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Journal of Child Neurology
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0883073808325650v1
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Article

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

Ibrahim Qaddoumi, MD1, Najeeb Ezam2, Maisa Swaidan, MD3, Imad Jaradat, MD4, Asem Mansour, MD3, Najyah Abuirmeileh, MD1, Eric Bouffet, MD5, and Maysa Al-Hussaini, MD6*

1 Department of Paediatrics, King Hussein Cancer Centre, Amman, Jordan
2 University of Jordan, Amman, Jordan
3 Department of Radiology, King Hussein Cancer Centre, Amman, Jordan
4 Department of Radiation Oncology, King Hussein Cancer Centre, Amman, Jordan
5 Paediatric Brain Tumour Program, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, Canada
6 Department of Pathology, King Hussein Cancer Centre, Amman, Jordan

* To whom correspondence should be addressed. E-mail: mhussaini{at}KHCC.JO.


  Abstract

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.

First published on December 10, 2008, doi:10.1177/0883073808325650

Journal of Child Neurology 2009;24:460.

A more recent version of this article appeared on April 1, 2009

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