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1. Wolff JE, Gnekow AK, Kortmann RD, Pietsch T, Urban C, Graf N, Kühl J: Preradiation chemotherapy for pediatric patients with high-grade glioma. Cancer; 2002 Jan 1;94(1):264-71
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  • [Title] Preradiation chemotherapy for pediatric patients with high-grade glioma.
  • BACKGROUND: To evaluate the feasibility and efficacy of intensive chemotherapy given prior to irradiation in pediatric patients with malignant glioma, the Society of Pediatric Oncology in Germany started a randomized trial in 1991.
  • The high-grade glioma strata had to be closed because of insufficient patient accrual.
  • METHODS: Fifty-two patients with World Health Organization (WHO) Grade 4 malignant glioma (n = 27 patients) or with WHO Grade 3 anaplastic astrocytoma (n = 25 patients) between the ages of 3 years and 17 years were available for analysis.
  • The tumor locations were supratentorial in 42 patients, the cerebellum in 8 patients, and the spinal cord in 2 patients (the brainstem was excluded).
  • Patients received either 54 grays of irradiation (n = 22 patients) followed by chemotherapy with lomustine, vincristine, and cisplatin (maintenance chemotherapy) or sandwich chemotherapy (n = 30 patients), which consisted of ifosfamide, etoposide, methotrexate, cisplatin, and cytosine arabinoside followed by irradiation.
  • After undergoing macroscopic total resection, sandwich chemotherapy (n = 15 patients) resulted in better overall survival (median, 5.2 years) compared with the maintenance protocol (n = 16 patients; median survival, 1.9 years; P = 0.015).
  • A Cox multivariate regression analysis showed better survival for female patients (P = 0.025), WHO Grade 3 disease (P = 0.016), tumor resection of > or = 90% (P = 0.003), irradiation with > or = 54 grays (P = 0.003), and sandwich chemotherapy (P = 0.006).
  • CONCLUSIONS: These data suggest that early, intensive chemotherapy increases survival rates in patients with malignant glioma who undergo complete resection.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Central Nervous System Neoplasms / drug therapy. Central Nervous System Neoplasms / radiotherapy. Glioma / drug therapy. Glioma / radiotherapy
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Combined Modality Therapy. Female. Humans. Male. Proportional Hazards Models. Retrospective Studies. Survival Analysis

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  • [Copyright] Copyright 2002 American Cancer Society.
  • (PMID = 11815986.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase III; Journal Article; Randomized Controlled Trial
  • [Publication-country] United States
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2. Schor NF: Pharmacotherapy for adults with tumors of the central nervous system. Pharmacol Ther; 2009 Mar;121(3):253-64
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  • [Title] Pharmacotherapy for adults with tumors of the central nervous system.
  • Malignant tumors of the brain and spinal cord collectively account for approximately 1.3% of all cancers and 2.2% of all cancer-related deaths.
  • Novel pharmacological approaches to nervous system tumors are urgently needed.
  • This review presents the current approaches and challenges to successful pharmacotherapy of adults with malignant tumors of the central nervous system and discusses novel approaches aimed at overcoming these challenges.

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  • (PMID = 19091301.001).
  • [ISSN] 0163-7258
  • [Journal-full-title] Pharmacology & therapeutics
  • [ISO-abbreviation] Pharmacol. Ther.
  • [Language] ENG
  • [Grant] United States / NINDS NIH HHS / NS / R01 NS038569; United States / NINDS NIH HHS / NS / NS038569-10; United States / NCI NIH HHS / CA / CA074289-09; United States / NCI NIH HHS / CA / R01 CA074289-09; United States / NCI NIH HHS / CA / R01 CA074289; United States / NINDS NIH HHS / NS / R01 NS038569-10
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 132
  • [Other-IDs] NLM/ NIHMS103661; NLM/ PMC2782733
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3. Schor NF: New approaches to pharmacotherapy of tumors of the nervous system during childhood and adolescence. Pharmacol Ther; 2009 Apr;122(1):44-55
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  • [Title] New approaches to pharmacotherapy of tumors of the nervous system during childhood and adolescence.
  • Malignant tumors of the brain collectively account for 21% of all cancers and 24% of all cancer-related deaths in this age group.
  • Neuroblastoma, a peripheral nervous system tumor, is the most common extracranial solid tumor of childhood, and 65% of children with this tumor have only a 10 or 15% chance of living 5 years beyond the time of initial diagnosis.
  • Novel pharmacological approaches to nervous system tumors are urgently needed.
  • This review presents the role of and current challenges to pharmacotherapy of malignant tumors of the nervous system during childhood and adolescence and discusses novel approaches aimed at overcoming these challenges.

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  • (PMID = 19318043.001).
  • [ISSN] 1879-016X
  • [Journal-full-title] Pharmacology & therapeutics
  • [ISO-abbreviation] Pharmacol. Ther.
  • [Language] ENG
  • [Grant] United States / NINDS NIH HHS / NS / R01 NS038569; United States / NINDS NIH HHS / NS / NS038569-10; United States / NCI NIH HHS / CA / CA074289-09; United States / NCI NIH HHS / CA / R01 CA074289-09; United States / NCI NIH HHS / CA / R01 CA074289; United States / NINDS NIH HHS / NS / R01 NS038569-10
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 141
  • [Other-IDs] NLM/ NIHMS112040; NLM/ PMC2699440
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4. Gilg AG, Tye SL, Tolliver LB, Wheeler WG, Visconti RP, Duncan JD, Kostova FV, Bolds LN, Toole BP, Maria BL: Targeting hyaluronan interactions in malignant gliomas and their drug-resistant multipotent progenitors. Clin Cancer Res; 2008 Mar 15;14(6):1804-13
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  • [Title] Targeting hyaluronan interactions in malignant gliomas and their drug-resistant multipotent progenitors.
  • PURPOSE: To determine if hyaluronan oligomers (o-HA) antagonize the malignant properties of glioma cells and treatment-resistant glioma side population (SP) cells in vitro and in vivo.
  • EXPERIMENTAL DESIGN: A single intratumoral injection of o-HA was given to rats bearing spinal cord gliomas 7 days after engraftment of C6 glioma cells.
  • At 14 days, spinal cords were evaluated for tumor size, invasive patterns, proliferation, apoptosis, activation of Akt, and BCRP expression.
  • C6SP were isolated by fluorescence-activated cell sorting and tested for the effects of o-HA on BCRP expression, activation of Akt and epidermal growth factor receptor, drug resistance, and glioma growth in vivo.
  • RESULTS: o-HA treatment decreased tumor cell proliferation, increased apoptosis, and down-regulated activation of Akt and the expression of BCRP. o-HA treatment of C6SP inhibited activation of epidermal growth factor receptor and Akt, decreased BCRP expression, and increased methotrexate cytotoxicity.
  • Interestingly, the spinal cord gliomas contained many BCRP+ cells that were not C6 or C6SP cells but that expressed nestin and/or CD45; o-HA treatment significantly decreased the recruitment of these BCRP+ progenitor cells into the engrafted gliomas.
  • CONCLUSIONS: o-HA suppress glioma growth in vivo by enhancing apoptosis, down-regulating key cell survival mechanisms, and possibly by decreasing recruitment of host-derived BCRP+ progenitor cells.
  • Thus, o-HA hold promise as a new biological therapy to inhibit HA-mediated malignant mechanisms in glioma cells and treatment-resistant glioma stem cells.
  • [MeSH-major] Drug Resistance, Neoplasm / drug effects. Glioma / drug therapy. Hyaluronic Acid / antagonists & inhibitors. Hyaluronic Acid / therapeutic use. Neoplastic Stem Cells / drug effects. Spinal Cord Neoplasms / drug therapy. Spinal Cord Neoplasms / metabolism
  • [MeSH-minor] Animals. Antigens, CD44 / drug effects. Antigens, CD44 / metabolism. Antineoplastic Agents / therapeutic use. Drug Delivery Systems. Drug Evaluation, Preclinical. Neoplasm Transplantation. Polymers / therapeutic use. Protein Binding / drug effects. Rats. Rats, Sprague-Dawley. Tumor Cells, Cultured

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  • (PMID = 18347183.001).
  • [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 / NCI NIH HHS / CA / CA073839; United States / NCI NIH HHS / CA / CA082867
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antigens, CD44; 0 / Antineoplastic Agents; 0 / Polymers; 9004-61-9 / Hyaluronic Acid
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5. Maria BL, Gupta N, Gilg AG, Abdel-Wahab M, Leonard AP, Slomiany M, Wheeler WG, Tolliver LB, Babcock MA, Lucas JT Jr, Toole BP: Targeting hyaluronan interactions in spinal cord astrocytomas and diffuse pontine gliomas. J Child Neurol; 2008 Oct;23(10):1214-20
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  • [Title] Targeting hyaluronan interactions in spinal cord astrocytomas and diffuse pontine gliomas.
  • Although significant advances have been made in treating malignant pediatric central nervous system tumors such as medulloblastoma, no effective therapy exists for diffuse pontine glioma or intramedullary spinal astrocytoma.
  • Biology of these 2 tumors is poorly understood, in part because diffuse pontine gliomas are not treated surgically, and tumor specimens from intramedullary spinal astrocytomas are rare and minuscule.
  • At the 2007 Neurobiology of Disease in Children Symposium, we presented evidence that malignant glioma behaviors, including antiapoptosis, invasiveness, and treatment resistance, are enhanced by hyaluronan, an extracellular glycosaminoglycan.
  • We review the clinical course of pediatric intramedullary spinal astrocytoma and diffuse pontine glioma, and show expression of membrane proteins that interact with hyaluronan: CD44, extracellular matrix metalloproteinase inducer, and breast cancer resistance protein (BCRP/ABCG2).
  • These findings suggest that hyaluronan antagonism has potential therapeutic value in malignant central nervous system tumors.
  • [MeSH-major] Astrocytoma / metabolism. Brain Stem Neoplasms / metabolism. Glioma / metabolism. Hyaluronic Acid / metabolism. Spinal Cord Neoplasms / metabolism
  • [MeSH-minor] ATP Binding Cassette Transporter, Sub-Family G, Member 2. ATP-Binding Cassette Transporters / genetics. ATP-Binding Cassette Transporters / metabolism. Animals. Basigin / genetics. Basigin / metabolism. Child. Disease Models, Animal. Drug Resistance, Neoplasm / genetics. Humans. Hyaluronan Receptors / genetics. Hyaluronan Receptors / metabolism. Neoplasm Proteins / genetics. Neoplasm Proteins / metabolism. Rats

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  • (PMID = 18952588.001).
  • [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 / NCI NIH HHS / CA / R01 CA073839; United States / NINDS NIH HHS / NS / 5R13NS040925-09; United States / NCRR NIH HHS / RR / C06RR015455; United States / NCI NIH HHS / CA / R01 CA082867; United States / NCI NIH HHS / CA / CA073839; United States / NCRR NIH HHS / RR / C06 RR015455; United States / NCI NIH HHS / CA / CA082867
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / ABCG2 protein, human; 0 / ATP Binding Cassette Transporter, Sub-Family G, Member 2; 0 / ATP-Binding Cassette Transporters; 0 / BSG protein, human; 0 / Hyaluronan Receptors; 0 / Neoplasm Proteins; 136894-56-9 / Basigin; 9004-61-9 / Hyaluronic Acid
  • [Number-of-references] 23
  • [Other-IDs] NLM/ NIHMS463105; NLM/ PMC3641563
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6. Merchant TE, Pollack IF, Loeffler JS: Brain tumors across the age spectrum: biology, therapy, and late effects. Semin Radiat Oncol; 2010 Jan;20(1):58-66
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  • [Title] Brain tumors across the age spectrum: biology, therapy, and late effects.
  • Compared with adults, pediatric tumor types (mostly glial and neuronal) are more sensitive to adjuvant irradiation and chemotherapy.
  • The spectrum of side effects is broader in the child based on age and extent of treatment: radiation therapy brings increased risk of severe long-term sequelae affecting neurologic, endocrine, and cognitive function.
  • In this review of glioma, ependymoma, and medulloblastoma, we highlight the differences between adults and children, including the higher incidence of spinal cord ependymoma and supratentorial high-grade glioma in the adult and a higher incidence of medulloblastoma in the child.
  • With the exception of completely resected low-grade glioma, radiation therapy remains a standard of care for most patients.
  • In some settings, the radiation oncologist should suggest further surgery or additional adjuvant therapy in an effort to optimize local tumor control.
  • An effort is underway to better characterize adult and pediatric brain tumors biologically with an emphasis on improving our understanding of tumor genesis, malignant transformation, and some of the similarities and differences between tumor types and their response to conventional therapy.
  • [MeSH-major] Brain Neoplasms / epidemiology. Brain Neoplasms / therapy. Glioma / epidemiology. Glioma / therapy. Radiotherapy / adverse effects
  • [MeSH-minor] Adolescent. Adult. Age Distribution. Child. Child, Preschool. Combined Modality Therapy / methods. Disease Progression. Ependymoma / epidemiology. Ependymoma / therapy. Humans. Incidence. Infant. Infant, Newborn. Medulloblastoma / epidemiology. Medulloblastoma / therapy. Radiation Injuries. Young Adult

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  • (PMID = 19959032.001).
  • [ISSN] 1532-9461
  • [Journal-full-title] Seminars in radiation oncology
  • [ISO-abbreviation] Semin Radiat Oncol
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / P30 CA021765
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 40
  • [Other-IDs] NLM/ NIHMS425593; NLM/ PMC3529408
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7. Thorarinsdottir HK, Rood B, Kamani N, Lafond D, Perez-Albuerne E, Loechelt B, Packer RJ, MacDonald TJ: Outcome for children <4 years of age with malignant central nervous system tumors treated with high-dose chemotherapy and autologous stem cell rescue. Pediatr Blood Cancer; 2007 Mar;48(3):278-84
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  • [Title] Outcome for children <4 years of age with malignant central nervous system tumors treated with high-dose chemotherapy and autologous stem cell rescue.
  • BACKGROUND: Children <4 years of age (yo) with malignant central nervous system (CNS) tumors have a dismal prognosis.
  • In an attempt to delay or obviate radiation therapy (XRT) and improve outcome, our institution has treated children <4 yo with newly diagnosed malignant CNS tumors with high-dose chemotherapy (HDC) and autologous stem cell rescue (ASCR) followed by selective XRT.
  • PROCEDURE: Fifteen children (age 4-38 months) with malignant CNS tumors have completed treatment with HDC/ASCR.
  • All patients received three cycles of induction chemotherapy (cisplatin 3.5 mg/kg- day 0, cyclophosphamide 60 mg/kg- day 1 and 2, etoposide 2.5 mg/kg- day 0-2, vincristine 0.05 mg/kg, day 0, 7, 14) followed by three cycles of HDC (carboplatin 17 mg/kg and thiotepa 6 mg/kg, day 0 and 1) with ASCR.
  • Histology included five medulloblastomas, four primitive neuroectodermal tumors (PNET), five malignant gliomas, and one ependymoma.
  • Outcome and treatment toxicities were evaluated by retrospective chart review.
  • RESULTS: Median follow-up time of the 15 patients is 22 months (range 8-82 months).
  • There was no treatment mortality.
  • CONCLUSIONS: We are encouraged by the outcome of 15 children <4 yo with malignant CNS tumors treated with tandem cycles of HDC and ASCR at our institution.
  • The treatment regimen is relatively well tolerated.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms / therapy. Oligodendroglioma / therapy. Peripheral Blood Stem Cell Transplantation
  • [MeSH-minor] Carboplatin / administration & dosage. Child, Preschool. Cisplatin / administration & dosage. Cognition Disorders / etiology. Cranial Irradiation / adverse effects. Cyclophosphamide / administration & dosage. Developmental Disabilities / etiology. Disease-Free Survival. Ependymoma / drug therapy. Ependymoma / mortality. Ependymoma / surgery. Etoposide / administration & dosage. Follow-Up Studies. Ganglioglioma / drug therapy. Ganglioglioma / metabolism. Ganglioglioma / radiotherapy. Ganglioglioma / surgery. Glioma / drug therapy. Glioma / mortality. Glioma / radiotherapy. Glioma / surgery. Humans. Infant. Medulloblastoma / drug therapy. Medulloblastoma / mortality. Medulloblastoma / radiotherapy. Medulloblastoma / surgery. Mitotic Index. Neuroectodermal Tumors, Primitive / drug therapy. Neuroectodermal Tumors, Primitive / mortality. Neuroectodermal Tumors, Primitive / radiotherapy. Neuroectodermal Tumors, Primitive / surgery. Quadriplegia / etiology. Retrospective Studies. Sensation Disorders / etiology. Spinal Cord Neoplasms / drug therapy. Spinal Cord Neoplasms / surgery. Thiotepa / administration & dosage. Transplantation, Autologous. Treatment Outcome. Vincristine / administration & dosage

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  • [Copyright] (c) 2006 Wiley-Liss, Inc.
  • (PMID = 16456857.001).
  • [ISSN] 1545-5009
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 8N3DW7272P / Cyclophosphamide; 905Z5W3GKH / Thiotepa; BG3F62OND5 / Carboplatin; Q20Q21Q62J / Cisplatin
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8. Ewelt C, Stummer W, Klink B, Felsberg J, Steiger HJ, Sabel M: Cordectomy as final treatment option for diffuse intramedullary malignant glioma using 5-ALA fluorescence-guided resection. Clin Neurol Neurosurg; 2010 May;112(4):357-61
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  • [Title] Cordectomy as final treatment option for diffuse intramedullary malignant glioma using 5-ALA fluorescence-guided resection.
  • BACKGROUND: We present a case of an anaplastic astrocytoma (WHO-grade III, AA III) in a 27-year-old woman treated by spinal cordectomy.
  • The patient was pretreated by surgery, radiation therapy and temozolomide chemotherapy and repeat surgery at recurrence.
  • Later on, she developed paraplegia and a diffuse severe pain syndrome.
  • PATIENTS COURSE: The spinal cord was amputated caudally to the root entry zones of the T10 sensory roots.
  • She refused additional adjuvant therapy.
  • CONCLUSION: Our observation suggests 5-ALA fluorescence-guided resections to be useful in the context of malignant spinal cord gliomas.
  • Furthermore, our particular case indicates that palliative spinal cordectomy with a wide margin and intraoperative resection using fluorescence guidance may be a final option for patients with recurrent spinal malignant glioma presenting with complete deficit below the lesion.
  • [MeSH-major] Aminolevulinic Acid. Astrocytoma / surgery. Cordotomy / methods. Neurosurgical Procedures / methods. Spinal Cord Neoplasms / surgery. Surgery, Computer-Assisted / methods
  • [MeSH-minor] Adult. Female. Humans. Magnetic Resonance Imaging. Pain / drug therapy. Pain / etiology. Paraplegia / etiology. Spine / pathology

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  • [Copyright] Copyright 2010 Elsevier B.V. All rights reserved.
  • (PMID = 20061079.001).
  • [ISSN] 1872-6968
  • [Journal-full-title] Clinical neurology and neurosurgery
  • [ISO-abbreviation] Clin Neurol Neurosurg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 88755TAZ87 / Aminolevulinic Acid
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9. Riffaud L, Bernard M, Lesimple T, Morandi X: Radiation-induced spinal cord glioma subsequent to treatment of Hodgkin's disease: case report and review. J Neurooncol; 2006 Jan;76(2):207-11
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  • [Title] Radiation-induced spinal cord glioma subsequent to treatment of Hodgkin's disease: case report and review.
  • Spinal cord glioma after radiation therapy is rare and half of the cases documented occurred after treatment of Hodgkin's disease.A 39-year-old male presented with a 1-month history of gradually worsening neck ache and paraparesis.
  • The patient had been treated for stage IB Hodgkin's disease 9 years previously with combined therapy: MOPP-ABV and a 40-Gray mediastinal radiotherapy from T1 to T10.
  • Magnetic resonance imaging disclosed an intramedullary lesion from C6 to T2 and histopathological examination from biopsy demonstrated a malignant glioma.
  • Despite chemotherapy and additional radiotherapy, the patient's neurological status worsened and he died 11 months after initial presentation.
  • We suggest a strategy aimed solely at obtaining a tissue diagnosis to differentiate myelitis from tumor, and, in the event of tumor, confirming the strong likelihood of a high histopathological grade.
  • The very limited survival associated with these tumors regardless of therapy advocates palliative therapies without attempting complete resection.
  • [MeSH-major] Glioma / etiology. Hodgkin Disease / complications. Hodgkin Disease / radiotherapy. Neoplasms, Radiation-Induced / pathology. Spinal Cord Neoplasms / etiology
  • [MeSH-minor] Adult. Humans. Magnetic Resonance Imaging. Male. Spinal Cord / pathology. Tomography, X-Ray Computed

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  • (PMID = 16158216.001).
  • [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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10. Clavo B, Robaina F, Morera J, Ruiz-Egea E, Pérez JL, Macías D, Caramés MA, Catalá L, Hernández MA, Günderoth M: Increase of brain tumor oxygenation during cervical spinal cord stimulation. Report of three cases. J Neurosurg; 2002 Jan;96(1 Suppl):94-100
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  • [Title] Increase of brain tumor oxygenation during cervical spinal cord stimulation. Report of three cases.
  • Malignant brain tumors have been shown to decrease O2 and blood flow resulting in hypoxia and low perfusion that in turn reduce radiation sensitivity and access by chemotherapeutic agents.
  • Spinal cord stimulation (SCS) is a procedure that has been used quite successfully in the treatment of pain and ischemic syndromes.
  • In the present study the authors applied the method and, with polarographic probes inserted in the tumor sites, measured the changes in tissue oxygenation and hypoxia in two separate tumor areas in three patients with high-grade astrocytomas.
  • In this report the authors describe a potential novel application of SCS, and the preliminary results suggest that tumor tissue oxygenation and hypoxia are significantly improved as a result.
  • If these findings are confirmed, the method may be applicable as an adjuvant to radiotherapy and chemotherapy regimens.
  • [MeSH-major] Astrocytoma / blood supply. Brain Neoplasms / blood supply. Cell Hypoxia / physiology. Electric Stimulation Therapy. Glioblastoma / blood supply. Glioma / blood supply. Oxygen Consumption / physiology. Spinal Cord / physiopathology
  • [MeSH-minor] Adult. Aged. Cerebral Cortex / blood supply. Cerebral Cortex / radiation effects. Cerebral Cortex / surgery. Combined Modality Therapy. Electrodes, Implanted. Female. Humans. Male. Middle Aged. Polarography. Radiotherapy, Adjuvant. Regional Blood Flow / physiology

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  • (PMID = 11795721.001).
  • [ISSN] 0022-3085
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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11. Gururangan S, McLaughlin CA, Brashears J, Watral MA, Provenzale J, Coleman RE, Halperin EC, Quinn J, Reardon D, Vredenburgh J, Friedman A, Friedman HS: Incidence and patterns of neuraxis metastases in children with diffuse pontine glioma. J Neurooncol; 2006 Apr;77(2):207-12
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  • [Title] Incidence and patterns of neuraxis metastases in children with diffuse pontine glioma.
  • PURPOSE: We performed a retrospective study of patients with diffuse pontine glioma (DPG) who suffered neuraxis metastasis (NM) and characterized the incidence, clinical features, radiologic findings, and patterns of disease dissemination.
  • Some patients also underwent magnetic resonance spectroscopy (MRS) (6 patients) and fluorodeoxyglucose positron emission tomography (FDG-PET) scans (13 patients) to further evaluate areas of metastatic disease.
  • RESULTS: Between 1986 and 2003, 18 of 96 patients (17.3%) with DPG developed NM.
  • The median age at diagnosis was 8 years (range, 4-17).
  • All patients had adjuvant chemotherapy and/or focal radiotherapy at diagnosis.
  • The NM occurred at a median of 15 months from diagnosis of DPG (range, 3-96).
  • Three patients also had histologic confirmation of malignant glioma at the site of NM.
  • Despite salvage therapy, all 18 patients have died of disease at a median of 5 months (range, 0.5-20) from diagnosis of neuraxis spread.
  • CONCLUSION: Our study emphasizes the need for screening patients with DPG for NM at the time of recurrence.
  • [MeSH-major] Brain Neoplasms / secondary. Brain Stem Neoplasms / pathology. Glioma / secondary. Spinal Cord Neoplasms / secondary
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Combined Modality Therapy. Female. Fluorodeoxyglucose F18. Humans. Incidence. Magnetic Resonance Imaging. Male. Positron-Emission Tomography. Retrospective Studies. Survival Analysis

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  • (PMID = 16568209.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0Z5B2CJX4D / Fluorodeoxyglucose F18
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12. Narayana A, Yamada J, Hunt M, Shah P, Gutin P, Leibel SA: Intensity modulated radiotherapy in high grade gliomas: Clinical and dosimetric results. J Clin Oncol; 2004 Jul 15;22(14_suppl):1532

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • : 1532 Background: Intensity Modulated Radiotherapy (IMRT) is an emerging treatment for brain tumors, but there is very little clinical or dosimetric data on doses and outcomes from IMRT treatment for malignant gliomas.
  • A dose of 59.4-60Gy using 1.8-2.0 Gy per fraction was delivered.
  • 80% of the patients received adjuvant chemotherapy.
  • The median disease free survival for anaplastic glioma and glioblastoma were 5.6 and 2.5 months.
  • The median overall survival for the anaplastic glioma and glioblastoma histologies were 16.5 and 10.6 months respectively.
  • A comparative dosimetric analysis revealed that regardless of tumor location, IMRT did not improve target coverage compared to conventional 3-dimensional treatment planning.
  • However, the use of IMRT resulted in a decreased dose to spinal cord, optic chiasm and brain stem by 19%, 4.5% and 8% respectively due to its improved dose conformality.
  • CONCLUSIONS: Use of IMRT did not increase either the disease free survival or the overall survival in patients with malignant gliomas when compared to historical controls.
  • However, it may result in decreased late toxicities associated with radiation therapy.

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  • (PMID = 28015407.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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13. Hyder DJ, Sung L, Pollack IF, Gilles FH, Yates AJ, Davis RL, Boyett JM, Finlay JL: Anaplastic mixed gliomas and anaplastic oligodendroglioma in children: results from the CCG 945 experience. J Neurooncol; 2007 May;83(1):1-8
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  • PURPOSE: To review interpathologist diagnosis variability and survival of children treated for either anaplastic mixed glioma (AMG) or anaplastic oligodendroglioma (AO) with surgery, irradiation and chemotherapy.
  • PATIENTS AND METHODS: Two hundred and fifty patients with an institutional diagnosis of malignant glioma were enrolled on Children's Cancer Group CCG-945 between 1985 and 1991, and administered vincristine during involved field radiotherapy, then six cycles of prednisone, lomustine and, vincristine; or two cycles of "eight-drugs-in-one-day" (8-in-1) chemotherapy then involved-field radiotherapy followed by six cycles of 8-in-1 chemotherapy.
  • CONCLUSION: Diagnosis of these tumors is challenging, with only 35% of institutional diagnoses confirmed for AMG and 25% for AO, and survival among children with these tumors is poor, despite intensive therapy.
  • This suggests reliable diagnostic markers and new therapeutic approaches are needed.
  • [MeSH-major] Central Nervous System Neoplasms / diagnosis. Central Nervous System Neoplasms / therapy. Glioma / diagnosis. Glioma / therapy. Oligodendroglioma / diagnosis. Oligodendroglioma / therapy
  • [MeSH-minor] Adolescent. Astrocytoma / diagnosis. Astrocytoma / therapy. Brain Neoplasms / diagnosis. Brain Neoplasms / therapy. Child. Child, Preschool. Cohort Studies. Drug Therapy. Female. Humans. Infant. Male. Neurosurgical Procedures. Radiotherapy. Spinal Cord Neoplasms / diagnosis. Spinal Cord Neoplasms / therapy. Survival Analysis

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  • (PMID = 17252186.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Journal Article; Randomized Controlled Trial
  • [Publication-country] United States
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14. 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.
  • 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.
  • [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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15. Oshiro S, Komatsu F, Tsugu H, Nabeshima K, Abe H, Ohkawa M, Inoue T: [A case of intramedullary cervical metastasis from cerebellar anaplastic oligodendroglioma without typical MR appearance for CSF dissemination]. No Shinkei Geka; 2010 Mar;38(3):279-85
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  • The case was a 73-year-old female who underwent tumor resection for cerebellar anaplastic oligodendroglioma following irradiation and TMZ chemotherapy.
  • One year and a half later, a small nodular lesion developed at the temporal lobe.
  • While treatment with TMZ was restarted during the course, another intramedullary cervical lesion produced additionally without any CSF dissemination or recurrence at the primary site.
  • The histological examination obtained in spinal surgery revealed evidence of similar features consistent with a previous cerebellar tumor with anaplastic oligodendroglioma.
  • Although CSF dissemination by malignant glioma with leptomeningeal enhancement is relatively well recognized at their terminal stage, cases with intramedullary cervical metastasis without any leptomeningeal enhancement have only been rarely described.
  • We discussed the mechanisms of intramedullary cervical metastasis from intracranial malignant glioma.
  • [MeSH-major] Cerebellar Neoplasms / pathology. Oligodendroglioma / pathology. Spinal Cord Neoplasms / secondary

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  • (PMID = 20229774.001).
  • [ISSN] 0301-2603
  • [Journal-full-title] No shinkei geka. Neurological surgery
  • [ISO-abbreviation] No Shinkei Geka
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
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16. Phillips NS, Sanford RA, Helton KJ, Boop FA, Zou P, Tekautz T, Gajjar A, Ogg RJ: Diffusion tensor imaging of intraaxial tumors at the cervicomedullary and pontomedullary junctions. Report of two cases. J Neurosurg; 2005 Dec;103(6 Suppl):557-62
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  • Diagnosis and treatment planning for these tumors is based on the observation of Epstein and Farmer that the growth of lesions with low malignant potential is limited by the anatomical structures of the brainstem.
  • Surgery is offered only to those patients with a high probability of harboring a low-grade tumor, because the attendant risk for significant morbidity outweighs the therapeutic benefit of debulking the tumor in cases of high-grade tumors.
  • The authors report two cases that highlight the potential of diffusion tensor (DT) imaging to identify local white matter tracts in the pons, medulla, and cervical cord and to improve the preoperative assessment of low-grade gliomas.
  • Preoperative DT imaging in both cases demonstrated that the white matter tracts were displaced by the bulk of the low-grade tumors but were structurally preserved.
  • Intraoperative and neurological findings were consistent with the preoperative interpretation of the DT images.
  • These cases demonstrate that DT imaging is a useful method for visualizing the relationship between tumor and normal brainstem white matter architecture, as well as for improving the surgical evaluation and management of pediatric brainstem tumors.
  • [MeSH-major] Central Nervous System Neoplasms / diagnosis. Diffusion Magnetic Resonance Imaging. Glioma / diagnosis
  • [MeSH-minor] Adolescent. Brain Stem Neoplasms / diagnosis. Brain Stem Neoplasms / surgery. Cervical Vertebrae. Child. Craniotomy. Fatal Outcome. Female. Humans. Laminectomy. Medulla Oblongata. Pons. Spinal Cord Neoplasms / diagnosis. Spinal Cord Neoplasms / surgery

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  • (PMID = 16383256.001).
  • [ISSN] 0022-3085
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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17. 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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  • 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 median age at initial diagnosis was 5 years and at LM diagnosis was 8.5 years.
  • 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-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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18. Maksoud YA, Hahn YS, Engelhard HH: Intracranial ependymoma. Neurosurg Focus; 2002 Sep 15;13(3):e4
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  • OBJECT: An intracranial ependymoma is a relatively rare but very interesting variety of glioma.
  • In this paper, the authors compiled a review of the pathological features, imaging characteristics, and treatment strategies related to this brain tumor.
  • Malignant ependymomas and ependymomas of the spinal cord (including myxopapillary ependymomas) were excluded from this review.
  • Because ependymomas often recur despite surgical intervention, radiotherapy and/or radiosurgery may also play an important role in their treatment.
  • The use of chemotherapy in the treatment of these tumors, especially in the very young, is still being studied.

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  • (PMID = 15844876.001).
  • [ISSN] 1092-0684
  • [Journal-full-title] Neurosurgical focus
  • [ISO-abbreviation] Neurosurg Focus
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 31
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19. 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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  • PURPOSE: To report preliminary clinical and dosimetric data from intensity-modulated radiotherapy (IMRT) for malignant gliomas.
  • 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.
  • However, IMRT resulted in a decreased maximum dose to the spinal cord, optic nerves, and eye by 16%, 7%, and 15%, respectively, owing to its improved dose conformality.
  • [MeSH-major] Brain Neoplasms / radiotherapy. Glioma / radiotherapy. Radiotherapy, Intensity-Modulated

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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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20. Pilkington GJ, Parker K, Murray SA: Approaches to mitochondrially mediated cancer therapy. Semin Cancer Biol; 2008 Jun;18(3):226-35
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  • [Title] Approaches to mitochondrially mediated cancer therapy.
  • For some malignant cancers even combined surgical, radiotherapeutic and chemotherapeutic approaches are not curative, indeed, in certain tumour types even a modest survival benefit is difficult to achieve.
  • There are various biological reasons which underlie this profound resistance but the propensity of cancer cells to repair breaks caused by DNA-damaging radiation and cytotoxic drugs is of major significance in this context.
  • Such highly resistant tumours include the malignant gliomas which are intrinsic to and directly affect the brain and spinal cord.
  • In the quest for agents which can selectively destroy neoplastic cells in this manner, whilst leaving normal adjacent cells intact, various tricyclic drugs have come under scrutiny.
  • In a range of laboratory assays we, and others, have established that certain cancers and, in particular, malignant glioma, are intrinsically sensitive to this approach.
  • While such archival tricyclics as the antidepressants, clomipramine and amitriptyline, have been used in these experiments their commercial development in cancer therapy has not been forthcoming and their clinical use in glioma has been confined to anecdotal cases.
  • In addition, the dose-dependant role of agents such as anticonvulsants and steroids commonly used in glioma patients in modulating efficacy of the tricyclics is a matter for continued investigation.
  • Other ways of targeting the mitochondrion for cancer therapy include exploitation of the 18kDa translocator protein (peripheral-type benzodiazepine receptor) within the mitochondrial permeability transition pore and enzymatic or molecular modification of a species of ganglioside (GD3/GD3(A)) expressed on the surface of neoplastic cells which are determinants of mitochondrially mediated apoptosis.
  • [MeSH-major] Mitochondria / drug effects. Mitochondria / metabolism. Neoplasms / drug therapy. Neoplasms / metabolism
  • [MeSH-minor] Animals. Dexamethasone / therapeutic use. Gangliosides / metabolism. Humans. Neoplastic Stem Cells / metabolism. Valproic Acid / therapeutic use

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  • (PMID = 18203619.001).
  • [ISSN] 1096-3650
  • [Journal-full-title] Seminars in cancer biology
  • [ISO-abbreviation] Semin. Cancer Biol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Gangliosides; 614OI1Z5WI / Valproic Acid; 7S5I7G3JQL / Dexamethasone
  • [Number-of-references] 61
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21. Broniscer A, Ke W, Fuller CE, Wu J, Gajjar A, Kun LE: Second neoplasms in pediatric patients with primary central nervous system tumors: the St. Jude Children's Research Hospital experience. Cancer; 2004 May 15;100(10):2246-52
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  • METHODS: The authors reviewed clinical and treatment data on all institutional patients age < 22 years at diagnosis of a primary CNS tumor who developed any type of SN.
  • Patients with neurofibromatosis type 1 were excluded.
  • RESULTS: The SNs investigated in the current study included 10 gliomas (42%), 5 meningiomas (21%), 2 desmoid tumors, 2 myelodysplastic syndromes, 2 basal cell carcinomas, 1 leukemia, 1 malignant fibrous histiocytoma, and 1 thyroid carcinoma.
  • Twenty-one patients had previously received radiotherapy, and 12 patients had received chemotherapy.
  • Eleven patients died of their SNs, including 8 patients with glioma and 2 patients with myelodysplastic syndromes.
  • The estimated 15-year cumulative incidence rate for malignant SNs was 4%.
  • No significant difference in the estimated cumulative incidence of SNs was found among patients who had received different types of therapy.
  • [MeSH-major] Brain Neoplasms / pathology. Brain Neoplasms / secondary. Neoplasms, Second Primary / pathology. Spinal Cord Neoplasms / pathology. Spinal Cord Neoplasms / secondary
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Agents / therapeutic use. Child. Child, Preschool. Combined Modality Therapy. Female. Humans. Incidence. Infant. Male. Radiotherapy. Retrospective Studies. Risk Factors. Survival Rate

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  • [Copyright] Copyright 2004 American Cancer Society.
  • (PMID = 15139071.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / P30 CA21765
  • [Publication-type] Journal Article; 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
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22. Tye SL, Gilg AG, Tolliver LB, Wheeler WG, Toole BP, Maria BL: Hyaluronan regulates ceruloplasmin production by gliomas and their treatment-resistant multipotent progenitors. J Child Neurol; 2008 Oct;23(10):1221-30
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  • [Title] Hyaluronan regulates ceruloplasmin production by gliomas and their treatment-resistant multipotent progenitors.
  • Ceruloplasmin (glycosylphosphatidylinositol-linked ferroxidase associated with normal astrocytes) can also be secreted by glioma cells, where its function is unknown.
  • Ceruloplasmin is not only present in glioma cells and in human glioma specimens but also is enriched in highly malignant glioma stem-like cells.
  • Hyaluronan is a large extracellular glycosaminoglycan that enhances malignant glioma behaviors by interacting with CD44 receptors and by downstream activation of signaling proteins and transporters associated with malignancy.
  • We examined the relationship between hyaluronan and ceruloplasmin expression in glioma stem-like cells.
  • Antagonism of hyaluronan interactions with short-fragment hyaluronan oligomers decreased ceruloplasmin expression in parental and stem-like glioma cells in vivo and in cell culture, implying that hyaluronan regulates ceruloplasmin expression.
  • Further gain and loss-of-function studies are needed to fully define the relationship between hyaluronan and ceruloplasmin, and ceruloplasmin's effect on malignant behaviors.

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  • (PMID = 18952589.001).
  • [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 / NCI NIH HHS / CA / R01 CA073839; United States / NINDS NIH HHS / NS / 5R13NS040925-09; United States / NCI NIH HHS / CA / R01 CA082867; United States / NCI NIH HHS / CA / CA073839; United States / NCRR NIH HHS / RR / C06 RR015455; United States / NCI NIH HHS / CA / CA082867
  • [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 / Antigens, CD44; 0 / Biomarkers, Tumor; 9004-61-9 / Hyaluronic Acid; EC 1.16.3.1 / Ceruloplasmin
  • [Other-IDs] NLM/ NIHMS463102; NLM/ PMC3640370
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