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1. Sands SA, Kellie SJ, Davidow AL, Diez B, Villablanca J, Weiner HL, Pietanza MC, Balmaceda C, Finlay JL: Long-term quality of life and neuropsychologic functioning for patients with CNS germ-cell tumors: from the First International CNS Germ-Cell Tumor Study. Neuro Oncol; 2001 07;3(3):174-83
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  • [Title] Long-term quality of life and neuropsychologic functioning for patients with CNS germ-cell tumors: from the First International CNS Germ-Cell Tumor Study.
  • This study evaluated the quality of life and neuropsychologic functioning among patients enrolled between 1989 and 1993 in the First International CNS Germ-Cell Tumor Study.
  • Those who received CNS radiation therapy (n = 29) reported significantly worse physical health, but similar psychosocial health, compared with those treated without radiation.
  • Younger patients diagnosed with CNS germ-cell tumors are at increased risk for psychosocial and physical problems as well as neuropsychologic deficits.
  • Exposure to irradiation adversely affects overall physical functioning, whereas tumor pathology appears to be a salient neurocognitive risk factor.
  • Collaborative and randomized studies are required to further elucidate the late effects arising from factors such as age at diagnosis, tumor histology, level of irradiation therapy, and chemotherapy toxicity among these young and potentially curable patients.
  • [MeSH-major] Central Nervous System Neoplasms / psychology. Intelligence. Neoplasms, Germ Cell and Embryonal / psychology. Quality of Life

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  • (PMID = 11465398.001).
  • [ISSN] 1522-8517
  • [Journal-full-title] Neuro-oncology
  • [ISO-abbreviation] Neuro-oncology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC1920620
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2. Yoo KH, Lee SH, Lee J, Sung KW, Jung HL, Koo HH, Lim DH, Kim JH, Shin HJ: Improved outcome of central nervous system germ cell tumors: implications for the role of risk-adapted intensive chemotherapy. J Korean Med Sci; 2010 Mar;25(3):458-65
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  • [Title] Improved outcome of central nervous system germ cell tumors: implications for the role of risk-adapted intensive chemotherapy.
  • To determine the impact of treatment protocols on the outcome of central nervous system germ cell tumors (CNS-GCTs), we reviewed the medical records of 53 patients who received front-line chemotherapy from September 1997 to September 2006.
  • Patients from different time periods were divided into 3 groups according to the chemotherapy protocols.
  • Group 1 (n=19) received 4 cycles of chemotherapy comprising cisplatin, etoposide and bleomycin.
  • Group 2 (n=16) and group 3 (n=18) received 4 cycles of chemotherapy with cisplatin, etoposide, cyclophosphamide and vincristine in the former and with carboplatin, etoposide, cyclophosphamide and bleomycin in the latter.
  • Radiotherapy was given after chemotherapy according to the clinical requirements.
  • Our data suggest that risk-adapted intensive chemotherapy may improve the outcome of patients with malignant CNS-GCTs.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Central Nervous System Neoplasms / therapy. Neoplasms, Germ Cell and Embryonal / therapy. Radiotherapy
  • [MeSH-minor] Adolescent. Biomarkers, Tumor / metabolism. Child. Combined Modality Therapy. Disease-Free Survival. Female. Humans. Kaplan-Meier Estimate. Male. Risk Factors. Treatment Outcome. Young Adult

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  • (PMID = 20191048.001).
  • [ISSN] 1598-6357
  • [Journal-full-title] Journal of Korean medical science
  • [ISO-abbreviation] J. Korean Med. Sci.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Korea (South)
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Biomarkers, Tumor
  • [Other-IDs] NLM/ PMC2826748
  • [Keywords] NOTNLM ; Central Nervous System / Drug Therapy / Neoplasms, Germ Cell and Embryonal / Survival
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3. Kretschmar C, Kleinberg L, Greenberg M, Burger P, Holmes E, Wharam M: Pre-radiation chemotherapy with response-based radiation therapy in children with central nervous system germ cell tumors: a report from the Children's Oncology Group. Pediatr Blood Cancer; 2007 Mar;48(3):285-91
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  • [Title] Pre-radiation chemotherapy with response-based radiation therapy in children with central nervous system germ cell tumors: a report from the Children's Oncology Group.
  • BACKGROUND: This Phase II study was designed to determine response to chemotherapy and survival after response-based radiation (RT) in children with CNS germ cell tumors.
  • PROCEDURE: Children with germinomas and normal markers received cisplatin 100 mg/m(2) + etoposide, alternating with vincristine + cyclophosphamide (CPM) 2 g/m(2)/d, for four cycles.
  • For germinoma patients in complete response (CR), RT was decreased from 50.4 to 30.6 Gy.
  • High-risk patients received neuraxis RT: 50.4 Gy local + 30.6 Gy neuraxis in CR; 54 Gy local + 36 Gy if less than CR.

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  • [Copyright] (c) 2006 Wiley-Liss, Inc.
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  • (PMID = 16598761.001).
  • [ISSN] 1545-5009
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / P30 CA006973
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Chorionic Gonadotropin; 0 / alpha-Fetoproteins; 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 8N3DW7272P / Cyclophosphamide; Q20Q21Q62J / Cisplatin
  • [Other-IDs] NLM/ NIHMS582771; NLM/ PMC4086720
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4. Matsutani M, Japanese Pediatric Brain Tumor Study Group: Combined chemotherapy and radiation therapy for CNS germ cell tumors--the Japanese experience. J Neurooncol; 2001 Sep;54(3):311-6
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  • [Title] Combined chemotherapy and radiation therapy for CNS germ cell tumors--the Japanese experience.
  • Among intracranial germ cell tumors, nongerminomatous tumors have proved refractory to conventional treatment with surgery and irradiation.
  • Since 1983, chemotherapy has been delivered in Japan as an adjuvant therapy in patients with intracranial nongerminomatous germ cell tumors.
  • Based on our clinical experience, we undertook a multi-institutional phase II study to establish post-surgical combined chemotherapy and radiation therapy for primary germ cell tumors in the brain.
  • We adopted carboplatin-etoposide (CARB-VP) or cisplatin-etoposide (PE) combination chemotherapy for patients with germinomas and those with tumors that placed them in the intermediate prognosis group, and ifosphamide-cisplatin-etoposide (ICE) for patients with tumors that placed them in the poor prognosis group.
  • Among patients with germinoma (n = 75), the rate or complete remission after combination therapy was 92.0%; it was 67.8% for patients in the intermediate prognosis group (n = 28).
  • Tumor recurrence was noted in 9 patients with germinoma and 2 patients in the intermediate prognosis group.
  • Of 9 patients with a poor prognosis, 4 experienced disease progression during treatment and died within 10 months.
  • There were no serious complications attributable to the combination therapy.
  • Our treatment protocols are effective for patients with germinomas and those with an intermediate prognosis.
  • [MeSH-major] Central Nervous System Neoplasms / drug therapy. Central Nervous System Neoplasms / radiotherapy. Germinoma / drug therapy. Germinoma / radiotherapy. Postoperative Care. Teratoma / drug therapy. Teratoma / radiotherapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Humans. Neoplasm Recurrence, Local. Prognosis. Remission Induction

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  • (PMID = 11767296.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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5. Dietrich J, Marienhagen J, Schalke B, Bogdahn U, Schlachetzki F: Vascular neurotoxicity following chemotherapy with cisplatin, ifosfamide, and etoposide. Ann Pharmacother; 2004 Feb;38(2):242-6
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  • [Title] Vascular neurotoxicity following chemotherapy with cisplatin, ifosfamide, and etoposide.
  • OBJECTIVE: To report a case of acute central nervous system (CNS) toxicity with multiple hemorrhages restricted to the corpus callosum associated with combination therapy of cisplatin, ifosfamide, and etoposide.
  • CASE SUMMARY: A 38-year-old white man with a testicular germ cell tumor received a cisplatin-based chemotherapy consisting of cisplatin 45 mg (20 mg/m2), etoposide 570 mg (250 mg/m2), and ifosfamide 4600 mg (2000 mg/m2) given on 5 consecutive days during each course.
  • After the first course of chemotherapy, the patient appeared to be neuropsychologically impaired with episodes of decreased alertness and features of a depressive syndrome.
  • He became severely diminished in mental function, orientation, and psychomotor activity after a second course of treatment.
  • An objective causality assessment revealed that an adverse drug reaction was probable.
  • In particular, cisplatin and ifosfamide can cause both acute and delayed CNS toxicity.
  • To our knowledge, as of December 2, 2003, vascular lesions restricted to the corpus callosum have not been reported as a complication of cisplatin- or ifosfamide-based chemotherapy.
  • Chemotherapy-induced neurotoxicity should be considered in the differential diagnosis.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Intracranial Hemorrhages / chemically induced. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adult. Cisplatin / administration & dosage. Cisplatin / adverse effects. Corpus Callosum / radionuclide imaging. Etoposide / administration & dosage. Germinoma / drug therapy. Humans. Ifosfamide / administration & dosage. Magnetic Resonance Imaging. Male

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  • (PMID = 14742759.001).
  • [ISSN] 1060-0280
  • [Journal-full-title] The Annals of pharmacotherapy
  • [ISO-abbreviation] Ann Pharmacother
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide
  • [Number-of-references] 29
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6. Souweidane MM, Krieger MD, Weiner HL, Finlay JL: Surgical management of primary central nervous system germ cell tumors: proceedings from the Second International Symposium on Central Nervous System Germ Cell Tumors. J Neurosurg Pediatr; 2010 Aug;6(2):125-30
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  • [Title] Surgical management of primary central nervous system germ cell tumors: proceedings from the Second International Symposium on Central Nervous System Germ Cell Tumors.
  • The successful treatment of children with a primary CNS germ cell tumor can be greatly influenced by the neurosurgeon involved in the diagnostic and therapeutic care of these children.
  • Variability in surgical philosophies no doubt exists due to the relatively infrequent incidence of these tumors, a lack of consensus regarding diagnostic and therapeutic approaches, and the advent of recent surgical innovations.
  • Many of these issues were discussed at the Second International Symposium on Central Nervous System Germ Cell Tumors through presented abstracts and invited presentations.
  • [MeSH-major] Brain Neoplasms / surgery. Neoplasms, Germ Cell and Embryonal / surgery
  • [MeSH-minor] Biomarkers, Tumor / cerebrospinal fluid. Biopsy. Brain / pathology. Brain / surgery. Child. Combined Modality Therapy. Diagnostic Imaging. Endoscopy / methods. Female. Germinoma / drug therapy. Germinoma / pathology. Germinoma / radiotherapy. Germinoma / surgery. Humans. Male. Microsurgery. Neoadjuvant Therapy. Neoplasm Recurrence, Local / drug therapy. Neoplasm Recurrence, Local / pathology. Neoplasm Recurrence, Local / radiotherapy. Neoplasm Recurrence, Local / surgery. Neuronavigation. Reoperation

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  • (PMID = 20672932.001).
  • [ISSN] 1933-0715
  • [Journal-full-title] Journal of neurosurgery. Pediatrics
  • [ISO-abbreviation] J Neurosurg Pediatr
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
  • [Number-of-references] 45
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7. Echevarría ME, Fangusaro J, Goldman S: Pediatric central nervous system germ cell tumors: a review. Oncologist; 2008 Jun;13(6):690-9

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Pediatric central nervous system germ cell tumors: a review.
  • Central nervous system (CNS) germ cell tumors (GCTs) represent approximately 3% of primary pediatric brain tumors and encompass a wide pathologic spectrum.
  • CNS GCTs are most commonly located in the pineal and suprasellar regions of the brain and can be divided into major groups including germinomas and nongerminomatous GCTs (NGGCTs), with teratomas often considered a separate category.
  • The rare exceptions are the cases where characteristic elevations of tumor markers, including alpha-fetoprotein and/or beta-human chorionic gonadotropin are documented in the serum and/or cerebrospinal fluid.
  • In these cases, the imaging findings along with the tumor marker elevation may be diagnostic in themselves without the need for tissue confirmation.
  • Treatment and prognosis differ greatly between groups.
  • More recently, the use of chemotherapy in addition to radiation therapy has afforded the ability to decrease the dose and volume of radiation therapy without affecting survival rates.
  • NGGCTs are less radiosensitive than germinomas, but the use of adjuvant chemotherapy has improved survival rates in this group as well.
  • The standard management for CNS GCTs remains controversial.
  • Treatment regimens aimed to improve progression-free and overall survival times are ongoing.
  • [MeSH-major] Central Nervous System Neoplasms / pathology. Neoplasms, Germ Cell and Embryonal / pathology
  • [MeSH-minor] Child. Combined Modality Therapy. Humans

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  • (PMID = 18586924.001).
  • [ISSN] 1083-7159
  • [Journal-full-title] The oncologist
  • [ISO-abbreviation] Oncologist
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 75
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8. da Silva NS, Cappellano AM, Diez B, Cavalheiro S, Gardner S, Wisoff J, Kellie S, Parker R, Garvin J, Finlay J: Primary chemotherapy for intracranial germ cell tumors: results of the third international CNS germ cell tumor study. Pediatr Blood Cancer; 2010 Mar;54(3):377-83
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  • [Title] Primary chemotherapy for intracranial germ cell tumors: results of the third international CNS germ cell tumor study.
  • BACKGROUND: The treatment of central nervous system (CNS) germ cell tumors (GCT) remains controversial.
  • The purpose of this study was to demonstrate efficacy of a chemotherapy only strategy, with less morbidity, when compared to regimens with irradiation.
  • METHODS: Between January 2001 and December 2004 newly diagnosed patients with CNS GCT were treated with one of two risk-tailored chemotherapy regimens.
  • Twenty-five patients aged 4 months to 24.5 years were stratified: Regimen A consisted of 4-6 cycles of carboplatin/etoposide alternating with cyclophosphamide/etoposide for low risk (LR) localized germinoma with normal cerebrospinal fluid (CSF) and serum tumor markers.
  • Seventeen (68%) patients achieved complete radiographic and marker responses after two courses and 19 (76%) after four courses of chemotherapy.
  • CONCLUSION: These intensive chemotherapy regimens proved less effective than irradiation containing regimens.
  • Our results indicate that, at the present time, standard treatment for CNS GCT continues to include irradiation either alone or combined with chemotherapy for pure germinomas and with chemotherapy for those with MMGCT.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms / drug therapy. Neoplasms, Germ Cell and Embryonal / drug therapy
  • [MeSH-minor] Adolescent. Adult. Carboplatin / administration & dosage. Carboplatin / adverse effects. Child. Child, Preschool. Combined Modality Therapy. Cyclophosphamide / administration & dosage. Cyclophosphamide / adverse effects. Etoposide / administration & dosage. Etoposide / adverse effects. Female. Humans. Infant. Male. Treatment Outcome. Young Adult

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  • [Copyright] Copyright 2009 Wiley-Liss, Inc.
  • (PMID = 20063410.001).
  • [ISSN] 1545-5017
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; 8N3DW7272P / Cyclophosphamide; BG3F62OND5 / Carboplatin
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9. Modak S, Gardner S, Dunkel IJ, Balmaceda C, Rosenblum MK, Miller DC, Halpern S, Finlay JL: Thiotepa-based high-dose chemotherapy with autologous stem-cell rescue in patients with recurrent or progressive CNS germ cell tumors. J Clin Oncol; 2004 May 15;22(10):1934-43
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  • [Title] Thiotepa-based high-dose chemotherapy with autologous stem-cell rescue in patients with recurrent or progressive CNS germ cell tumors.
  • PURPOSE: To evaluate the efficacy and toxicity of high-dose chemotherapy (HDC) followed by autologous stem-cell rescue (ASCR) in patients with relapsed or progressive CNS germ cell tumors (GCTs).
  • PATIENTS AND METHODS: Twenty-one patients with CNS GCTs who experienced relapse or progression despite having received initial chemotherapy and/or radiotherapy were treated with thiotepa-based HDC regimens followed by ASCR.
  • However, only four of 12 patients (33%) with nongerminomatous germ cell tumors (NGGCTs) survived without evidence of disease, with a median survival of 35 months.
  • CONCLUSION: Dose escalation of chemotherapy followed by ASCR is effective therapy for patients with recurrent CNS germinomas and might be effective in patients with recurrent NGGCTs with a low tumor burden.
  • [MeSH-major] Antineoplastic Agents, Alkylating / administration & dosage. Brain Neoplasms / therapy. Germinoma / therapy. Hematopoietic Stem Cell Transplantation. Neoplasm Recurrence, Local / therapy. Thiotepa / administration & dosage
  • [MeSH-minor] Adolescent. Adult. Child. Child, Preschool. Disease-Free Survival. Female. Humans. Infant. Male. Medical Records. New York. Retrospective Studies. Salvage Therapy. Survival Analysis. Treatment Outcome

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  • (PMID = 15143087.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; 905Z5W3GKH / Thiotepa
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10. Tscherry G, Jacky E, Jost LM, Stahel RA: Risk-adapted chemotherapy of germ cell tumors with carboplatin, etoposide and bleomycin for low-risk and cisplatin, etoposide and ifosfamide for high-risk patients. A single-center study. Oncology; 2000 Aug;59(2):110-7
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  • [Title] Risk-adapted chemotherapy of germ cell tumors with carboplatin, etoposide and bleomycin for low-risk and cisplatin, etoposide and ifosfamide for high-risk patients. A single-center study.
  • The prognosis of germ cell tumors treated with chemotherapy depends on the presence of nonseminomatous tumor, clinical parameters based on the tumor volume and site, as well as on the level of the tumor markers AFP, betaHCG and LDH.
  • We report here on the results of a risk-adapted approach to the chemotherapy of germ cell tumors.
  • Patients with low-risk tumors, defined as seminomatous disease and/or nonseminomatous disease with a tumor mass <10 cm, less than 20 lung metastases, no liver, bone, or CNS metastases, and levels of AFP <1,000 IU/ml and betaHCG <10,000 IU/l, were to receive 4 cycles of carboplatin 400 mg/m(2) i.v. day 1, etoposide 120 mg/m(2) i.v. days 1-3 and bleomycin 30 IU i.v. days 1, 8 and 15 during the first 3 cycles (CEB(90)).
  • Four patients with CR relapsed between 4 to 8 months after the start of chemotherapy.
  • Of the 6 patients failing CEB(90), 3 were treated successfully with surgery or further chemotherapy.
  • All 3 patients failing VIP had successful salvage therapy.
  • Forty-six patients receiving CEB(90) were retrospectively classified to be in the good prognosis group according to the international germ cell consensus classification.
  • We thus confirm that CEB(90) is a well-tolerated outpatient regimen with good results in good prognosis germ cell tumors.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Germinoma / drug therapy
  • [MeSH-minor] Adolescent. Adult. Bleomycin / administration & dosage. Bleomycin / adverse effects. Carboplatin / administration & dosage. Carboplatin / adverse effects. Cisplatin / administration & dosage. Cisplatin / adverse effects. Etoposide / administration & dosage. Etoposide / adverse effects. Follow-Up Studies. Humans. Ifosfamide / administration & dosage. Ifosfamide / adverse effects. Middle Aged. Risk Factors. Treatment Outcome

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  • [Copyright] Copyright 2000 S. Karger AG, Basel.
  • (PMID = 10971168.001).
  • [ISSN] 0030-2414
  • [Journal-full-title] Oncology
  • [ISO-abbreviation] Oncology
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; BG3F62OND5 / Carboplatin; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide; ICE protocol 1; JEB protocol
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11. Khatua S, Dhall G, O'Neil S, Jubran R, Villablanca JG, Marachelian A, Nastia A, Lavey R, Olch AJ, Gonzalez I, Gilles F, Nelson M, Panigrahy A, McComb G, Krieger M, Fan J, Sposto R, Finlay JL: Treatment of primary CNS germinomatous germ cell tumors with chemotherapy prior to reduced dose whole ventricular and local boost irradiation. Pediatr Blood Cancer; 2010 Jul 15;55(1):42-6
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  • [Title] Treatment of primary CNS germinomatous germ cell tumors with chemotherapy prior to reduced dose whole ventricular and local boost irradiation.
  • BACKGROUND: The purpose of this study was to evaluate a reduced irradiation dose strategy for newly diagnosed primary central nervous system (CNS) germinomas.
  • In 18 patients, chemotherapy was followed by whole ventricular irradiation to 21.6-25.5 Gy with a simultaneous integrated or sequential primary site boost to 30-30.6 Gy.
  • Initial tumor markers for beta-human chorionic gonadotrophin (HCGbeta) and alpha-fetoprotein (AFP) were evaluated in serum and lumbar cerebrospinal fluid (CSF).
  • Neurocognitive function was evaluated periodically following treatment.
  • RESULTS: Eighteen of 20 patients are without evidence of residual or recurrent tumor.
  • Both relapsing patients were subsequently determined to harbor malignant non-germinomatous germ cell tumor (NGGCT).
  • CONCLUSION: Chemotherapy followed by reduced dose whole ventricular and local boost irradiation appears to be effective in patients with localized pure CNS germinoma with evidence of preservation of neurocognitive function.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms / therapy. Central Nervous System Neoplasms / therapy. Germinoma / therapy. Neoplasms, Germ Cell and Embryonal / therapy
  • [MeSH-minor] Adolescent. Adult. Carboplatin / adverse effects. Carboplatin / therapeutic use. Child. Child, Preschool. Chorionic Gonadotropin, beta Subunit, Human / blood. Combined Modality Therapy. Dose-Response Relationship, Radiation. Etoposide / adverse effects. Etoposide / therapeutic use. Female. Humans. Infant. Magnetic Resonance Imaging. Male. Retrospective Studies. Young Adult. alpha-Fetoproteins / analysis

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  • (PMID = 20222020.001).
  • [ISSN] 1545-5017
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin, beta Subunit, Human; 0 / alpha-Fetoproteins; 6PLQ3CP4P3 / Etoposide; BG3F62OND5 / Carboplatin
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12. Hartmann JT, Rick O, Thomas M, Schleicher J, Metzner B, Flasshove M, Kollmannsberger C, Schmoll HJ, Kanz L, Bokemeyer C: The role of paclitaxel in the first-line treatment of patients with 'poor prognosis' germ cell tumor (GCT) undergoing sequential high dose chemotherapy. J Clin Oncol; 2004 Jul 15;22(14_suppl):4633

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The role of paclitaxel in the first-line treatment of patients with 'poor prognosis' germ cell tumor (GCT) undergoing sequential high dose chemotherapy.
  • METHODS: In the first trial pts have received high dose VIP chemotherapy (HD-VIP) at dose level [etoposide 250 mg/sqm, ifosfamide 2 g/sqm, cisplatin 20 mg/sqm, d1-5, q d22] for 3 consecutive cycles as part of a phase I/II dose trial.
  • Pts received G-CSF 5 μg/kg s.c. from d+1 after treatment to leukocyte recovery >2000/μl and reinfusion of PBSC at day +2.
  • Pts characteristics (HD-VIP compared to HDVIP+T): Median age 29 (16-42) vs. 31 yrs (18-54), mediastinal primary 11 vs. 24%, liver mets 40 vs. 40%, bone 7 vs. 4%, CNS 20 vs. 19%, elevated AFP, HCG, LDH: 39 vs. 30%, 61 vs. 58% and 77 vs. 77%.
  • Dose intensity of the 3- vs. 4-drug regimen achieved have been 98% and 95%.
  • Median time to recovery of granulocytes and thrombocytes (>500/μl resp.
  • CONCLUSIONS: The addition of paclitaxel to HD-VIP dose level 6 as first-line therapy was associated with a moderately elevated toxicity.

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  • (PMID = 28015771.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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13. Hasegawa T, Kondziolka D, Hadjipanayis CG, Flickinger JC, Lunsford LD: Stereotactic radiosurgery for CNS nongerminomatous germ cell tumors. Report of four cases. Pediatr Neurosurg; 2003 Jun;38(6):329-33
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Stereotactic radiosurgery for CNS nongerminomatous germ cell tumors. Report of four cases.
  • In this study, we evaluated the results in four patients with nongerminomatous germ cell tumors (NGGCT) of the pineal region.
  • All underwent radiosurgery in conjunction with surgical resection, fractionated radiotherapy or chemotherapy.
  • One patient was diagnosed by serum and CSF tumor markers.
  • The mean tumor volume was 10.5 cm(3).
  • Radiosurgery was performed with mean maximum and marginal doses of 28 and 14 Gy, respectively.

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  • [Copyright] Copyright 2003 S. Karger AG, Basel
  • (PMID = 12759512.001).
  • [ISSN] 1016-2291
  • [Journal-full-title] Pediatric neurosurgery
  • [ISO-abbreviation] Pediatr Neurosurg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Switzerland
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14. Calaminus G, Bamberg M, Harms D, Jürgens H, Kortmann RD, Sörensen N, Wiestler OD, Göbel U: AFP/beta-HCG secreting CNS germ cell tumors: long-term outcome with respect to initial symptoms and primary tumor resection. Results of the cooperative trial MAKEI 89. Neuropediatrics; 2005 Apr;36(2):71-7
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  • [Title] AFP/beta-HCG secreting CNS germ cell tumors: long-term outcome with respect to initial symptoms and primary tumor resection. Results of the cooperative trial MAKEI 89.
  • PURPOSE: The aim of the present study was to evaluate survival and factors influencing long-term outcome of patients with AFP/beta-HCG secreting (non-seminomatous) central nervous system germ cell tumors (secCNSGCT), who were prospectively collected in the cooperative MAKEI (German: maligne Keimzelltumoren) 89 protocol.
  • The protocol recommended, after a clinically or histologically proven diagnosis and cisplatin-based chemotherapy, a resection of residual tumor and craniospinal irradiation (30 Gy) with a tumor boost (20 Gy).
  • With respect to long-term survival, the combination of marked neurological symptoms at diagnosis along with primary tumor resection seem to be the main negative prognostic risk factors (Fisher exact test p < 0.05).
  • CNS dissemination at diagnosis can also be considered as a negative risk factor as 3 of 5 patients with primary dissemination died of the disease.
  • CONCLUSION: Cisplatin-based three agent chemotherapy followed by resection of the residual tumor and craniospinal irradiation (CSI) with tumor boost is a successful and well-tolerated treatment for secCNSGCTs.
  • The possibility of a clinical diagnosis based on MRI and tumor markers together with the use of modern neurosurgical techniques gives us the chance to postpone or even avoid major surgery.
  • [MeSH-major] Central Nervous System Neoplasms / mortality. Central Nervous System Neoplasms / surgery. Evaluation Studies as Topic. Germinoma / mortality. Germinoma / surgery
  • [MeSH-minor] Adolescent. Antineoplastic Agents / therapeutic use. Antineoplastic Combined Chemotherapy Protocols. Biomarkers, Tumor. Child. Child, Preschool. Cisplatin / therapeutic use. Cognition / physiology. Combined Modality Therapy / methods. Cranial Irradiation. Female. Humans. Lindane / metabolism. Longitudinal Studies. Male. Prognosis. Prospective Studies. Retrospective Studies. Survival Rate. Time. Time Factors. Treatment Outcome. alpha-Fetoproteins / secretion

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  • (PMID = 15822019.001).
  • [ISSN] 0174-304X
  • [Journal-full-title] Neuropediatrics
  • [ISO-abbreviation] Neuropediatrics
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Biomarkers, Tumor; 0 / alpha-Fetoproteins; 319-85-7 / beta-hexachlorocyclohexane; 59NEE7PCAB / Lindane; Q20Q21Q62J / Cisplatin
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15. Hartmann JT, Nichols CR, Droz JP, Horwich A, Gerl A, Fossa SD, Beyer J, Pont J, Kanz L, Einhorn L, Bokemeyer C: Prognostic variables for response and outcome in patients with extragonadal germ-cell tumors. Ann Oncol; 2002 Jul;13(7):1017-28
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Prognostic variables for response and outcome in patients with extragonadal germ-cell tumors.
  • BACKGROUND: This investigation evaluates prognostic variables in patients with seminomatous and non-seminomatous extragonadal germ-cell tumors (EGCT) in order to identify relevant factors for long-term outcome following cisplatin-based chemotherapy.
  • Uni- and multivariate analyses of prognostic variables for survival and for response to chemotherapy were performed.
  • For non-seminomatous EGCT the following independent adverse factors were identified: presence of either liver, lung or central nervous system metastases, primary mediastinal tumor or elevation of pretreatment beta-human gonadotropin; for extragonadal seminoma (only univariate) adverse factors were: presence of liver metastases, two or greater metastatic sites or International Germ Cell Cancer Collaborative Group (IGCCCG) grouping (intermediate versus good).
  • Classification and regression tree (CART) modeling confirmed histology and location of primary tumor as the major prognosticators.
  • Multivariate testing for the probability to respond to chemotherapy revealed non-seminomatous histology, primary mediastinal tumor site, and the presence of liver, lung or CNS metastases as independent adverse factors.
  • CONCLUSIONS: In EGCT, prognostic variables for the outcome and for the response to chemotherapy could be identified, which in part differ from gonadal GCT.
  • The proposed model might help to better understand the specific prognosis of EGCT and to tailor risk-adapted treatment strategies.

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  • (PMID = 12176779.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Chorionic Gonadotropin; 0 / alpha-Fetoproteins
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16. Göbel U, Schneider DT, Teske C, Schönberger S, Calaminus G: Brain metastases in children and adolescents with extracranial germ cell tumor - data of the MAHO/MAKEI-registry. Klin Padiatr; 2010 May;222(3):140-4
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  • [Title] Brain metastases in children and adolescents with extracranial germ cell tumor - data of the MAHO/MAKEI-registry.
  • BACKGROUND: We analyzed 15 children and adolescents with extracranial germ cell tumor (GCT) and brain metastases reported to the MAHO/MAKEI registry.
  • All patients with advanced malignant GCTs received cisplatin-based chemotherapy (overall survival: 0.81+/-0.04 (734/823).
  • RESULTS: 15 patients with brain metastases were reported; in 6 of them at diagnosis and 9 respectively during follow-up (6 weeks-28 months after end of therapy, mean=10 months).
  • In all patients with secondary brain metastases the previously normalised tumor markers AFP and/ or HCG increased again prior to the onset of neurological symptoms.
  • Only 1 of the patients with primary brain metastases survived, whereas 4 of 9 with secondary metastases are in remission after additional treatment.
  • Development of neurological symptoms at initial diagnosis or during follow-up should lead to rapid clinical re-evaluation including CNS imaging and assessment of tumor markers.
  • Treatment of brain metastases includes intensified chemotherapy and surgical resection, irradiation has to be considered in special clinical situations.
  • [MeSH-major] Brain Neoplasms / secondary. Neoplasms, Germ Cell and Embryonal / secondary. Registries
  • [MeSH-minor] Adolescent. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biomarkers, Tumor / blood. Child. Child, Preschool. Cisplatin / administration & dosage. Combined Modality Therapy. Cranial Irradiation. Craniotomy. Female. Humans. Infant. Male. Prospective Studies. Risk Factors. Survival Rate

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  • (PMID = 20514616.001).
  • [ISSN] 1439-3824
  • [Journal-full-title] Klinische Pädiatrie
  • [ISO-abbreviation] Klin Padiatr
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; Q20Q21Q62J / Cisplatin
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17. Kim A, Ji L, Balmaceda C, Diez B, Kellie SJ, Dunkel IJ, Gardner SL, Sposto R, Finlay JL: The prognostic value of tumor markers in newly diagnosed patients with primary central nervous system germ cell tumors. Pediatr Blood Cancer; 2008 Dec;51(6):768-73
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The prognostic value of tumor markers in newly diagnosed patients with primary central nervous system germ cell tumors.
  • BACKGROUND: To determine the impact of diagnostic serum and/or cerebrospinal fluid (CSF) alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (b-HCG) elevations on survival in newly diagnosed patients with central nervous system germ cell tumors (CNS GCT) treated with chemotherapy with the intent to avoid irradiation.
  • PROCEDURE: Seventy-five patients with newly diagnosed CNS GCT enrolled in two sequential internationally conducted clinical trials with serum and CSF AFP and b-HCG levels available from initial diagnosis were retrospectively analyzed.
  • Subjects received platinum based chemotherapy and were followed with serial imaging and tumor marker evaluations.
  • RESULTS: The 5-year overall survival (OS) and event free survival (EFS) for patients with normal tumor markers compared with those with elevated markers at diagnosis was 78% (95% CI 51-91%) versus 60% (95% CI 46-72%) (P = 0.08) and 22% (95% CI 7-43%) versus 28% (95% CI 16-40%) (P = 0.68).
  • The hazard ratio of death for patients with elevated markers was 1.9 times as high as that for those with normal markers (95% CI 0.58-6.5) after adjusting for other baseline characteristics.
  • CONCLUSIONS: Patients with elevated tumor markers appear to have poorer OS independent of tumor histology, although these differences do not reach statistical significance (P < or = 0.05).
  • No differences were observed in EFS between groups likely due to the poor response of chemotherapy only approach to patients with normal markers. b-HCG elevations in biopsy proven germinomas do not seem to alter a patient's prognosis.
  • [MeSH-major] Biomarkers, Tumor / blood. Biomarkers, Tumor / cerebrospinal fluid. Brain Neoplasms / mortality. Neoplasms, Germ Cell and Embryonal / mortality
  • [MeSH-minor] Adolescent. Child. Chorionic Gonadotropin, beta Subunit, Human / blood. Chorionic Gonadotropin, beta Subunit, Human / cerebrospinal fluid. Disease-Free Survival. Female. Humans. Male. Neoplasm Staging. Prognosis. Retrospective Studies. Survival Rate. Treatment Outcome. alpha-Fetoproteins / analysis. alpha-Fetoproteins / cerebrospinal fluid

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  • (PMID = 18802946.001).
  • [ISSN] 1545-5017
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / AFP protein, human; 0 / Biomarkers, Tumor; 0 / Chorionic Gonadotropin, beta Subunit, Human; 0 / alpha-Fetoproteins
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18. Göbel U, Calaminus G, Schneider DT, Schmidt P, Haas RJ, MAKEI and MAHO Study Groups of the German Society of Pediatric Oncology and Hematology, and the SIOP CNS GCT Study Group: Management of germ cell tumors in children: approaches to cure. Onkologie; 2002 Feb;25(1):14-22
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Management of germ cell tumors in children: approaches to cure.
  • The introduction of cisplatinum chemotherapy and current advances in the surgical treatment have resulted in a dramatic improvement of the prognosis of children with malignant germ cell tumors (GCT).
  • Cisplatinum chemotherapy generally results in sufficient systemic tumor control, but local relapses may still occur in patients who did not receive adequate local treatment.
  • Therefore, the therapeutic consideration must take into account age, primary site of the tumor, and its histology.
  • In gonadal tumors, there is a high chance of primary complete resection since these tumors tend to be encapsulated, and particularly testicular GCT are often detected at a low tumor stage.
  • In these tumors, a neoadjuvant or preoperative chemotherapy after clinical diagnosis by imaging and evaluation of tumor markers significantly facilitates complete resection on delayed surgery.
  • In addition, the impact of chemotherapy on local tumor control may be enhanced by locoregional hyperthermia.
  • In intracranial GCT, radiotherapy significantly contributes to local tumor control, and doses are stratified according to histology.
  • These general considerations have been integrated into national and international cooperative treatment protocols.
  • In most current protocols, treatment is stratified according to an initial risk assessment that includes the parameters age, site, histology, stage, completeness of resection and the tumor markers alpha(1)-fetoprotein (AFP) and human choriogonadotropin (beta-HCG).
  • Moreover, the previously high-risk groups may now expect a favorable prognosis with this risk-adapted treatment, whereas an increasing number of low-risk patients are treated expectantly or with significantly reduced chemotherapy.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / therapy
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Chorionic Gonadotropin, beta Subunit, Human / blood. Cisplatin / administration & dosage. Cisplatin / adverse effects. Combined Modality Therapy. Female. Humans. Infant. Infant, Newborn. Male. Neoadjuvant Therapy. Neoplasm Staging. Prognosis. alpha-Fetoproteins / metabolism

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  • [Copyright] Copyright 2002 S. Karger GmbH, Freiburg
  • (PMID = 11893878.001).
  • [ISSN] 0378-584X
  • [Journal-full-title] Onkologie
  • [ISO-abbreviation] Onkologie
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin, beta Subunit, Human; 0 / alpha-Fetoproteins; Q20Q21Q62J / Cisplatin
  • [Number-of-references] 66
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19. Kollmannsberger C, Nichols C, Meisner C, Mayer F, Kanz L, Bokemeyer C: Identification of prognostic subgroups among patients with metastatic 'IGCCCG poor-prognosis' germ-cell cancer: an explorative analysis using cart modeling. Ann Oncol; 2000 Sep;11(9):1115-20
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  • [Title] Identification of prognostic subgroups among patients with metastatic 'IGCCCG poor-prognosis' germ-cell cancer: an explorative analysis using cart modeling.
  • OBJECTIVES: The IGCCCG classification has identified three prognostic groups of patients with metastatic germ-cell tumors.
  • 'Poor prognosis' is based on primary tumor localization, the presence of visceral metastases, and/or high tumor-marker levels.
  • The following variables were included: primary tumor localization, presence of visceral or lung metastases, presence of an abdominal tumor, number of metastatic sites, serum levels of beta-HCG, AFP and LDH.
  • All patients had been treated with cisplatin-etoposide-based chemotherapy within controlled clinical trials between 1984 and 1997.
  • RESULTS: gonadal/retroperitoneal (G/R) primary tumor 260 patients (78%), mediastinal primary tumor 72 patients (22%), visceral metastases 205 patients (62%) including 33 patients with CNS metastases, lung metastases 247 patients (74%), abdominal tumor 241 patients (72%), elevated AFP, beta-HCG or LDH levels 235 (71%), 253 (76%) and 275 (83%) of patients, respectively.
  • Patients with primary mediastinal disease plus lung metastases exhibited the worst two-year PFS (28%), whereas patients with a primary G/R tumor and without visceral metastases showed the highest chance of two-year PFS (75%).
  • The latter group of patients without visceral metastases and with a primary G/R tumor also had the most favourable two-year OS (84%).
  • In contrast, patients with a primary mediastinal tumor and visceral metastases displayed the worst two-year OS (49%).
  • Identifying subgroups of 'very poor-prognosis' among 'poor-prognosis' patients may allow to test for new treatment strategies in selected subgroups.

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  • (PMID = 11061604.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Clinical Trial; Journal Article; Randomized Controlled Trial
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin; 0 / alpha-Fetoproteins; EC 1.1.1.27 / L-Lactate Dehydrogenase
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20. Rosenfeld A, Kletzel M, Duerst R, Jacobsohn D, Haut P, Weinstein J, Rademaker A, Schaefer C, Evans L, Fouts M, Goldman S: A phase II prospective study of sequential myeloablative chemotherapy with hematopoietic stem cell rescue for the treatment of selected high risk and recurrent central nervous system tumors. J Neurooncol; 2010 Apr;97(2):247-55
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  • [Title] A phase II prospective study of sequential myeloablative chemotherapy with hematopoietic stem cell rescue for the treatment of selected high risk and recurrent central nervous system tumors.
  • High risk/recurrent CNS tumors have a poor prognosis.
  • We studied tandem high dose chemotherapy (HDC) with hematopoietic progenitor stem cell rescues (HPCR) as potentially curative therapy.
  • Diagnoses were medulloblastoma (n = 9), germ cell tumor (n = 4), high grade astrocytoma (n = 2), supratentorial PNET (n = 1), pineoblastoma (n = 2), or papillary meningioma (n = 1).
  • Toxicity was significant with six treatment related deaths including four with veno-occlusive disease.
  • This regimen of sequential HDC/HPCR in high risk/recurrent CNS tumor patients is not feasible due to toxicity.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Central Nervous System Neoplasms / therapy. Hematopoietic Stem Cell Transplantation / methods
  • [MeSH-minor] Adolescent. Carboplatin / administration & dosage. Carboplatin / adverse effects. Child. Child, Preschool. Combined Modality Therapy. Cyclophosphamide / administration & dosage. Etoposide / administration & dosage. Etoposide / adverse effects. Female. Humans. Infant. Kaplan-Meier Estimate. Male. Melphalan / administration & dosage. Melphalan / adverse effects. Thiotepa / administration & dosage. Thiotepa / adverse effects. Transplantation Conditioning

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  • [Cites] Med Pediatr Oncol. 1997 Dec;29(6):553-9 [9324343.001]
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  • (PMID = 19768658.001).
  • [ISSN] 1573-7373
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; 8N3DW7272P / Cyclophosphamide; 905Z5W3GKH / Thiotepa; BG3F62OND5 / Carboplatin; Q41OR9510P / Melphalan
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21. Doyle DM, Einhorn LH: Delayed effects of whole brain radiotherapy in germ cell tumor patients with central nervous system metastases. Int J Radiat Oncol Biol Phys; 2008 Apr 1;70(5):1361-4
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  • [Title] Delayed effects of whole brain radiotherapy in germ cell tumor patients with central nervous system metastases.
  • PURPOSE: Central nervous system (CNS) metastases are uncommon in patients with germ cell tumors, with an incidence of 2-3%.
  • CNS metastases have been managed with whole brain radiotherapy (WBRT) and concomitant cisplatin-based combination chemotherapy.
  • Our previous study did not observe serious CNS toxicity (Int J Radiat Oncol Biol Phys 1991;22:17-22).
  • We now report on 5 patients who developed delayed significant CNS toxicity.
  • PATIENTS AND METHODS: We observed 5 patients with delayed CNS toxicity.
  • All patients had poor-risk disease according to the International Germ Cell Consensus Collaborative Group criteria.
  • Of the 5 patients, 3 had CNS metastases at diagnosis and 2 developed relapses with CNS metastases.
  • These 5 patients underwent WBRT to 4,000-5,000 cGy in 18-28 fractions concurrently with cisplatin-based chemotherapy.
  • RESULTS: All 5 patients developed delayed symptoms consistent with progressive multifocal leukoencephalopathy.
  • The median time from WBRT to CNS symptoms was 72 months (range, 9-228).
  • Treatment with surgery and/or steroids had modest benefit.
  • CONCLUSION: Whole brain radiotherapy is not innocuous in young patients with germ cell tumors and can cause late CNS toxicity.
  • [MeSH-major] Brain / radiation effects. Brain Neoplasms / radiotherapy. Cranial Irradiation / adverse effects. Neoplasms, Germ Cell and Embryonal / radiotherapy. Radiation Injuries / complications. Testicular Neoplasms
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Choriocarcinoma / blood. Choriocarcinoma / drug therapy. Choriocarcinoma / radiotherapy. Choriocarcinoma / secondary. Chorionic Gonadotropin / blood. Cisplatin / administration & dosage. Combined Modality Therapy / adverse effects. Combined Modality Therapy / methods. Fatal Outcome. Humans. Leukoencephalopathy, Progressive Multifocal / etiology. Lung Neoplasms / secondary. Male. Neoplasm Proteins / blood. Radiotherapy Dosage. Salvage Therapy / methods. Stem Cell Transplantation. Time Factors

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  • [CommentIn] Int J Radiat Oncol Biol Phys. 2008 Apr 1;70(5):1300-2 [18374219.001]
  • (PMID = 18374223.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin; 0 / Neoplasm Proteins; Q20Q21Q62J / Cisplatin
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22. Sakurada K, Saino M, Mouri W, Sato A, Kitanaka C, Kayama T: Nestin expression in central nervous system germ cell tumors. Neurosurg Rev; 2008 Apr;31(2):173-6; discussion 176-7

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Nestin expression in central nervous system germ cell tumors.
  • Central nervous system (CNS) germ cell tumors constitute a unique class of rare tumors that mainly affect children and adolescents.
  • These tumors are believed to originate from displaced primordial germ cells.
  • Recently, results of treatment of germ cell tumors have improved with use of radiotherapy and combination chemotherapy.
  • However, some tumors have proven refractory to intensive treatment with surgery, radiation, and combination chemotherapy.
  • Nestin is an intermediate filament protein expressed in undifferentiated cells during CNS development and in CNS tumors and is used as a marker of immature elements of tumors, including brain tumor stem cells.
  • In this study, we examined for the first time nestin expression in 19 CNS germ cell tumors (nine pure germinomas, five germinomas with syncytiotrophoblastic giant cells, one yolk sac tumor, one choriocarcinoma, one embryonal carcinoma, and two mature teratomas).
  • These findings suggest that the detection of nestin expression could be useful in the management of CNS germ cell tumors, as an auxiliary predictor of dissemination and/or progression.
  • [MeSH-major] Biomarkers, Tumor / biosynthesis. Biomarkers, Tumor / genetics. Central Nervous System Neoplasms / genetics. Intermediate Filament Proteins / biosynthesis. Intermediate Filament Proteins / genetics. Neoplasms, Germ Cell and Embryonal / genetics. Nerve Tissue Proteins / biosynthesis. Nerve Tissue Proteins / genetics
  • [MeSH-minor] Adolescent. Adult. Child. Choriocarcinoma / genetics. Choriocarcinoma / metabolism. Choriocarcinoma / pathology. Endodermal Sinus Tumor / genetics. Endodermal Sinus Tumor / metabolism. Endodermal Sinus Tumor / pathology. Female. Germinoma / genetics. Germinoma / metabolism. Germinoma / pathology. Giant Cell Tumors / genetics. Giant Cell Tumors / metabolism. Giant Cell Tumors / pathology. Humans. Hypopituitarism / etiology. Immunoenzyme Techniques. Magnetic Resonance Imaging. Male. Nestin. Teratoma / genetics. Teratoma / metabolism. Teratoma / pathology. Vision Disorders / etiology

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  • [Cites] J Neurosurg. 1999 Feb;90(2):258-64 [9950496.001]
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  • (PMID = 18092184.001).
  • [ISSN] 0344-5607
  • [Journal-full-title] Neurosurgical review
  • [ISO-abbreviation] Neurosurg Rev
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Intermediate Filament Proteins; 0 / NES protein, human; 0 / Nerve Tissue Proteins; 0 / Nestin
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23. Yang QY, Sun XF, Huang HQ, Zhen ZJ, Xia Y, Cai QQ, Ling JY: [Treatment outcome of primary central nervous system germ cell tumors after combined therapy: a report of 23 cases]. Ai Zheng; 2008 Apr;27(4):438-41
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  • [Title] [Treatment outcome of primary central nervous system germ cell tumors after combined therapy: a report of 23 cases].
  • BACKGROUND & OBJECTIVE: Primary central nervous system (CNS) germ cell tumors (GCTs) are rare malignant neoplasms with various histological types.
  • Excluding pure germinoma and mature teratoma, other types carry a poor prognosis.
  • Previous investigations focused on combined modality treatment including chemotherapy to improve survival.
  • This study was to analyze the efficacy and toxicity of chemotherapy combined with surgery and/or radiotherapy on CNS GCTs.
  • METHODS: A total of 23 patients with CNS GCTs were treated in Cancer Center of Sun Yat-sen University from May 2002 to Jun. 2006.
  • All patients were treated with chemotherapy of PEB regimen combined with surgery and/or radiotherapy.
  • RESULTS: Of the 23 patients, 17 newly diagnosed patients received induction chemotherapy followed by radiotherapy or surgery/radiotherapy followed by adjuvant chemotherapy; 6 recurrent patients received salvage chemotherapy, of which 3 patients with disseminated tumor received salvage chemotherapy followed by craniospinal irradiation.
  • Chemotherapy alone gained a response rate of 87.0% and a complete remission rate of 30.4%.
  • Incomplete tumor resection or biopsy was performed in 13 patients.
  • Fourteen patients (60.9%) were alive without evidence of diseases after combined modality treatment.
  • CONCLUSIONS: The combined modality treatment including PEB regimen is highly effective in treating CNS GCTs patients, especially in the patients with elevated tumor markers.
  • [MeSH-major] Central Nervous System Neoplasms / therapy. Neoplasms, Germ Cell and Embryonal / therapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bleomycin / therapeutic use. Cisplatin / therapeutic use. Combined Modality Therapy. Etoposide / therapeutic use. Female. Humans. Male. Survival Rate

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  • (PMID = 18423134.001).
  • [Journal-full-title] Ai zheng = Aizheng = Chinese journal of cancer
  • [ISO-abbreviation] Ai Zheng
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; BEP protocol
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24. Merchant TE, Kiehna EN, Li C, Shukla H, Sengupta S, Xiong X, Gajjar A, Mulhern RK: Modeling radiation dosimetry to predict cognitive outcomes in pediatric patients with CNS embryonal tumors including medulloblastoma. Int J Radiat Oncol Biol Phys; 2006 May 01;65(1):210-21
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Modeling radiation dosimetry to predict cognitive outcomes in pediatric patients with CNS embryonal tumors including medulloblastoma.
  • PURPOSE: Model the effects of radiation dosimetry on IQ among pediatric patients with central nervous system (CNS) tumors.
  • METHODS AND MATERIALS: Pediatric patients with CNS embryonal tumors (n = 39) were prospectively evaluated with serial cognitive testing, before and after treatment with postoperative, risk-adapted craniospinal irradiation (CSI) and conformal primary-site irradiation, followed by chemotherapy.
  • For most models, each Gy of exposure had a similar effect on IQ decline, regardless of dose level.
  • Despite measures to reduce radiation dose and treatment volume, the volume that receives the highest dose continues to have the greatest effect, which supports current volume-reduction efforts.
  • [MeSH-major] Central Nervous System Neoplasms / radiotherapy. Cognition Disorders / etiology. Intelligence / radiation effects. Models, Psychological. Neoplasms, Germ Cell and Embryonal / radiotherapy
  • [MeSH-minor] Child. Child, Preschool. Cranial Irradiation / methods. Dose-Response Relationship, Radiation. Female. Humans. Intelligence Tests. Male. Medulloblastoma / drug therapy. Medulloblastoma / radiotherapy. Neuroectodermal Tumors / drug therapy. Neuroectodermal Tumors / radiotherapy. Prospective Studies. Radiotherapy Dosage. Rhabdoid Tumor / drug therapy. Rhabdoid Tumor / radiotherapy. Supratentorial Neoplasms / drug therapy. Supratentorial Neoplasms / radiotherapy. Temporal Lobe / radiation effects

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  • (PMID = 16472938.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / R25 CA023944; United States / NCI NIH HHS / CA / CA21765
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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25. Cohn DA, Stuart-Harris R: Isolated central nervous system relapse of non-seminomatous germ cell tumour of the testis. A case report and review of the literature. Oncology; 2001;61(3):184-8
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  • [Title] Isolated central nervous system relapse of non-seminomatous germ cell tumour of the testis. A case report and review of the literature.
  • Isolated central nervous system (CNS) relapse of non-seminomatous germ cell tumour (NSGCT) of the testis has been reported in only 12 patients previously.
  • We report a patient with an isolated CNS relapse of NSGCT, following a prior systemic relapse.
  • From a review of previous cases, isolated CNS relapse appears to be more common in patients with embryonal cell histology (alone or mixed with other elements) and occurred after a median of 8.5 months following initial presentation.
  • Long-term survival appears possible using multi-modal treatment with whole-brain radiotherapy, surgery and/or chemotherapy.
  • However, the optimal treatment of isolated CNS relapse remains undefined.
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biomarkers, Tumor / analysis. Cisplatin / administration & dosage. Combined Modality Therapy. Cranial Irradiation. Etoposide / administration & dosage. Humans. Lung Neoplasms / drug therapy. Lung Neoplasms / secondary. Lymphatic Metastasis. Male. Orchiectomy. Radiotherapy, Adjuvant. Remission Induction. Tomography, X-Ray Computed. Vision Disorders / etiology. alpha-Fetoproteins / analysis

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  • [Copyright] Copyright 2001 S. Karger AG, Basel
  • (PMID = 11574772.001).
  • [ISSN] 0030-2414
  • [Journal-full-title] Oncology
  • [ISO-abbreviation] Oncology
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / alpha-Fetoproteins; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
  • [Number-of-references] 10
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26. Gardner SL: Application of stem cell transplant for brain tumors. Pediatr Transplant; 2004 Jun;8 Suppl 5:28-32
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Application of stem cell transplant for brain tumors.
  • Brain tumors are the second most common malignancy in children and the most common solid tumor.
  • The majority of children are treated with surgery alone or in combination with radiation and/or chemotherapy.
  • Recently investigators have used high dose chemotherapy with autologous stem cell rescue (ASCR) in patients with malignant brain tumors.
  • This approach has been most successful in chemosensitive tumors including medulloblastoma, supratentorial primitive neuroectodermal tumors (SPNET) and central nervous system germ cell tumors (CNS GCT).
  • In addition, the use of high dose chemotherapy has enabled the reduction and in many cases elimination of radiation therapy to very young children.
  • To date there have been no prospective randomized studies comparing high dose chemotherapy and ASCR with conventional therapy.
  • Radiation therapy is often not an option for patients with recurrent disease and conventional dose chemotherapy rarely if ever results in long-term survival.
  • Unfortunately, the majority of studies using conventional therapy in order to delay irradiation in young children newly diagnosed with malignant brain tumors have been unsuccessful.
  • Although the numbers are small, preliminary data suggest that not only is survival but also quality of life is superior with the use of high dose chemotherapy.
  • In addition, through the use of peripheral blood stem cells and improvements in supportive care, multiple courses of high dose chemotherapy can be administered.
  • High dose chemotherapy with ASCR is a foundation upon which many different types of therapies can be built.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms / therapy. Hematopoietic Stem Cell Transplantation
  • [MeSH-minor] Combined Modality Therapy. Humans. Pediatrics

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  • (PMID = 15125703.001).
  • [ISSN] 1397-3142
  • [Journal-full-title] Pediatric transplantation
  • [ISO-abbreviation] Pediatr Transplant
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Denmark
  • [Number-of-references] 25
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27. Al-Hussain TO, Dababo MA: Posterior fossa tumor in a 2 year-old girl. Brain Pathol; 2009 Apr;19(2):343-6

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Posterior fossa tumor in a 2 year-old girl.
  • We report a case of a 2 year-old girl who presented with three weeks' history of deterioration of walking, then became unable to walk and later she developed projectile vomiting.
  • The tumor was diagnosed as an embryonal tumor with abundant neuropil and true rosettes (ETANTR).
  • The tumor cells in the neuroblastic component were diffusely positive for synaptophysin and CD56, with scattered positive cells for glial fibrillary acidic protein.
  • Our patient developed recurrent disease 6 months after resection and chemotherapy.
  • ETANTR is a very rare aggressive embryonal CNS tumor that combines features of neuroblastoma and ependymoblastoma.
  • [MeSH-major] Infratentorial Neoplasms / pathology. Neoplasms, Germ Cell and Embryonal / pathology

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  • (PMID = 19291003.001).
  • [ISSN] 1750-3639
  • [Journal-full-title] Brain pathology (Zurich, Switzerland)
  • [ISO-abbreviation] Brain Pathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Switzerland
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28. Blaney SM, Boyett J, Friedman H, Gajjar A, Geyer R, Horowtiz M, Hunt D, Kieran M, Kun L, Packer R, Phillips P, Pollack IF, Prados M, Heideman R: Phase I clinical trial of mafosfamide in infants and children aged 3 years or younger with newly diagnosed embryonal tumors: a pediatric brain tumor consortium study (PBTC-001). J Clin Oncol; 2005 Jan 20;23(3):525-31
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  • [Title] Phase I clinical trial of mafosfamide in infants and children aged 3 years or younger with newly diagnosed embryonal tumors: a pediatric brain tumor consortium study (PBTC-001).
  • PURPOSE: A phase I trial of intrathecal (IT) mafosfamide was performed to determine the optimal dose, dose-limiting toxicities, and incidence and severity of other toxicities when administered in association with concomitant multiagent systemic chemotherapy to children younger than 3 years with newly diagnosed embryonal tumors.
  • CONCLUSION: The maximum tolerated dose and recommended phase II dose of IT mafosfamide in patients younger than 3 years with newly diagnosed embryonal CNS tumors is 14 mg.
  • A trial to assess the efficacy of regional therapy with IT mafosfamide administered with intensive systemic chemotherapy in children younger than 3 years with primary intracranial embryonal tumors is now in progress.
  • [MeSH-major] Antineoplastic Agents / adverse effects. Antineoplastic Agents / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms / drug therapy. Cyclophosphamide / analogs & derivatives. Cyclophosphamide / therapeutic use. Neoplasms, Germ Cell and Embryonal / drug therapy

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  • (PMID = 15659498.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA 98007
  • [Publication-type] Clinical Trial; Clinical Trial, Phase I; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Analgesics, Opioid; 0 / Antineoplastic Agents; 0 / Glucocorticoids; 5970HH9923 / mafosfamide; 76I7G6D29C / Morphine; 7S5I7G3JQL / Dexamethasone; 8N3DW7272P / Cyclophosphamide
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29. Dalmau J, Porta-Etessam J: [Paraneoplastic cerebral syndromes with oto-neuro-ophthalomologic manifestations]. Rev Neurol; 2000 Dec 16-31;31(12):1213-9

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The management of these syndromes depends on their rapid identification as paraneoplastic disorders and on the early diagnosis and treatment of the cancer.
  • Patients with anti-Ta (or anti Ma-2) antibodies may improve with treatment of the cancer, usually a germ-cell tumor of the testis.
  • Paraneoplastic opsoclonus-myoclonus of infancy usually improves with treatment that combines chemotherapy, steroids, and intravenous immunoglobulins, although neurological sequelae (psychomotor and language retardation) are frequent.
  • Detection of antineuronal antibodies facilitates the early identification of some of these syndromes and associated tumors.
  • In general, the management of these syndromes is based on treatment of the associated cancer.
  • [MeSH-major] Demyelinating Autoimmune Diseases, CNS / etiology. Paraneoplastic Syndromes, Nervous System / etiology
  • [MeSH-minor] Antibodies, Neoplasm / immunology. Autoantibodies / immunology. Autoantigens / immunology. Hearing Loss, Sensorineural / etiology. Hearing Loss, Sensorineural / immunology. Humans. Lambert-Eaton Myasthenic Syndrome / etiology. Lambert-Eaton Myasthenic Syndrome / immunology. Neoplasm Proteins / immunology. Neoplasms / complications. Neoplasms / immunology. Nerve Tissue Proteins / immunology. Neurons / immunology. Ophthalmoplegia / etiology. Ophthalmoplegia / immunology. Paraneoplastic Cerebellar Degeneration / etiology. Paraneoplastic Cerebellar Degeneration / immunology

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  • (PMID = 11205562.001).
  • [ISSN] 0210-0010
  • [Journal-full-title] Revista de neurologia
  • [ISO-abbreviation] Rev Neurol
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Spain
  • [Chemical-registry-number] 0 / Antibodies, Neoplasm; 0 / Autoantibodies; 0 / Autoantigens; 0 / Neoplasm Proteins; 0 / Nerve Tissue Proteins
  • [Number-of-references] 44
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30. Hale GA, Greenwood MF, Geil JD, Moscow JA: Langerhans cell histiocytosis after therapy for a malignant germ cell tumor of the central nervous system. J Pediatr Hematol Oncol; 2000 Jul-Aug;22(4):355-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Langerhans cell histiocytosis after therapy for a malignant germ cell tumor of the central nervous system.
  • Langerhans cell histiocytosis (LCH) is a clonal neoplastic disorder that results in a spectrum of clinical manifestations.
  • A child with a malignant germ cell tumor of the brain who subsequently experienced LCH is reported.
  • The 8-year-old boy was treated for an immature teratoma of the posterior fossa with gross total resection and craniospinal irradiation preceding bleomycin, etoposide, and vinblastine chemotherapy for four cycles.
  • Seven months after completion of therapy, he experienced multifocal bone disease with LCH.
  • [MeSH-major] Bone Neoplasms / etiology. Brain Neoplasms / pathology. Histiocytosis, Langerhans-Cell / etiology. Neoplasms, Second Primary / etiology. Teratoma / pathology


31. Bhat SR, Goodwin TL, Burwinkle TM, Lansdale MF, Dahl GV, Huhn SL, Gibbs IC, Donaldson SS, Rosenblum RK, Varni JW, Fisher PG: Profile of daily life in children with brain tumors: an assessment of health-related quality of life. J Clin Oncol; 2005 Aug 20;23(24):5493-500
ClinicalTrials.gov. clinical trials - ClinicalTrials.gov .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • PURPOSE: The survival of children with CNS tumors approaches 70%, yet health-related quality of life (HRQOL) has not been investigated rigorously in this population.
  • RESULTS: One hundred thirty-four patients (73 male; mean age +/- standard deviation, 11.8 +/- 5.4 years; 55 had low-grade glioma, 32 had medulloblastoma/primitive neuroectodermal tumor/embryonal tumor, 17 had malignant astrocytoma, nine had germ-cell tumor, and 21 had other types of tumors) were assessed, each in less than 20 minutes.
  • Children receiving radiation therapy (XRT) but no chemotherapy had significantly lower total, psychosocial, emotional, and social functioning than those receiving other treatments, including XRT plus chemotherapy.
  • CONCLUSION: The PedsQL can be used to assess HRQOL rapidly and easily in children with CNS tumors, who have significantly worse HRQOL than healthy children.
  • Children receiving XRT fare worse overall; chemotherapy added to XRT does not seem to worsen HRQOL.

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  • [CommentIn] J Clin Oncol. 2005 Aug 20;23(24):5424-6 [16110000.001]
  • (PMID = 16110009.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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32. Halperin EC: Neonatal neoplasms. Int J Radiat Oncol Biol Phys; 2000 Apr 1;47(1):171-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • PURPOSE: To describe neoplasms diagnosed in children </= 28 days of age along with their treatment, associated congenital anomalies, and the long-term consequences of the diagnoses and treatments.
  • METHODS AND MATERIALS: Utilizing autopsy records, a computerized tumor registry, and medical records, we identified patients and stillborns at Duke University Medical Center (DUMC) diagnosed with neoplasms at </= 28 days of age between 1930 and 1998.
  • The 20 patients identified via the computerized registry system for 1980-1998 constitute 2% (20/925) of all neoplasms seen in patients </= 16 years of age over this same time period at DUMC.
  • The histologic diagnoses were teratoma/germ cell tumor (n = 8, 35%), neuroblastoma (n = 5, 22%), retinoblastoma (n = 4, 17%), primary central nervous system (CNS) tumor (n = 3, 13%), and one case each of rhabdomyosarcoma, glossal glial choristoma, and hemangioma in the setting of Kasabach-Merritt Syndrome.
  • Of the eight teratoma/germ cell tumor patients, 6 were female (75%) and 2 male (25%).
  • There was one malignant germ cell tumor, 2 immature teratomas, and 5 teratomas.
  • The one patient with malignant germ cell tumor, treated with surgery and chemotherapy, died.
  • Two were treated with surgery + chemotherapy + radiotherapy; two with surgery + chemotherapy; and one with surgery alone.
  • A child with a dumbbell neuroblastoma, treated with surgery and chemotherapy, is paraplegic.
  • The two children with trilateral retinoblastoma died after therapy with surgery, craniospinal and orbital irradiation, and chemotherapy.
  • Two children with bilateral disease are long-term survivors: one treated with radiotherapy + chemotherapy and one with radiotherapy alone.
  • The three patients with CNS tumors were female.
  • Two of the patients are long-term survivors after surgery + chemotherapy.
  • Six children received eight courses of radiation therapy: 2 for Stage 4S neuroblastoma with respiratory compromise from an enlarging liver and 4 for retinoblastoma.
  • The two infants with trilateral retinoblastoma received two courses of irradiation each: one of the treatment of intraocular tumor and a second, at an older age, for the pineal tumor.
  • The most serious complication of anesthesia was a case of enterobacter cloacae sepsis in the central venous access line used for repetitively administering the anesthetic.
  • CONCLUSION: The most common neonatal neoplasm histologic diagnoses are teratoma/germ cell tumor, neuroblastoma, and retinoblastoma.
  • Radiation therapy is administered infrequently in a population highly susceptible to late ill effects.
  • When radiotherapy is required, anesthesia may be repetitively administered to aid in reproducible treatment.
  • [MeSH-minor] Anesthesia. Brain Neoplasms / epidemiology. Brain Neoplasms / pathology. Brain Neoplasms / therapy. Female. Follow-Up Studies. Hemangioma / epidemiology. Hemangioma / pathology. Hemangioma / therapy. Humans. Infant, Newborn. Male. Neuroblastoma / epidemiology. Neuroblastoma / pathology. Neuroblastoma / therapy. Registries. Retinoblastoma / epidemiology. Retinoblastoma / pathology. Retinoblastoma / therapy. Survivors. Teratoma / epidemiology. Teratoma / pathology. Teratoma / therapy

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  • (PMID = 10758320.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] UNITED STATES
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33. Weiner HL, Lichtenbaum RA, Wisoff JH, Snow RB, Souweidane MM, Bruce JN, Finlay JL: Delayed surgical resection of central nervous system germ cell tumors. Neurosurgery; 2002 Apr;50(4):727-33; discussion 733-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Delayed surgical resection of central nervous system germ cell tumors.
  • OBJECTIVE: To determine the value of delayed surgical resection in patients with central nervous system germ cell tumors who exhibit less than complete radiographic response despite declining serum and cerebrospinal fluid (CSF) tumor markers after initial chemotherapy.
  • METHODS: We retrospectively analyzed 126 patients enrolled on two international multicenter clinical trials (the First and Second International Central Nervous System Germ Cell Tumor Studies) for patients with newly diagnosed central nervous system germ cell tumors.
  • After at least three cycles of chemotherapy, 10 of these patients underwent delayed surgical resection owing to evidence of residual radiographic abnormalities despite declining or completely normalized serum and CSF levels of alpha-fetoprotein and human chorionic gonadotropin.
  • RESULTS: Eight of these patients demonstrated nongerminomatous germ cell tumor elements at the time of initial diagnosis.
  • In these patients, either serum or CSF tumor markers were elevated initially.
  • Two patients demonstrated pure germinomas with normal levels of serum and CSF tumor markers.
  • After chemotherapy, radiographic evaluation revealed a partial response in seven patients, a minor response in one patient, and stable disease in two patients.
  • All 10 patients had either normal or decreasing levels of serum and CSF tumor markers before second-look surgery.
  • Pathological findings at second-look surgery demonstrated three patients to have mature teratomas, two with immature teratomas, and five with necrotic or scar tissue alone.
  • To date, 7 of the 10 patients have had no recurrence during an average follow-up time of 36.9 months (range, 3-96 mo).
  • Three of four patients with nongerminomatous germ cell tumors who had tumor markers that were decreased, but not normalized, before second-look surgery eventually developed tumor dissemination/progression, and they required subsequent radiation therapy despite having teratoma or necrosis/scar tissue at delayed surgery.
  • In contrast, three of four patients with nongerminomatous germ cell tumors and completely normalized markers did not progress and did not require radiation therapy.
  • CONCLUSION: Delayed surgical resection should be considered in patients with central nervous system germ cell tumors who have residual radiographic abnormalities and normalized tumor markers, because these lesions are likely to be teratoma or necrosis/scar tissue.
  • However, second-look surgery should be avoided in patients whose tumor markers have not normalized completely.
  • [MeSH-major] Central Nervous System Neoplasms / surgery. Germinoma / surgery
  • [MeSH-minor] Adolescent. Adult. Child. Clinical Trials as Topic. Humans. Male. Multicenter Studies as Topic. Retrospective Studies. Survival Analysis. Time Factors. Treatment Outcome

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  • [CommentIn] Neurosurgery. 2002 Dec;51(6):1530 [12484353.001]
  • (PMID = 11904022.001).
  • [ISSN] 0148-396X
  • [Journal-full-title] Neurosurgery
  • [ISO-abbreviation] Neurosurgery
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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34. Nurzyńska-Flak J, Zawitkowska-Klaczyńska J, Katski K, Kowalczyk JR: [Central nervous system metastases in children with solid tumours]. Med Wieku Rozwoj; 2004 Apr-Jun;8(2 Pt 1):175-82
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  • [Title] [Central nervous system metastases in children with solid tumours].
  • BACKGROUND: Central nervous system (CNS) metastases occur in 20-30% of adult patients with systemic cancers. but they rarely occur in children with solid tumours.
  • AIM: clinical and prognostic characteristics of CNS recurrence in children treated for solid tumours were analysed.
  • The diagnosis in this group was as follow: soft tissue sarcomas -- 51 patients, bone tumours -- 50.
  • Wilms' tumour -- 48, neuroblastoma (NBL) -- 36, germ cell tumours -- 33: Children with primary CNS tumours, retinoblastoma, lymphoma and rare tumours were not analysed.
  • RESULTS: CNS metastases were diagnosed in five children (2.3%) - (2 boys.
  • None of the children with bone tumours had CNS metastases.
  • Diagnosis of CNS metastases was confirmed by imaging studies (CT, MRI).
  • The median time from initial diagnosis to the detection of CNS metastases was 14 months.
  • One of them was also irradiated and received chemotherapy and only this child is alive and achieved complete remission.
  • CONCLUSIONS: CNS metastases may occur in children with the recurrence of primary neoplastic disease.
  • [MeSH-major] Central Nervous System Neoplasms / secondary. Central Nervous System Neoplasms / therapy. Leiomyosarcoma / secondary. Neuroblastoma / secondary. Teratoma / secondary. Wilms Tumor / secondary
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Female. Humans. Male. Neoplasm Staging. Poland. Prognosis. Retrospective Studies. Risk Factors. Survival Analysis

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  • (PMID = 15738591.001).
  • [Journal-full-title] Medycyna wieku rozwojowego
  • [ISO-abbreviation] Med Wieku Rozwoj
  • [Language] pol
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Poland
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