Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN 46202-5289, USA.
Int J Radiat Oncol Biol Phys. 2012 Jan 1;82(1):341-7. doi: 10.1016/j.ijrobp.2010.08.020. Epub 2010 Oct 29.
To evaluate the incidence of infant brain tumors and survival outcomes by disease and treatment variables.
The Surveillance, Epidemiology, and End Results (SEER) Program November 2008 submission database provided age-adjusted incidence rates and individual case information for primary brain tumors diagnosed between 1973 and 2006 in infants less than 12 months of age.
Between 1973 and 1986, the incidence of infant brain tumors increased from 16 to 40 cases per million (CPM), and from 1986 to 2006, the annual incidence rate averaged 35 CPM. Leading histologies by annual incidence in CPM were gliomas (13.8), medulloblastoma and primitive neuroectodermal tumors (6.6), and ependymomas (3.6). The annual incidence was higher in whites than in blacks (35.0 vs. 21.3 CPM). Infants with low-grade gliomas had the highest observed survival, and those with atypical teratoid rhabdoid tumors (ATRTs) or primary rhabdoid tumors of the brain had the lowest. Between 1979 and 1993, the annual rate of cases treated with radiation within the first 4 months from diagnosis declined from 20.5 CPM to <2 CPM. For infants with medulloblastoma, desmoplastic histology and treatment with both surgery and upfront radiation were associated with improved survival, but on multivariate regression, only combined surgery and radiation remained associated with improved survival, with a hazard ratio for death of 0.17 compared with surgery alone (p = 0.005). For ATRTs, those treated with surgery and upfront radiation had a 12-month survival of 100% compared with 24.4% for those treated with surgery alone (p = 0.016). For ependymomas survival was higher in patients treated in more recent decades (p = 0.001).
The incidence of infant brain tumors has been stable since 1986. Survival outcomes varied markedly by histology. For infants with medulloblastoma and ATRTs, improved survival was observed in patients treated with both surgery and early radiation compared with those treated with surgery alone.
通过疾病和治疗变量评估婴儿脑肿瘤的发生率和生存结果。
监测、流行病学和最终结果（SEER）计划 2008 年 11 月提交的数据库提供了 1973 年至 2006 年间年龄调整后的发病率和 12 个月以下婴儿原发性脑肿瘤的个体病例信息。
1973 年至 1986 年，婴儿脑肿瘤的发病率从每百万（CPM）16 例增加到 40 例，1986 年至 2006 年，年发病率平均为 35 CPM。按年发病率计算，主要组织学类型为神经胶质瘤（13.8）、髓母细胞瘤和原始神经外胚层肿瘤（6.6）和室管膜瘤（3.6）。白人的年发病率高于黑人（35.0 比 21.3 CPM）。低级别神经胶质瘤患儿的观察生存率最高，而具有典型性畸胎瘤样横纹肌样肿瘤（ATRT）或原发性脑横纹肌样瘤的患儿生存率最低。1979 年至 1993 年，从诊断后 4 个月内开始接受放疗的病例年发生率从 20.5 CPM 降至<2 CPM。对于髓母细胞瘤患儿，间变组织学和手术加初始放疗治疗与生存改善相关，但在多变量回归中，只有手术加放疗与生存改善相关，死亡风险比为 0.17，与单独手术相比（p = 0.005）。对于 ATRTs，接受手术和初始放疗的患儿 12 个月生存率为 100%，而单独手术的患儿为 24.4%（p = 0.016）。对于室管膜瘤，在最近几十年接受治疗的患者中，生存率更高（p = 0.001）。
自 1986 年以来，婴儿脑肿瘤的发病率一直保持稳定。生存结果因组织学而异。对于髓母细胞瘤和 ATRTs 患儿，与单独手术相比，接受手术和早期放疗的患者生存改善。
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