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Diffuse Pontine Glioma in Jordan and Impact of Up-front Prognosis Disclosure With Parents and Families

Department of Paediatrics, King Hussein Cancer Centre, Amman, Jordan

Najeeb Ezam

University of Jordan, Amman, Jordan

Maisa Swaidan, MD

Department of Radiology, King Hussein Cancer Centre, Amman, Jordan

Imad Jaradat, MD

Department of Radiation Oncology, King Hussein Cancer Centre, Amman, Jordan

Asem Mansour, MD

Department of Radiology, King Hussein Cancer Centre, Amman, Jordan

Najyah Abuirmeileh, MD

Department of Paediatrics, King Hussein Cancer Centre, Amman, Jordan

Eric Bouffet, MD

Paediatric Brain Tumour Program, Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada

Maysa Al-Hussaini, MD

Department of Pathology, King Hussein Cancer Centre, Amman, Jordan, mhussaini{at}KHCC.JO

For patients with diffuse pontine glioma, our institution offers local radiotherapy and supportive care only. The prognosis and do-not-resuscitate orders are discussed upfront with patients' parents. To investigate the effectiveness of this policy, we retrospectively reviewed records of patients with diffuse pontine glioma treated at the institution over a 49-month period. This study included 19 children (16 girls and 3 boys). The median age at diagnosis was 7 years. One patient remained alive at the end of the study, 2 were lost to follow-up, and 16 were confirmed dead. The median survival was 8.2 months. Do-not-resuscitate discussion was documented for 14 patients and successfully initiated for 11. None of those confirmed dead had been offered life support. Contrary to the common belief, our study showed that do not resuscitate should be addressed in Muslim patients with high-risk malignancies. We also found that diffuse pontine glioma warrants further study in developing countries.

Key Words: diffuse pontine glioma • do-not-resuscitate

This version was published on April 1, 2009

Journal of Child Neurology, Vol. 24, No. 4, 460-465 (2009)
DOI: 10.1177/0883073808325650


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