Building a Neuro-Oncology Program and Epidemiological Profiling of Pediatric Brain Tumors in a Tertiary Cancer Care Center in India

Treatment of childhood brain tumours requires coordinated efforts by multiple specialities - neurosurgery, neuroradiology, neuropathology, oncology, and radiotherapy. The outcome is worse in developing countries compared to developed countries because of deficiencies in proper registry, failure of timely diagnosis, lack of availability and co-ordination of multiple specialists required for comprehensive management and high abandonment rates.
The pediatric neuro-oncology program was initiated in collaboration with the neighbouring neurosurgery institution as a step towards improving care for pediatric brain tumor patients in our hospital. Epidemiology, treatment and followup of brain tumours in children aged 1-14 years attending the pediatric oncology department were studied. Patients received multimodality treatment with surgery, radiotherapy and chemotherapy by specialists in both centres. The study period was from January 2008 to December 2012.
There were 375 pediatric brain tumour patients during the study period. 166 patients (44.2%) had supratentorial tumors and 209 (55.73%) had infratentorial tumors. 42.6% of tumours were high-grade and 53.6% were low grade. The commonest histopathological tumour type was astrocytoma (48.8%) followed by medullobastoma (24.5%). 287 (76.5%) patients underwent surgery, 216 (57.6%) patients received radiotherapy, 97 (25.8%) patients received chemotherapy and 94 (25%) required follow-up only. Patient follow-up rates improved from 37.2% to 82.6% and treatment abandonment decreased from 35.8% to 14.8% over these years.
Impact of the pediatric neuro-oncology program in our hospital has made it possible to provide comprehensive multidisciplinary treatment in a co-ordinated manner, describe the epidemiology of pediatric brain tumors, reduce treatment abandonment, and improve the follow-up of pediatric brain tumour patients.