QOL-56. THE RELAPSED AND OR PROGRESSED BRAIN TUMOURS IN CHILDREN: RHC, GLASGOW EXPERIENCE

INTRODUCTION: The outcome for children with relapsed or progressed brain tumours is poor. The aim of this project was to identify total number of children who have relapsed or progressed with Brain tumour and to determine the types of tumours, treatment offered and assess outcome. METHODS: This is a retrospective study of all patients treated for relapsed or progressed brain tumours between 2007 and 2017 at the Royal Hospital for children. Patients were identified using the unit database. Clinical data included demographics, histologic diagnosis, treatment characteristics and outcome which was obtained from electronic records. RESULTS: 46 children were included (22M:24F). The median age of diagnosis was 5 years. There were 16 histological subtypes of brain tumours: pilocytic astrocytoma (n=12, 26%), optic pathway glioma (n=4,7%), medulloblastoma (n=8, 17%), ependymoma (n=4, 9%), high grade glioma (n=3, 7%, DIPG (n=2, 4%) and others 13(32.2%). 28(61%) had relapsed at a median time of 18 months. Tumour progression occurred in 18(31%) at a median time of 21.5 months. Post-relapse or progression therapy included surgery (14, 30%), chemotherapy (17, 40%) and radiotherapy (5, 10.9%). 50% of the patients remain alive with 17(37%) being stable and 6(13%) with progression of disease. 50% had died of disease progression. CONCLUSIONS: The relapse and or progression was seen 61% of patients. The commonest tumours in this cohort were pilocytic astrocytoma and medulloblastoma. Chemotherapy was the most used regimen followed by surgery and radiotherapy. Primary dissemination at the time of diagnosis was associated with poor prognosis.