Five- Year Survival Rate of Children with Central Nervous System Tumors in Shiraz, Iran

Background: Reduced survival and impaired quality of life of the children affected by cancers is one of the most important health problems. In this study, 5-year survival of children affected with Central nervous system (CNS) tumors and its related factors were evaluated. Materials and Methods: Participants in this historical cohort study consisted of 161children with mean age of diagnosis 72 ± 51 months (median:60 months, range from 1 month to 17 years) who were diagnosed with CNS tumors from 1999 to 2005. All patients had referred to Oncology hospitals of Shiraz University of Medical Sciences, Shiraz, Iran. Data were extracted by checklist from their medical records.  Result: Five-year overall survival (OS) and disease free survival (DFS) of the patients were 59% (standard error: 5%) and 51.7% (standard error: 5%). Moreover, 10- year OS was calculated as 47% (standard error: 7%).  Based on tumor histology, OS was 70% for low grade tumors and 52% for high grade tumors (P=0.202). Based on the results, gender (girls had longer survival than boys), recurrence, neurologic deficit and age of diagnosis (60-119 months had longer survival), were determined as the influencing factors on OS rate (HR (95% CI) =0.48 (0.24-0.98), P=0.044, 0.48(0.25-0.93) P=0.031, 0.42 (0.18-0.95), P=0.039, and 0.32 (0.11-0.88), P=0.029, respectively). Moreover, tumor location in diencephalon was determined as poor prognostic factors ((HR (95% CI) =10 (1.9-57), P=0.007). Conclusion: Aforementioned prognostic factors should be taken into account by oncologists to make better decisions in the management of the patients with CNS tumors. It seems that survival is a multifactorial event and besides these prognostic factors, it might be also related to different clinical settings, ethnicity and type of treatment. Further studies with more focus on different treatment modalities are suggested.