Outcomes of Glioblastoma in Children and Adolessents Under 21 Years of Age in A Single Tertiary Care Center

Abstract Purpose: Pediatric Glioblastoma is an aggressive tumor which occurs less often in children and carries a dismal prognosis with median survival of approximately 20 months. Factors including early presentation, complete resection and supratentorial location are associated with better outcomes. Management of Pediatric Glioblastoma is very challenging and includes safe surgical resection along with chemotherapy and radiation. Due to rarity of pediatric data on glioblastoma in low- and middle-income countries, this study will give a comprehensive overview on clinical characteristics and outcomes of pediatric glioblastoma. Methods: In this study, twenty patients who were less than 21 years old, diagnosed as glioblastoma were enrolled at a tertiary care center between January 2015- December 2017 and their clinical characteristics, treatment strategies and outcomes were recorded. Results: Out of 20 patients, 55% were female with mean age of 11.5 years. Vomiting and headache (92%) were commonly found symptoms and supratentorial region (65%) was most common location of the tumor. Subtotal resection (STR) was performed in 55% of patients as compared to gross total resection (GTR) which was performed in 35% of patients. After surgery, only 7 (35%) patients received chemo-radiation, 4 (20%) patients were managed with only radiation and 9(45%) patients didn’t receive any therapy. 4 (20%) patients were lost to follow up, 14 (87%) expired whereas 2 (10%) patients are alive with residual disease at 23 months since the time of diagnosis. Conclusion: Pediatric glioblastoma is a rapidly growing aggressive tumor with worst outcomes in children and needs further studies to overcome the challenges in its management and to improve survival. Key Words: Pediatric glioblastoma, Clinical Characteristics, Outcomes