HGG-42. CLINICAL FEATURES AND TREATMENT OUTCOME OF MALIGNANT GLIOMAS IN CHILDREN AND ADOLESCENTS

INTRODUCTION: Malignant gliomas in children and adolescents are rare. They are difficult to treat and are associated with an extremely poor prognosis. SUBJECTS AND METHODS: The treatment and outcomes of WHO grade IV -gliomas and diffuse intrinsic pontine gliomas (DIPG) in children and adolescents (Age 4–39, median 28) treated at our institute since 2001 were retrospectively reviewed. Thirty-five cases were included in this study. Nine cases were located in their brain stem and 2 of them were diagnosed as DIPG clinically without biopsy. Three (brain stem -2, thalamus- 1) cases were diffuse midline glioma H3 K27 M mutant. Remaining 30 cases were diagnosed histologically as glioblastoma. Expect for 2 cases, all were irradiated. Twenty-four cases were treated with temozolomide (TMZ). Bevacizumab (BEV) was administrated as an initial therapy in 10 cases (concomitant with TMZ in 9 cases) and was administrated at the time of relapse in 9 cases. In summary, 19 cases were treated with BEV. RESULTS: Median survival time (MST) of all cases was 16.8 (4.4 -152.3) months. In total, BEV did not prolonged overall survival (OS), MST 16.02 vs 14.44, (p=0.498). Among adolescents (age 15–39), patients treated with BEV had a trend of longer OS but did not reached statistical significance, MST 19.64 vs 10.76 (p=0.167). An extent of resection and KPS =>70 at discharge from hospital were beneficial factors associated with prolonged OS. CONCLUSION: As well as in elderly cases, multidisciplinary treatment including resection, radiation and chemotherapy including BEV improves outcomes.