Complete surgical resection is the initial goal, but is accomplished in only about 50% of cases. Supratentorial tumors are more successfully resected due to the limited involvement of critical structures. Radiation therapy has been the standard adjunctive modality chosen to attempt a reduction in the rate of recurrence. Generally, radiation doses less than 4500 cGy are ineffective. Overall, 5-year survival ranges from 40% to 60%. The factors that affect survival include age at diagnosis, extent of surgical resection and location (supratentorial having better outcome than infratentorial). Interestingly, survival does not seem to correlate with histological degree of anaplasia to nearly the same extent as with other glial tumors. Children less than 3 years of age were found to have a worse outcome than older children. In order to avoid the complications associated with radiation therapy in younger patients, more aggressive chemotherapy regimens including bone-marrow transplantation are being utilized. In general, however, the results with chemotherapy are disappointing.
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