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Background: Apparent diffusion coefficient (ADC) statistics can be valuable in distinguishing three types of brain tumors. The aim is to evaluate the capability of volume under the receiver operating characteristic (ROC) surface (VUS) for concurrent differential diagnosis of glioblastoma (GBM), lymphoma (LYM), and metastatic tumor(s) (MTTs) lesions of brain malignancies. Methods: Investigated Magnetic Resonance Imaging (MRI) included 57 GBM, 25 LYM, and 25 MTT that were pathological diagnoses, after MR imaging. Region of interest (ROI) was taken from tumor regions (TUMOR), enhancement area (ENHANCED), and peritumoral edema (EDEM) regions. ADC maps were obtained after selecting a region of interest, and First-Order Histogram Features (FOHs) were extracted. Statistical analysis was performed by MedCalc version 15.8 for comparison of continuous variables between three groups of lesions and plotting the ROC curves. For VUS and correct classification rates (CCR) calculations the R software v2.13.1 with the DiagTest3grp package was used. The confidence interval level was 95% for significant results. Diagnostic accuracy of ADC in the differentiation of mentioned three groups was performed using ROC surface. Results: ADCMin, ADC75 and ADC95 Percentile values in TUMOR groups of ROI, ADCMaximum, ADCMin, ADCMean, ADCMedian, ADCUniformity and ADCEntropy in ENHANCED and ADC25, ADC75, ADC95 Percentiles, ADCMean, ADCNormal Mean, ADCMedian, ADCEntropy, ADCThird Moment and ADCStandardDeviation in EDEM had significant VUS values results among GBM, LYM and MTTs. Conclusion: VUS analysis is a helpful statistical method for categorizing types of brain tumors. Using the application of FOHs and proposed cut-off points for them by the VUS analysis, the differentiation of more than two types of brain tumors would be possible, concurrently. This will help neurologists and neurosurgeons to plan their treatment and surgery or monitor the status of patients' therapeutic needs. [ABSTRACT FROM AUTHOR]

Background: Brain tumors in children can involve different parts of the brain and cause high mortality. These tumors have different types, and they cause different conflicts and complications. So far, limited studies have been conducted in Iran on children's brain tumors. This study aimed to evaluate radiographic, neuropathological, and demographic findings in children aged 1 to 18 years with brain tumors. Materials and Methods: In this descriptive study, which was conducted for children aged 1 to 18 years with brain tumors admitted to the children's ward of Shohada Hospital (Iran-Tehran) in 2012-2018, 64 children were evaluated. Patient information was extracted from patients' files, including basic data radiological and clinical findings. A significance level was considered less than 0.05. Results: Twenty-six patients (40.6%) were girls, and 38 (59.4%) were boys. 96.9% of the children were term, and the mortality rate was 40.6%. 57.8% were diagnosed in less than one month from the onset of symptoms. 47.6% of patients had a positive family history, and none of them had a history of brain infection. The most common clinical complaint was N/V. The most common location of the tumor was the fourth ventricle (31.3%), and acute hydrocephalus was also seen in 19 patients (29.7%). The most common tumor was medulloblastoma (93.8%), and the most common stage was grade 4 (98.4%). Desmoplastic medulloblastoma was the most common form of medulloblastoma. 9.4% of patients were positive for tumor marker P53. None of the patients were positive for Beta-Catenin. Conclusion: The findings have shown that being a boy, involvement of the fourth ventricle and medulloblastoma are the most common characteristics of brain tumor involvement in Iranian children. [ABSTRACT FROM AUTHOR]

Background: Changes in the body fluid and serum electrolyte status following major operations, such as brain tumor resection, are always expected. These changes can increase post-operation morbidity and mortality. Objectives: We aimed to evaluate the changes in serum electrolyte levels and renal function parameters in brain tumor patients after operation. Materials & Methods: This cross-sectional study was performed on 168 patients with supratentorial tumors in Poursina Hospital, Rasht City, Iran, in 2020. The study parameters included patients' demographics, hemodynamic stability, serum sodium, potassium, blood urea nitrogen (BUN) and creatinine levels, urine specific gravity, and urinary output, measured immediately and 12 hours after the operation. Results: This study revealed statistically significant increases in serum sodium level (from 139.70±5.60 meq/L to 140.34±6.23 meq/L, P=0.002), urinary output (from 1043.70±455.00 mL to 1967.50±661.10 mL, P=0.008), urine specific gravity (from 1.010±0.007 to 1.012±0.008, P=0.011), and in serum BUN level (from 17.46±6.92 to 18.41±6.40, P=0.001), but significant decrease in serum potassium level (from 3.88±0.49 meq/L to 3.78±0.28 meq/L, P=0.017) during the first 12 hours after operation. However, the change in serum creatinine level was not significant (from 1.18±2.08 mg/dL to 1.17±2.08 mg/dL, P=0.787). Conclusion: Significant changes in serum electrolytes (sodium and potassium) and renal function indicators (urine output, specific gravity, and serum BUN) are expected within the first 12 hours after brain tumor operation. [ABSTRACT FROM AUTHOR]

Context: Primary brain tumor (PBT) causes poor prognosis and significant complications, which include movement problems such as balance disorders, failed return to work, and daily life activities. Objectives: The aim of the present study is to estimate the prevalence of PBT in Iran, using a meta-analysis method. Methods: This meta-analysis study was conducted in Iran in 2023 and articles published until the beginning of 2023 were included in the study, using the English keywords of brain cancer, brain tumor, tumor prevalence, prevalence, cancer, nervous system cancer, and their Persian equivalents. Data analysis was carried out, using CMA software. Results: After the initial search, 890 articles on BT were found, and 21 eligible articles were included in the meta-analysis. Also, the prevalence of brain cancer is 4% (95%CI:3.3-4.8) in men and 2.9% (95%CI: 2.3-3.6) in women. Conclusions: According to the result, the BT incidence rate is 4% for males and 2.9% for females. Therefore, it is necessary to take necessary preventive measures in this regard. [ABSTRACT FROM AUTHOR]

Background & Objective: Brain tumors are the most frequent solid tumors in children. High-grade tumors are more challenging in diagnosis. Atypical teratoid rhabdoid tumor (ATRT) may be mistaken for other high-grade brain tumors. Molecular genetic analysis of ATRT has shown deletion and mutation in the hSNF5/INI1 gene in most of the cases. The INI1 protein expression can be helpful for the accurate diagnosis. Methods: In this study, immunohistochemical staining (IHC) using INI1 antibody was performed to determine the possibility of ATRT misdiagnosis. Totally, 147 tumors including 6 ATRTs, 81 medulloblastomas, and 60 other CNS tumors were examined in children between 0 and 17 years old. Results: No nuclear staining was found in the six ATRT cases, while most of other CNS tumors demonstrated nuclear staining. Five cases were previously diagnosed with medulloblastoma, primitive neuroectodermal tumor (PNET), and anaplastic oligodendroglioma, while the diagnoses were changed to ATRT based on the reevaluation of the H&E slides and INI1 study. Additionally, two cases were recurrent tumors whose features were consistent with those of ATRT. The INI1 immunostaining was negative in these cases. Conclusion: INI1 was very helpful in distinguishing ATRT from its mimickers in challenging cases. All known ATRT cases in this study were immunonegative for INI1. Thus, INI1 is recommended to be used in the initial IHC panel for the high-grade brain tumors, especially in children under the age of three years, so that they can benefit from intensified therapeutic regimens. [ABSTRACT FROM AUTHOR]

This study explored spatial patterns of the 10 most prevalent cancers in north-eastern Iran. Getis-Ord G* and Anselin Local Moran's Index ‎were used for identifying ‎hotspots and local clusters. Except for breast cancer, all cancer types were more frequent among males. Cluster analysis in men showed hotspots of breast cancer in the South-West, skin cancer in the East/South-East, and brain tumours in the North. Among women, there were hotspots for skin cancer in the East and South-East, bladder cancer in the Central and East. ‎This study indicates a possible relationship between the high ‎incidence of certain cancers and environmental factors. [ABSTRACT FROM AUTHOR]

Background Cancer is the leading cause of death in the world after cardiovascular disease, and is the third leading cause of death in Iran. Objective This epidemiological study aims to investigate different types of cancers in Sowme’e Sara County, Guilan, Iran. Methods This analytical cross-sectional study is a part of the PERSIAN Guilan cohort study that was conducted on 10520 adult men and women in Sowme’e Sara County. The prevalence rate was determined per 100,000 people. Descriptive statistics (mean, standard deviation, frequency, and percentage) were used for describing data. Statistical analyzes were performed in STATA version 13 software. Results In this study, 94 patients with cancer and 98 types of cancer were recorded. Most of patients were female (n=65, 68.4%). The mean age at diagnosis in men and women was 47.61±11.23 and 44.30±7.87 years, respectively (Total=45.58±10.09 years). The most common cancers were breast cancer, brain & central nervous system cancer, and prostate cancer. The minimum age for diagnosis in men and women were 23 and 19 years, respectively,. Conclusion Screening for breast cancer in women and prostate cancer in men living in Sowme’e Sara County should be done which is currently underway using mammography and prostate specific antigen tests. [ABSTRACT FROM AUTHOR]

Although glycemic index (GI) and load (GL) have been linked with several health outcomes, no information is available linking dietary GI and GL with glioma. This study aimed to investigate the relationship between dietary GI and GL and odds of glioma. This hospital-based case-control study was conducted between November 2009 and September 2011 in the hospital affiliated to Shahid Beheshti University of Medical Sciences. We recruited 128 newly diagnosed cases of glioma and 256 age- and sex-matched controls. All cases were pathologically diagnosed with glioma patients, with no history of any type of other pathologically confirmed cancers and chemotherapy or radiotherapy (due to cancers). Dietary GI and GL were measured by using a validated, self-administered, dish-based, semi-quantitative food-frequency questionnaire. A significant positive association was found between dietary GI and glioma (OR: 3.01; 95% CI: 1.75–5.17, P < 0.001); such that after considering for potential confounders, participants in the highest tertile of dietary GI had 3.51 times greater risk of glioma than those in the lowest tertile (OR: 3.51; 95% CI: 1.69–7.28, Ptrend = 0.001). Furthermore, we observed a significant positive association between dietary and glioma (OR: 3.74; 95% CI: 1.97–6.11, Ptrend < 0.001). This association remained significant even after further controlling for potential confounders (OR: 2.42; 95% CI: 1.02–5.69, Ptrend = 0.04). We observed a significant positive association between dietary GI and GL and risk of glioma in adults. However, prospective cohort studies are required to confirm this association. [ABSTRACT FROM AUTHOR]

Background: The current study aimed to determine the trends in esophageal cancer (EC) patients and examine the impact of the type and anatomical location of the tumor and the site of metastasis on their survival. Method: In this retrospective cohort study, we investigated 305 patients with a definite diagnoses of EC, who had been hospitalized at the Mahdie Hospital of Hamadan, Iran, during ten years from 2005-2015. EC-related survival considering different types and locations of the tumor, as well as the sites of metastasis, was evaluated. Survival was calculated using Kaplan-Meier curves and a multivariable Cox regression analysis (MVA) was performed. Results: Squamous cell carcinoma was found in 76.6% of the patients and 23.4% had adenocarcinoma (AC). There was a significant relationship between the location and pathological type of tumor; 87% of ACs happened in the lower part of the esophagus (P = 0.015). The 1- to 5-year relative survival of the patients was 46%, 25%, 22%, 12%, and 7%, respectively. The rate of death in liver, lung, brain, pancreas, abdomen, and lymph nodes metastasis were respectively 42.9%, 21.4%, 14.3%, 7.1%, 7.1%, and 7.1%. No significant relationships were observed between the tumor type and metastasis (P = 0.14) or between the tumor type and the location of metastasis (P = 0.7). Conclusion: Similar to other reports, the rate of survival was higher in AC type, yet the rate of total survival in Iran was much lower than that in developed countries. There were no differences in the survival rate concerning the location of the tumor. The obtained results did not show any relationships among the tumor type, the location of metastasis, and the total survival. [ABSTRACT FROM AUTHOR]

Background: The rate of childhood cancer death has dropped steadily over the past 50 years. The pediatric cancer risk has remained under investigation. Objectives: This study aims at investigating the associated factors with the survival of pediatric patients with retinoblastoma, sarcoma, brain tumor, and leukemia cancer. Methods: The cohort study of 1879 children with retinoblastoma, sarcoma, brain tumor, and leukemia aged < 1, 1 - 5, 6 - 10, 11 - 15, and > 15 years in Mahak Hospital and Rehabilitation Complex from 2007 to 2016 were enrolled in the study. Median survival time was reported for each cancer. Parametric survival models including Gompertz, Weibull, lognormal, and log-logistic models were fitted. Then, the model with almost minimum Akaike information criterion (AIC) was chosen. The hazard ratio (HR) and the analysis were performed by R3.5.1. Results: Totally, 270 (14.37%) patients with Retinoblastoma, 667 (35.5%) with leukemia, 625 (33.26%) with a Brain tumor, and317 (16.87%) with Sarcoma were included in this study; 815 (43.37%) patients were female. Gompertz's model was chosen to fit the data due to the minimum AIC. The associated factors with the survival of childhood cancers were as follows: age < 1 year, parental relation, locoregional relapse and chemotherapy alone (HR: 7.63, 1.56, 4.61, 1.12) in leukemia, other nationalities, metastasis or metastasis and loco-regional relapse and chemotherapy alone (HR = 3.74, 5.75, 2.12) in retinoblastoma, loco-regional relapse and metastasis (HR = 2.40, 3.71) in brain tumor, other ages except for 5 - 10 years, parental relation, chemotherapy alone, and metastasis (HR = 33.3, 1.80, 3.57, 3.8) in sarcoma. Conclusions: Age, parental familial relationships, combination therapy, and metastasis of primary cancer were the risk factors for survival of children with 4 common cancers of leukemia, retinoblastoma, brain tumors, and sarcoma, using the Gompertz model. [ABSTRACT FROM AUTHOR]

To determine the clinical characteristics and outcomes of COVID-19 in a large cohort of new cancer patients referred to an oncology clinic in the north of Iran. During the 20-month COVID-19 pandemic, new cancer patients were followed-up. Demographic, pathologic, and clinical variables were collected for each patient. COVID-19 was confirmed based on a positive polymerase chain reaction test. Analyses were performed using the STATA version 14.0 at a significance level of 0.05. In this study, 1294 new cancer patients were followed for 24 months (mean age: 58.7 years [range 10–95]). During the study period, COVID-19 was diagnosed in 9.4% of the patients with hospitalization rate of 3.4%, an ICU admission rate of 0.7%, and COVID-19 mortality rate of 4.9%. Hematological malignancies (ORU= 2.6, CI95% 1.28–5.34), receiving palliative treatments (ORA=3.03, CI95% 1.6–5.45) and receiving radiotherapy (ORA=2.07, 1.17–3.65) were the most common predictive factors of COVID infection in cancer patients. Also, the COVID mortality was higher in brain cancer patients (p = 0.07), metastatic disease (p = 0.01) and patients receiving palliative treatments (p = 0.02). In patients suffering from cancer, COVID-19 infection can be predicted by cancer type, palliative care, and radiotherapy in cancer patients. Furthermore, brain cancers, metastasis, and palliative care were all associated with COVID-19-related mortality. [ABSTRACT FROM AUTHOR]

Objectives Cognitive abilities might be impaired due to brain lesions in children and adolescents. This study aimed to investigate neuropsychiatric indicators in children and adolescents with primary brain tumors and other brain space-occupying lesions (SOLs) before and after the surgical procedure. Materials & Methods The current pre-post study was conducted on 81 patients with brain SOLs aged under 18 years hospitalized in the Neurosurgery Ward of Imam Reza university hospital, Tabriz, Iran, within 20 December 2016 to 20 December 2017. The patients with metastatic brain tumors were excluded. Before and after the surgical procedure, Digit Span forward and backward task (to assess working memory), Stroop Task and Trail Making Task A and B (to assess attention), and Rey-Osterrieth Complex Figure Test (ROCF) (to assess visuospatial memory) were carried out. Then, the scores of the tests were compared to standard values and postsurgical scores. Results The most prevalent type of brain SOLs was medulloblastoma, and the most prevalent region of involvement was the posterior fossa. The scores of all tests after the surgery were significantly improved, compared to those before the surgery (P<0.05). In the assessment of Digit Span forward and backward task scores, there was no significant difference between the scores of patients before the surgery and standard values (P>0.05). Regarding the scores of various stages of the ROCF, the scores of the immediate recall stage were significantly low (P<0.05). Regarding Trail Making Task A and B and Stroop Task before the surgery, only Trail Making Task A and B scores were significantly increased (P<0.05). The scores of Trail Making Task A were significantly higher in patients with medulloblastoma and anatomically in left temporal tumors, which indicated greater damage to the attention field (P<0.05). In addition, in cerebellar tumors, the scores of the immediate recall stage of the ROCF were significantly lower than in other brain tumors or SOLs (P<0.05). Conclusion The visuospatial memory and attention of preoperative assessments were significantly impaired, compared to those of the healthy population (P<0.05). Working memory, visuospatial memory, and attention showed improvement, compared to those before the surgery. Deficits in the attention domain were greater in medulloblastoma. [ABSTRACT FROM AUTHOR]

Introduction: In recent decades, the incidence and mortality rate of brain tumours, especially in adults, has increased. In order to better plan to reduce the burden of this cancer, knowledge of the epidemiological aspects of this disease is essential. Therefore, due to the lack of a comprehensive study on brain cancer in Iran, this study aimed to investigate the epidemiological aspects of this cancer in Iran. Methods: In June 2020, keywords of 'brain tumour', 'nervous system tumours', 'nervous system neoplasm', 'nervous system cancer', 'central nervous system (CNS)' and 'Iran' were searched on Medline/PubMed and Web of Science databases Scopus, Embase, SID, IranMedex, and Google Scholar. The search results were entered Endnotes Version 8; finally, 35 full papers were reviewed and included in the study. Results: The incidence of brain cancer and CNS tumour is lower in children in central Iran. The incidence of CNS cancer was relatively high among children in Golestan province. Furthermore, the standardised incidence of primary CNS tumours in Iran is 5.69 per 100,000, which is lower than in other countries. Nervous system malignancies were more common in men than in women (age-standardized rate 3 versus 2.2 per 100,000 in men and women, respectively). Tehran had the highest incidence of CNS tumours. Meningiomas were the only most common tumour in women. Gliomas were the most common primary brain tumour, and most of the lesions in this subgroup were in low-grade astrocytoma and ependymomas. Brain cancer mortality was higher in men than in women. Age is a potential risk factor, and the incidence of CNS tumours increases with increasing age after 30 years. Conclusion: Nervous system cancers are on the rise in Iran due to lifestyle changes and increased risk factors. Planning to reduce risk factors and early detection of the disease can be helpful in reducing cases and reducing mortality. [ABSTRACT FROM AUTHOR]

Purpose: Primary pediatric tumors are the most common solid tumors in children. There are limited reports on the management and outcome of these tumors in the developing countries. In recent years, advances have been done in the diagnosis, treatment, and outcome of these tumors. The aim of this study was to evaluate the histopathology, characteristics, and outcome of primary pediatric tumors in Iran. Methods: This retrospective study examines primary brain tumors in children below 14 years of age who have undergone surgery. Histopathological characteristics according to WHO 2017 classification, age, sex, tumor resection rate, and patient outcome were extracted and studied. The results of the study were compared with the results of similar reports from neighboring countries and other parts of the world. Results: In this study, 199 primary pediatric tumors were examined. Out of 199 cases, 114 cases were males, and 85 cases were females, and the male/female ratio was 1.34. The most common tumor group in this study was astrocytic tumors (68.3%) and the most common tumor was pilocytic astrocytoma (22.1%). In terms of malignancy, 50.7% of tumors were benign, and 49.3% were malignant. Total resection was done in 46% and subtotal resection in 35%. The mortality rate was found 19.2%. َAmong the remaining cases during follow-up, 76.6% had a good outcome without neurological deficits or mild disability and 23.4% had moderate to severe disability. Conclusions: The results of the study in terms of pathology and demographic characteristics were mainly similar to other reports. The mean age of patients was lower, and the patients' outcome was better than the other countries in the region. [ABSTRACT FROM AUTHOR]

A 10‐year‐old boy who was referred due to acute hydrocephalus symptoms was diagnosed as the first case of pediatric DLGNT in Iran. The results suggested that using shunting for hydrocephaly and anti‐seizure medicines, as well as chemotherapeutic agents, can be an effective treatment strategy for DLGNT. Although the patient was stable without a tumor recurrence for a limited follow‐up period of 22 months, further studies are expected. [ABSTRACT FROM AUTHOR]

Introduction. Malignant glioma is resistant brain tumor to treatment and considered by aggressiveness that fails successful resection. Molecular pathways including PTEN related with tumor behavior. Materials and methods. We studied the immunohistochemichal expression of PTEN in 32 brain surgical resection specimens with different histologic grades. All samples were from pathology department of Sina hospital in Tehran-Iran from 2020-2021. Results. From 32 patients, 21 (65.6%) had no PTEN staining. There was significant relationship between high age and no PTEN expression and average age with no PTEN staining was 54.05±14.01 years (P value: 0.044). There was significant relationship between necrosis in histopathologic evaluation with no PTEN staining (P value: 0.016). Also, there was no significant relationship between sex, tumor’s size, Tumor’s site, tumor’s grade, and primary or secondary type of tumor with PTEN staining (P value > 0.05). Conclusion. PTEN expression related to histopathologic features such as necrosis and age. PTEN can be introduced as an important prognostic indicator in high grade. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was investigation of COVID-19 disease and its outcome in cancer patients who needed treatment, in a 90-day period. Methods: Cancer patient who required treatment, were evaluated for potential COVID-19 infection in a 90-day period, starting from beginning of this epidemic in Iran, January, to April 19, 2020. For treatment of solid tumor patients, if they did not have symptoms related to COVID-19, just chest X-ray was requested. If they showed COVID-19 related symptoms, high resolution CT scan of lungs was requested. For hematology cancer patients, PCR test for COVID-19 infection was requested as well. Protection measures were considered for personnel of oncology wards. Results: 279 Patients were followed up in this 90-day period. No COVID-19 infection was observed in 92 cases of breast cancer, 14 cases of gastric cancer and 12 cases of pancreaticobiliary cancer. However, in 72 cases of colon cancer, 11 cases of lung cancer, 5 cases brain tumors and 12 cases ovarian cancer; 4 cases of COVID-19 were observed. In the hematology cancers group, which included 14 cases of Hodgkin's disease, 23 cases of lymphoproliferative disorder, 12 cases of acute leukemia and 12 cases of multiple myeloma; 3 cases of COVID-19 were observed. Conclusion: Patients with cancer who need treatment can be treated by taking some measures. These measures include observing individual and collective protection principles in patients and health-care personnel, increasing patients' awareness particularly about self-care behavior, performing a COVID-19 test, and taking a chest X-ray, before the treatment starts [ABSTRACT FROM AUTHOR]

Background: Cerebral meningiomas are among the most prevalent brain tumors. Most cases of cerebral meningioma are benign and respond well to the treatment. However, there is no conclusive laboratory method for screening of such tumors. Given the lack of a screening approach for meningiomas, we examined the expressions of human leukocyte antigen (HLA)-B5, 7, 8, 27, and 51 in patients with cerebral meningioma in this research in order to achieve a reliable laboratory parameter in this regard. Materials and Methods: Patients with cerebral meningioma who referred to Golestan Hospital, namely one of the largest neurosurgery centers in the southwest of Iran, were identified and examined over a 2-year period. After confirmation of cerebral meningioma diagnosis, the patients were enrolled in the study. Results: There was no significant relationship between the expressions of the abovementioned HLAs with platelet parameters, lymphocyte, monocyte, and neutrophil counts, clinical manifestations, family history, drug consumption, and alcohol abuse. A higher expression level of HLA-B5 was observed in the patients. Conclusion: With regard to the expression of HLA-B5 in nearly one-third of patients, it is likely to use this antigen or its serotype, namely HLA-B51, as a laboratory marker for screening of disease in the future through the study of larger populations. [ABSTRACT FROM AUTHOR]

Background: Brain and other central nervous system (CNS) tumors represent almost 3% of all new cancer cases worldwide and comprise a heterogeneous group of tumors with varying epidemiologic and clinical characteristics. The aim of this study is to present the distribution and trends in brain and other CNS cancer incidence in Golestan, Iran during a 10-year period. Methods: Data on primary brain and other CNS cancers diagnosed between 2004 and 2013 were obtained from the Golestan population-based cancer registry (GPCR) dataset. We computed age-standardized incidence rates (ASRs) per 100 000 person-years. In order to assess changes in incidence over time, we calculated the estimated annual percentage change (EAPC) and corresponding 95% confidence intervals (CIs) to detect significant trends. Results: Over the 10-year period (2004-2013), the incidence of brain and other CNS cancer was observed to increase for all ages (EAPC: 1.13, 95% CI: -6.06, 8.87). After 2008, the trends appear to have stabilized. Incidence rates were higher in males than females (ratio: 1.2) and glioblastoma was the most common tumor subtype (15.1% of all malignant tumors). Conclusion: Trends and patterns in the burden of brain and other CNS cancer require careful monitoring alongside future research to increase our understanding of potential risk factors. [ABSTRACT FROM AUTHOR]

Background: In brain metastatic lesions, peritumoral edema assessed by advanced imaging modalities is reported to have infiltration by neoplastic cells; however, determining the tumor border is still inaccurately depicted even by applying such modalities. More importantly, the apparent diffusion coefficient (ADC) values of this area for predicting tumor-related characteristics such as diametric and morphologic characteristics of lesions, as well as their primary source, remain uncertain. Objectives: In the current study, we aimed at assessing the value of ADCs in both intratumoral and peritumoral areas to determine the metastatic brain tumor source and to predict the morphological characteristics of the tumor. Methods: This study was conducted on 80 biopsy-proven patients with brain metastasis and underwent magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) examination. All tumor characteristics including the number and size of lesions, the origin of metastasis, the zone of metastasis, and the presence of necrosis or edema in the lesions were collected based on imaging. The origins of the metastasis were also determined. Results: The ADCmin and ADmean values of the peritumoral area were strongly associated with the grade of edema in this area; however, none of the values could accurately predict the origin of metastasis. Determining the ADCmin and ADCmean in the intratumoral area could not be indicators for lesion characteristics such as size and location of the lesion, the presence of necrosis or edema, as well as the source of the metastatic tumor such as breast or lung. Similarly, the ADCmin and ADCmean in the peritumoral area could not be an effective predictor for determining the source of metastasis and also diameter, location, or necrotic nature of the tumor and only can predict the edematous pattern of the lesion. Conclusions: The ADC values in both intratumoral and peritumoral areas of the brain tumor metastatic lesion may not be predictive for the assessment of tumor morphology or its origin. [ABSTRACT FROM AUTHOR]

Introduction: U87 cell line contains glioblastoma cancer cells as the most acute type of human brain tumor. Increased expression of Bcl-2 gene in cancer cells has anti-apoptotic effect. In the present study the effect of Spirulina extract on gene expression in cancer cell line was investigated. Materials and Methods: In this in laboratory study, the U87 cell line was used. The brain cancer cell line was procured and cultivated from the Iranian Biological Resource Center. Cells were divided into two treatment and control groups. Spirulina alga extract was affected on the treatment group and its toxicity was measured using MTT assay (compound 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromidefor). The reference gene in this study was GAPDH. RNA was extracted from control and control cells and cDNA was made. The expression of genes was evaluated using ΔΔCt in Real-time PCR. Results: The result of MTT assay showed that the IC50 (Median Inhibition Concentration) value was 10.01 mg/ml for the 48 hour treatment. The result of Real-time PCR showed that the expression of Bcl-2 and the anti-apoptotic gene significantly decreased 3 folds in treatment group. Conclusion: According to the results of MTT assay and Real-time PCR, the expression of Bcl-2 significantly decreased 3 times in treatment group. [ABSTRACT FROM AUTHOR]

Background: Brain tumors are one of the important causes of morbidity and mortality, where surgery is usually used to treat tumor. Therefore, the aim of this study was to determine the postoperative survival of patients with brain tumors in Markazi province of Iran. Methods: In a retrospective study, the medical records of patients with brain tumors after surgery were assessed from 2006 to 2015 in Vali-e-Asr Hospital, Arak, Iran. The survival time of patients was considered from diagnosis to death. The effects of age, sex, tumor location, size and tumor grade on survival were also evaluated. Data analysis was performed using the Cox regression method using SPSS21 software. Results: 51 patients with an average age of 56.67 years were included in the study, of which 72.54% were women. The overall survival rate was 4.58 years, and 2, 5, 10-year survival rates were determined as 90.1, 43.13 and 5.88%, respectively. Conclusion: The results of this study suggested that gender, age, grade and size of tumor had no significant effect on survival, but there was a significant relationship between tumor location and survival rate. [ABSTRACT FROM AUTHOR]

Background: Cancer, a common disease in adulthood, is a rare albeit slowly increasing condition among children. Currently, limited data are available on the incidence, prevalence, and mortality of these diseases in many regions, including developing countries. Herein, we are reporting national and sub-national estimates on deaths due to childhood cancers between 2000 and 2015 in Iran. Methods: Cancer mortality rates were estimated using the national death registration system's data after addressing its incompleteness and misclassification, using demographic (complete birth history and summary birth history) and statistical analysis (spatiotemporal, Gaussian process regression, and generalized linear mixed models). We included data from cemeteries of two cities (Tehran and Isfahan) that were not included in the death registration system. We used census data and household expenditure and income surveys for data on population and other covariates used in the modeling. Results: The overall age-standardized death rate (ASDR) of childhood cancers have decreased by 69.52% (80.67-49.71) in Iran (equal to an annual percent change of -3.63 [-4.53- -2.24]), declining from 12.24 (95% UI: 10.52-14.49) in 2000 to 3.73 (2.8-5.29) deaths per 100 000 in 2015. This decrement was equal to an annual percent change of 4.35% over these years. Leukemia, brain, and nervous system malignancies accounted for about 66% of all cancer-related mortalities among children and adolescents in 2015, which had a 10% increase compared to 2000. Moreover, trends at the sub-national level showed that the highest and lowest ASDR of childhood cancers ranged from 2.12 to 4.99 across provinces of Iran in 2015. Conclusion: Although the overall mortalities have decreased, there is still inequality in the distribution of the recorded deaths. This inequality should be addressed with the improvement of the quality of care and better access to pediatric hospitals and oncologists in these areas. [ABSTRACT FROM AUTHOR]

Introduction: Tumors are the second-most common cause of death after cardiovascular diseases. Due to the high prevalence and mortality rate, brain tumors are of great importance and makeup about 5% of all tumors. Different types of brain tumors have their special pattern based on age, sex, complaints on admission, radiological signs and sometimes, their family history and seem these patterns are changing according to the geographic region over time. In this study, we evaluate the incidence of brain tumors in the northwest of Iran. Materials and Methods: All patients with brain tumor diagnosis that were hospitalized between April 2011 and March 2016 evaluated. Exclusion criteria were considered as secondary tumors of the central nervous system (CNS) (metastases) and duplicate records for the recurrent disease of the same patient. Data collected from their documents and analyzed with SPSS version 16. Results: In the present study, male to female (M: F) ratio is 1:1. 92.5% of tumors are primary in which meningiomas (22%) and glioblastoma multiforme (GBM) (19.6%) are the most common types. The rarest tumor types are neurocytoma (0.3%) and chondroid chordoma (0.3%). GBM is the most common tumor in the male population and meningiomas are most common in females. Medulloblastoma and meningioma with a median age of 11 and 58 years, respectively, were known as the most common primary CNS malignancy of the youngest and oldest age of study group. Conclusion: The obtained data from this study revealed that age and sex are associated with the tumor types, which is consistent with the previous results. Brain tumors involvement pattern is changing in male patients somehow there is a tendency of involving more aggressive and malignant tumor types in male individuals could be seen. [ABSTRACT FROM AUTHOR]

Background: Cancer cells bear various metabolic alterations in order to survive and progress. Neoplastic cells rewire their metabolic pathways for fermentation of glucose and production of more lactate. Microenvironment acidification is a common feature of many neoplastic lesions. In other words, most cancer cells produce energy ineffectively, by aerobic glycolysis, considered as "Warburg effect". Mounting on previous evidence, hypoxia also induces tumor stemness, diminished apoptosis, and more invasive behavior as well as angiogenesis. In this study, we aimed to investigate whether more lactate concentration in stereotactic puncture specimen of various brain lesions can be an alarming sign of malignancy and higher grades. The current study aims at providing a rapid prognostic biomarker of higher grades for cystic brain lesions approached stereotactically before the complete pathologic grading report is prepared. Methods: We investigated the biochemical cyst content of 44 patients with astrocytomas, 8 craniopharyngiomas, 1 oligodendroglioma and 2 cases with metastatic lesions after stereotactic surgery (47 patients were enrolled in the study). Cyst fluid was analyzed for pH, total protein concentration, cytology, and lactate. The association of these parameters was explored relative to tumor behavior (e.g., tumor grade, type, and cyst progression). The current study was conducted at Firoozgar hospital, Tehran, Iran. Patients were followed for any possible progression from 2014 to 2017. Results: The analyses revealed a significant and positive correlation between grade and lactate concentration (P ≤ 0.001); as well as between grade and mean total protein concentration (P = 0.046). This suggests that more lactate and total protein concentration in stereotactic specimen can be an alarming sign of higher grades and poor outcome in astrocytoma cysts. However, craniopharyngiomas; as benign lesions; had significantly lower lactate (P ≤ 0.001) and total protein concentrations (P = 0.018) than astrocytomas. Conclusion: Higher total protein and lactate concentrations in the stereotactic biopsy specimens are alarming signs of poor outcome and higher grades in astrocytomas. Trial Ethics Registration: IR.IUMS.FMD.REC 1396.88215207. [ABSTRACT FROM AUTHOR]

Background: We aimed to evaluate completeness and accuracy of the Golestan Death Registry (GDR) to identify cancer-related causes of death (CCoD). Methods: The GDR data (2004-2015) were compared with cancer data collected from clinical/pathological sources (the considered gold standard) by the Golestan Population-Based Cancer Registry (GPCR). Using a linkage method, matched cases, including subjects with CCoD and those with ill-defined cause of death (ICoD) (garbage codes), were identified and entered into the final analysis as study subjects. The completeness (percentage of study subjects with CCoD) and accuracy (number of subjects with correct CoD from the total number of study subjects) of the GDR were calculated. Results: In total, 3,766 matched cases were enrolled. Overall, the completeness and accuracy of the GDR for identifying CCoD were 92.7% and 53.2%, respectively. There were variations by cancer site and age group, with completeness and accuracy highest for brain cancer (96.3%) and leukaemia (79.8%) while the lowest accuracy was observed for colorectal cancer (29.9%). The completeness and accuracy of GDR was higher in patients aged under 60 years (95.7% and 53.6%, respectively). We also found higher completeness (93.7%) and accuracy (55.8%) in residents of rural areas. Conclusion: Linkage of death registry data with cancer registry data can be a significant resource for evaluating quality of the death registry data. Our findings suggested that completeness of the GDR for identifying CCoD is reasonable, but accuracy is relatively low. Access to clinical and pathological data from other sources and enhanced training of death certifiers can improve the present situation. [ABSTRACT FROM AUTHOR]

Background: Cancer is the second most common cause of morbidity and mortality in children. This study aimed to epidemiologically and demographically assess common cancers in children in Iran. Materials and Methods: This cohort study was conducted on children registered in Mahak Hospital and Rehabilitation Complex (which is a non-governmental organizations (NGO)-related hospital for only malignant diseases). A total of 2232 questionnaires were filled out for cancer patients between 2007 and 2016. The factors including age, gender, race, family history, type of treatment, and type of cancer were entered into Cox regression model to examine their effect on mortality of children diagnosed with cancer. Results: The Cox regression model showed that age, race, type of cancer, family history of cancer, and type of treatment had a significant effect on mortality of children diagnosed with cancer (P < 0.05). The hazard ratio (HR) of mortality in 10-15 years old was higher than that of 1-5 years old (P = 0.03, HR = 1.3). The HR of mortality in patients with brain tumor (P < 0.01, HR = 2.24), sarcoma (P < 0.01, HR = 2.32), and neuroblastoma (P < 0.01, HR = 2.56) was twice the value in patients with leukemia. The HR of mortality in patients who had a family history of cancer was higher than that of patients without it (P < 0.01, HR = 1.33). Patients who had undergone chemotherapy along with surgery and radiotherapy (P = 0.02, HR = 0.68) and patients who received chemotherapy along with surgery (P = 0.01, HR = 0.67) had a lower HR of mortality compared to the chemotherapy group. Conclusion: Young age, multidisciplinary approach, and absence of family history were associated with lower hazard of death in children diagnosed with cancer; brain tumor, leukemia, and sarcoma had higher hazard of mortality compared to leukemia. Children with a family history of cancer should be under regular follow-up. Treatment should be multidisciplinary and comprehensive. [ABSTRACT FROM AUTHOR]

Background: Brain cancer is an illness with serious symptoms and poor prognosis. Tumors of the central nervous system is about 2% of all cancers with mortality rate about 4.2-5.4 per 100,000 persons per year worldwide. This study evaluates the incidence during 2000 to 2005 in 6 geographical areas in Iran using national cancer registry data. Materials and Methods: Data from the cancer registry system in Iran during 2000 to 2005 was extracted. Incidence rates were standardized directly using WHO population and also 95% confidence intervals were calculated in STATA. The significant incidence of changes over the years under study were tested by Poisson regression models. Results: The age-standardized incidence rate of brain cancer, in 2000 in men and women respectively reached from 0.6 and 0.4 per 100000 to 2.4 and 1.6 per 100000 in 2005. The highest incidence rate of brain cancer seen in the provinces of mountains areas and the lowest rate seen in the province settled in Central and Western area of the Caspian Sea. Trends incidence in all geographic areas of the country is rising despite the difference in slope. Ratios of male to female was 1.54 and the mean age of patients was 39.2 with a standard deviation of 19.6. Conclusion: In general, along with other cancers, the incidence of brain cancer is growing in all geographic regions in Iran. [ABSTRACT FROM AUTHOR]

Hadron therapy (HT) with protons and carbon ions is an advanced radiotherapy technique. As the first report addressing this topic, the present study aimed to estimate the number of patients eligible for HT in Fars province and the whole of Iran. The data were collected through direct inspection of medical records of the patients treated at the Radiotherapy Department, Namazi Hospital, Shiraz, Iran in 2014. The patients who were treated with external-beam radiotherapy and declared to be a resident of Fars province were extracted from the medical records. After classification based on appropriate indications and factors, the number of eligible patients in Iran was calculated by scaling (Iran: Fars population). Of the 2,932 medical records, 1,943 patients were treated with external-beam radiotherapy, among which 1,536 were from Fars. The total number of patients eligible for HT in Fars was >351 cases/year (22.9% of the treated patients). The cancer site distribution of the eligible Fars residents was central nervous system primary tumors (n=31), brain metastases (n=64), eye (n=7), head and neck (n=28); thyroid (n=4), lung (n=17), breast (n=56), esophagus (n=5); pancreas (n=5), gastric (n=32), liver and bile duct (n=0), rectum and anus (n=26); prostate (n=27), bladder (n=8), cervix (n=6), soft tissue (n=17); kidney (n=1), Hodgkin lymphoma (n=9), non-Hodgkin lymphoma (n=4), and bone metastases (n=4). A total number of 5,756 cases/year was estimated for the entire country. Considering the experiences of other countries, these results suggest that establishing at least two HT centers (covering the northern and southern parts of Iran) is justified based on the total number of patients. Further accurate estimations and cost evaluations are recommended. [ABSTRACT FROM AUTHOR]

Background: The central nervous system (CNS) belongs to heterogeneous group of glial and non-glial brain tumors. Increase in the frequency of brain and CNS tumors in Iran have been a cause for debate and concern. Objectives: The aim of this study was to estimate the frequency of the principal CNS cancers, using CNS cancer data records in a 7-year period in a hospital in Mashhad, Iran. Methods: This study is based on the records of department of surgical pathology, Razavi hospital, Mashhad, Iran. We analyzed 1,164 brain tumors and CNS cancers diagnosed from 2006 to 2013. It includes data on spinal cord tumors, primary brain such as lymphomas, which are hematological malignancies and metastatic tumors originating from external to the central nervous system. The frequency varies widely across this 7-year period. Results: The majority of brain tumor locations were frontal (13.2%), pituitary (11.7%), parietal (10.6%), Spinal (8.9%), Temporal (8%), and base of skull (6.3%). The most frequently reported histologies were meningiomas (33.6%) and glioblastomamultiforme (15.8%) that are strongly influenced the overall results. Higher numbers for glioblastoma, myxopapillaryependymoma, fibrillary astrocytoma, craniopharyngioma, hemangio-blastoma, oligodendro-glioma, and sarcoma were observed in male than in female patients. Meningioma, neurofibroma, and choroid plexus papilloma were the only tumors with a significant excess in female. Conclusions: We noted that higher frequency of brain tumors and CNS cancers occurred at age group of 51 to 60 years. Although data are hospital-based, is the first study to delineate the brain tumors and CNS cancers burden in north-east of Iran by age, sex, histology type, anatomical site, and laterality. [ABSTRACT FROM AUTHOR]

Establishing a robust teamwork model in the practice of neuro-oncology requires continued interdisciplinary efforts. The Neuro-Oncology Scientific Club (NOSC) initiative is an interdisciplinary clinical forum promoting the comprehensive approach across involved disciplines in the management of central nervous system (CNS) malignancies. With its provincial founding panels and national steering board, NOSC has been operational in Iran since 2011. This initiative has pursued its mission through interval strategic meetings, tumor boards, case discussions as well as publishing neuro-oncology updates, case study periodicals, and newsletters. A provincial meeting of NOSC in Shiraz put together insights from international practice guidelines, emerging evidence, and expert opinions to draw a position statement on high-grade glioma management in adults. The present report summarizes key highlights from the above clinical forum. [ABSTRACT FROM AUTHOR]

Background: Low-grade gliomas (LGGs) are the second most prevalent type of primary brain tumors in adults. The prognosis for LGGs can differ according to the clinical-pathological prognostic factors determined during diagnosis and treatment. The purpose of this study was to identify 10-year, disease-free survival (DFS), 10-year overall survival (OS), and related clinical-pathological prognostic factors of adult patients with supratentorial, low-grade gliomas who were treated with or without surgery and radiation therapy. Methods: The study included 110 patients who were confirmed to have low-grade, supratentorial gliomas and who had received surgery and adjuvant radiation therapy or salvage radiotherapy as part of their treatment. These patients were followed by the radiation-oncology ward at Shohada-e-Tajrish Hospital in Tehran, Iran, between 2002 and 2012. The log-rank test (univariate) and the Cox proportional hazards model (multivariate) were used to examine the 10-year DFS and OS and to assess the strengths of various histo-clinical factors relative to 10-year DFS and OS. Results: The study included 110 patients for whom 10-year DFS and OS were found to be 23 and 28%, respectively. Favorable prognostic factors in the univariate analysis using the Kaplan-Meier 10-year OS analysis were the following: age below 40, karnofsky performance status (KPS) more than 70, the presence of oligodendroglioma, tumor size of < 5 cm, and gross-total resection (p=0.02, p=0.01, p=0.03, p=0.01, p=0.02, respectively). Good prognostic factors in multivariate analysis using the Cox regression model were as follows: age below 40, the presence of oligodendroglioma, tumor size< 5 cm, and gross total resection in10-year OS (p=0.01, p=0.03, p=0.00, p=0.02, respectively). Conclusions: Gross-total resection, tumor size < 5 cm, age below 40, and the presence of oligodendroglioma had better 10-year DFS and OS rates. We recommend that all patients with LGG tumors be referred to neurooncology centers that have sufficient experience to achieve the best results of treatment. [ABSTRACT FROM AUTHOR]

Objective Few studies exist on the demographics and trends of pediatric central nervous system (CNS) tumors in Iran. In this study, we retrospectively reviewed all cases with confirmed CNS tumors admitted to Mofid Pediatric Hospital, Tehran, Iran during the last 18 years. Materials & Methods Data on gender, age of diagnosis, pathologic classification and tumor location were extracted from the available medical records. We used the last version of International Classification of Childhood Cancer. Result Overall, 258 (81.9%) brain tumors and 57 (18.1%) spinal tumors were identified. Our subjects comprised of 147 (46.7%) female and 168 (53.3%) male children. More male dominancy was observed in brain tumors with a male to female ratio of 1.2 compared with 1.03 of spinal tumors. Malignant CNS tumors were most common in 1-4 yr age group. The four most common brain tumors in our subjects were astrocytomas, medulloblastoma, ependymoma and craniopharyngioma. Overall, 53.1% of the brain tumors were supratentorial. Gliomas, PNET and neuroblastma were the most frequent primary spinal tumors in our study. We observed an increasing trend for both brain and spinal tumors that was more remarkable in the last 5 years. Conclusion Our results are comparable with similar single center studies on CNS tumors during childhood. The observed disparities could be attributed to the single center nature of our study and geographical, environmental and racial variations in pediatric CNS tumors. The increasing trend of both brain and spinal tumors could warrant further investigations at provincial and national levels to investigate probable contributing environmental risk factors. [ABSTRACT FROM AUTHOR]

Background: High-grade astrocytoma (Grade 4) or glioblastoma multiforme (GBM) are deadly brain tumors. New therapies attempt to increase lifetime and quality of life in patients with malignant astrocytoma. O6-methylguanine-DNA methyltransferase (MGMT) enzyme expression may be effective in prognosis and response to treatment of these patients. The aim of this study was assessment of MGMT enzyme expression in patients with astrocytoma Grade 4. Materials and Methods: In this study, 48 patients with GBM that were treated with surgery, chemotherapy and radiotherapy were investigated and followed-up for 47 months for the survival rate. Pathology blocks of patients were examined for MGMT enzyme expression using immunohistochemistry method. Results: The patients were 34 males and 14 females. The ages ranged from 24 to 77 years, with a mean age of 53.52 ± 13.39 years. There was no significant difference between two groups (positive and negative MGMT enzyme expression) in overall survival (median [range] 11.5 [4-30] vs. 13 [5-22], P = 0.9). The results of our study showed that patients although who were undergone near total surgery had higher overall survival than the group of patients who had biopsy only however, it was not significant. Patients who were treated with temozolomide (TMZ) (Temodal, Merck Canada) had significant overall median survival (14.5) more than the patients who were treated with Procarbazine (Roche, Swiss)-Lomustine (Lilly, USA)-Vincristine (Lilly, USA) regimen (8.75) (P < 0.05). Conclusion: O6-methylguanine-DNA methyltransferase enzyme expression had no effect on survival of patients with Grade 4 brain astrocytoma TMZ may increase survival rate. [ABSTRACT FROM AUTHOR]

Meningiomas are slow-growing neoplasms which recur locally, their morphologic grading is simple but do not always correlate with patient outcome. The aim of present study is to evaluate the status of progesterone receptor (PR) and proliferation marker Ki67 in various grades of meningioma in a group of Iranian patients. 78 cases of meningioma were selected from the file of a hospital university. All archival H&E stained sections were reviewed and regraded according to WHO criteria. Immunohistochemical analysis for PR and Ki67 was performed on formalin- fixed, paraffin- embedded samples. PR status considered positive if > 10% of tumor cell's nuclei were strongly immunoreactive, or if > 50% of nuclei were stained with medium intensity. The Ki67 labeling index (LI) is defined as the percentage area with strongest immunostaining. PR were positive in 61/63(96.8%) of grade I tumors,2/10(20%) of grade II,and 0/5(0%) of grade III tumors.Ki67 LI was %2.98±2.27 in grade I tumors, %9.30±5.79 in grade II tumors and %34.00±5.47 in grade III tumors. For both markers, differences between grade I,II and III tumors were significant(P<0.001).There was a reverse relationship between mean of Ki67 LI and PR status,with increasing grade of tumor. Evaluation of PR status and Ki67 LI together with conventional histologic evaluation can help in providing more information about the biologic behaviour of meningiomas,especially for those that histological grading is not straightforward. [ABSTRACT FROM AUTHOR]

Background: Meningiomas are among the most common tumors of the brain. Skull base meningiomas comprise s major part of brain meningiomas. They are difficult to treat because of proximity to major vital neuro-vascular structures which makes their surgical resection hazardous and fraught with a high rate of complications. Radiosurgery is considered as an alternative efficient way to treat them, which targets the tumor and its supplying vasculature. The standard treatment consists of tumor eradication and its supplying vessels through homogeneous dose of 201 rays of cobalt 60 source. Methods: In a case-series study, we report 230 meningiomas referred to Iraninan Gamma Knife Center, treated by radiosurgery with type C Gamma Knife. Radio-surgery was performed at a mean dose of 15 Gy and 50% isodose. Results: Two hundred and thirty of all meningioma cases refered to our institute were skull base lesions. Eighty (35%) were new case and the rest were previously treated microsurgically one or more times. None of the patients died after treatment and the most common post-operative complications were headache (30 patients) and peritumoral edema (12 patients). Conclusion: Tumoral control is defined as reduced tumor volume or as no change in tumor volume. Tumor control was achieved in 218 (95%) patients. In those who were not treated microsurgically, clinical improvement was more pronounced. Thus when suitable (favorable tumor size and absence of progressive mass effect signs) the patients could be primarily treated with Gamma knife. Other patients could be managed complementarily with radiosurgery after they are treated surgically. [ABSTRACT FROM AUTHOR]

AbstractBackground??Brain tumors are the second most common neoplasm in children. Pattern of primary brain tumors in children has not been reported in Iran. Brain tumors have been the subject of controversy both with respect to pattern of occurrence and to potential causes.Objective??To determine the age, sex, location, and histologic diagnosis of intracranial tumors in children less than 15?years of age.Materials and methods??A retrospective study of 619 children who were admitted to the neurosurgical center between 1978 and 2003 was performed. Charts were reviewed to extract information about demographics, location, and histopathological diagnosis of tumors. All patients entered into this study had pathologically proven brain tumor. The frequency distribution of brain tumors by age and sex, location, and histopathology was calculated.Results??The male?female ratio, 58.1 to 41.9%, vary significantly (p<0.05). The mean age of the patients at time of diagnosis was 8.8?years (SD=3.9). Fifty-one percent of brain tumors were located in supratentorial, and 49.0% in the infratentorial region. In supratentorial region, 57.0% of the tumors were in the hemispheric. In infratentorial region, 68% of the tumors were in the midline. The mixed five most common histological diagnoses in patients were astrocytoma (40.4%), followed by medulloblastoma (18.4%), ependymoma (10.5%), craniopharyngioma (8.8%), and meningioma (4.2%). Most of the brain tumor types (85%) occurred in children between 5 to 15?years of age. Astrocytoma occurred mostly in children aged 5?15?years (87%).Conclusion??Males were affected more than females. A significant male predominance was observed in craniopharyngioma and medulloblastoma. Astrocytoma was the first most common brain tumor in all age groups. Certain tumor types show a predilection for the certain period of life. [ABSTRACT FROM AUTHOR]