Patients and methods
In this cross-sectional study,88 children with primary brain tumor who
referred to Amir Oncology Hospital during the years 2008_2018 were
studied based on the available clinical protocols. All data including
age, sex, tumor type and size, initial symptoms, location of the tumor,
MRI history preceding and following surgery, type of surgery, type of
the chemotherapy regimen and the objective response rate (ORR)were
extracted from the patients’ medical records. Patients who hadn’t
received the Irinotecan based regimen since the onset of the tumor or
after the relapse, were excluded from this study.
All patients underwent brain and spinal cord MRI in the first
Chemotherapy session and this was repeated every 3_6 months during the
treatment course. The average tumor size was measured through the
Bidirectional(2D) Area method and the correlated response rates were
determined based on the McDonald Criteria that was suggested for the
quantitative evaluation of ORR in 1990.
According to the McDonald Criteria, a total tumor signal termination in
brain MRI indicates a Complete Response(CR) while a reduced tumor size
by more than 50% indicates a Partial Response(PR) and a decrease or
increase in tumor size by 0_25 % is referred to as a Stable Disease
(SD) while an increase by more than 25% shows a Progressive
Disease(PD).
In this study, patients received different chemotherapy regimens based
on their tumor size, tumor type and its functionality, anatomical
location of the tumor, tumor’s grade determined by the WHO system and
other related parameters.
The regimens are as follows:
1)Regimen A which consists of Vincristine, Lomustine (CCNU) and
Cisplatin.
2)Regimen B which consists of Irinotecan, Temozolomide،Bevacizumab and
Vincristine
Moreover, patients who received none of the above are shown with W and
those who received both regimens sequentially are labeled as AB. Also,
patients who received a regimen else than A at first and then received
regimen B are labeled as WB.
The collected data were analyzed using SPSS V.19 and Pearson’s
correlation test, Kaplan-Meier analysis and descriptive statistics
including Central Tendency, Frequency Distribution and Distribution
Ratio, as it is noticed in the respective tables and charts. A P_value
of less than 0.05 was considered statistically significant.