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1. Battaglia F, Uro-Coste E, Delisle MB, Tannier C: [Radiation-induced cavernoma: two cases]. Rev Neurol (Paris); 2008 May;164(5):468-71
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  • Only a few cases of cavernomas induced by radiation treatment, 78 patients, have been reported in the literature.
  • Cavernomas occur several years after radiotherapy for brain neoplasia.
  • Medulloblastoma, glioma and acute lymphoblastic lymphoma are commonly diagnosed and treated in childhood, generally in males.
  • We report new cases of cavernomas induced by radiation treatment.
  • The first case was a 55-year-old man given radiation and chemotherapy for frontal astrocytoma at the age of 46.
  • The second concerned a 30-year-old woman treated by radiation and surgery for brainstem medulloblastoma at the age of four.
  • [MeSH-major] Hemangioma, Cavernous, Central Nervous System / etiology. Hemangioma, Cavernous, Central Nervous System / pathology. Radiotherapy / adverse effects
  • [MeSH-minor] Adult. Astrocytoma / radiotherapy. Cerebellar Neoplasms / radiotherapy. Cerebral Hemorrhage / pathology. Cerebral Ventricles / pathology. Female. Histocytochemistry. Humans. Magnetic Resonance Imaging. Male. Medulloblastoma / radiotherapy. Middle Aged. Pons / pathology

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  • (PMID = 18555880.001).
  • [ISSN] 0035-3787
  • [Journal-full-title] Revue neurologique
  • [ISO-abbreviation] Rev. Neurol. (Paris)
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] France
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2. Tan CH, Rahman A: Systemic lupus erythematosus presenting with brainstem lesions. Hosp Med; 2002 Feb;63(2):115-7
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  • [Title] Systemic lupus erythematosus presenting with brainstem lesions.
  • [MeSH-major] Brain Diseases / diagnosis. Brain Stem. Lupus Erythematosus, Systemic / diagnosis
  • [MeSH-minor] Adult. Diagnosis, Differential. Female. Glioma / diagnosis. Glioma / drug therapy. Glioma / radiotherapy. Humans. Magnetic Resonance Imaging. Pregnancy. Pregnancy Complications / diagnosis


3. Blaney S, Berg SL, Pratt C, Weitman S, Sullivan J, Luchtman-Jones L, Bernstein M: A phase I study of irinotecan in pediatric patients: a pediatric oncology group study. Clin Cancer Res; 2001 Jan;7(1):32-7
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  • An MTD was defined in heavily pretreated and less-heavily pretreated (i.e., two prior chemotherapy regimens, no prior bone marrow transplantation, and no radiation to the spine, skull, ribs, or pelvic bones) patients.
  • Stable disease (4-20 cycles) was observed in seven patients with a variety of malignancies including neuroblastoma, pineoblastoma, glioblastoma, brainstem glioma, osteosarcoma, hepatoblastoma, and a central nervous system rhabdoid tumor.
  • [MeSH-major] Antineoplastic Agents, Phytogenic / therapeutic use. Camptothecin / analogs & derivatives. Camptothecin / therapeutic use. Enzyme Inhibitors / therapeutic use. Neoplasms / drug therapy. Topoisomerase I Inhibitors
  • [MeSH-minor] Adolescent. Adult. Child. Child, Preschool. Dose-Response Relationship, Drug. Drug Administration Schedule. Female. Hematologic Tests. Humans. Infant. Infusions, Intravenous. Male. Toxicity Tests. Treatment Outcome

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  • (PMID = 11205914.001).
  • [ISSN] 1078-0432
  • [Journal-full-title] Clinical cancer research : an official journal of the American Association for Cancer Research
  • [ISO-abbreviation] Clin. Cancer Res.
  • [Language] eng
  • [Grant] United States / NCRR NIH HHS / RR / MO1RR00188; United States / NCI NIH HHS / CA / U01CA57745
  • [Publication-type] Clinical Trial; Clinical Trial, Phase I; Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 0 / Enzyme Inhibitors; 0 / Topoisomerase I Inhibitors; 7673326042 / irinotecan; XT3Z54Z28A / Camptothecin
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4. Terasaki M, Bouffet E, Katsuki H, Fukushima S, Shigemori M: Pilot trial of the rate of response, safety, and tolerability of temozolomide and oral VP-16 in patients with recurrent or treatment-induced malignant central nervous system tumors. Surg Neurol; 2008 Jan;69(1):46-50
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  • [Title] Pilot trial of the rate of response, safety, and tolerability of temozolomide and oral VP-16 in patients with recurrent or treatment-induced malignant central nervous system tumors.
  • BACKGROUND: The aim of this study was to determine the response and toxicity of patients with recurrent or treatment-induced brain tumors to TMZ and oral VP-16.
  • METHODS: Eleven patients with recurrent or treatment-induced malignant CNS tumors, including treatment-induced PNET (in 1 patient), brainstem glioma (in 3 patients; 1 with treatment-induced, 2 with recurrence), recurrent anaplastic astrocytoma (in 3 patients), and recurrent glioblastoma (in 4 patients) were evaluated in a pilot study of TMZ and oral VP-16 chemotherapy.
  • RESULTS: None experienced major acute toxicity related to TMZ and oral VP-16 during a total of 52 treatment courses.
  • Five (45%) of 11 patients showed a PR to treatment.
  • Among the 11 patients enrolled, 7 patients are alive with disease at a median of 9 months from time of study entry.
  • The histologic subtype of the tumor, its location, and its maximum response to chemotherapy did not have an impact on the duration of disease control.
  • CONCLUSION: This limited pilot study confirms the innocuousness and the activity of the combination of TMZ and oral VP-16 in recurrent malignant brain tumors.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Brain Neoplasms / drug therapy. Dacarbazine / analogs & derivatives. Etoposide / administration & dosage. Neoplasm Recurrence, Local / drug therapy. Neoplasms, Neuroepithelial / drug therapy. Neoplasms, Second Primary / drug therapy
  • [MeSH-minor] Administration, Oral. Adolescent. Adult. Aged. Drug Therapy, Combination. Female. Humans. Male. Middle Aged. Pilot Projects. Treatment Outcome

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  • (PMID = 18054615.001).
  • [ISSN] 0090-3019
  • [Journal-full-title] Surgical neurology
  • [ISO-abbreviation] Surg Neurol
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 6PLQ3CP4P3 / Etoposide; 7GR28W0FJI / Dacarbazine; 85622-93-1 / temozolomide
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5. Lesniak MS, Klem JM, Weingart J, Carson BS Sr: Surgical outcome following resection of contrast-enhanced pediatric brainstem gliomas. Pediatr Neurosurg; 2003 Dec;39(6):314-22
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  • [Title] Surgical outcome following resection of contrast-enhanced pediatric brainstem gliomas.
  • BACKGROUND: The role of surgery in the management of gadolinium-enhancing pediatric brainstem lesions on magnetic resonance imaging (MRI) has been a matter of open debate.
  • METHODS: We retrospectively reviewed the charts of all pediatric patients admitted to the Johns Hopkins Hospital with a diagnosis of a brainstem tumor between January 1985 and December 2000.
  • Fifty-seven patients (64.0%) underwent surgical resection while 32 (36%) were treated with radiation and/or chemotherapy.
  • The remaining cases consisted of 10 patients (17.5%) with fibrillary astrocytomas, 3 (5.3%) with gangliogliomas, 1 (1.8%) with an oligodendroglioma and 1 (1.8%) with a primitive neuroectodermal tumor.
  • CONCLUSIONS: This case series illustrates that contrast-enhanced MRI has positive prognostic value in the management of pediatric brainstem gliomas.
  • Consequently, we recommend surgical resection and pathological diagnosis of all enhancing brainstem tumors with adjuvant therapy reserved for recurrent or unresectable cases.
  • [MeSH-major] Brain Stem Neoplasms / pathology. Brain Stem Neoplasms / surgery. Glioma / pathology. Glioma / surgery. Magnetic Resonance Imaging / methods
  • [MeSH-minor] Adolescent. Adult. Chemotherapy, Adjuvant. Child. Child, Preschool. Combined Modality Therapy. Contrast Media / administration & dosage. Female. Humans. Infant. Male. Prognosis. Radiotherapy, Adjuvant. Retrospective Studies. Sensitivity and Specificity. Survival Analysis. Treatment Outcome

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  • [Copyright] Copyright 2003 S. Karger AG, Basel
  • [CommentIn] Pediatr Neurosurg. 2004 Mar-Apr;40(2):99; author reply 100 [15292646.001]
  • (PMID = 14734866.001).
  • [ISSN] 1016-2291
  • [Journal-full-title] Pediatric neurosurgery
  • [ISO-abbreviation] Pediatr Neurosurg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Contrast Media
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6. Marcus KJ, Dutton SC, Barnes P, Coleman CN, Pomeroy SL, Goumnerova L, Billett AL, Kieran M, Tarbell NJ: A phase I trial of etanidazole and hyperfractionated radiotherapy in children with diffuse brainstem glioma. Int J Radiat Oncol Biol Phys; 2003 Apr 1;55(5):1182-5
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  • [Title] A phase I trial of etanidazole and hyperfractionated radiotherapy in children with diffuse brainstem glioma.
  • PURPOSE: To determine the toxicity and maximum tolerated dose of etanidazole administered concurrently with hyperfractionated radiation therapy (HRT) for children with brainstem glioma.
  • METHODS AND MATERIALS: Eighteen patients with brainstem glioma were treated with etanidazole and HRT on a dose escalation protocol (Phase I trial) between 1990 and 1996.
  • All patients had MRI confirmation of diffuse pontine glioma and signs/symptoms of cranial nerve deficit, ataxia, or long tract signs of <6 months' duration.
  • Patients (median age: 8.5 years; 11 males, 7 females) received HRT to the tumor volume plus a 2-cm margin with parallel-opposed 6-15-MV photons.
  • The total dose was 66 Gy in 44 fractions (1.5 Gy b.i.d., with at least 6 h between fractions) for the first 3 patients and 63 Gy in 42 fractions for the subsequent 15 patients.
  • The median survival from the start of treatment was 8.5 months (range: 3-58 months).
  • CONCLUSION: The MTD of etanidazole in children receiving HRT for brainstem glioma is 42 g/m(2), with cutaneous rash as the dose-limiting toxicity.
  • This is in contrast to the adult experience, which demonstrates a 24% lower MTD of 34 g/m(2) limited by peripheral neuropathy.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Brain Stem Neoplasms / radiotherapy. Cranial Irradiation. Dose Fractionation. Etanidazole / therapeutic use. Glioma / radiotherapy. Radiation-Sensitizing Agents / therapeutic use. Radiotherapy, High-Energy
  • [MeSH-minor] Adolescent. Adult. Astrocytoma / drug therapy. Astrocytoma / radiotherapy. Child. Child, Preschool. Combined Modality Therapy. Dose-Response Relationship, Radiation. Drug Administration Schedule. Female. Glioblastoma / drug therapy. Glioblastoma / radiotherapy. Humans. Male. Survival Analysis. Treatment Outcome

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  • (PMID = 12654425.001).
  • [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] Clinical Trial; Clinical Trial, Phase I; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Radiation-Sensitizing Agents; 30DKA3Q1HL / Etanidazole
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7. Uchino M, Haga D, Mito T, Kuramitsu T, Nakamura N: Primary midbrain cystic germinoma mimicking glioma: a case with neuroendoscopic biopsy. J Neurooncol; 2006 Sep;79(3):255-8
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  • [Title] Primary midbrain cystic germinoma mimicking glioma: a case with neuroendoscopic biopsy.
  • We present the first reported case of cystic midbrain germinoma that lacked evident solid components and mimicked a midbrain glioma.
  • The preoperative diagnosis included brain stem glioma, metastasis, and neuroepithelial cyst.
  • The patient responded well to chemotherapy and radiotherapy.
  • The case illustrates the diagnostic value of neuroendoscopic biopsy in the differential diagnosis of brainstem lesions in adult.
  • [MeSH-major] Brain Stem Neoplasms / pathology. Germinoma / pathology. Glioma / pathology
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biopsy. Diagnosis, Differential. Diplopia / etiology. Endoscopy. Headache / etiology. Humans. Magnetic Resonance Imaging. Male

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  • (PMID = 16557347.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
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  • [Publication-type] Case Reports; Journal Article
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8. Frappaz D, Schell M, Thiesse P, Marec-Bérard P, Mottolese C, Perol D, Bergeron C, Philip T, Ricci AC, Galand-Desme S, Szathmari A, Carrie C: Preradiation chemotherapy may improve survival in pediatric diffuse intrinsic brainstem gliomas: final results of BSG 98 prospective trial. Neuro Oncol; 2008 Aug;10(4):599-607
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  • [Title] Preradiation chemotherapy may improve survival in pediatric diffuse intrinsic brainstem gliomas: final results of BSG 98 prospective trial.
  • Radiation therapy remains the only treatment that provides clinical benefit to children with diffuse brainstem tumors.
  • The authors report a prospective trial of frontline chemotherapy aimed at delaying radiation until time of clinical progression.
  • The aim was to investigate the possibility that radiotherapy would maintain its activity in children whose disease progressed after chemotherapy.
  • Twenty-three patients took part in this protocol, the BSG 98 protocol, which consisted of frontline chemotherapy alternating hematotoxic and nonhematotoxic schedules.
  • Twenty of the 23 patients eventually received local radiation therapy.
  • A historical cohort of 14 patients who received at least local radiation therapy served as controls.
  • Although frontline chemotherapy alternating hematotoxic and nonhematotoxic schedules significantly increases overall median survival, its cost from infection and hospitalization deserves honest discussion with the children and their parents.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Brain Stem Neoplasms / mortality. Brain Stem Neoplasms / therapy. Glioma / mortality. Glioma / therapy
  • [MeSH-minor] Adolescent. Adult. Child. Child, Preschool. Combined Modality Therapy. Female. Humans. Kaplan-Meier Estimate. Male. Neoadjuvant Therapy. Quality of Life. Radiotherapy


9. Torcuator R, Zuniga R, Loutfi R, Mikkelsen T: Bevacizumab and irinotecan treatment for progressive diffuse brainstem glioma: case report. J Neurooncol; 2009 Jul;93(3):409-12
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  • [Title] Bevacizumab and irinotecan treatment for progressive diffuse brainstem glioma: case report.
  • Diffuse brainstem glioma carries a dismal prognosis.
  • The current cornerstone of treatment is radiation therapy.
  • Chemotherapy appears to be ineffective and the role of this treatment in the recurrent or progressive setting is not known.
  • In this paper, we report our experience in an adult patient with progressive diffuse brainstem glioma treated with bevacizumab and irinotecan.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Stem Neoplasms / drug therapy. Glioma / drug therapy
  • [MeSH-minor] Adult. Antibodies, Monoclonal / administration & dosage. Antibodies, Monoclonal, Humanized. Bevacizumab. Camptothecin / administration & dosage. Camptothecin / analogs & derivatives. Combined Modality Therapy. Female. Humans. Magnetic Resonance Imaging. Radiotherapy

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  • (PMID = 19139822.001).
  • [ISSN] 1573-7373
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Humanized; 0H43101T0J / irinotecan; 2S9ZZM9Q9V / Bevacizumab; XT3Z54Z28A / Camptothecin
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10. Hargrave D: Paediatric high and low grade glioma: the impact of tumour biology on current and future therapy. Br J Neurosurg; 2009 Aug;23(4):351-63
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  • [Title] Paediatric high and low grade glioma: the impact of tumour biology on current and future therapy.
  • Gliomas are the most common type of paediatric brain tumour and range from benign low grade gliomas which can be resected/observed to aggressive brainstem gliomas with dismal survival rates.
  • Current therapies rely on neurosurgery, radiotherapy, chemotherapy or combination of these conventional modalities and although histopathology helps to direct therapy, molecular pathology has so far not played a major role in the management of paediatric glioma.
  • However, increasing knowledge of glioma biology is starting to impact on drug development towards targeted therapies.
  • Pilocytic astrocytoma, the most common childhood low grade brain tumour, has recently been shown to harbour an activated BRAF/MAPK/ERK pathway in the majority of cases; this represents an attractive target for new agents.
  • The molecular biology of adult malignant glioma is now well described and targeted therapies against VEGFR are already playing a role in the management of glioblastoma.
  • It is likely that high grade gliomas in children and adults share common aberrant molecular pathways but the frequency and mechanisms involved probably will exhibit key differences and on-going comprehensive molecular analyses of paediatric high grade glioma are essential to determine which targets are important in children.
  • However, selection for specific targeted therapy is unlikely to be based on, or restricted by, age but will require individual case by case testing for target presence in order to direct and maximise the efficacy of molecular therapy.
  • Brainstem glioma remains a tumour with a dismal prognosis but relatively little is known about the underlying biology and progress will require a concerted effort to collect tissue by biopsy and autopsy to allow appropriate analysis to identify and validate targets.
  • A new era of molecular based therapies offers the promise of major benefits in the management of paediatric glioma but translating this promise into reality will require further understanding of the biology driving these tumours.
  • [MeSH-major] Brain Neoplasms. Glioma / pathology
  • [MeSH-minor] Adolescent. Adult. Astrocytoma / genetics. Astrocytoma / pathology. Astrocytoma / therapy. Child. Child, Preschool. Combined Modality Therapy. Drug Delivery Systems. Genetic Predisposition to Disease. Genome-Wide Association Study. Hamartoma Syndrome, Multiple / genetics. Humans. Infant. Neoplasm Staging. Neurofibromatosis 1 / genetics. Prognosis. Tuberous Sclerosis / genetics


11. Fouladi M, Nicholson HS, Zhou T, Laningham F, Helton KJ, Holmes E, Cohen K, Speights RA, Wright J, Pollack IF, Children's Oncology Group: A phase II study of the farnesyl transferase inhibitor, tipifarnib, in children with recurrent or progressive high-grade glioma, medulloblastoma/primitive neuroectodermal tumor, or brainstem glioma: a Children's Oncology Group study. Cancer; 2007 Dec 1;110(11):2535-41
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A phase II study of the farnesyl transferase inhibitor, tipifarnib, in children with recurrent or progressive high-grade glioma, medulloblastoma/primitive neuroectodermal tumor, or brainstem glioma: a Children's Oncology Group study.
  • BACKGROUND: An open-label Phase II study of tipifarnib was conducted to evaluate its safety and efficacy in children with recurrent or refractory medulloblastoma (MB)/primitive neuroectodermal tumor (PNET), high-grade glioma (HGG), and diffuse intrinsic brainstem glioma (BSG).
  • CONCLUSIONS: Tipifarnib tolerated well but had little activity as a single agent in children with recurrent central nervous system malignancies.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Brain Neoplasms / drug therapy. Brain Stem Neoplasms / drug therapy. Glioma / drug therapy. Medulloblastoma / drug therapy. Quinolones / therapeutic use
  • [MeSH-minor] Adolescent. Adult. Child. Child, Preschool. Disease Progression. Female. Humans. Male. Neuroectodermal Tumors / drug therapy. Treatment Outcome


12. Yamada K, Miura M, Miyayama H, Sakashita N, Kochi M, Ushio Y: Diffuse brainstem glioma in a patient with Laurence-Moon-(Bardet-)Biedl syndrome. Pediatr Neurosurg; 2000 Dec;33(6):323-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Diffuse brainstem glioma in a patient with Laurence-Moon-(Bardet-)Biedl syndrome.
  • An autopsy case of a patient with diffuse brainstem glioma associated with Laurence-Moon-(Bardet-)Biedl syndrome is described.
  • She developed dizziness, headache and consequent consciousness disturbance.
  • By means of combined chemotherapy and radiation, she survived for 15 months.
  • Histopathological diagnosis for postmortem specimens obtained from the brainstem was glioblastoma multiforme.
  • No pathogenetic association between the syndrome and brainstem gliomas is known, and the literature contains no cases of patients with this coincidence.
  • [MeSH-major] Brain Stem Neoplasms / complications. Glioblastoma / complications. Laurence-Moon Syndrome / complications
  • [MeSH-minor] Adolescent. Adult. Autopsy. Brain / pathology. Fatal Outcome. Female. Humans. Magnetic Resonance Imaging


13. Fuchs I, Kreil W, Sutter B, Papaethymiou G, Pendl G: Gamma Knife radiosurgery of brainstem gliomas. Acta Neurochir Suppl; 2002;84:85-90
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  • [Title] Gamma Knife radiosurgery of brainstem gliomas.
  • From August 1992 until December 1999 Gamma Knife radiosurgery (GKRS) was applied to 21 patients (male to female ratio 14:7) with brainstem gliomas.
  • A median dose of 12 Gy (9-20 Gy) was applied to the tumour margin by the median isodose of 45%.
  • Prior to radiosurgery 4 patients were treated by conventional radiotherapy, 1 had radiotherapy and chemotherapy, 1 patient underwent chemotherapy, and 1 patient was shunted due to hydrocephalus.
  • Microsurgical cyst fenestration was performed in 1 patient after GKRS, shunting procedure was necessary for 2 patients.
  • GKRS is an effective treatment modality for brainstem gliomas with satisfying tumour control and functional outcome.
  • [MeSH-major] Brain Stem Neoplasms / surgery. Glioma / surgery. Medulla Oblongata / surgery. Mesencephalon / surgery. Pons / surgery. Radiosurgery
  • [MeSH-minor] Adolescent. Adult. Brain Damage, Chronic / diagnosis. Child. Cranial Nerve Diseases / diagnosis. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neurologic Examination. Postoperative Complications / diagnosis. Tomography, X-Ray Computed

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  • (PMID = 12379009.001).
  • [ISSN] 0065-1419
  • [Journal-full-title] Acta neurochirurgica. Supplement
  • [ISO-abbreviation] Acta Neurochir. Suppl.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Austria
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14. Rosenthal MA, Ashley DM, Drummond KJ, Dally M, Murphy M, Cher L, Thursfield V, Giles GG: Brain stem gliomas: patterns of care in Victoria from 1998-2000. J Clin Neurosci; 2008 Mar;15(3):237-40
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  • [Title] Brain stem gliomas: patterns of care in Victoria from 1998-2000.
  • This study describes the management of and outcomes for adult and paediatric patients with newly diagnosed brain stem gliomas during 1998-2000 in Victoria.
  • Adult patients were identified in a retrospective cohort study conducted by surveying doctors involved in managing incident brainstem glioma cases identified from the population-based Victorian Cancer Registry.
  • Paediatric cases were identified from a retrospective analysis of the Victorian Paediatric Brain tumour database for the same period.
  • Ten adult and 14 paediatric patients were considered eligible for this study.
  • A variety of tumour types and grades were observed with surgery and radiotherapy the mainstays of therapy.
  • No adult patients and only eight (57%) paediatric patients received chemotherapy.
  • The median survivals for adult patients, paediatric patients with pontine lesions and paediatric patients with non-pontine lesions were: 57, 10 and 60+ months respectively.
  • [MeSH-major] Brain Stem Neoplasms / surgery. Glioma / surgery. Neurosurgery / methods
  • [MeSH-minor] Adolescent. Adult. Aged. Cohort Studies. Female. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Registries / statistics & numerical data. Retrospective Studies. Survival Rate. Tomography, X-Ray. Victoria / epidemiology

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  • (PMID = 18226529.001).
  • [ISSN] 0967-5868
  • [Journal-full-title] Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
  • [ISO-abbreviation] J Clin Neurosci
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Scotland
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15. Hukin J, Siffert J, Velasquez L, Zagzag D, Allen J: Leptomeningeal dissemination in children with progressive low-grade neuroepithelial tumors. Neuro Oncol; 2002 10;4(4):253-60
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  • Our purpose is to describe the incidence and clinical features of leptomeningeal dissemination (LM) in children with progressive low-grade neuroepithelial tumor (LGN).
  • We have continuously tracked all patients with primary CNS tumors since 1986.
  • Satisfactorily followed data were obtained on 427 of the 588 patients with localized LGN at diagnosis between 1986 and 1998, 177 (42%) of whom developed progressive or recurrent disease.
  • The primary tumor sites were diencephalon (6), brainstem (3), cerebellum (2), cerebrum (1), and spinal cord (1).
  • The histologies were pilocytic astrocytoma (4), ganglioglioma (4), fibrillary astrocytoma (3), mixed glioma (1), and glioneurofibroma (1).
  • Management included chemotherapy (2) or radiotherapy (3) or both (7); 1 patient received only radical resections of symptomatic lesions.
  • We strongly urge that for optimum treatment planning all patients with recurrent LGN be staged with an enhanced spine and brain MRI before adjuvant therapy is initiated.
  • The good survival of patients with LGN and LM reflects a more indolent disease than malignant CNS tumors with LM.
  • [MeSH-major] Central Nervous System Neoplasms / pathology. Meningeal Neoplasms / secondary. Neoplasms, Neuroepithelial / secondary
  • [MeSH-minor] Adolescent. Adult. Child. Child, Preschool. Combined Modality Therapy. Disease Progression. Female. Humans. Infant. Magnetic Resonance Imaging. Male. Neoplasm Recurrence, Local / epidemiology. Neoplasm Recurrence, Local / therapy. Survival Analysis. Treatment Outcome

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  • (PMID = 12356355.001).
  • [ISSN] 1522-8517
  • [Journal-full-title] Neuro-oncology
  • [ISO-abbreviation] Neuro-oncology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC1920666
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16. Laigle-Donadey F, Doz F, Delattre JY: Brainstem gliomas in children and adults. Curr Opin Oncol; 2008 Nov;20(6):662-7
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  • [Title] Brainstem gliomas in children and adults.
  • PURPOSE OF REVIEW: The purpose of this review is to determine if recent advances in diagnostic and treatment modalities result in improvement in the pattern of care of brainstem gliomas.
  • RECENT FINDINGS: New MRI techniques may contribute to differential diagnosis and aid neurosurgeons in removing resectable brainstem tumors.
  • However, biopsy remains indicated in many contrast enhancing brainstem masses in adults because of the great variety of differential diagnosis.
  • SUMMARY: Diffuse brainstem glioma is the most common subtype of brainstem tumor and remains a devastating malignancy in children.
  • Conventional radiotherapy is the standard of care and chemotherapy has been disappointing to date.
  • Given the lack of efficacy of conventional drugs, a better understanding of the biology of this tumor is the key to more targeted therapy.
  • [MeSH-major] Brain Neoplasms / drug therapy. Brain Stem / pathology. Glioma / drug therapy
  • [MeSH-minor] Adult. Angiogenesis Inhibitors / therapeutic use. Antineoplastic Agents / therapeutic use. Biopsy. Child. Drug Delivery Systems. Humans. Magnetic Resonance Imaging / methods. Medical Oncology / methods. Neoplasm Metastasis. Neurofibromatosis 1 / drug therapy. Neurofibromatosis 1 / pathology. Signal Transduction

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  • (PMID = 18841048.001).
  • [ISSN] 1531-703X
  • [Journal-full-title] Current opinion in oncology
  • [ISO-abbreviation] Curr Opin Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Angiogenesis Inhibitors; 0 / Antineoplastic Agents
  • [Number-of-references] 57
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17. Finlay JL, Zacharoulis S: The treatment of high grade gliomas and diffuse intrinsic pontine tumors of childhood and adolescence: a historical - and futuristic - perspective. J Neurooncol; 2005 Dec;75(3):253-66
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  • [Title] The treatment of high grade gliomas and diffuse intrinsic pontine tumors of childhood and adolescence: a historical - and futuristic - perspective.
  • Pediatric high grade gliomas represent a heterogeneous group of tumors with poor prognoses despite the use of multimodal treatment.
  • Very little progress has been made over the past decades in identifying efficacious therapeutic modalities against both high grade gliomas and diffuse brainstem gliomas in children.
  • The role of radiation therapy in the treatment of older children with high grade gliomas and diffuse brain stem gliomas is undisputed; however the benefit of using radiation for patients less than 6 years of age (with high grade gliomas) might be questionable.
  • Despite the absence of solid evidence to support its use, chemotherapy is routinely used against these tumors.
  • Currently temozolomide is being investigated due to its activity in adult trials and based on preliminary data regarding recurrent disease.
  • A small subgroup of patients can be successfully treated with high dose chemotherapy followed by autologous stem cell rescue.
  • High dose chemotherapy with autologous stem cell rescue in selected patients with minimal residual disease, angiogenesis inhibitors, radiosensitizers and other biological modifiers are being currently investigated in phase I/II trials.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms / drug therapy. Brain Neoplasms / surgery. Glioma / drug therapy. Glioma / surgery
  • [MeSH-minor] Adolescent. Angiogenesis Inhibitors / therapeutic use. Child. Clinical Trials as Topic. Hematopoietic Stem Cell Transplantation. History, 20th Century. Humans. Morbidity. Mortality. Patient Selection

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  • (PMID = 16195805.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Historical Article; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Angiogenesis Inhibitors
  • [Number-of-references] 131
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18. Pollack IF, Jakacki RI, Blaney SM, Hancock ML, Kieran MW, Phillips P, Kun LE, Friedman H, Packer R, Banerjee A, Geyer JR, Goldman S, Poussaint TY, Krasin MJ, Wang Y, Hayes M, Murgo A, Weiner S, Boyett JM: Phase I trial of imatinib in children with newly diagnosed brainstem and recurrent malignant gliomas: a Pediatric Brain Tumor Consortium report. Neuro Oncol; 2007 Apr;9(2):145-60
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  • [Title] Phase I trial of imatinib in children with newly diagnosed brainstem and recurrent malignant gliomas: a Pediatric Brain Tumor Consortium report.
  • This study estimated the maximum tolerated dose (MTD) of imatinib with irradiation in children with newly diagnosed brainstem gliomas, and those with recurrent malignant intracranial gliomas, stratified according to use of enzyme-inducing anticonvulsant drugs (EIACDs).
  • In the brainstem glioma stratum, imatinib was initially administered twice daily during irradiation, but because of possible association with intratumoral hemorrhage (ITH) was subsequently started two weeks after irradiation.
  • Twenty-four evaluable patients received therapy before the amendment, and three of six with a brainstem tumor experienced dose-limiting toxicity (DLT): one had asymptomatic ITH, one had grade 4 neutropenia and, one had renal insufficiency.
  • None of 18 patients with recurrent glioma experienced DLT.
  • After protocol amendment, 3 of 16 patients with brainstem glioma and 2 of 11 patients with recurrent glioma who were not receiving EIACDs experienced ITH DLTs, with three patients being symptomatic.
  • The recommended phase II dose for brainstem gliomas was 265 mg/m(2).
  • Three of 27 patients with brainstem gliomas with imaging before and after irradiation, prior to receiving imatinib, had new hemorrhage, excluding their receiving imatinib.
  • In summary, recommended phase II imatinib doses were determined for children with newly diagnosed brainstem glioma and recurrent high-grade glioma who were not receiving EIACDs.
  • Imatinib may increase the risk of ITH, although the incidence of spontaneous hemorrhages in brainstem glioma is sufficiently high that this should be considered in studies of agents in which hemorrhage is a concern.

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  • (PMID = 17293590.001).
  • [ISSN] 1522-8517
  • [Journal-full-title] Neuro-oncology
  • [ISO-abbreviation] Neuro-oncology
  • [Language] ENG
  • [Grant] United States / NCRR NIH HHS / RR / M01 RR000188; United States / NCI NIH HHS / CA / U01 CA081457; United States / NCRR NIH HHS / RR / M01 RR00188-37; United States / NCI NIH HHS / CA / U01 CA81457
  • [Publication-type] Clinical Trial, Phase I; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Benzamides; 0 / Piperazines; 0 / Pyrimidines; 8A1O1M485B / Imatinib Mesylate
  • [Other-IDs] NLM/ PMC1871662
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19. Salmaggi A, Fariselli L, Milanesi I, Lamperti E, Silvani A, Bizzi A, Maccagnano E, Trevisan E, Laguzzi E, Rudà R, Boiardi A, Soffietti R, Associazione Italiana di Neuro-oncologia: Natural history and management of brainstem gliomas in adults. A retrospective Italian study. J Neurol; 2008 Feb;255(2):171-7
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  • [Title] Natural history and management of brainstem gliomas in adults. A retrospective Italian study.
  • Brainstem gliomas in adults are rare tumors, with heterogeneous clinical course; only a few studies in the MRI era describe the features in consistent groups of patients.
  • In this retrospective study, we report clinical features at onset, imaging characteristics and subsequent course in a group of 34 adult patients with either histologically proven or clinico-radiologically diagnosed brainstem gliomas followed at two centers in Northern Italy.
  • In 8 of the patients, an initial watch and wait policy was adopted, while 24 were treated shortly after diagnosis with either radiotherapy alone [4] or radiotherapy and chemotherapy [20] (mostly temozolomide).
  • Only minor radiological responses were observed after treatments; in a significant proportion of patients (9 out of 15) clinical improvement during therapy occurred in the context of radiologically (MRI) stable disease.
  • Median overall survival time was of 59 months.
  • Investigation of putative prognostically relevant parameters showed that a short time between disease onset and diagnosis was related to a shorter survival.
  • Compared with literature data, our study confirms the clinical and radiological heterogeneity of adult brainstem gliomas and underscores the need for multicenter trials in order to assess the efficacy of treatments in these tumors.
  • [MeSH-major] Brain Stem Neoplasms / pathology. Brain Stem Neoplasms / therapy. Glioma / pathology. Glioma / therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Antineoplastic Agents / adverse effects. Antineoplastic Agents / therapeutic use. Brain / pathology. Disease Progression. Female. Fluorodeoxyglucose F18. Humans. Image Processing, Computer-Assisted. Italy. Magnetic Resonance Imaging. Male. Middle Aged. Positron-Emission Tomography. Prognosis. Radiopharmaceuticals. Retrospective Studies. Spinal Cord / pathology. Survival Analysis. Treatment Outcome

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  • (PMID = 18293027.001).
  • [ISSN] 0340-5354
  • [Journal-full-title] Journal of neurology
  • [ISO-abbreviation] J. Neurol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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20. Badhe PB, Chauhan PP, Mehta NK: Brainstem gliomas--a clinicopathological study of 45 cases with p53 immunohistochemistry. Indian J Cancer; 2004 Oct-Dec;41(4):170-4
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  • [Title] Brainstem gliomas--a clinicopathological study of 45 cases with p53 immunohistochemistry.
  • BACKGROUND: Brainstem tumors represent 10% of central nervous system tumors, accounting for 30% of pediatric posterior fossa tumors.
  • AIMS: The aim of this study was to clinicopathologically correlate 45 cases of brain stem gliomas and determine the occurrence and prognostic significance of p53 expression.
  • MATERIALS AND METHOD: 45 cases of brain stem gliomas encountered during a 19-year period.
  • The WHO brain tumor classification and Stroink's CT classification were applied.
  • Grade II astrocytomas were treated with excision and radiotherapy, while grade III and IV tumors were treated with radiotherapy and chemotherapy (CCNU).
  • The outcome was better in patients who were treated surgically. p53 is a frequently mutated gene in brain stem astrocytomas.
  • [MeSH-major] Biomarkers, Tumor / metabolism. Brain Stem Neoplasms / metabolism. Glioma / metabolism. Tumor Suppressor Protein p53 / metabolism
  • [MeSH-minor] Adolescent. Adult. Child. Child, Preschool. Female. Humans. Immunohistochemistry. India / epidemiology. Infant. Infant, Newborn. Male. Middle Aged. Retrospective Studies. Survival Rate

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  • (PMID = 15659871.001).
  • [ISSN] 0019-509X
  • [Journal-full-title] Indian journal of cancer
  • [ISO-abbreviation] Indian J Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] India
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Tumor Suppressor Protein p53
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21. Broniscer A, Laningham FH, Kocak M, Krasin MJ, Fouladi M, Merchant TE, Kun LE, Boyett JM, Gajjar A: Intratumoral hemorrhage among children with newly diagnosed, diffuse brainstem glioma. Cancer; 2006 Mar 15;106(6):1364-71
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  • [Title] Intratumoral hemorrhage among children with newly diagnosed, diffuse brainstem glioma.
  • BACKGROUND: Children with diffuse brainstem glioma (BSG) commonly undergo novel therapies because their outcome is poor with radiation therapy (RT).
  • METHODS: All available brain imaging studies and medical records of 48 consecutive patients with newly diagnosed BSG treated at the study institution over a 10-year interval (1992-2002) were reviewed.
  • Treatment was comprised of RT and various regimens of conventional chemotherapy; none of these patients received biologic agents.
  • At the time of last follow-up, all patients had died of tumor progression.
  • RESULTS: The authors reviewed 319 imaging studies (251 magnetic resonance imaging scans and 68 computed tomography scans).
  • IH was present in 6.25% of patients at the time of diagnosis.
  • All cases of IH at the time of diagnosis and 78% of symptomatic cases that developed after diagnosis were located in necrotic areas.
  • CONCLUSIONS: Although IH is uncommon at the time of diagnosis, symptomatic IH may occur among nearly 20% of children after the diagnosis of BSG.
  • The uniform occurrence of IH among patients treated with various chemotherapeutic regimens and its association with necrotic areas suggests that tumor biology plays a significant role in this event.
  • [MeSH-major] Brain Stem Neoplasms / diagnosis. Cerebral Hemorrhage / diagnosis. Glioma / diagnosis
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Agents / therapeutic use. Child. Child, Preschool. Combined Modality Therapy. Cranial Irradiation. Female. Humans. Magnetic Resonance Imaging. Male. Necrosis. Prognosis. Retrospective Studies. Survival Rate. Treatment Outcome

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  • [Copyright] (c) 2006 American Cancer Society.
  • (PMID = 16463390.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / P30 CA 21765
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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22. Burzynski SR, Janicki TJ, Weaver RA, Burzynski B: Targeted therapy with antineoplastons A10 and AS2-1 of high-grade, recurrent, and progressive brainstem glioma. Integr Cancer Ther; 2006 Mar;5(1):40-7
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  • [Title] Targeted therapy with antineoplastons A10 and AS2-1 of high-grade, recurrent, and progressive brainstem glioma.
  • BACKGROUND: Brainstem glioma carries the worst prognosis of all malignancies of the brain.
  • Most patients with brainstem glioma fail standard radiation therapy and chemotherapy and do not survive longer than 2 years.
  • Treatment is even more challenging when an inoperable tumor is of high-grade pathology (HBSG).
  • Twelve patients suffered from recurrence, and 6 patients did not have radiation therapy or chemotherapy.
  • Responses were assessed by gadolinium-enhanced magnetic resonance imaging and positron emission tomography.
  • CONCLUSION: Antineoplastons contributed to more than a 5-year survival in recurrent diffuse intrinsic glioblastomas and anaplastic astrocytomas of the brainstem in a small group of patients.
  • [MeSH-major] Benzeneacetamides / administration & dosage. Brain Stem Neoplasms / drug therapy. Glioma / drug therapy. Glutamine / analogs & derivatives. Neoplasm Recurrence, Local / drug therapy. Phenylacetates / administration & dosage. Piperidones / administration & dosage
  • [MeSH-minor] Adolescent. Adult. Child. Child, Preschool. Dose-Response Relationship, Drug. Drug Administration Schedule. Drug Combinations. Female. Follow-Up Studies. Humans. Injections, Intravenous. Magnetic Resonance Imaging. Male. Maximum Tolerated Dose. Neoplasm Staging. Risk Assessment. Survival Analysis. Treatment Outcome

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  • (PMID = 16484713.001).
  • [ISSN] 1534-7354
  • [Journal-full-title] Integrative cancer therapies
  • [ISO-abbreviation] Integr Cancer Ther
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Benzeneacetamides; 0 / Drug Combinations; 0 / Phenylacetates; 0 / Piperidones; 0RH81L854J / Glutamine; 104624-98-8 / antineoplaston AS 2-1; 91531-30-5 / antineoplaston A10
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23. Giussani C, Poliakov A, Ferri RT, Plawner LL, Browd SR, Shaw DW, Filardi TZ, Hoeppner C, Geyer JR, Olson JM, Douglas JG, Villavicencio EH, Ellenbogen RG, Ojemann JG: DTI fiber tracking to differentiate demyelinating diseases from diffuse brain stem glioma. Neuroimage; 2010 Aug 1;52(1):217-23
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] DTI fiber tracking to differentiate demyelinating diseases from diffuse brain stem glioma.
  • OBJECT: Intrinsic diffuse brainstem tumors and demyelinating diseases primarily affecting the brainstem can share common clinical and radiological features, sometimes making the diagnosis difficult especially at the time of first clinical presentation.
  • To explore the potential usefulness of new MRI sequences in particular diffusion tensor imaging fiber tracking in differentiating these two pathological entities, we review a series of brainstem tumors and demyelinating diseases treated at our institution.
  • MATERIAL AND METHODS: The clinical history including signs and symptoms and MRI findings of three consecutive demyelinating diseases involving the brainstem that presented with diagnostic uncertainty and three diffuse intrinsic brainstem tumors were reviewed, along with a child with a supratentorial tumor for comparison.
  • Fiber tracking of the pyramidal tracts was performed for each patient using a DTI study at the time of presentation.
  • RESULTS: Routine MR imaging was unhelpful in differentiating between intrinsic tumor and demyelination.
  • In contrast, retrospective DTI fiber tracking clearly differentiated the pathology showing deflection of the pyramidal tracts posteriorly and laterally in the case of intrinsic brainstem tumors and, in the case of demyelinating disease, poorly represented and truncated fibers.
  • CONCLUSION: DTI fiber tracking of the pyramid tracts in patients with suspected intrinsic brainstem tumor or demyelinating disease presents two clearly different patterns that may help in differentiating between these two pathologies when conventional MRI and clinical data are inconclusive.
  • [MeSH-major] Brain Diseases / pathology. Brain Stem Neoplasms / pathology. Demyelinating Diseases / pathology. Diagnosis, Computer-Assisted / methods. Diffusion Tensor Imaging / methods. Glioma / pathology
  • [MeSH-minor] Adolescent. Brain Stem / pathology. Child. Child, Preschool. Diagnosis, Differential. Female. Humans. Magnetic Resonance Imaging / methods. Male. Pyramidal Tracts / pathology. Retrospective Studies. Supratentorial Neoplasms / diagnosis. Supratentorial Neoplasms / pathology. Young Adult

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  • [Copyright] Copyright 2010 Elsevier Inc. All rights reserved.
  • (PMID = 20363335.001).
  • [ISSN] 1095-9572
  • [Journal-full-title] NeuroImage
  • [ISO-abbreviation] Neuroimage
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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24. Narayana A, Yamada J, Berry S, Shah P, Hunt M, Gutin PH, Leibel SA: Intensity-modulated radiotherapy in high-grade gliomas: clinical and dosimetric results. Int J Radiat Oncol Biol Phys; 2006 Mar 1;64(3):892-7
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  • A dose of 59.4-60 Gy at 1.8-2.0 Gy per fraction was delivered.
  • Surgery consisted of biopsy only in 26% of the patients, and 80% received adjuvant chemotherapy.
  • The median progression-free survival time for anaplastic astrocytoma and glioblastoma histology was 5.6 and 2.5 months, respectively.
  • The overall survival time for anaplastic glioma and glioblastoma was 36 and 9 months, respectively.
  • A comparative dosimetric analysis revealed that regardless of tumor location, IMRT did not significantly improve target coverage compared with three-dimensional planning.
  • The mean brainstem dose also decreased by 7%.
  • Intensity-modulated radiotherapy delivered with a limited number of beams did not result in an increased dose to the normal brain.
  • [MeSH-major] Brain Neoplasms / radiotherapy. Glioma / radiotherapy. Radiotherapy, Intensity-Modulated
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Brain / radiation effects. Disease Progression. Female. Glioblastoma / radiotherapy. Humans. Male. Middle Aged. Neoplasm Recurrence, Local. Oligodendroglioma / radiotherapy. Radiotherapy Dosage. Retrospective Studies

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  • (PMID = 16458777.001).
  • [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] Evaluation Studies; Journal Article
  • [Publication-country] United States
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25. Guillamo JS, Monjour A, Taillandier L, Devaux B, Varlet P, Haie-Meder C, Defer GL, Maison P, Mazeron JJ, Cornu P, Delattre JY, Association des Neuro-Oncologues d'Expression Française (ANOCEF): Brainstem gliomas in adults: prognostic factors and classification. Brain; 2001 Dec;124(Pt 12):2528-39
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  • [Title] Brainstem gliomas in adults: prognostic factors and classification.
  • In contrast to childhood brainstem gliomas, adult brainstem gliomas are rare and poorly understood.
  • The charts of 48 adults suffering from brainstem glioma were reviewed in order to determine prognostic factors, evaluate the effect of treatment and propose a classification of these tumours.
  • Treatment consisted of partial resection (8%), radiotherapy (94%) and chemotherapy (56%).
  • Eighty-five percent of the tumours could be classified into one of the following three groups on the basis of clinical, radiological and histological features. (i) Diffuse intrinsic low-grade gliomas (46%) usually occurred in young adults with a long clinical history before diagnosis and a diffusely enlarged brainstem on MRI that did not show contrast enhancement.
  • These patients were improved by radiotherapy in 62% of cases and had a long survival time (median 7.3 years).
  • These tumours were highly resistant to treatment and the patients had a median survival time of 11.2 months. (iii) Focal tectal gliomas (8%) occurred in young patients and were often revealed by isolated hydrocephalus.
  • In conclusion, adult brainstem gliomas are different from the childhood forms and resemble supratentorial gliomas in adults.
  • The optimum timing of treatment for supratentorial low-grade tumours remains unclear.
  • In high-grade gliomas, the prognosis remains extremely poor despite aggressive treatment with radiotherapy and chemotherapy.
  • [MeSH-major] Brain Stem Neoplasms / classification. Brain Stem Neoplasms / mortality. Glioma / classification. Glioma / mortality
  • [MeSH-minor] Adult. Age Factors. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Stem / pathology. Disease Progression. Female. Humans. Hydrocephalus / etiology. Hydrocephalus / pathology. Magnetic Resonance Imaging. Male. Multivariate Analysis. Prognosis. Radiotherapy. Survival Rate. Tectum Mesencephali / pathology

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  • (PMID = 11701605.001).
  • [ISSN] 0006-8950
  • [Journal-full-title] Brain : a journal of neurology
  • [ISO-abbreviation] Brain
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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26. Benesch M, Lackner H, Sovinz P, Suppan E, Schwinger W, Eder HG, Dornbusch HJ, Moser A, Triebl-Roth K, Urban C: Late sequela after treatment of childhood low-grade gliomas: a retrospective analysis of 69 long-term survivors treated between 1983 and 2003. J Neurooncol; 2006 Jun;78(2):199-205
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  • [Title] Late sequela after treatment of childhood low-grade gliomas: a retrospective analysis of 69 long-term survivors treated between 1983 and 2003.
  • Eighty-seven patients with low-grade gliomas grouped according to tumor location (cerebellum: n=28; cerebral hemispheres: n=21; central midline: n=15; brainstem: n=12; tectum: n=5; other locations: n=6) were evaluated for tumor- and/or treatment-related late effects by analysis of medical and computer records, and personal interviews.
  • Seventy patients underwent neurosurgery, 29 patients received additional radiotherapy and 20 additional chemotherapy.
  • Median follow-up of survivors is 96 months with an overall survival of 79% (cerebellum: 89%; cerebral hemispheres: 95%; central midline: 80%; brainstem: 25%; tectum: 100%; other locations: 66%).
  • Chronic medical problems (mild ataxia to multiple severe neuroendocrine deficits) are observed in 100% of patients with brainstem/central midline tumors and in 40-50% of patients with low-grade gliomas of other locations.
  • Tumor- and treatment-related late effects are common in patients with low-grade gliomas with the most severe occurring in patients with brainstem or central midline tumors.
  • As long-term survival is excellent in patients with low-grade gliomas except for tumors located in the brainstem, future treatment studies should focus on avoiding long-term late effects.
  • [MeSH-major] Brain Neoplasms / therapy. Endocrine System Diseases / epidemiology. Glioma / therapy. Nervous System Diseases / epidemiology
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Agents / adverse effects. Austria / epidemiology. Child. Child, Preschool. Cohort Studies. Combined Modality Therapy / adverse effects. Disease-Free Survival. Female. Follow-Up Studies. Hearing Disorders / epidemiology. Hearing Disorders / etiology. Humans. Infant. Male. Radiation Injuries / epidemiology. Retrospective Studies. Survivors / statistics & numerical data. Vision Disorders / epidemiology. Vision Disorders / etiology


27. Daw NC, Furman WL, Stewart CF, Iacono LC, Krailo M, Bernstein ML, Dancey JE, Speights RA, Blaney SM, Croop JM, Reaman GH, Adamson PC, Children's Oncology Group: Phase I and pharmacokinetic study of gefitinib in children with refractory solid tumors: a Children's Oncology Group Study. J Clin Oncol; 2005 Sep 1;23(25):6172-80
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  • Disease stabilized for 8 to > or = 60 weeks in two patients with Wilms' tumor and two with brainstem glioma (one exophytic).
  • At 400 mg/m2, the median peak gefitinib plasma concentration was 2.2 microg/mL (range, 1.2 to 3.6 microg/mL) and occurred at a median of 2.3 hours (range, 2.0 to 8.3 hours) after drug administration.
  • Development of the drug in combination with cytotoxic chemotherapy will be pursued.
  • [MeSH-major] Antineoplastic Agents / adverse effects. Antineoplastic Agents / pharmacokinetics. Neoplasms / drug therapy. Quinazolines / adverse effects. Quinazolines / pharmacokinetics
  • [MeSH-minor] Administration, Oral. Adolescent. Adult. Age Factors. Child. Child, Preschool. Female. Humans. Infant. Male. Receptor, Epidermal Growth Factor / antagonists & inhibitors. Treatment Outcome

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  • (PMID = 16135484.001).
  • [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 97452
  • [Publication-type] Clinical Trial; Clinical Trial, Phase I; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Quinazolines; EC 2.7.10.1 / Receptor, Epidermal Growth Factor; S65743JHBS / gefitinib
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28. Joshi BH, Puri RA, Leland P, Varricchio F, Gupta G, Kocak M, Gilbertson RJ, Puri RK, US Pediatric Brain Tumor Consortium: Identification of interleukin-13 receptor alpha2 chain overexpression in situ in high-grade diffusely infiltrative pediatric brainstem glioma. Neuro Oncol; 2008 Jun;10(3):265-74
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  • [Title] Identification of interleukin-13 receptor alpha2 chain overexpression in situ in high-grade diffusely infiltrative pediatric brainstem glioma.
  • Human malignant glioma cell lines and adult brain tumors overexpress high levels of interleukin-13 receptor alpha2 chain (IL-13Ralpha2).
  • Because the IL-13Ralpha2 chain is an important target for cancer therapy and prognosis for patients with brainstem glioma (BSG) remains dismal, we investigated the expression of this receptor in specimens of diffusely infiltrative pediatric BSG relative to normal brain tissue.
  • Twenty-eight BSG specimens and 15 normal brain specimens were investigated for IL-13Ralpha2 protein expression by immunohistochemical analysis (IHC) using two different antibodies in two different laboratories.
  • Highly sensitive Q-dot-based IHC and in situ hybridization (ISH) assays were also developed to identify IL-13Ralpha2 protein and RNA in these specimens.
  • By Q-dot IHC or a standard IHC assay, 17 of 28 (61%) tumor specimens showed modest to strong staining for IL-13Ralpha2, while 15 normal brain tissue samples showed weak expression for IL-13Ralpha2 protein.
  • High-level IL-13Ralpha2 RNA expression was detected in tumor samples by Q-dot ISH, but only weak RNA expression was observed in normal brain.
  • IL-13Ralpha2 protein and mRNA are expressed to significantly higher levels in BSG than in normal brain tissue.
  • Both IHC and ISH represent robust methods to detect expression of the IL-13Ralpha2 receptor in BSG that could represent an important new drug target for treatment of this disease.

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  • (PMID = 18430795.001).
  • [ISSN] 1522-8517
  • [Journal-full-title] Neuro-oncology
  • [ISO-abbreviation] Neuro-oncology
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / U01 CA081457; United States / NCI NIH HHS / CA / U01 CA81457
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Interleukin-13 Receptor alpha2 Subunit; 0 / RNA, Messenger
  • [Other-IDs] NLM/ PMC2563049
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