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1. Cohen KJ, Broniscer A, Glod J: Pediatric glial tumors. Curr Treat Options Oncol; 2001 Dec;2(6):529-36
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  • [Title] Pediatric glial tumors.
  • Glial neoplasms in children comprise many heterogeneous tumors that include pilocytic and fibrillary astrocytomas, ependymomas, and the diffuse intrinsic pontine gliomas.
  • In contrast to adults, most of whom present with high-grade fibrillary neoplasms, alternate histologies represent most cases seen in the pediatric setting.
  • In addition, although most adult gliomas are supratentorial in location, in pediatrics infratentorial tumors (posterior fossa and brain stem) predominate.
  • We discuss three specific tumors: diffuse intrinsic pontine gliomas; pilocytic astrocytomas; and ependymomas.
  • Maximal surgical resection is the mainstay of therapy for both pilocytic astrocytomas and ependymomas.
  • Failure to achieve an optimal resection often results in progression and the need for further therapy for patients with pilocytic astrocytomas, and is ultimately fatal in most children with subtotally resected ependymomas.
  • Surgical resection has no role in the treatment of pontine gliomas.
  • Focal radiation therapy is included routinely in the treatment of ependymomas, and it has been shown to improve event-free survival.
  • This therapy also is used in the treatment of pontine gliomas because radiation treatment appears to slow inevitable tumor progression.
  • Radiation therapy in pilocytic astrocytomas is generally reserved for patients who progress after an initial surgical resection or for those patients with midline tumors; these patients are poor candidates for aggressive surgical resection.
  • The role of chemotherapy in these tumors is in evolution.
  • Chemotherapy for pilocytic astrocytomas, particularly in young children (for whom radiation therapy is avoided), appears to be effective in the treatment of a subset of patients.
  • Up-front chemotherapy is generally reserved for the youngest children who present with ependymoma.
  • In the recurrence setting, chemotherapy has shown some activity, although this approach is never curative.
  • Despite the application of various chemotherapeutics and other biologic agents, none of these therapies has improved the prognosis for patients with the uniformly lethal pontine glioma.
  • [MeSH-major] Brain Neoplasms / therapy. Glioma / therapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Astrocytoma / mortality. Astrocytoma / therapy. Cerebrospinal Fluid Shunts. Chemotherapy, Adjuvant. Child. Child, Preschool. Combined Modality Therapy. Cranial Irradiation. Craniotomy. Disease Progression. Ependymoma / mortality. Ependymoma / therapy. Epidemiologic Methods. Humans. Hydrocephalus / etiology. Hydrocephalus / surgery. Infant. Infratentorial Neoplasms / mortality. Infratentorial Neoplasms / therapy. Palliative Care. Pons. Prognosis. Radiotherapy, Adjuvant. Treatment Outcome

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  • (PMID = 12057098.001).
  • [ISSN] 1527-2729
  • [Journal-full-title] Current treatment options in oncology
  • [ISO-abbreviation] Curr Treat Options Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 30
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2. Boguszewicz L, Blamek S, Sokół M: Pattern recognition methods in (1)H MRS monitoring in vivo of normal appearing cerebellar tissue after treatment of posterior fossa tumors. Acta Neurochir Suppl; 2010;106:171-5
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  • [Title] Pattern recognition methods in (1)H MRS monitoring in vivo of normal appearing cerebellar tissue after treatment of posterior fossa tumors.
  • The objective of this study was to investigate the metabolic responses of normal appearing cerebellar tissue after posterior fossa tumor treatment, and to identify characteristics of the particular treatment method.
  • Moreover, this work examined the metabolic alterations of normal appearing tissue induced by a particular tumor state including resection, stagnation, progression, and recurrence.
  • The studied group consisted of 29 patients treated for posterior fossa tumors.
  • All of them were irradiated with a total dose of 54 Gy at 1.8 Gy/fraction (median values).
  • In addition, 13 underwent chemotherapy, 25 underwent total tumor resection, 18 were tumor-free in control examinations, 5 had a stable disease, and tumor progression or recurrence was observed in 2 and 4 cases, respectively.
  • Patients treated with chemotherapy showed an elevated band between 1.15-1.75 and 2.7-3.0 ppm and had decreases in the remaining parts of the spectra.
  • Increases in lactate and decreases in the remaining metabolites were characteristic for the tumor progression/recurrence group.
  • Pattern recognition methods coupled with MRS revealed significant treatment-dependent alterations in normal appearing cerebellar tissue, as well as metabolic changes induced by tumor progression/recurrence.
  • [MeSH-major] Cerebellum / pathology. Infratentorial Neoplasms / pathology. Infratentorial Neoplasms / physiopathology. Magnetic Resonance Spectroscopy / methods. Pattern Recognition, Physiological / physiology
  • [MeSH-minor] Adolescent. Combined Modality Therapy. Electrons. Female. Humans. Magnetic Resonance Imaging / methods. Male. Multivariate Analysis. Neuropsychological Tests. Radiotherapy Dosage

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  • (PMID = 19812943.001).
  • [ISSN] 0065-1419
  • [Journal-full-title] Acta neurochirurgica. Supplement
  • [ISO-abbreviation] Acta Neurochir. Suppl.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Austria
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3. Penn A, Lowis SP, Stevens MC, Hunt LP, Shortman RI, McCarter RJ, Pauldhas D, Curran AL, Sharples PM: Family, demographic and illness-related determinants of HRQL in children with brain tumours in the first year after diagnosis. Pediatr Blood Cancer; 2009 Dec;53(6):1092-9
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  • PROCEDURE: Longitudinal prospective study: Semi-structured interviews took place approximately 1, 6 and 12 months after diagnosis.
  • Tumour and treatment variables considered included tumour site and grade, hydrocephalus at diagnosis, chemotherapy and radiotherapy.
  • Univariate analyses were used at all three time points, and to identify potential early predictors of HRQL at 1 year.
  • Treatment with radio- or chemotherapy correlated with child-report HRQL only at some time points.
  • Multivariate analysis showed infratentorial tumour site, and poor HRQL at 1 month best predicted poor self- and parent-report HRQL at 12 months.
  • CONCLUSION: Children with infratentorial tumours and poor HRQL early after diagnosis tend to have poor HRQL at 1 year.
  • [MeSH-major] Brain Neoplasms / rehabilitation. Family. Quality of Life
  • [MeSH-minor] Child. Family Health. Humans. Infratentorial Neoplasms. Longitudinal Studies. Multivariate Analysis. Parent-Child Relations. Prognosis. Surveys and Questionnaires

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  • (PMID = 19743518.001).
  • [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
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4. Kombogiorgas D, Sgouros S, Walsh AR, Hockley AD, Stevens M, Grundy R, Peet A, English M, Spooner D: Outcome of children with posterior fossa medulloblastoma: a single institution experience over the decade 1994-2003. Childs Nerv Syst; 2007 Apr;23(4):399-405
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  • AIM: While the impact of radiotherapy in the management of medulloblastoma was recognised, the introduction of chemotherapy was investigated in clinical trials and shown to confer an additional advantage.
  • The effect of surgery, radiotherapy, chemotherapy and metastasis on survival was analysed.
  • CONCLUSION: The contribution of chemotherapy in the improvement of the overall survival appears more evident in children younger than 3 years or presenting with metastases.
  • [MeSH-major] Cerebellar Neoplasms / therapy. Infratentorial Neoplasms / therapy. Medulloblastoma / therapy. Treatment Outcome
  • [MeSH-minor] Child. Child, Preschool. Combined Modality Therapy. Female. Humans. Hydrocephalus. Infant. Infant, Newborn. Male. Neoplasm Metastasis. Radiosurgery. Retrospective Studies. Survival Rate

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  • (PMID = 17119978.001).
  • [ISSN] 0256-7040
  • [Journal-full-title] Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
  • [ISO-abbreviation] Childs Nerv Syst
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Germany
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5. Thomas PR, Deutsch M, Kepner JL, Boyett JM, Krischer J, Aronin P, Albright L, Allen JC, Packer RJ, Linggood R, Mulhern R, Stehbens JA, Langston J, Stanley P, Duffner P, Rorke L, Cherlow J, Friedman HS, Finlay JL, Vietti TJ, Kun LE: Low-stage medulloblastoma: final analysis of trial comparing standard-dose with reduced-dose neuraxis irradiation. J Clin Oncol; 2000 Aug;18(16):3004-11
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  • PURPOSE: To evaluate prospectively the effects on survival, relapse-free survival, and patterns of relapse of reduced-dose (23.4 Gy in 13 fractions) compared with standard-dose (36 Gy in 20 fractions) neuraxis irradiation in patients 3 to 21 years of age with low-stage medulloblastoma, minimal postoperative residual disease, and no evidence of neuraxis disease.
  • PATIENTS AND METHODS: The Pediatric Oncology Group and Children's Cancer Group randomized 126 patients to the study.
  • All patients received posterior fossa irradiation to a total dose of 54 Gy in addition to the neuraxis treatment.
  • Patients were staged postoperatively with contrast-enhanced cranial computed tomography, myelography, and CSF cytology.
  • RESULTS: The planned interim analysis that resulted in closure of the protocol showed that patients randomized to the reduced neuraxis treatment had increased frequency of relapse.
  • In the final analysis, eligible patients receiving standard-dose neuraxis irradiation had 67% event-free survival (EFS) at 5 years (SE = 7.4%), whereas eligible patients receiving reduced-dose neuraxis irradiation had 52% event-free survival at 5 years (SE = 7.7%) (P =.080).
  • At 8 years, the respective EFS proportions were also 67% (SE = 8.8%) and 52% (SE = 11%) (P =.141).
  • These data confirm the original one-sided conclusions but suggest that differences are less marked with time.
  • CONCLUSION: Reduced-dose neuraxis irradiation (23.4 Gy) is associated with increased risk of early relapse, early isolated neuraxis relapse, and lower 5-year EFS and overall survival than standard irradiation (36 Gy).
  • The 5-year EFS for patients receiving standard-dose irradiation is suboptimal, and improved techniques and/or therapies are needed to improve ultimate outcome.
  • Chemotherapy may contribute to this improvement.
  • [MeSH-major] Central Nervous System / radiation effects. Infratentorial Neoplasms / radiotherapy. Medulloblastoma / radiotherapy. Skull Base Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Central Nervous System Neoplasms / secondary. Child. Child, Preschool. Cranial Fossa, Posterior. Disease-Free Survival. Dose-Response Relationship, Radiation. Female. Humans. Male. Neoplasm Staging. Neoplasm, Residual / radiotherapy. Prospective Studies. Radiotherapy Dosage. Radiotherapy, Adjuvant. Recurrence. Statistics, Nonparametric. Treatment Failure

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  • (PMID = 10944134.001).
  • [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-29691; United States / NCI NIH HHS / CA / CA-33625; United States / NCI NIH HHS / CA / CA-41573; etc
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
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6. Rivera-Luna R, Zapata-Tarrés M, Medina-Sansón A, López-Aguilar E, Niembro-Zúñiga A, Amador Zarco J, Marhx-Bracho A, Rueda-Franco F, Bornstein-Quevedo L: Long-term survival in children under 3 years of age with low-grade astrocytoma. Childs Nerv Syst; 2007 May;23(5):543-7
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  • Thirty-one (72.1%) children had incomplete surgical tumor resection and 12 (27.9%) had a complete tumor resection.
  • Twelve (27.9%) patients had cranial radiotherapy and 17 (39.5%) received chemotherapy.
  • DFS for the supratentorial group was 60% at 250 months, whereas, for the infratentorial, it was 22% at 120 months (p = 0.008).
  • Radiotherapy and chemotherapy did not alter the outcome.
  • [MeSH-major] Astrocytoma / therapy. Brain Neoplasms / therapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Child, Preschool. Combined Modality Therapy. Disease Progression. Female. Humans. Infant. Infant, Newborn. Male. Neurosurgical Procedures. Postoperative Complications / epidemiology. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 17226033.001).
  • [ISSN] 0256-7040
  • [Journal-full-title] Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
  • [ISO-abbreviation] Childs Nerv Syst
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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7. Agaoglu FY, Ayan I, Dizdar Y, Kebudi R, Gorgun O, Darendeliler E: Ependymal tumors in childhood. Pediatr Blood Cancer; 2005 Sep;45(3):298-303
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  • [Title] Ependymal tumors in childhood.
  • BACKGROUND: Ependymal tumors are classified as ependymoma (benign or low grade) versus anaplastic ependymoma (malignant or high grade).
  • Ependymomas represent 5-10% of intracranial neoplasm in children.
  • In this study, demographic data and the treatment results of pediatric patients with ependymal tumors, treated in a single institute, is reported.
  • PATIENTS AND METHODS: Between 1989 and 2001, 40 (22 M/18 F) previously untreated patients with a median age of 5.5 years (3 months-15 years), of histologically proven ependymal tumors (except ependymoblastomas) were referred to the Institute of Oncology, University of Istanbul.
  • The localization was supratentorial in 18, infratentorial in 20, both supra and infratentorial in two patients.
  • Total tumor resection was performed in 20 patients (50%), subtotal in 18 patients (45%), and biopsy only in 2 patients (5%).
  • Postoperative treatment consisted of regional (8 patients) or craniospinal (CSI) (9 patients) radiotherapy (RT) in patients with ependymoma; regional (7 patients) or CSI RT (14 patients) with chemotherapy (ChT) in patients with anaplastic ependymoma; ChT only (1 patient) in patients less than 3 years of age.
  • The standard technique for posterior fossa irradiation was parallel-opposed lateral fields and total dose was 45-54 Gy.
  • Median time for progression or relapse was 24.3 months and there were 19 patients (43.6%) with relapse or progression.
  • CONCLUSIONS: The majority of complete responders were patients who had total tumor removal.
  • Treatment failure occurred mainly within the first 2 years, and outcome was dismal for patients who relapsed or had progressive disease.
  • [MeSH-major] Brain Neoplasms. Ependymoma

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  • [Copyright] (c) 2004 Wiley-Liss, Inc.
  • (PMID = 15770637.001).
  • [ISSN] 1545-5009
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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8. Hong TS, Mehta MP, Boyett JM, Donahue B, Rorke LB, Zeltzer PM: Patterns of treatment failure in infants with primitive neuroectodermal tumors who were treated on CCG-921: a phase III combined modality study. Pediatr Blood Cancer; 2005 Oct 15;45(5):676-82
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  • [Title] Patterns of treatment failure in infants with primitive neuroectodermal tumors who were treated on CCG-921: a phase III combined modality study.
  • PURPOSE: To analyze patterns of treatment failure in infants with primitive neuroectodermal tumors (PNETs) who were treated primarily with chemotherapy in a large multi-institutional study.
  • MATERIALS AND METHODS: Sixty-five prospectively staged patients with PNET confirmed by central pathology review, who were 18 months or younger were treated on Children's Cancer Group Study 921 (CCG-921) primarily with chemotherapy.
  • Forty-six patients had posterior fossa (PF) primary tumors and 19 patients had supratentorial (ST) primaries.
  • Patterns of sites of initial treatment failure were analyzed and compared to failure patterns of 180 older children who had PF-PNETs, and 44 older children with ST-PNETs who were treated on the same protocol.
  • Cumulative 5-year relapse incidence (+/-SE) for younger patients with PF-PNETs was 64.5 +/- 8.9% for patients without metastases (M0) compared to 71.4 +/- 13.4% for patients with metastases (M+).
  • The overall treatment failure rate was significantly higher for younger compared to older patients with PF-PNET and ST-PNET.
  • There was no statistically significant difference in relapse patterns between patients with PF primary tumors and ST primaries when stratified by stage.
  • All patients had a high risk of recurrence at primary tumor site.
  • Younger patients who had PF primary tumors without metastasis at presentation were significantly more likely to relapse in PF than older patients.
  • CONCLUSIONS: Despite aggressive chemotherapy, younger children with PNETs have high rates of treatment failure and fare worse than high-risk, older patients with PF-PNETs, indicating the need to maximize local, regional, and systemic therapies.
  • [MeSH-major] Brain Neoplasms / therapy. Neuroectodermal Tumors, Primitive / therapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Clinical Trials, Phase III as Topic. Combined Modality Therapy. Disease Progression. Disease-Free Survival. Humans. Infant. Infratentorial Neoplasms / mortality. Infratentorial Neoplasms / pathology. Infratentorial Neoplasms / therapy. Neoplasm Recurrence, Local. Supratentorial Neoplasms / mortality. Supratentorial Neoplasms / pathology. Supratentorial Neoplasms / therapy. Survival Rate. Treatment Failure

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  • (PMID = 16007595.001).
  • [ISSN] 1545-5009
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA21765
  • [Publication-type] 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
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9. Kim YS, Ahn SD, Choi EK, Kim JH, Lee SW, Noh YJ, Kim CJ, Kim JH, Kwun BD: Ependymoma: a Retrospective Analysis of 25 Cases. Cancer Res Treat; 2002 Dec;34(6):450-6
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  • PURPOSE: We evaluated the patterns of failure, survival rate, prognostic factors and treatment related complication in postoperative radiation treatment of patients with ependymoma.
  • The study group comprised of 16 men and 9 women, with a median age of 23 years; including 6 supratentorial, 15 infratentorial and 4 spinal cord lesions.
  • The extents of resection were ranked as either: gross total, near total, subtotal, partial resection or biopsy, with these types of surgical resection being performed in 13, 3, 6, 1 and 2 patients, respectively.
  • Twelve of the patients had low grade ependymoma, and the other 13 a high grade tumor.
  • The postoperative irradiation was administered using 4 MV or 6 MV photons, up to median dose of 55.0 Gy (range, 45.0~59.4 Gy), with the radiation field encompassing the preoperative tumor volume plus a 2 cm margin.
  • Only 8 of the patients received either pre- or postoperative chemotherapy.
  • RESULTS: Ten of the 25 patients (40%) developed a recurrence, and 5 died.
  • Of the 10 recurred patients, 6 showed an in-field recurrence, and one developed both an in-field and an out of field recurrence.
  • There were no significant treatment related complications, with the exception of one case of panhypopituitarism, which occurred 30 months after completion of the radiotherapy.
  • In order to improve the local control, and to reduce complications, advanced radiation treatment techniques, such as 3 dimensional radiotherapy, may be needed.

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  • (PMID = 26680904.001).
  • [ISSN] 1598-2998
  • [Journal-full-title] Cancer research and treatment : official journal of Korean Cancer Association
  • [ISO-abbreviation] Cancer Res Treat
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Korea (South)
  • [Keywords] NOTNLM ; Ependymoma / Prognostic factor / Radiotherapy
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10. Fangusaro JR, Jubran RF, Allen J, Gardner S, Dunkel IJ, Rosenblum M, Atlas MP, Gonzalez-Gomez I, Miller D, Finlay JL: Brainstem primitive neuroectodermal tumors (bstPNET): results of treatment with intensive induction chemotherapy followed by consolidative chemotherapy with autologous hematopoietic cell rescue. Pediatr Blood Cancer; 2008 Mar;50(3):715-7
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  • [Title] Brainstem primitive neuroectodermal tumors (bstPNET): results of treatment with intensive induction chemotherapy followed by consolidative chemotherapy with autologous hematopoietic cell rescue.
  • We have evaluated the response rate and survival utilizing intensified chemotherapy followed by myeloablative chemotherapy with autologous hematopoietic cell rescue (AuHCR) and adjuvant radiation therapy in six young children with newly diagnosed brainstem primitive neuroectodermal tumors (bstPNET).
  • Following maximum surgical resection of the tumor, patients received high dose induction chemotherapy including vincristine, cisplatin, cyclophosphamide, and etoposide.
  • Eligible patients received a single cycle of myeloablative chemotherapy followed by AuHCR.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bone Marrow Transplantation. Brain Stem. Infratentorial Neoplasms / drug therapy. Neuroectodermal Tumors, Primitive / drug therapy. Peripheral Blood Stem Cell Transplantation
  • [MeSH-minor] Brain Damage, Chronic / etiology. Carboplatin / administration & dosage. Child. Child, Preschool. Cisplatin / administration & dosage. Combined Modality Therapy. Cranial Irradiation. Cyclophosphamide / administration & dosage. Etoposide / administration & dosage. Humans. Infant. Leucovorin / administration & dosage. Mesna / administration & dosage. Methotrexate / administration & dosage. Remission Induction. Thiotepa / administration & dosage. Transplantation, Autologous. Vincristine / administration & dosage

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  • [Copyright] (c) 2007 Wiley-Liss, Inc.
  • (PMID = 17009232.001).
  • [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] 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 8N3DW7272P / Cyclophosphamide; 905Z5W3GKH / Thiotepa; BG3F62OND5 / Carboplatin; NR7O1405Q9 / Mesna; Q20Q21Q62J / Cisplatin; Q573I9DVLP / Leucovorin; YL5FZ2Y5U1 / Methotrexate
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11. Distel L, Neubauer S, Varon R, Holter W, Grabenbauer G: Fatal toxicity following radio- and chemotherapy of medulloblastoma in a child with unrecognized Nijmegen breakage syndrome. Med Pediatr Oncol; 2003 Jul;41(1):44-8
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  • [Title] Fatal toxicity following radio- and chemotherapy of medulloblastoma in a child with unrecognized Nijmegen breakage syndrome.
  • BACKGROUND: In large-scale pediatric chemo- and radiotherapy trials a proportion of patients as high as 10-15% is usually reported as having severe treatment related toxicity occasionally resulting in toxic death.
  • Several hereditary disorders including immunodeficiency (ID) syndromes or repair disorders, Ataxia Telangiectasia (AT), and Nijmegen breakage syndrome (NBS) were associated with an elevated risk for severe treatment related toxicity.
  • PROCEDURE: This report involves the case of a 7-year-old boy with medulloblastoma who suffered from remarkably severe side effects during and after postoperative radio- and chemotherapy.
  • Several months following craniospinal radiation with a total dose of 36 Gy, late normal tissue side effects were observed within the treated volume.
  • Eighteen months after initiation of treatment the patient died due to protracted cardiopulmonary failure.
  • RESULTS: To quantify the intrinsic radiation sensitivity, lymphoblastoid cells were used to examine chromosomal aberrations by fluorescence in situ hybridization detecting between two to ninefold higher chromosomal breakage rates in comparison to cells of average cancer patients.
  • CONCLUSIONS: This case highlights that severe treatment related complications in pediatric cancer patients may be the result of increased intrinsic radio- and chemosensitivity due to NBS, AT, and other ID syndromes.
  • [MeSH-major] Abnormalities, Multiple / diagnosis. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Chromosome Breakage. Infratentorial Neoplasms / drug therapy. Medulloblastoma / drug therapy

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  • [Copyright] Copyright 2003 Wiley-Liss, Inc.
  • (PMID = 12764742.001).
  • [ISSN] 0098-1532
  • [Journal-full-title] Medical and pediatric oncology
  • [ISO-abbreviation] Med. Pediatr. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Cell Cycle Proteins; 0 / NBN protein, human; 0 / Nuclear Proteins; 04079A1RDZ / Cytarabine; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide; YL5FZ2Y5U1 / Methotrexate
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12. Rivera E, Meyers C, Groves M, Valero V, Francis D, Arun B, Broglio K, Yin G, Hortobagyi GN, Buchholz T: Phase I study of capecitabine in combination with temozolomide in the treatment of patients with brain metastases from breast carcinoma. Cancer; 2006 Sep 15;107(6):1348-54
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  • [Title] Phase I study of capecitabine in combination with temozolomide in the treatment of patients with brain metastases from breast carcinoma.
  • BACKGROUND: A single-institution Phase I clinical trial was conducted to determine the maximum tolerated dose (MTD) and define the safety profile of temozolomide and capecitabine when used in combination to treat brain metastases from breast cancer.
  • METHODS: Patients were eligible if they had bidimensionally measurable supratentorial or infratentorial brain metastasis from histologically confirmed breast carcinoma.
  • Patients could have received up to 3 prior chemotherapy regimens.
  • Only 1 patient was chemotherapy-naive.
  • The median response duration was 8 weeks (range, 6-64 weeks) and the median time to progression in the brain was 12 weeks (range, 3-70 weeks).
  • The observed antitumor activity warrants further evaluation of this combination as an alternative to or in combination with whole-brain radiation therapy for the treatment of multiple brain metastases.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms / drug therapy. Breast Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Capecitabine. Cohort Studies. Dacarbazine / administration & dosage. Dacarbazine / adverse effects. Dacarbazine / analogs & derivatives. Deoxycytidine / administration & dosage. Deoxycytidine / adverse effects. Deoxycytidine / analogs & derivatives. Dose-Response Relationship, Drug. Drug Administration Schedule. Fatigue / chemically induced. Female. Fluorouracil / analogs & derivatives. Humans. Middle Aged. Nausea / chemically induced. Treatment Outcome. Vomiting / chemically induced

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  • [Copyright] (c) 2006 American Cancer Society.
  • (PMID = 16909414.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase I; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0W860991D6 / Deoxycytidine; 6804DJ8Z9U / Capecitabine; 7GR28W0FJI / Dacarbazine; 85622-93-1 / temozolomide; U3P01618RT / Fluorouracil
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13. Zhang WD, Wu PH, Xie CM, Li H: [Magnetic resonance imaging features of primary brain lymphoma:a report of nine cases]. Ai Zheng; 2007 Jul;26(7):775-7
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  • BACKGROUND & OBJECTIVE: Primary brain lymphoma, a rare tumor, is often misdiagnosed as malignant glioma or metastases before operation.
  • A definite preoperative diagnosis of primary brain lymphoma is of great significance because of its sensitive to chemotherapy and irradiation.
  • METHODS: MRI findings in 9 patients with pathologically proved primary brain lymphoma were analyzed for the number of lesions, tumor site, signal intensity, peritumoral edema, mass effect and contrast enhancement patterns.
  • RESULTS: Of the 9 patients, 8 had supratentorial solitary lesion, and 1 had supratentorial and infratentorial solitary lesion.
  • [MeSH-major] Brain Neoplasms / diagnosis. Brain Neoplasms / pathology. Lymphoma, Large B-Cell, Diffuse / diagnosis. Lymphoma, Large B-Cell, Diffuse / pathology. Magnetic Resonance Imaging / methods

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  • (PMID = 17626758.001).
  • [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] K2I13DR72L / Gadolinium DTPA
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14. Krampulz T, Hans VH, Oppel F, Dietrich U, Puchner MJ: Long-term relapse-free survival with supratentorial primitive neuroectodermal tumor in an adult: a case report. J Neurooncol; 2006 May;77(3):291-4
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  • [Title] Long-term relapse-free survival with supratentorial primitive neuroectodermal tumor in an adult: a case report.
  • OBJECTIVE: In adults, supratentorial primitive neuroectodermal tumor (sPNET) is a very rare undifferentiated embryoblastic neoplasm.
  • Prognosis is worse in comparison to infratentorial medulloblastoma.
  • CT- and MRI-scans revealed a right occipital tumor with moderate contrast enhancement.
  • The tumor was completely removed.
  • The original histological diagnosis was that of an undifferentiated sarcoma, malignant hemangioendothelioma, grade III.
  • The patient was treated by CyVADIC chemotherapy and conventional radiation therapy (60 Gy).
  • Microscopy revealed a malignant, highly cellular, poorly differentiated tumor with a desmoplastic component.
  • Up to 20% of tumor nuclei were labeled for Ki-67.
  • Other tumor entities were excluded by immunohistochemistry.
  • The value of chemotherapy is an issue of continuous investigation.
  • [MeSH-major] Biomarkers, Tumor / metabolism. Neuroectodermal Tumors, Primitive / pathology. Sarcoma / pathology. Supratentorial Neoplasms / pathology
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Diagnosis, Differential. Disease-Free Survival. Humans. Ki-67 Antigen / metabolism. Male. Receptor, Nerve Growth Factor / metabolism. Treatment Outcome

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  • (PMID = 16528456.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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15. Roberts-Thomson R, Rosenthal MA, Gonzales M, Drummond K: Brain metastases in hormone refractory prostate cancer: a changing natural history? Intern Med J; 2009 Mar;39(3):205-6
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  • [Title] Brain metastases in hormone refractory prostate cancer: a changing natural history?
  • [MeSH-major] Adenocarcinoma / pathology. Brain Neoplasms / secondary. Infratentorial Neoplasms / secondary. Neoplasms, Hormone-Dependent / pathology. Prostatic Neoplasms / pathology
  • [MeSH-minor] Aged. Antineoplastic Agents / therapeutic use. Combined Modality Therapy. Craniotomy. Drug Resistance, Neoplasm. Humans. Male


16. Puget S, Boddaert N, Viguier D, Kieffer V, Bulteau C, Garnett M, Callu D, Sainte-Rose C, Kalifa C, Dellatolas G, Grill J: Injuries to inferior vermis and dentate nuclei predict poor neurological and neuropsychological outcome in children with malignant posterior fossa tumors. Cancer; 2009 Mar 15;115(6):1338-47
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  • [Title] Injuries to inferior vermis and dentate nuclei predict poor neurological and neuropsychological outcome in children with malignant posterior fossa tumors.
  • BACKGROUND: Children treated for a malignant posterior fossa tumor (PFT) are at risk of intellectual impairment.
  • The current study was designed to define the correlations between the anatomical damage and the neurological/neuropsychological deficits in children with a malignant PFT.
  • METHODS: Sixty-one consecutive children (mean age, 6.0 years) treated for a malignant PFT with surgery, chemotherapy, and radiotherapy underwent a detailed neuropsychological evaluation, including a full-scale intelligence quotient (FSIQ), on average 5.6 years after the diagnosis.
  • The neurological examination was recorded 1 month after surgery and at the time of the neuropsychological evaluation.
  • CONCLUSIONS: Damage to the dentate nuclei and to the inferior vermis, observed on MRI, predict the degree of impairment of neurological and neuropsychological functions in children treated for a malignant PFT.
  • [MeSH-major] Cerebellar Neoplasms / complications. Cerebellar Neoplasms / therapy. Cerebellar Nuclei / injuries. Cognition Disorders / etiology. Infratentorial Neoplasms / complications. Infratentorial Neoplasms / therapy. Intelligence. Motor Skills

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  • [Copyright] Copyright (c) 2009 American Cancer Society.
  • (PMID = 19195041.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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17. Sandberg DI, Crandall KM, Koru-Sengul T, Padgett KR, Landrum J, Babino D, Petito CK, Solano J, Gonzalez-Brito M, Kuluz JW: Pharmacokinetic analysis of etoposide distribution after administration directly into the fourth ventricle in a piglet model. J Neurooncol; 2010 Mar;97(1):25-32
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  • We hypothesize that infusion of chemotherapeutic agents directly into the fourth ventricle potentially may play a role in treating malignant posterior fossa brain tumors.
  • Accordingly, we used a piglet model developed in our laboratory to test the safety of etoposide infusions into the fourth ventricle and to study the pharmacokinetics associated with these infusions.
  • For CSF samples, area under the concentration-time curve (AUC) was calculated.
  • Piglets underwent daily neurological examinations, a 4.7 Tesla MRI scan, and then were sacrificed for post-mortem brain examination.
  • No neurological deficits or signs of meningitis were caused by intraventricular chemotherapy infusions.
  • Statistically significant differences between fourth ventricle and lumbar AUC were noted at peaks (DeltaAUC = 3384196 ng h/ml with 95%CI: 1758625, 5009767, P = 0.0044) and at all collection time points (DeltaAUC = 1422977 ng h/ml with 95%CI: 732188, 2113766, P = 0.0046) but not at troughs (DeltaAUC = -29546 ng h/ml (95%CI: -147526, 88434.2, P = 0.5251).
  • [MeSH-major] Antineoplastic Agents, Phytogenic / administration & dosage. Antineoplastic Agents, Phytogenic / pharmacokinetics. Etoposide / administration & dosage. Etoposide / pharmacokinetics. Fourth Ventricle / drug effects. Infratentorial Neoplasms / pathology
  • [MeSH-minor] Animals. Area Under Curve. Cell Count. Chromatography, High Pressure Liquid / methods. Confidence Intervals. Disease Models, Animal. Magnetic Resonance Imaging / methods. Neurologic Examination / methods. Swine. Time Factors

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  • (PMID = 19688296.001).
  • [ISSN] 1573-7373
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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18. Chi SN, Zimmerman MA, Yao X, Cohen KJ, Burger P, Biegel JA, Rorke-Adams LB, Fisher MJ, Janss A, Mazewski C, Goldman S, Manley PE, Bowers DC, Bendel A, Rubin J, Turner CD, Marcus KJ, Goumnerova L, Ullrich NJ, Kieran MW: Intensive multimodality treatment for children with newly diagnosed CNS atypical teratoid rhabdoid tumor. J Clin Oncol; 2009 Jan 20;27(3):385-9
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  • [Title] Intensive multimodality treatment for children with newly diagnosed CNS atypical teratoid rhabdoid tumor.
  • PURPOSE: Atypical teratoid rhabdoid tumor (ATRT) of the CNS is a highly malignant neoplasm primarily affecting young children, with a historic median survival ranging from 6 to 11 months.
  • PATIENTS AND METHODS: Treatment was divided into five phases: preirradiation, chemoradiation, consolidation, maintenance, and continuation therapy.
  • Intrathecal chemotherapy was administered, alternating intralumbar and intraventricular routes.
  • Radiation therapy (RT) was prescribed, either focal (54 Gy) or craniospinal (36 Gy, plus primary boost), depending on age and extent of disease at diagnosis.
  • Gross total resection of the primary tumor was achieved in 11 patients.
  • Fifteen patients received radiation therapy: 11 focal and four craniospinal.
  • CONCLUSION: This intensive multimodality regimen has resulted in a significant improvement in time to progression and overall survival for patients with this previously poor-prognosis tumor.
  • [MeSH-major] Brain Neoplasms / therapy. Rhabdoid Tumor / therapy. Teratoma / therapy
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Combined Modality Therapy. Humans. Infratentorial Neoplasms. Prognosis. Prospective Studies. Supratentorial Neoplasms. Young Adult


19. Sato I, Higuchi A, Yanagisawa T, Mukasa A, Ida K, Sawamura Y, Sugiyama K, Saito N, Kumabe T, Terasaki M, Nishikawa R, Ishida Y, Kamibeppu K: Development of the Japanese version of the Pediatric Quality of Life Inventory Brain Tumor Module. Health Qual Life Outcomes; 2010;8:38
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  • [Title] Development of the Japanese version of the Pediatric Quality of Life Inventory Brain Tumor Module.
  • The PedsQL Brain Tumor Module is comprised of six scales: Cognitive Problems, Pain and Hurt, Movement and Balance, Procedural Anxiety, Nausea, and Worry.
  • In the present study, we developed the Japanese version of the PedsQL Brain Tumor Module and investigated its feasibility, reliability, and validity among Japanese children and their parents.
  • Participants were recruited from 6 hospitals in Japan and the Children's Cancer Association of Japan, and questionnaires were completed by 137 children with brain tumors and 166 parents.
  • Feasibility of the questionnaire was determined based on the amount of time required to complete the form and the percentage of missing values.
  • Known-groups validity was described with regard to whole brain irradiation, developmental impairment, infratentorial tumors, paresis, and concurrent chemotherapy.
  • Evaluation of known-groups validity confirmed that the Cognitive Problems scale was sensitive for developmental impairment, the Movement and Balance scale for infratentorial tumors or paresis, and the Nausea scale for a patient currently undergoing chemotherapy.
  • CONCLUSIONS: The Japanese version of the PedsQL Brain Tumor Module is suitable for assessing health-related quality of life in children with brain tumors in clinical trials and research studies.
  • [MeSH-major] Brain Neoplasms. Quality of Life. Surveys and Questionnaires

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  • [ISO-abbreviation] Health Qual Life Outcomes
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  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Validation Studies
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2873593
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20. Nejat F, El Khashab M, Rutka JT: Initial management of childhood brain tumors: neurosurgical considerations. J Child Neurol; 2008 Oct;23(10):1136-48
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  • [Title] Initial management of childhood brain tumors: neurosurgical considerations.
  • Intracranial tumors are the most common solid tumors in children.
  • The infratentorial compartment will be the primary site for 60% to 70% of these tumors, including astrocytomas, medulloblastomas, and ependymomas.
  • Several technological advancements have increased our knowledge of the cell biology of pediatric brain tumors, facilitated earlier diagnosis, and improved neurosurgical resections while minimizing neurological deficits.
  • These in turn have not only improved the survival of children with brain tumors but also their quality of life.
  • Current management strategies in most cases rely on surgery coupled with adjuvant therapies, including radiation therapy and chemotherapy.
  • The vulnerability of the immature brain to adjuvant therapies creates many challenges for the treating physician.
  • We review current diagnostic and therapeutic approaches and outcome for children harboring the most common pediatric brain tumors: astrocytomas (low-grade and high-grade glioma), ependymoma, medulloblastoma, and craniopharyngioma.
  • The emphasis will be on the neurosurgical management of children with these tumors.

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  • (PMID = 18952580.001).
  • [ISSN] 1708-8283
  • [Journal-full-title] Journal of child neurology
  • [ISO-abbreviation] J. Child Neurol.
  • [Language] ENG
  • [Grant] United States / NINDS NIH HHS / NS / R13 NS040925; United States / NINDS NIH HHS / NS / 5R13NS040925-09
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Review
  • [Publication-country] United States
  • [Number-of-references] 92
  • [Other-IDs] NLM/ NIHMS487102; NLM/ PMC3714852
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21. Merchant TE, Li C, Xiong X, Kun LE, Boop FA, Sanford RA: Conformal radiotherapy after surgery for paediatric ependymoma: a prospective study. Lancet Oncol; 2009 Mar;10(3):258-66
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  • BACKGROUND: Therapy for ependymoma includes aggressive surgical intervention and radiotherapy administered by use of methods that keep the risk of side-effects to a minimum.
  • We extended this treatment approach to include children under the age of 3 years with the aim of improving tumour control.
  • 85 patients had anaplastic ependymoma; the tumours of 122 were located in the infratentorial region, and 35 had received previous chemotherapy.
  • Patients received conformal radiotherapy after definitive surgery (125 patients had undergone gross total, 17 near total, and 11 subtotal resection).
  • Doses of 59.4 Gy (n=131) or 54.0 Gy (n=22) were prescribed to a 10 mm margin around the target volume.
  • Variables considered included tumour grade, tumour location, ethnic origin, sex, age when undergoing conformal radiotherapy, total radiotherapy dose, number of surgical procedures, surgery extent, and preradiotherapy chemotherapy.
  • In the 107 patients treated with immediate postoperative conformal radiotherapy (without delay or chemotherapy), 7-year local control, EFS, and overall survival were 88.7% (77.9-99.5), 76.9% (63.4-90.4), and 85.0% (74.2-95.8), respectively; the cumulative incidence of local and distant failure were 12.6% (5.1-20.1), and 8.6% (2.8-14.3), respectively.
  • The incidence of secondary malignant brain tumour at 7 years was 2.3% (0-5.6) and brainstem necrosis 1.6% (0-4.0).
  • INTERPRETATION: Treatment of ependymoma should include surgery with the aim of gross-total resection and conformal, high-dose, postoperative irradiation.
  • Future trials might consider treatment stratification based on sex and age.
  • [MeSH-major] Brain Neoplasms / therapy. Ependymoma / therapy. Radiotherapy, Conformal / methods
  • [MeSH-minor] Adolescent. Adult. Child. Child, Preschool. Combined Modality Therapy. Female. Humans. Infant. Male. Prospective Studies. Treatment Failure

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  • (PMID = 19274783.001).
  • [ISSN] 1474-5488
  • [Journal-full-title] The Lancet. Oncology
  • [ISO-abbreviation] Lancet Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / P30 CA021765
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Other-IDs] NLM/ NIHMS429992; NLM/ PMC3615425
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22. Morris EB, Phillips NS, Laningham FH, Patay Z, Gajjar A, Wallace D, Boop F, Sanford R, Ness KK, Ogg RJ: Proximal dentatothalamocortical tract involvement in posterior fossa syndrome. Brain; 2009 Nov;132(Pt 11):3087-95
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  • Posterior fossa syndrome is characterized by cerebellar dysfunction, oromotor/oculomotor apraxia, emotional lability and mutism in patients after infratentorial injury.
  • We used pre- and postoperative neuroimaging to investigate proximal dentatothalamocortical tract involvement in childhood embryonal brain tumour patients who developed posterior fossa syndrome following tumour resection.
  • In patients who developed posterior fossa syndrome, initial tumour resided higher in the 4th ventricle (P = 0.035).

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  • (PMID = 19805491.001).
  • [ISSN] 1460-2156
  • [Journal-full-title] Brain : a journal of neurology
  • [ISO-abbreviation] Brain
  • [Language] ENG
  • [Grant] United States / NICHD NIH HHS / HD / HD49888; 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] England
  • [Other-IDs] NLM/ PMC2781745
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23. Reddy AT, Janss AJ, Phillips PC, Weiss HL, Packer RJ: Outcome for children with supratentorial primitive neuroectodermal tumors treated with surgery, radiation, and chemotherapy. Cancer; 2000 May 1;88(9):2189-93
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  • [Title] Outcome for children with supratentorial primitive neuroectodermal tumors treated with surgery, radiation, and chemotherapy.
  • BACKGROUND: The outcome of a child with a primitive neuroectodermal tumors arising supratentorially (SPNET) is not well characterized and may differ from the outcome of a patient with a histologically similar cerebellar tumor (medulloblastoma [MB]).
  • Recently, 5-year progression free survival rates as high as 80% have been reported for children with MB treated with craniospinal radiation (CRT) and chemotherapy including cisplatin, lomustine (CCNU), and vincristine (VCR).
  • Tumor location included was 13 pineal, 6 cortical, and 3 thalamic or suprasellar.
  • All patients underwent surgery and staging, followed by CRT and chemotherapy with cisplatin, CCNU, and VCR.
  • RESULTS: Of the 22 patients, 13 had developed disease progression and 10 had died at the time of last follow-up.
  • There was no statistical association between tumor location and survival.
  • CONCLUSIONS: The results of the current study demonstrate that the outcome for children with SPNET treated with radiation and chemotherapy appears worse than for children with MB treated with identical therapy.
  • This suggests that there may be biologic differences between supratentorial and infratentorial primitive neuroectodermal tumors, thus requiring refinements in treatment.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cranial Irradiation. Neuroectodermal Tumors, Primitive / surgery. Supratentorial Neoplasms / surgery
  • [MeSH-minor] Adolescent. Antineoplastic Agents / administration & dosage. Antineoplastic Agents, Alkylating / administration & dosage. Antineoplastic Agents, Phytogenic / administration & dosage. Cerebral Cortex / drug effects. Cerebral Cortex / radiation effects. Cerebral Cortex / surgery. Child. Child, Preschool. Cisplatin / administration & dosage. Disease Progression. Disease-Free Survival. Follow-Up Studies. Humans. Linear Models. Lomustine / administration & dosage. Neoplasm Staging. Pinealoma / drug therapy. Pinealoma / radiotherapy. Pinealoma / surgery. Retrospective Studies. Survival Rate. Thalamic Diseases / drug therapy. Thalamic Diseases / radiotherapy. Thalamic Diseases / surgery. Treatment Outcome. Vincristine / administration & dosage

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  • (PMID = 10813733.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Antineoplastic Agents, Alkylating; 0 / Antineoplastic Agents, Phytogenic; 5J49Q6B70F / Vincristine; 7BRF0Z81KG / Lomustine; Q20Q21Q62J / Cisplatin
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24. Cordeiro JG, Prevedello DM, da Silva Ditzel LF, Pereira CU, Araújo JC: Cerebral metastasis of cervical uterine cancer: report of three cases. Arq Neuropsiquiatr; 2006 Jun;64(2A):300-2
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  • [Title] Cerebral metastasis of cervical uterine cancer: report of three cases.
  • Cervical uterine cancer (CUC) spreads locally (pelvis and paraortic lymphnodes) or distantly (lungs, liver and bones).
  • Three cases of CNS metastasis from CUC are reported, one infratentorial and two supratentorials in location.
  • In one patient, the initial manifestation was due to the cerebral lesion, a feature reported for the first time.
  • All cases were treated by surgery, radiotherapy and/or chemotherapy.
  • Clinical findings and treatment options of these rare lesions are reviewed.
  • [MeSH-major] Adenocarcinoma / pathology. Brain Neoplasms / secondary. Uterine Cervical Neoplasms / pathology


25. Welzel T, Niethammer A, Mende U, Heiland S, Wenz F, Debus J, Krempien R: Diffusion tensor imaging screening of radiation-induced changes in the white matter after prophylactic cranial irradiation of patients with small cell lung cancer: first results of a prospective study. AJNR Am J Neuroradiol; 2008 Feb;29(2):379-83
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  • [Title] Diffusion tensor imaging screening of radiation-induced changes in the white matter after prophylactic cranial irradiation of patients with small cell lung cancer: first results of a prospective study.
  • MATERIALS AND METHODS: A prospective study by use of DTI and conventional T2-weighted MR images was performed with a 1.5T unit with 16 patients with small cell lung cancer and undergoing PCI.
  • Measurements of FA were performed before, at the end of, and 6 weeks after radiation therapy.
  • RESULTS: Fractional anisotropy decreased significantly in supratentorial and infratentorial normal-appearing white matter from the beginning to the end of PCI (P < .01).
  • [MeSH-major] Carcinoma, Small Cell / prevention & control. Carcinoma, Small Cell / radiotherapy. Diffusion Magnetic Resonance Imaging / methods. Lung Neoplasms / radiotherapy. Nerve Fibers, Myelinated / pathology. Nerve Fibers, Myelinated / radiation effects. Radiation Injuries / etiology. Radiation Injuries / pathology
  • [MeSH-minor] Aged. Dose Fractionation. Female. Humans. Magnetic Resonance Imaging / methods. Male. Middle Aged. Pilot Projects. Treatment Outcome


26. Bruna J, González L, Miró J, Velasco R, Gil M, Tortosa A, Neuro-Oncology Unit of the Institute of Biomedical Investigation of Bellvitge: Leptomeningeal carcinomatosis: prognostic implications of clinical and cerebrospinal fluid features. Cancer; 2009 Jan 15;115(2):381-9
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  • BACKGROUND: Leptomeningeal carcinomatosis (LC) represents a devastating complication of systemic cancer, and patients with LC have a dismal prognosis and increased mortality.
  • Thus, the treatment of LC remains controversial, and no straightforward guidelines exist in the literature.
  • The objective of the current study was to identify prognostic markers related to LC survival to better select patients who are eligible for intensive treatment.
  • METHODS: Seventy patients who had a diagnosis of LC were reviewed, and clinical data, cerebrospinal fluid (CSF) parameters, tumor-related characteristics, and treatment information were registered.
  • RESULTS: The multivariate analysis revealed that Radiation Therapy Oncology Group score<or=2 (P=.028), a glucose level in CSF>or=2.7 mmol/L (P=.001), the presence of infratentorial symptoms at onset (P=.026), and intrathecal treatment (P<.001) were associated independently with longer overall survival in patients with LC.
  • In addition, the same clinical factors also predicted response to treatment in such patients.
  • CONCLUSIONS: The predictive factors for patients with LC that were identified in this study could help to better select patients who are more likely to benefit from chemotherapy.

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  • [Copyright] Copyright (c) 2009 American Cancer Society.
  • (PMID = 19109820.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] IY9XDZ35W2 / Glucose
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27. Postovsky S, Ben Arush MW, Elhasid R, Davidson S, Leshanski L, Vlodavsky E, Guilburd JN, Amikam D: A novel case of a CAT to AAT transversion in codon 179 of the p53 gene in a supratentorial primitive neuroectodermal tumor harbored by a young girl. Case report and review of the literature. Oncology; 2003;65(1):46-51
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  • [Title] A novel case of a CAT to AAT transversion in codon 179 of the p53 gene in a supratentorial primitive neuroectodermal tumor harbored by a young girl. Case report and review of the literature.
  • BACKGROUND: The most common cytogenetic abnormality encountered in primitive neuroectodermal tumors (PNET)/medulloblastoma is loss of heterozygosity in the region of the short arm of chromosome 17.
  • There is some evidence that supratentorial PNET has different cytogenetic markers than infratentorial PNET/medulloblastoma.
  • Analysis of the tumor suppressor gene p53 in the tumorous tissue revealed a rare transversion mutational event of CAT to AAT in position 179 of exon 5.
  • Histological examination of the macroscopic resection of the tumor revealed PNET of the brain.
  • Therapy was started according to the Children's Cancer group protocol (CCG-99702) designated for treatment of high-risk central nervous system embryonal tumors.
  • She received an initial course of chemotherapy, consisting of cyclophosphamide and vincristine for mobilizing and harvesting peripheral blood stem cells (PBSCs).
  • Then she was given craniospinal irradiation (3,600 cGy) with a boost to the tumor bed (1,980 cGy) and three consecutive courses of high-dose chemotherapy with carboplatin, vincristine and thiotepa/cyclophosphamide, with PBSCs support after each course.
  • There are only 12 known mutations of the reported type, and the finding of such a rare mutational event in a low-incidence p53 mutation tumor, such as SPNET, might add additional insight into the p53-SPNET relationship in tumorigenesis.
  • Although not widely accepted, it is possible that different mutations of the p53 gene in patients with brain tumors may imply a different ultimate prognosis.
  • In our case, we cannot exclude the fact that transversion of CAT to AAT in position 179 of exon 5 may explain prolonged survival of a patient with good response to therapy.
  • [MeSH-major] Genes, p53 / genetics. Loss of Heterozygosity. Neuroectodermal Tumors, Primitive / diagnosis. Neuroectodermal Tumors, Primitive / genetics. Supratentorial Neoplasms / diagnosis. Supratentorial Neoplasms / genetics
  • [MeSH-minor] Child. Combined Modality Therapy. Diagnosis, Differential. Female. Headache / etiology. Humans. Magnetic Resonance Imaging. Nausea / etiology. Polymerase Chain Reaction. Vision Disorders / etiology


28. Merchant TE, Kun LE, Krasin MJ, Wallace D, Chintagumpala MM, Woo SY, Ashley DM, Sexton M, Kellie SJ, Ahern V, Gajjar A: Multi-institution prospective trial of reduced-dose craniospinal irradiation (23.4 Gy) followed by conformal posterior fossa (36 Gy) and primary site irradiation (55.8 Gy) and dose-intensive chemotherapy for average-risk medulloblastoma. Int J Radiat Oncol Biol Phys; 2008 Mar 1;70(3):782-7
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  • [Title] Multi-institution prospective trial of reduced-dose craniospinal irradiation (23.4 Gy) followed by conformal posterior fossa (36 Gy) and primary site irradiation (55.8 Gy) and dose-intensive chemotherapy for average-risk medulloblastoma.
  • PURPOSE: Limiting the neurocognitive sequelae of radiotherapy (RT) has been an objective in the treatment of medulloblastoma.
  • METHODS AND MATERIALS: Between October 1996 and August 2003, 86 patients, 3-21 years of age, with newly diagnosed, average-risk medulloblastoma were treated in a prospective, institutional review board-approved, multi-institution trial of risk-adapted RT and dose-intensive chemotherapy.
  • RT began within 28 days of definitive surgery and consisted of craniospinal irradiation (23.4 Gy), conformal PF RT (36.0 Gy), and primary site RT (55.8 Gy).
  • The planning target volume for the primary site included the postoperative tumor bed surrounded by an anatomically confined margin of 2 cm that was then expanded with a geometric margin of 0.3-0.5 cm.
  • Chemotherapy was initiated 6 weeks after RT and included four cycles of high-dose cyclophosphamide, cisplatin, and vincristine.
  • The targeting guidelines used in this study resulted in a mean reduction of 13% in the volume of the PF receiving doses >55 Gy compared with conventionally planned RT.
  • CONCLUSION: This prospective trial has demonstrated that irradiation of less than the entire PF after 23.4 Gy craniospinal irradiation for average-risk medulloblastoma results in disease control comparable to that after treatment of the entire PF.

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  • (PMID = 17892918.001).
  • [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 / CA021765-28; United States / NCI NIH HHS / CA / P30 CA021765; United States / NCI NIH HHS / CA / CA21765; United States / NCI NIH HHS / CA / P30 CA021765-28
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 5J49Q6B70F / Vincristine; 8N3DW7272P / Cyclophosphamide; Q20Q21Q62J / Cisplatin
  • [Other-IDs] NLM/ NIHMS40526; NLM/ PMC2716663
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29. Peltier J, Vinchon M, Baroncini M, Kerdraon O, Dhellemmes P: Bifocal mixed germ-cell tumor with growing teratoma syndrome and metachronous mature metastases: case report. J Neurooncol; 2008 Oct;90(1):111-5
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  • [Title] Bifocal mixed germ-cell tumor with growing teratoma syndrome and metachronous mature metastases: case report.
  • The authors report the case of a 16-year-old male who presented with a bifocal diencephalic tumor arising both in the neurohypophysis and the pineal region with hydrocephalus.
  • MRI revealed an increase of the neoplasm during chemotherapy with recurrent obstructive hydrocephalus.
  • Subsequently, this patient developed metachronous cystic metastases in the cerebello-pontine angles, which were resected and identified as mature teratoma, then we observed a lesion of the brachium conjunctivum which stayed stable after 29 consecutive months.
  • To our knowledge, this is the fifth case of the growing teratoma syndrome located in the brain but the first case with simultaneously bifocal location and infratentorial disseminated metastasis.
  • Obviously surgical removal is the treatment of reference for teratomas.
  • Primary intracranial germ-cell tumors (CGT) arise in the midline of the brain and are located in the diencephalon.
  • Germ cell tumor (CGT) includes germinomas and non-germinomatous tumors, mature and immature teratomas account for 19.6 % [1].
  • Curiously, teratomas are able to grow during the first weeks of chemotherapy while serum markers remain normal.
  • This situation was originally described and designed as "the growing teratoma syndroma" (GTS) in primary testis tumors by Logothetis in 1982 [2].
  • [MeSH-major] Brain Neoplasms / pathology. Teratoma / secondary
  • [MeSH-minor] Adolescent. Antineoplastic Agents / therapeutic use. Combined Modality Therapy. Humans. Magnetic Resonance Imaging. Male. Neurosurgical Procedures. Pineal Gland / pathology. Pineal Gland / physiopathology

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  • (PMID = 18574668.001).
  • [ISSN] 0167-594X
  • [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 / Antineoplastic Agents
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30. Hurwitz CA, Strauss LC, Kepner J, Kretschmar C, Harris MB, Friedman H, Kun L, Kadota R: Paclitaxel for the treatment of progressive or recurrent childhood brain tumors: a pediatric oncology phase II study. J Pediatr Hematol Oncol; 2001 Jun-Jul;23(5):277-81
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  • [Title] Paclitaxel for the treatment of progressive or recurrent childhood brain tumors: a pediatric oncology phase II study.
  • PURPOSE: To assess the efficacy and define the toxicity of paclitaxel given at a dosage of 350 mg/m2 every 3 weeks as a 24-hour continuous infusion to children with recurrent or progressive primary brain tumors.
  • PATIENTS AND METHODS: Seventy-three eligible patients, ages 4 months to 19 years, with progressive or recurrent primary brain tumors were treated according to a Pediatric Oncology Group (POG) phase II protocol with paclitaxel (POG 9330).
  • Tumor histologic strata included: astrocytoma (n = 4), malignant glioma (n = 13), medulloblastoma (n = 16), brain stem glioma (n = 15), ependymoma (n = 13), and miscellaneous histologies (n = 12).
  • All patients had previous histologic confirmation of a primary intracranial or spinal cord tumor with magnetic resonance imaging or computed tomography documentation of unequivocally measurable progressive or recurrent disease.
  • All patients had received previous therapy including surgery, radiation therapy, and/or chemotherapy, but no patient had been previously treated on more than one phase II trial.
  • Patients were allowed to continue therapy for a total of 18 cycles in the absence of progressive disease or unacceptable toxicity.
  • RESULTS: Seventy-five patients were enrolled onto the POG 9330 protocol; two ineligible patients were removed from the study before receiving any therapy.
  • CONCLUSION: Paclitaxel is well tolerated in children with recurrent or progressive brain tumors at this dosage and schedule and may result in short-term disease stabilization in this patient population.
  • [MeSH-major] Antineoplastic Agents, Phytogenic / therapeutic use. Brain Neoplasms / drug therapy. Paclitaxel / therapeutic use
  • [MeSH-minor] Adolescent. Astrocytoma / drug therapy. Astrocytoma / pathology. Child. Child, Preschool. Dexamethasone / therapeutic use. Disease Progression. Drug Hypersensitivity / prevention & control. Ependymoma / drug therapy. Ependymoma / pathology. Female. Glioma / drug therapy. Glioma / pathology. Humans. Immunosuppressive Agents / therapeutic use. Infant. Infratentorial Neoplasms / drug therapy. Infratentorial Neoplasms / pathology. Infusions, Intravenous. Male. Medulloblastoma / drug therapy. Medulloblastoma / pathology. Nausea / chemically induced. Neoplasm Recurrence, Local. Neutropenia / chemically induced. Remission Induction. Salvage Therapy. Treatment Failure

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  • (PMID = 11464982.001).
  • [ISSN] 1077-4114
  • [Journal-full-title] Journal of pediatric hematology/oncology
  • [ISO-abbreviation] J. Pediatr. Hematol. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA03161; United States / NCI NIH HHS / CA / CA07431; United States / NCI NIH HHS / CA / CA15525; etc
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 0 / Immunosuppressive Agents; 7S5I7G3JQL / Dexamethasone; P88XT4IS4D / Paclitaxel
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31. Chang RH, Young YH: Posterior fossa lymphoma with initial vertigo presentation. Eur Arch Otorhinolaryngol; 2009 Apr;266(4):495-500
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Two patients received lumbar puncture for cytological examination of cerebrospinal fluid (CSF) which disclosed lymphoma cells, while the other four patients underwent craniotomy for tissue proof, and the histopathological study confirmed as lymphoma.
  • Then, all patients underwent irradiation coupled with chemotherapy.
  • [MeSH-major] Infratentorial Neoplasms / diagnosis. Lymphoma / diagnosis. Vertigo / etiology

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  • (PMID = 18688628.001).
  • [ISSN] 1434-4726
  • [Journal-full-title] European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
  • [ISO-abbreviation] Eur Arch Otorhinolaryngol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
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32. Kieffer-Renaux V, Viguier D, Raquin MA, Laurent-Vannier A, Habrand JL, Dellatolas G, Kalifa C, Hartmann O, Grill J: Therapeutic schedules influence the pattern of intellectual decline after irradiation of posterior fossa tumors. Pediatr Blood Cancer; 2005 Nov;45(6):814-9
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  • [Title] Therapeutic schedules influence the pattern of intellectual decline after irradiation of posterior fossa tumors.
  • BACKGROUND: To evaluate intellectual decline in children with posterior fossa (PF) tumors treated with different therapeutic protocols.
  • PROCEDURE: Forty children had a complete neuropsychological evaluation prospectively twice, at least 6 months year (y) after the end of their treatment.
  • Patients were classified into four groups according to treatment schedules: Group 1 (n = 7) PF radiotherapy (PFRT) alone at 50 Gy; Group 2 (n = 13) reduced-dose cranio-spinal irradiation (CSI) at 25 Gy with a PF boost; Group 3 (n = 9) standard CSI at 35 Gy and a PF boost; and Group 4 (n = 11) high-dose chemotherapy with stem cell support followed by PFRT at 50 Gy.
  • A FSIQ decline was observed in all treatment groups except Group 1 (P = 0.005).
  • The differences in FSIQ observed initially between the four treatment groups persisted at the second evaluation.
  • CONCLUSIONS: This study shows that FSIQ continues to decline more than 4 years after the diagnosis but this yearly decline seems to decrease with time from diagnosis.
  • Therapeutic schedules influence the magnitude of this decline.
  • [MeSH-major] Cognition Disorders / etiology. Infratentorial Neoplasms / complications. Infratentorial Neoplasms / radiotherapy. Intelligence / radiation effects. Radiotherapy / adverse effects
  • [MeSH-minor] Adolescent. Adult. Appointments and Schedules. Child. Child, Preschool. Combined Modality Therapy. Dose-Response Relationship, Radiation. Female. Follow-Up Studies. Humans. Infant. Intelligence Tests. Male. Time Factors

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  • [Copyright] (c) 2005 Wiley-Liss, Inc.
  • (PMID = 15924360.001).
  • [ISSN] 1545-5009
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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