Supratentorial astrocytic tumours of childhood: a clinicopathologic study of 41 cases.

Forty-one patients with ages from 0 to 16 years harbouring supratentorial astrocytic tumours were treated between 1964 and 1986. Twenty-four of them were located in the cerebral hemisphere or in the ventricle, and 17 were in the basal ganglia, thalamus, and/or optico-hypothalamic region. There were nine glioblastomas multiforme, four anaplastic astrocytomas, 11 fibrillary astrocytomas, 12 pilocytic astrocytomas, two pleomorphic xanthoastrocytomas, two subependymal giant cell astrocytomas and one primitive astrocytic tumour. Low grade tumours tended to occur in young subjects near the midline, and high grade one in older patients in the hemisphere. Initial treatment in most the patients was a resection or biopsy followed by radiation therapy. Eleven patients were retreated for their recurrent tumours with combinations of surgical removal of the tumour, radiotherapy, and/or chemotherapy. After a follow-up of 3 months to 17 years, 51% of the patients survived with a median survival of 7 years. Outcome of the patients with supratentorial astrocytomas correlated mostly with the histological grade of malignancy of the tumour, and to a lesser degree with the tumour location. The biological behavior and treatment of supratentorial astrocytomas in childhood are discussed.