Pediatric glioma therapy has evolved to delay or eliminate radiation for low-grade tumors. This study examined these temporal changes in therapy with long-term outcomes in adult survivors of childhood glioma. Among 2,501 5-year survivors of glioma in the Childhood Cancer Survivor Study diagnosed 1970–1999, exposure to radiation decreased over time. Survivors from more recent eras were at lower risk of late mortality (≥5 years from diagnosis), severe/disabling/life-threatening chronic health conditions (CHCs) and subsequent neoplasms (SNs). Adjusting for treatment exposure (surgery only, chemotherapy, or any cranial radiation) attenuated this risk (for example, CHCs (1990s versus 1970s), relative risk (95% confidence interval), 0.63 (0.49–0.80) without adjustment versus 0.93 (0.72–1.20) with adjustment). Compared to surgery alone, radiation was associated with greater than four times the risk of late mortality, CHCs and SNs. Evolving therapy, particularly avoidance of cranial radiation, has improved late outcomes for childhood glioma survivors without increased risk for late recurrence.

儿科神经胶质瘤治疗已经发展到可以延迟或消除低级别肿瘤的放射治疗。这项研究检查了治疗中的这些时间变化以及儿童神经胶质瘤成年幸存者的长期结果。1970-1999 年儿童癌症幸存者研究中诊断出的 2,501 名 5 年神经胶质瘤幸存者中，暴露于辐射的情况随着时间的推移而减少。最近时代的幸存者发生晚期死亡（诊断后≥5年）、严重/致残/危及生命的慢性健康状况（CHC）和随后的肿瘤（SN）的风险较低。调整治疗暴露（仅手术、化疗或任何颅脑放射）可降低这种风险（例如，CHC（1990 年代与 1970 年代），相对风险（95% 置信区间），未经调整为 0.63 (0.49–0.80)，而调整为 0.93 (0.72) –1.20) 进行调整)。与单独手术相比，放疗与晚期死亡率、CHC 和 SN 的风险高出四倍以上。不断发展的治疗，特别是避免颅脑辐射，改善了儿童神经胶质瘤幸存者的晚期结果，而没有增加晚期复发的风险。