome of glioblastoma multiforme (GBM) in the pediatric population. Previous data suggest that there is a difference in overall survival (OS) between pediatric patients and adult patients with GBMs; however, there have been no direct comparisons in the literature. We compared pediatric and adult GBM outcome measures using the Surveillance, Epidemiology, and End Results (SEER) database, a program of the National Cancer Institute that collects cancer incidence and survival data from approximately 28% of the US population.

MATERIALS AND METHODS: Patients with pathologically confirmed grade 4 gliomas diagnosed between 1980 and 2011 were included in this analysis. Patients aged older than 60 years were excluded from the analysis. Pediatric cases were classified as those aged ≤21 years. Cause-specific survival (CSS) and overall survival (OS) were estimated by Kaplan-Meier (product-limit) method. Cox proportional hazards analyses were performed, evaluating potential predictors of CSS and OS.

RESULTS: There were 6,351 patients available for comparison; 6,099 patients were adults, and 252 patients were pediatric. The median age for the pediatric patients was 13 years, and the median age for the adults was 52 years. The OS time was the same as the CSS for pediatric patients (16 mo). The same observation was seen for adults (12 mo). Pediatric patients had a significantly better OS (P < .001) and CSS (P < .0001) when compared with adults. The 3-year OS was 23.4% for pediatrics vs 11.8% for adults, and the 3-year CSS was 24.3% for pediatrics vs 12.9% for adults. These results persisted when stratified by decade of diagnosis (1980s: P = .0008; 1990s: P = .0229; and 2000s: P < .0001). Univariate analysis indicated female sex (P = .03), use of radiation (P < .0001), surgical resection (P < .0001), age (P < .0001), recent year of diagnosis (P < .0001), and pediatric patients (P < .0001) to be significant predictors of improved OS. Multivariate analysis demonstrated that pediatric status, use of surgery, use of radiation, and recent decade of diagnosis were significant predictors of OS and CSS (P < .0001 for all variables). Race was found to be a significant predictor of CSS (P = .0132) but not of OS (P = .667).

CONCLUSION: This is the first report to directly compare pediatric and adult patients with GBM. Pediatric patients had significantly superior OS and CSS when compared with adults, and these differences remained significant over time and on multivariate analysis. The underlying cause of these survival differences between pediatrics and adults requires exploration, with attention to molecular biological tumor differences.

Proceedings of the 97th Annual Meeting of the American Radium Society - americanradiumsociety.org

Articles in this issue

(P005) Ultrasensitive PSA Identifies Patients With Organ-Confined Prostate Cancer Requiring Postop Radiotherapy
(P001) Disparities in the Local Management of Breast Cancer in the United States According to Health Insurance Status
(P002) Predictors of CNS Disease in Metastatic Melanoma: Desmoplastic Subtype Associated With Higher Risk
(P003) Identification of Somatic Mutations Using Fine Needle Aspiration: Correlation With Clinical Outcomes in Patients With Locally Advanced Pancreatic Cancer
(P004) A Retrospective Study to Assess Disparities in the Utilization of Intensity-Modulated Radiotherapy (IMRT) and Proton Therapy (PT) in the Treatment of Prostate Cancer (PCa)
(S001) Tumor Control and Toxicity Outcomes for Head and Neck Cancer Patients Re-Treated With Intensity-Modulated Radiation Therapy (IMRT)-A Fifteen-Year Experience
(S003) Weekly IGRT Volumetric Response Analysis as a Predictive Tool for Locoregional Control in Head and Neck Cancer Radiotherapy 
(S004) Combination of Radiotherapy and Cetuximab for Aggressive, High-Risk Cutaneous Squamous Cell Cancer of the Head and Neck: A Propensity Score Analysis
(S005) Radiotherapy for Carcinoma of the Hypopharynx Over Five Decades: Experience at a Single Institution
(S002) Prognostic Value of Intraradiation Treatment FDG-PET Parameters in Locally Advanced Oropharyngeal Cancer
(P006) The Role of Sequential Imaging in Cervical Cancer Management
(P008) Pretreatment FDG Uptake of Nontarget Lung Tissue Correlates With Symptomatic Pneumonitis Following Stereotactic Ablative Radiotherapy (SABR)
(P009) Monte Carlo Dosimetry Evaluation of Lung Stereotactic Body Radiosurgery
(P010) Stereotactic Body Radiotherapy for Treatment of Adrenal Gland Metastasis: Toxicity, Outcomes, and Patterns of Failure
(P011) Stereotactic Radiosurgery and BRAF Inhibitor Therapy for Melanoma Brain Metastases Is Associated With Increased Risk for Radiation Necrosis
Related Videos
Considering cystectomy in patients with bladder cancer may help with managing the shortage of Bacillus Calmette-Guerin, according to Joshua J. Meeks, MD, PhD, BS.
Anemia in patients who receive talazoparib plus enzalutamide for metastatic castration-resistant prostate cancer appears to be manageable without any compromises in patient-reported outcomes and quality of life.
Patients with locally advanced or metastatic urothelial cancer and visceral disease may particularly benefit from enfortumab vedotin plus pembrolizumab, according to Amanda Nizam, MD.
High-grade adverse effects with zanidatamab plus palbociclib and fulvestrant seem to be uncommon in patients with HER2-positive, hormone receptor–positive, metastatic breast cancer, according to Sara Hurvitz, MD, FACP.
Black male patients with breast cancer appear to experience worse survival outcomes compared with White patients when controlling for clinicopathological variables, according to Jason (Jincong) Q. Freeman, MPH, MS.
Results from the ECOG-ACRIN E4112 trial appear to support the use of DCIS scores for identifying patients with breast cancer who may be eligible to omit radiotherapy following MRI-guided surgery.
Providers should inform patients with breast cancer that selecting later-line therapies following prior treatment with CDK4/6 inhibitors is a “developing area,” says Abigail M. Johnston, JD.
Data from the phase 3 NATALEE trial highlight a positive toxicity profile for ribociclib as an adjuvant therapy for patients with hormone receptor–positive, HER2-negative breast cancer, says Neil M. Iyengar, MD.
Future research will focus on ctDNA dynamics change over time in the full translational cohort of patients with hormone receptor–positive breast cancer in the phase 3 monarchE study, says Stephanie L. Graff, MD.
Findings from a National Cancer Database analysis highlight no statistically significant differences in survival outcomes with chemotherapy for patients over 81 years old with triple-negative breast cancer compared with those who do not receive chemotherapy.
Related Content