Pediatric brain tumor care in a Sub-Saharan setting: current poise of a precariously loaded dice

Abstract

Objective

To evaluate the current status of pediatric brain tumor (PBT) care and identify determinants and profiles of survival and school attendance

Methods

An 8-year institution-based prospective longitudinal study. All cases investigated with neuroimaging and treated were enrolled. Data was analyzed with SPSS (Inc) Chicago IL, USA version 23. Chi Square test, One-way ANOVA and confidence limits were used to evaluate associations at the 95% level of significance. Ethical approval for our study was obtained Health Research Ethics Committee of our hospital.

Results

Among 103 patients enrolled, 92 satisfied our study criteria. There were 45 males and 39 females, M: F = 0.8. The mean age was 9.5 ± 2.1 years 95%CI with a range of 7 months to 16 years. The most common symptom was headache for supratentorial lesions (73%) and gait disturbance (80.2%) for infratentorial lesions. More tumors were supratentorial in location 51 (55.4%), 35 (38.1%) were infratentorial and 6 (6.5%) were transtentorial. Craniopharyngiomas (n = 23), medulloblastomas (n = 22) and astrocytomas (n = 15) were the most common tumors. Hemoglobin genotype (AA and AS) had some influence on tumor phenotype FT, P = 0.033. 76 cases were microsurgically resected while 16 patients were treated with radiotherapy alone. The 30-day mortality for operated cases is 7.2 ± 0.7%. Overall 1-year and 5-year survival was 66.7 and 52.3%, respectively. School attendance, performance and outcome varied among treatment subgroups.

Conclusion

Survival profile in this series suggests some improvement in comparison to previous studies from our region, Hemoglobin genotype profiles may signature paediatric brain tumor phenotypes in our setting.

Keywords:

• Pediatric brain tumors
• micro neurosurgery
• radiotherapy
• school performance
• survival

Acknowledgement

The authors wish to acknowledge our hospital’s neurosurgical ward nursing staff for their invaluable contributions to the care of our pediatric patients with brain tumor.

Author contributions

All the authors contributed significantly to the study and all have given final approval for submission and publication of the manuscript.