Characterization and outcomes of infratentorial malignant glioma: A population-based study using the Surveillance Epidemiology and End-Results database

Purpose: Using a population-based database, we sought to characterize brainstem gliomas and to evaluate the prognosis of various subgroups. Materials and methods: Using the Surveillance Epidemiology and End-Results (SEER) database we identified patients diagnosed with malignant infratentorial gliomas between 1988 and 2003 who underwent a surgical procedure and/or received radiation therapy (RT). Results: A total of 455 patients were identified with a median age at diagnosis of 13 years (range 0-87). The overwhelming majority, 95.6%, received RT. Median survival (MS) was 11 months. Those not undergoing RT had a MS of 3 months. MS varied significantly by age, p < 0.001. MS for patients aged 0-18 years was 11 months; 19-29 years was 35 months; 30-49 years was 17 months; 50-69 years was 6 months; and 70 years or older was 3 months. The small group with grades I and II tumors had improved MS of 58 and 37 months, respectively. There was no difference in survival by the year of diagnosis (<= 1999 versus 2000 or later) with MS of 10 versus 11 months, respectively, p = 0.949. Conclusion: Brainstem glioma is primarily a childhood malignancy with a generally poor prognosis. A minority of patients has favorable features and can achieve long-term survival. (C) 2010 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 95 (2010) 321-326