RADT-69. PATTERNS OF CARE AND CLINICAL OUTCOME OF BRAIN STEM GLIOMA: 10-YEAR DATA FROM TERTIARY CANCER CENTRE

Abstract BACKGROUND brainstem glioma accounts for 10-20% of all brain tumors in children. Radiation therapy forms a cornerstone in the management of brainstem glioma- the prognosis, however, continues to be guarded. METHODS We performed an audit of patients with brainstem glioma treated at our center from January 2013 to December 2023. RESULTS A total of 232 patients with brainstem glioma were diagnosed between January 2013 to December 2023. The median age at presentation was 13 years and majority 146 (62%) were males. The median size of tumor was 4.9cm, range (2.3cm-11cm), 210 (90%) of patients had high grade and 22 patients had low-grade glioma radiologically, 138 (59.5%), 65(28%) and 29 patients had an ECOG PS of 1, 2 and 3, respectively. Sensory and motor dysfunction was present in 14% and 41% patients, respectively. The most common cranial nerve involvement was of CN VI (48%) followed by can VII (39%). Only 20 patients underwent surgery, and 17 patients had H3K27M mutation. Radiotherapy was received by 215 (92%) of patients, of which 190 (81%) was treated with radical intent. The most common radical radiotherapy dose was 60Gy/30 fractions, 120 (56%) patients received conformal radiotherapy while 95 (44%) patients received bilateral parallel opposed fields in tele-cobalt machine, 52 (24%) patients received concurrent and/or adjuvant temozolomide and the median adjuvant temozolomide cycles were 6, 171 (79%) patients could complete the planned radiation therapy treatment. The median overall survival of the entire cohort is 7.8 months range (3-89months). CONCLUSION Treatment strategies of hypofractionation, dose escalation and systemic therapy needs to be explored in brainstem glioma.