Articole semnate de acelasi autor in Revista Romana de Pediatrie:

Risk factors in pediatric central nervous system tumors

Revista Romana de PEDIATRIE | Volumul LXII, Nr. 2, An 2013

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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Antonela Ciobanu, Anca Viorica Ivanov, Ramona Filipescu and Ingrith Miron

ABSTRACT

Central nervous system (CNS) tumors are the first encountered solid tumor in pediatric oncology and represent an important therapeutic challenge for a multidisciplinar team. Brain tumors are diagnosed at any age; sign and symptoms are related to age, site and tumor growth. Histological features are important to classification (Bailey and Cushing, Kernohan, World Health Organisation) and prognosis. Aim of the present study was to find prognostic features of pediatric CNS tumors. We studied a group of 99 children diagnosed with CNS tumors between 1990 and 2008, 66 boys, 33 girls; 59.6% from rural areas. Median age at onset was 8 years and 5 months, without gender difference. Time of onset ranged from 4 hours to 2 years. There were 46 astrocytomas, 23 medulloblastomas, 17 ependymomas, 3 craniopharingiomas, 1 hipophiseal tumor and 9 other types of tumors. Onset symptoms included increased intracranial pressure (70 cases), neurological disorders (74 cases), visual disturbances (24 cases), seizures (7 cases), other symptoms (14 cases) and coma (2 cases). Surgical treatment was: total tumor resection (34 cases), subtotal resection (27 cases) and partial resection (19 cases); 6 cases underwent only tumoral biopsy, 8 cases did not undergo surgery. Median value of Erythrocite Sedimentation Rate (ESR) at onset – 17.00 mm/h. Median values of Fibrinogen (FG) at onset – 3.6150 g/L. Median value of Lacticdehidrogenosis (LDH) – 379.5 IU/L. Overall survival was variable, from less than 1 year in 34 cases, between 1 and 3 years in 19 cases and over 3 years in 46 cases. 50% of cases were dead in the first 3 years after diagnose. Analysis of survival according to ESR, FG and LDH showed no statistically significant differencies between them but between type of surgery and death is a direct relationship. Survival analysis for the event death according to age at onset revealed no significant differences between categories of patients ordered by age. Type of surgery seems to be the most important feature involved in prognosis in CNS tumors of children.

Key words: central nervous system tumors

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Antonela Ciobanu

FACTORI DE RISC IMPLICATI IN PATOLOGIA TUMORALA CEREBRALA LA COPIL

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

Antonela Ciobanu, Anca Viorica Ivanov, Ramona Filipescu and Ingrith Miron

REZUMAT

Tumorile sistemului nervos central (SNC) sunt cele mai frecvente tumori solide din patologia tumorală pediatrică şi reprezintă o provocare terapeutică pentru o echipă medicală multidisciplinară. Tumorile cerebrale pot fi diagnosticate la orice vârstă; semnele şi simptomele depind de vârsta pacientului, de sediul tumoral, precum şi de ritmul de creştere al tumorii. Clasificarea (Bailey şi Cushing, Kernohan, Organizaţia Mondială a Sănătăţii – OMS) şi prognosticul sunt dictate de histologia tumorală. Prezentul studiu îşi propune evidenţierea unor factori de prognostic implicaţi în evoluţia tumorilor SNC la copil. Lotul de studiu a inclus 99 de copii diagnosticaţi cu tumori SNC în perioada 1990-2008, 66 de băieţi şi 33 de fete; 59,6% din mediul rural. Vârsta medie la debut a fost de 8 ani şi 5 luni, fără diferenţe pe sexe. Durata debutului a variat de la 4 ore la 2 ani. Histologic, au fost 46 de astrocitoame, 23 de meduloblastoame, 17 ependimoame, 3 craniofaringioame, un caz de tumoră hipofizară şi 9 alte tipuri de tumori. Simptomatologia de debut a inclus hipertensiunea intracraniană (70 cazuri), tulburările neurologice (74 cazuri), tulburările vizuale (24 cazuri), convulsiile (7 cazuri), alte simptome (14 cazuri) şi coma în 2 cazuri. Intervenţiile chirurgicale au fost de tipul: ablaţie totală (34 cazuri), subtotală (27 cazuri), parţială (19 cazuri); în 6 cazuri a fost efectuată doar biopsia tumorală, iar în 8 cazuri nu s-a intervenit chirurgical. Investigaţiile biologice efectuate au arătat: VSH – valoarea medianei – 17 mm ⁄ h, Fg – 3,6150 g/L, LDH – 379,5 UI/L. În primii 3 ani de la diagnostic au decedat 50% dintre pacienţi, cu o rată de supravieţuire repartizată astfel: 34 de cazuri mai puţin de 1 an, 19 cazuri între 1 şi 3 ani, 46 de cazuri peste 3 ani. În lotul studiat nu au fost descoperite diferenţe semnificativ statistice între valorile VSH, Fg, LDH, vârstă la debut şi supravieţuire; doar sexul masculin şi tipul intervenţiei chirurgicale se corelează statistic cu supravieţuirea şi pot fi considerate de importanţă prognostică.

Cuvinte cheie: tumorile sistemului nervos central

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Antonela Ciobanu