| Part OneClinical analysis of 431 children with central nervous system tumorsObjective:Central nervous system(CNS)tumors are the most common solid tumors in children,but there are few studies on systematic and comprehensive analysis of CNS tumors in children,and there is a lack of statistical data on CNS tumors in children.In this study,patients under 18 years of age who were diagnosed with CNS tumors and received tumor-related treatments in our hospital during six years from January 1,2015 to December 31,2020 were included in this research,and the morbidity,clinical characteristics,treatments and prognosis of patients with CNS tumors under 18 years of age were statistically analyzed for epidemiology that could reveal the current related problems.Methods:A cross-sectional retrospective analysis was performed for the demographics(age of onset,sex ratio),tumor histological types,tumor occurrence site,treatment protocols and survival prognosis of 431 patients under 18 years of age who were diagnosed and treated for CNS tumors in our hospital from January 1,2015 to December 31,2020.Descriptive statistics,including median,mean,range,and 95%confidence intervals,were applied as statistical data,and patient survival prognostic analysis based on the Kaplan-Meier method was performed by using SPSS 21.0 software.Results:Among the 431 patients with CNS tumors under 18 years of age,the median age of onset was 7 years old,and the male to female ratio was 1.71.The occurrence sites of CNS tumors were mainly supratentorial tumors(60.56%),subtentorial tumors accounting for 33.18%,and spinal cord tumors accounting for 6.26%.The most common types of histological types for CNS tumors were glioma(26.70%),medulloblastoma(14.92%),hemangiomas(8.90%),ependymomas(7.85%),nongerminating cell tumors(7.07%)and germ cell tumors(6.28%).362 children underwent surgery,20 received chemotherapy or radiotherapy alone,and 49 abandoned treatments after examination or conservative treatment.Up to 29 March,2021,308 cases were alive,82 cases had been fatal and 41 cases had been lost to follow-up.Conclusion:The epidemiology of childhood CNS tumors is special,and the common histological types vary from place to place,which has guiding significance for future diagnosis and treatments.However,the rate of refusal and abandonment of treatments in children with central nervous system tumors is still high today,and the survival prognosis is relatively poor,so more efforts will be needed to solve this problem in the future.Part TwoClinical analysis of brainstem tumors in childrenObjective:Brainstem tumor is a fatal tumor among childhood CNS tumors,of which diffuse glioma is the more common histological type.Regarding the cases diagnosed with brainstem tumors in the first part as the research objects,the relevant epidemiological data were statistically analyzed to provide reference for the clinical data of childhood CNS tumors.Methods:Clinical manifestations,imaging results,pathological types,treatment regimens and survival prognosis of 24 children with brainstem tumors were collected in this cross-sectional retrospective research.Results:Among the 24 children with brainstem tumors,including 14 non-DIPG patients and 10 DIPG patients,62.5%of the patients had intracranial hypertension and 45.83%had pyramidal abnormalities.Thirteen patients underwent surgery and histological diagnosis,including 6 low-grade gliomas patients,3 high-grade gliomas patients and 4 hemangiomas patients.Up to March 29,2021,the overall survival time for non-DIPG patients was 47.10 months,compared to only 4.31 months for DIPG patients.Conclusion:Brainstem tumors pose a great threat to children’s life and health,that is,high fatality,and there is no effective treatment protocol and prognosis of patients,so it is very important to explore new effective treatment strategies to improve the situation of patients with brainstem tumors. |
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