Research Information System
Thesis Type: Expertise In Medicine
Institution Of The Thesis: Gazi Üniversitesi, Tıp Fakültesi, Turkey
Approval Date: 2013
Student: HACER YİĞİT
Supervisor: FARUK GÜÇLÜ PINARLI
Abstract:Central Nervous System (CNS) tumors is the second most frequent cancer in childhood after hematologic malignancies and the third common childhood cancer in Turkey, after lymphomas. The object of this study is to make a retrospective review of children with CNS tumors in Gazi University Faculty of Medicine, Department of Pediatric Oncology, the histological subtypes, grade, localization, symptom duration, clinical findings, neuro-imaging techniques, treatment approach, recurrence, and survival rates. One hundred eigty-nine patients with primary CNS tumors were reviewed. Male were 54% of the patients with a male / female ratio 1,17 / 1. Mean symptom interval was 5,6 mounth (0,1- 96 mounth) and headache was the most comman symptom. Tumors of glial origin were most frequent (53,7%), followed by embryonal tumors (27,2%), and craiopharyngioma (4,8%). Infratentorial, supratentorial and spinal localizations were seen in 51,8%, 46,6%, and 1,6% of the patients, respectively. Low grade tumors were (50,7%) predominant than high grade tumors. At diagnosis, 13,8% of the tumors were metastatic and the most frequent metastasis location was spinal cord. There was 167 patients who underwent surgical intervention: Gross-total excision was performed in 67 patients, total excision was performed in 26 patients, subtotal excision was performed in 41 patients, partial excision was performed in 6 patients, and 27 patients underwent biopsy only. Radiotherapy was applied in 72,3% of the patients. Adjuvant chemotherapy was administered in 86 of 131 eligible patients: HRM protocol (n=11); PCV protocol (n=16); Temazolamid (n=8); combined multiagent chemotherapy (n=22) chemotherapy; and other chemotherapy (n=29). Recurrence was observed in 50,8% of patients, and the most frequent recurrence site was the primary tumor location. Five year overall survival and disease free survival rates were %63 and %42,4 respectively. In conclusion, the clinical features, histologic subtypes, location, grade and survival rates of the pediatric primary central nerve system tumors were consistent with literature findings.