Forty-five children harboring
brain-stem tumors were treated at the University of California, San Francisco, between 1969 and 1979. Pathological diagnoses were made in 19 patients. All patients received
radiation therapy (RT). Thirteen patients received
chemotherapy before, during, or immediately after RT. Twenty-four patients were treated with
chemotherapy at the time of
tumor progression, after initial treatment with RT alone. No statistically significant difference in time to
tumor progression or survival was found for treatment with
chemotherapy as an adjuvant to RT compared to treatment with RT alone followed by
chemotherapy administered at the time of
tumor progression. There were, however, more long-term survivors in the group that was first treated with
chemotherapy at the time of
tumor progression. There was no statistically significant correlation between survival and
tumor pathology or location, although there were more long-term survivors among patients harboring low-grade
gliomas and among patients with
tumors confined to the midbrain. The authors documented the response of some
brain-stem tumors to
chemotherapy; however, cooperative controlled studies will be required to determine the optimum treatment for this disease.