Brain metastases of pediatric solid tumors

ABSTRACT

The aim of the current study is to evaluate the incidence, pattern of metastases [whether isolated, multiple or associated with local recurrence of primary tumor or metastases to other sites], treatment outcome and prognosis of brain metastases in pediatric patients with extracranial solid tumors excluding lymphomas. Eighteen patients with extracranial pediatric solid tumors [excluding lymphomas] and brain metastases, were retrospectively studied during the period from September 1997 till January 2003. The relevant data of each patient were obtained from the medical records of The Pediatric Unit of Kasr El-Aini Center of Radiation Oncology and Nuclear Medicine [NEMROCK]. At diagnosis all patients were assessed by careful history taking, complete physical examination, laboratory as well as radiological assessment. Follow-up was done by radiological imaging of the primary tumor as well as the metastatic sites [including the brain] immediately after finishing active treatment and then every 3 months for 1 year. Brain metastases occurred after initial treatment of the primary tumor with a median period of 6 months [range 1-11 months]. Eight patients had solitary metastases and in 10 patients metastases were multiple. The median time for disease progression was 19 months and median survival was 5.8 months [3 days - 12 months]. The median survival of solitary and multiple metastases was 5.5 and 4.1 months respectively, and the median survival of metachronous and synchronous brain metastases was 5 months and 2.9 months respectively. The possibility of development of brain metastases is highly increased with the presence of poor prognostic features. Patients presented with disseminated disease, especially in the presence of poor performance status are better to receive no active treatment, only supportive measures as the treatment outcome is very poor