The Role of Neoadjuvant Surgical Intervention in the Primary and Repeat Treatment of Malignant Brainstem Tumors in Children and Adolescents

Objective. To study and analyze the significance of the degree and possibility of surgical resection of a brainstem tumor in children and adolescents on the results of treatment in relation to various prognostic factors.

Material and methods. This investigation enrolled 102 children with a brainstem tumor. A morphological study was not performed because of the location of the tumor and the inability to perform a surgical intervention. The patients’ mean age was 7.1 ± 3.4 years. The results of the study were assessed in terms of overall cumulative survival rates.

Results. Primary chemoradiotherapy was performed in 52 of the 102 patients; 50 children underwent repeat chemoradiotherapy. In the entire group, 89 (87%) patients received no surgical treatment;  while subtotal resection or ventriculoperitoneal bypass surgery (VBS) could be done in 13 (13%) children; the median follow-up of the entire group was 19.2 weeks. In the study groups, the statistical  differences in overall survival rates were significant (Log-Rank p = 0.044).

Conclusion. Regardless of primary or repeat  radiotherapy  and  chemotherapy, surgical intervention, including VBS in children and adolescents, significantly affects overall survival rates.

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