LGG-30. CLINICAL CHARACTERIZATION OF PEDIATRIC LOW-GRADE GLIOMAS REQUIRING MULTIPLE ANTI-TUMOR TREATMENTS

In pediatric low-grade gliomas (pLGG), central nervous system World Health Organization grade 1-2 tumors, the majority of patients achieve favorable outcomes. However, a significant minority requires multiple anti-tumor treatments. The objective of this study is to identify the clinical characteristics of patients requiring multiple anti-tumor treatments, enabling early detection and the subsequent adjustment of treatment strategies

Data was retrieved on tumor location, age at diagnosis, gender, NF1 status, extent of resection, and number and type of anti-tumor treatments of 282 patients from our institution. Patients were categorized into a single (STG) and multi-treatment group (MTG). Multi-treatment was defined as tumor progression after initial anti-tumor treatment requiring additional treatment, including more than a 3-month waiting period between initial surgery and subsequent treatment.

The median follow-up was 3 years. Optic pathway glioma was more prevalent in the MTG vs the STG, 62% vs 22%, respectively. Patients in the MTG were younger at diagnosis vs the STG (4.9 vs 8.5 yrs, P < 0.001). There was no significant difference in NF1 prevalence or gender between both groups. The predominant characteristic of patients in the MTG was carboplatin and vincristine as initial treatment, with a tumor in the optic pathway and a mean age at diagnosis of 4.9 yrs. In addition, the patients in the MTG mostly underwent partial resection (PR) and never gross total resection (GTR).

Our results indicate that a younger age at diagnosis, a tumor in the optic pathways and not undergoing GTR are prognostic factors for multi-treatment. The goal of anti-tumor treatment is to achieve senescence. Our results show that in the MTG, this is not attainable with the current treatment strategies. Therefore, exploring alternative treatment strategies is essential to diminish morbidity and mortality and enhance the quality of life for these patients.