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1. Gururangan S, Chi SN, Young Poussaint T, Onar-Thomas A, Gilbertson RJ, Vajapeyam S, Friedman HS, Packer RJ, Rood BN, Boyett JM, Kun LE: Lack of efficacy of bevacizumab plus irinotecan in children with recurrent malignant glioma and diffuse brainstem glioma: a Pediatric Brain Tumor Consortium study. J Clin Oncol; 2010 Jun 20;28(18):3069-75
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  • [Title] Lack of efficacy of bevacizumab plus irinotecan in children with recurrent malignant glioma and diffuse brainstem glioma: a Pediatric Brain Tumor Consortium study.
  • PURPOSE: A phase II study of bevacizumab (BVZ) plus irinotecan (CPT-11) was conducted in children with recurrent malignant glioma (MG) and intrinsic brainstem glioma (BSG).
  • PATIENTS AND METHODS: Eligible patients received two doses of BVZ intravenously (10 mg/kg) 2 weeks apart and then BVZ plus CPT-11 every 2 weeks until progressive disease, unacceptable toxicity, or a maximum of 2 years of therapy.
  • Median time to progression for all 34 eligible patients enrolled was 127 days for MG and 71 days for BSG.
  • Vascular permeability parameters did not change significantly after therapy in either stratum.
  • CONCLUSION: BVZ plus CPT-11 was well-tolerated but had minimal efficacy in children with recurrent malignant glioma and brainstem glioma.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms / drug therapy. Brain Stem Neoplasms / drug therapy. Glioma / drug therapy. Neoplasm Recurrence, Local / drug therapy
  • [MeSH-minor] Adolescent. Adult. Antibodies, Monoclonal / administration & dosage. Antibodies, Monoclonal, Humanized. Bevacizumab. Camptothecin / administration & dosage. Camptothecin / analogs & derivatives. Child. Diffusion Magnetic Resonance Imaging. Humans. Phosphorylation. Survival Rate. Treatment Outcome. Vascular Endothelial Growth Factor Receptor-2 / metabolism. Young Adult

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  • (PMID = 20479404.001).
  • [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
  • [Grant] United States / NCRR NIH HHS / RR / M01 RR000188; United States / NCI NIH HHS / CA / U01 CA081457; United States / NCRR NIH HHS / RR / M01RR00188; United States / NCI NIH HHS / CA / U01CA81457
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Humanized; 0H43101T0J / irinotecan; 2S9ZZM9Q9V / Bevacizumab; EC 2.7.10.1 / Vascular Endothelial Growth Factor Receptor-2; XT3Z54Z28A / Camptothecin
  • [Other-IDs] NLM/ PMC2903337
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2. Suzuki Y, Tanaka K, Negishi D, Shimizu M, Yoshida Y, Hashimoto T, Yamazaki H: Pharmacokinetic investigation of increased efficacy against malignant gliomas of carboplatin combined with hyperbaric oxygenation. Neurol Med Chir (Tokyo); 2009 May;49(5):193-7; discussion 197
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  • The efficacy of intravenous administration of 400 mg carboplatin/m(2) body surface area over 60 minutes combined with hyperbaric oxygenation (HBO) therapy (0.2 MPa for 60 min) was investigated in 6 Japanese patients (aged 36-67 years) with malignant or brainstem gliomas.
  • Brain tumor response was evaluated by magnetic resonance imaging as a function of maximum plasma concentration, area under the curve, or mean residence time (MRT) for carboplatin.
  • These results suggest that HBO therapy prolongs the biological residence time of carboplatin.
  • MRT for carboplatin may be useful for predicting continuation or modification of chemotherapy and/or clinical antitumor effects in patients with malignant gliomas.
  • [MeSH-major] Antineoplastic Agents, Alkylating / therapeutic use. Brain Neoplasms / therapy. Carboplatin / therapeutic use. Glioblastoma / therapy. Hyperbaric Oxygenation
  • [MeSH-minor] Adult. Aged. Astrocytoma / drug therapy. Astrocytoma / radiotherapy. Astrocytoma / surgery. Astrocytoma / therapy. Brain Stem Neoplasms / drug therapy. Brain Stem Neoplasms / radiotherapy. Brain Stem Neoplasms / surgery. Brain Stem Neoplasms / therapy. Chromatography, High Pressure Liquid. Combined Modality Therapy. Cranial Irradiation. Drug Synergism. Female. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Neoplasm Recurrence, Local / drug therapy. Neoplasm Recurrence, Local / therapy. Salvage Therapy. Treatment Outcome

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  • (PMID = 19465788.001).
  • [ISSN] 1349-8029
  • [Journal-full-title] Neurologia medico-chirurgica
  • [ISO-abbreviation] Neurol. Med. Chir. (Tokyo)
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; BG3F62OND5 / Carboplatin
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3. Hukin J, Siffert J, Velasquez L, Zagzag D, Allen J: Leptomeningeal dissemination in children with progressive low-grade neuroepithelial tumors. Neuro Oncol; 2002 10;4(4):253-60
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  • Our purpose is to describe the incidence and clinical features of leptomeningeal dissemination (LM) in children with progressive low-grade neuroepithelial tumor (LGN).
  • Satisfactorily followed data were obtained on 427 of the 588 patients with localized LGN at diagnosis between 1986 and 1998, 177 (42%) of whom developed progressive or recurrent disease.
  • The primary tumor sites were diencephalon (6), brainstem (3), cerebellum (2), cerebrum (1), and spinal cord (1).
  • 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.
  • [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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4. Weybright P, Maly P, Gomez-Hassan D, Blaesing C, Sundgren PC: MR spectroscopy in the evaluation of recurrent contrast-enhancing lesions in the posterior fossa after tumor treatment. Neuroradiology; 2004 Jul;46(7):541-9
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  • [Title] MR spectroscopy in the evaluation of recurrent contrast-enhancing lesions in the posterior fossa after tumor treatment.
  • Recurrent contrast-enhancing lesions arising within foci of prior brain neoplasms treated with chemotherapy and/or radiation therapy pose a significant diagnostic dilemma, as they may represent recurrent or residual tumor, treatment-related changes, or a combination of both.
  • We explored the feasibility of 2D-CSI MR spectroscopy in the evaluation of recurrent contrast-enhancing lesions in eight consecutive patients who had undergone treatment for posterior fossa or brainstem tumors.
  • Mean Cho/Cr (choline/creatine) ratios obtained by 2D-CSI in recurrent tumor, treatment-related changes, and normal white matter were 2.93, 1.62, and 0.97, respectively, mean Cho/NAA (choline/N-Acetyl aspartate) ratios were 4.34, 1.74, and 0.93, and mean NAA/Cr (N-acetyl aspartate/creatine) ratios were 0.74, 0.92, and 1.26, respectively.
  • In conclusion, also in the posterior fossa, MR spectroscopy is likely to be useful as an adjunct to conventional imaging characteristics in distinguishing recurrent tumor from treatment-related changes, irrespectively of the MRS technique used.
  • [MeSH-major] Brain Neoplasms / diagnosis. Brain Stem Neoplasms / diagnosis. Infratentorial Neoplasms / diagnosis. Magnetic Resonance Imaging. Magnetic Resonance Spectroscopy. Neoplasm Recurrence, Local / diagnosis
  • [MeSH-minor] Adult. Feasibility Studies. Female. Humans. Male

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  • (PMID = 15105980.001).
  • [ISSN] 0028-3940
  • [Journal-full-title] Neuroradiology
  • [ISO-abbreviation] Neuroradiology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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5. Abe M, Tokumaru S, Tabuchi K, Kida Y, Takagi M, Imamura J: Stereotactic radiation therapy with chemotherapy in the management of recurrent medulloblastomas. Pediatr Neurosurg; 2006;42(2):81-8
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  • [Title] Stereotactic radiation therapy with chemotherapy in the management of recurrent medulloblastomas.
  • Very few patients survive with conventional treatment.
  • This report documents the preliminary study results of a treatment for recurrent medulloblastomas consisting of stereotactic radiation therapy (SRT) with chemotherapy.
  • All patients then received systemic chemotherapy.
  • Five patients were treated with one to two sequential courses of high-dose chemotherapy with peripheral blood stem cell transplantation.
  • The reduction in tumor size after SRT was often remarkable.
  • Two of 4 patients who had local recurrences without apparent metastasis at the time of SRT are alive without evidence of disease 70 and 72 months after SRT, respectively.
  • In contrast, all 8 patients with metastasis had new lesions either in the spinal canal or on the surface of the brain outside the target area of SRT.
  • Median progression-free survival and overall survival from the time of SRT were 9 and 19 months, respectively.
  • One patient had brainstem edema after SRT causing bulbar palsy and quadriparesis.
  • One patient died of toxicity of chemotherapy.
  • Our experience suggests that local recurrence can be controlled by SRT with chemotherapy but survival of patients with metastases can not be improved effectively by SRT in conjunction with aggressive chemotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cerebellar Neoplasms / therapy. Medulloblastoma / therapy. Neoplasm Recurrence, Local / therapy. Radiosurgery / methods
  • [MeSH-minor] Adolescent. Adult. Chemotherapy, Adjuvant. Child. Child, Preschool. Cisplatin / administration & dosage. Dose-Response Relationship, Drug. Etoposide / administration & dosage. Female. Humans. Ifosfamide / administration & dosage. Male. Peripheral Blood Stem Cell Transplantation. Radiotherapy Dosage. Retrospective Studies

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  • [Copyright] Copyright (c) 2006 S. Karger AG, Basel.
  • (PMID = 16465076.001).
  • [ISSN] 1016-2291
  • [Journal-full-title] Pediatric neurosurgery
  • [ISO-abbreviation] Pediatr Neurosurg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide
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6. Packer RJ, Gajjar A, Vezina G, Rorke-Adams L, Burger PC, Robertson PL, Bayer L, LaFond D, Donahue BR, Marymont MH, Muraszko K, Langston J, Sposto R: Phase III study of craniospinal radiation therapy followed by adjuvant chemotherapy for newly diagnosed average-risk medulloblastoma. J Clin Oncol; 2006 Sep 1;24(25):4202-8
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  • [Title] Phase III study of craniospinal radiation therapy followed by adjuvant chemotherapy for newly diagnosed average-risk medulloblastoma.
  • METHODS: Four hundred twenty-one patients between 3 years and 21 years of age with nondisseminated medulloblastoma (MB) were prospectively randomly assigned to treatment with 23.4 Gy of CSRT, 55.8 Gy of posterior fossa RT, plus one of two adjuvant chemotherapy regimens: lomustine (CCNU), cisplatin, and vincristine; or cyclophosphamide, cisplatin, and vincristine.
  • EFS was unaffected by sex, race, age, treatment regimen, brainstem involvement, or excessive anaplasia.
  • CONCLUSION: This study discloses an encouraging EFS rate for children with nondisseminated MB treated with reduced-dose craniospinal radiation and chemotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cerebellar Neoplasms / drug therapy. Cerebellar Neoplasms / radiotherapy. Medulloblastoma / drug therapy. Medulloblastoma / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Chemotherapy, Adjuvant / adverse effects. Child. Child, Preschool. Cisplatin / administration & dosage. Cyclophosphamide / administration & dosage. Disease-Free Survival. Female. Humans. Lomustine / administration & dosage. Male. Neoplasm Staging. Neoplasms, Second Primary / diagnosis. Prognosis. Radiotherapy Dosage. Radiotherapy, Adjuvant / adverse effects. Risk Factors. Survival Analysis. Vincristine / administration & dosage


7. Jian JJ, Cheng SH, Tsai SY, Yen KC, Chu NM, Chan KY, Tan TD, Cheng JC, Lin YC, Leu SY, Hsieh CI, Tsou MH, Lin CY, Huang AT: Improvement of local control of T3 and T4 nasopharyngeal carcinoma by hyperfractionated radiotherapy and concomitant chemotherapy. Int J Radiat Oncol Biol Phys; 2002 Jun 1;53(2):344-52
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  • [Title] Improvement of local control of T3 and T4 nasopharyngeal carcinoma by hyperfractionated radiotherapy and concomitant chemotherapy.
  • PURPOSE: When the primary tumor of nasopharyngeal carcinoma (NPC) is treated at the base of skull and intracranium with conventional radiotherapy, the result is generally poor.
  • In this report, we investigated whether hyperfractionated radiotherapy (HFRT) and concomitant chemotherapy (CCT) could achieve better local control and survival in NPC patients with T3 and T4 lesions.
  • HFRT was administered at 1.2 Gy per fraction, two fractions per day, Monday-Friday for 62 fractions for a total dose of 74.4 Gy.
  • Concomitant chemotherapy consisting of cis-diamino-dichloroplatinum (CDDP) alone or CDDP and 5-fluorouracil was delivered simultaneously with radiotherapy during Weeks 1 and 6.
  • Adjuvant chemotherapy consisted of CDDP and 5-fluorouracil for 2 to 3 cycles and was given monthly beginning 1 month after completion of radiation.
  • Most patients tolerated the combined modality treatments relatively well; 88% of patients completed their radiation treatment within 8 weeks.
  • The treatment-related toxicity was acceptable and reversible.
  • We would recommend using HFRT with CCT for advanced T-stage NPC if the three-dimensional conformal radiation planning shows a significant portion of the brainstem to be inside the treatment field.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Cisplatin / administration & dosage. Combined Modality Therapy. Dose Fractionation. Female. Fluorouracil / administration & dosage. Follow-Up Studies. Humans. Male. Middle Aged. Mouth Mucosa. Neoplasm Metastasis. Neoplasm Staging. Patient Compliance. Stomatitis / etiology. Survival Rate. Weight Loss

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  • (PMID = 12023138.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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8. Laigle-Donadey F, Doz F, Delattre JY: Brainstem gliomas in children and adults. Curr Opin Oncol; 2008 Nov;20(6):662-7
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  • [Title] Brainstem gliomas in children and adults.
  • PURPOSE OF REVIEW: The purpose of this review is to determine if recent advances in diagnostic and treatment modalities result in improvement in the pattern of care of brainstem gliomas.
  • RECENT FINDINGS: New MRI techniques may contribute to differential diagnosis and aid neurosurgeons in removing resectable brainstem tumors.
  • However, biopsy remains indicated in many contrast enhancing brainstem masses in adults because of the great variety of differential diagnosis.
  • SUMMARY: Diffuse brainstem glioma is the most common subtype of brainstem tumor and remains a devastating malignancy in children.
  • Conventional radiotherapy is the standard of care and chemotherapy has been disappointing to date.
  • Given the lack of efficacy of conventional drugs, a better understanding of the biology of this tumor is the key to more targeted therapy.
  • [MeSH-major] Brain Neoplasms / drug therapy. Brain Stem / pathology. Glioma / drug therapy
  • [MeSH-minor] Adult. Angiogenesis Inhibitors / therapeutic use. Antineoplastic Agents / therapeutic use. Biopsy. Child. Drug Delivery Systems. Humans. Magnetic Resonance Imaging / methods. Medical Oncology / methods. Neoplasm Metastasis. Neurofibromatosis 1 / drug therapy. Neurofibromatosis 1 / pathology. Signal Transduction

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  • (PMID = 18841048.001).
  • [ISSN] 1531-703X
  • [Journal-full-title] Current opinion in oncology
  • [ISO-abbreviation] Curr Opin Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Angiogenesis Inhibitors; 0 / Antineoplastic Agents
  • [Number-of-references] 57
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9. Burzynski SR, Janicki TJ, Weaver RA, Burzynski B: Targeted therapy with antineoplastons A10 and AS2-1 of high-grade, recurrent, and progressive brainstem glioma. Integr Cancer Ther; 2006 Mar;5(1):40-7
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  • [Title] Targeted therapy with antineoplastons A10 and AS2-1 of high-grade, recurrent, and progressive brainstem glioma.
  • BACKGROUND: Brainstem glioma carries the worst prognosis of all malignancies of the brain.
  • Most patients with brainstem glioma fail standard radiation therapy and chemotherapy and do not survive longer than 2 years.
  • Treatment is even more challenging when an inoperable tumor is of high-grade pathology (HBSG).
  • Twelve patients suffered from recurrence, and 6 patients did not have radiation therapy or chemotherapy.
  • Responses were assessed by gadolinium-enhanced magnetic resonance imaging and positron emission tomography.
  • CONCLUSION: Antineoplastons contributed to more than a 5-year survival in recurrent diffuse intrinsic glioblastomas and anaplastic astrocytomas of the brainstem in a small group of patients.
  • [MeSH-major] Benzeneacetamides / administration & dosage. Brain Stem Neoplasms / drug therapy. Glioma / drug therapy. Glutamine / analogs & derivatives. Neoplasm Recurrence, Local / drug therapy. Phenylacetates / administration & dosage. Piperidones / administration & dosage
  • [MeSH-minor] Adolescent. Adult. Child. Child, Preschool. Dose-Response Relationship, Drug. Drug Administration Schedule. Drug Combinations. Female. Follow-Up Studies. Humans. Injections, Intravenous. Magnetic Resonance Imaging. Male. Maximum Tolerated Dose. Neoplasm Staging. Risk Assessment. Survival Analysis. Treatment Outcome

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  • (PMID = 16484713.001).
  • [ISSN] 1534-7354
  • [Journal-full-title] Integrative cancer therapies
  • [ISO-abbreviation] Integr Cancer Ther
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Benzeneacetamides; 0 / Drug Combinations; 0 / Phenylacetates; 0 / Piperidones; 0RH81L854J / Glutamine; 104624-98-8 / antineoplaston AS 2-1; 91531-30-5 / antineoplaston A10
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10. Chan AW, Tarbell NJ, Black PM, Louis DN, Frosch MP, Ancukiewicz M, Chapman P, Loeffler JS: Adult medulloblastoma: prognostic factors and patterns of relapse. Neurosurgery; 2000 Sep;47(3):623-31; discussion 631-2
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  • [Title] Adult medulloblastoma: prognostic factors and patterns of relapse.
  • OBJECTIVE: To determine the patterns of relapse and the prognostic factors for adult medulloblastomas treated in the magnetic resonance imaging era.
  • METHODS: Between 1986 and 1996, 32 adult patients (age, > or =16 yr) with medulloblastomas confined to the craniospinal axis were treated in our institutions.
  • Brainstem invasion was present in nine patients.
  • All patients received postoperative radiotherapy, with median doses of 36 Gy to the entire craniospinal axis and 55 Gy to the posterior fossa.
  • Twenty-four patients received chemotherapy (20 before radiotherapy, 3 after radiotherapy, and 1 before and after radiotherapy).
  • Twenty-nine percent of all relapses occurred more than 5 years after treatment.
  • In univariate analyses, factors adversely affecting posterior fossa control were less than complete resection (P<0.001), the presence of brainstem invasion (P = 0.02), and the use of chemotherapy (P = 0.03).
  • CONCLUSION: Late relapse is common among adult patients with medulloblastomas, and long-term follow-up monitoring is important.
  • Because of the high risk of systemic failure among the low-risk patients treated with radiotherapy alone, the role of chemotherapy for this group of patients needs to be further investigated.
  • Complete resection, the absence of brainstem invasion, and an overall radiotherapy duration of less than 48 days are important prognostic factors.
  • [MeSH-minor] Adolescent. Adult. Cerebellum / pathology. Cerebellum / surgery. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Neoadjuvant Therapy. Neoplasm Recurrence, Local / mortality. Neoplasm Recurrence, Local / pathology. Neoplasm Recurrence, Local / surgery. Neoplasm Staging. Prognosis. Salvage Therapy. Survival Rate

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  • (PMID = 10981749.001).
  • [ISSN] 0148-396X
  • [Journal-full-title] Neurosurgery
  • [ISO-abbreviation] Neurosurgery
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] UNITED STATES
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11. Rorke-Adams LB, Portnoy H: Long-term survival of an infant with gliomatosis cerebelli. J Neurosurg Pediatr; 2008 Nov;2(5):346-50

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  • Gliomatosis cerebri is an uncommon but well-established central nervous system neoplasm that occurs primarily in adults.
  • Although the neoplastic process typically arises in the cerebrum, it often spreads to brainstem, cerebellum, or even the spinal cord.
  • In this report the authors document the surgical treatment of a 13-month-old boy whose tumor arose in the cerebellum and over time extended to the thalamus where its growth halted at age 3 years and 10 months.
  • Aside from 2 partial resections the patient underwent neither radiotherapy nor chemotherapy.
  • [MeSH-minor] Adult. Disease-Free Survival. Humans. Infant. Male. Neoplasm Invasiveness. Treatment Outcome

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  • (PMID = 18976105.001).
  • [ISSN] 1933-0707
  • [Journal-full-title] Journal of neurosurgery. Pediatrics
  • [ISO-abbreviation] J Neurosurg Pediatr
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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12. Terasaki M, Bouffet E, Katsuki H, Fukushima S, Shigemori M: Pilot trial of the rate of response, safety, and tolerability of temozolomide and oral VP-16 in patients with recurrent or treatment-induced malignant central nervous system tumors. Surg Neurol; 2008 Jan;69(1):46-50
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  • [Title] Pilot trial of the rate of response, safety, and tolerability of temozolomide and oral VP-16 in patients with recurrent or treatment-induced malignant central nervous system tumors.
  • BACKGROUND: The aim of this study was to determine the response and toxicity of patients with recurrent or treatment-induced brain tumors to TMZ and oral VP-16.
  • METHODS: Eleven patients with recurrent or treatment-induced malignant CNS tumors, including treatment-induced PNET (in 1 patient), brainstem glioma (in 3 patients; 1 with treatment-induced, 2 with recurrence), recurrent anaplastic astrocytoma (in 3 patients), and recurrent glioblastoma (in 4 patients) were evaluated in a pilot study of TMZ and oral VP-16 chemotherapy.
  • RESULTS: None experienced major acute toxicity related to TMZ and oral VP-16 during a total of 52 treatment courses.
  • Five (45%) of 11 patients showed a PR to treatment.
  • Among the 11 patients enrolled, 7 patients are alive with disease at a median of 9 months from time of study entry.
  • The histologic subtype of the tumor, its location, and its maximum response to chemotherapy did not have an impact on the duration of disease control.
  • CONCLUSION: This limited pilot study confirms the innocuousness and the activity of the combination of TMZ and oral VP-16 in recurrent malignant brain tumors.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Brain Neoplasms / drug therapy. Dacarbazine / analogs & derivatives. Etoposide / administration & dosage. Neoplasm Recurrence, Local / drug therapy. Neoplasms, Neuroepithelial / drug therapy. Neoplasms, Second Primary / drug therapy
  • [MeSH-minor] Administration, Oral. Adolescent. Adult. Aged. Drug Therapy, Combination. Female. Humans. Male. Middle Aged. Pilot Projects. Treatment Outcome

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  • (PMID = 18054615.001).
  • [ISSN] 0090-3019
  • [Journal-full-title] Surgical neurology
  • [ISO-abbreviation] Surg Neurol
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 6PLQ3CP4P3 / Etoposide; 7GR28W0FJI / Dacarbazine; 85622-93-1 / temozolomide
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13. Riffaud L, Saikali S, Leray E, Hamlat A, Haegelen C, Vauleon E, Lesimple T: Survival and prognostic factors in a series of adults with medulloblastomas. J Neurosurg; 2009 Sep;111(3):478-87
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  • OBJECT: In this article, the authors report their experience in the management of adult patients with medulloblastoma at their institution to identify prognostic factors important for survival and disease control.
  • Staging according to the Chang classification showed 4 patients with tumors invading the brainstem (2 with Stage T3b and 2 with Stage T4), 3 patients with metastases (2 with Stage M2 and 1 with Stage M3), and 1 patient in whom the stage was unknown (Stage MX) who died 10 days postoperatively.
  • Seven patients received chemotherapy before radiotherapy.
  • The median overall survival time was 17.7 years.
  • The median event-free survival time was 17.9 years.
  • Patient age, duration of symptoms, Karnofsky Performance Scale score at presentation, hydrocephalus, tumor location, brainstem invasion, extent of resection, histological subtype, preradiotherapy chemotherapy, risk group, and period of presentation were not significant variables.
  • Multivariate analysis identified sex and M stage as well as the period of presentation as independent prognostic factors for overall and event-free survival times.
  • Eleven patients suffered tumor recurrence within a median time of 4.2 years.
  • All patients in whom the tumor recurred have died despite aggressive treatments.
  • The median survival time after diagnosis of recurrence was 2.5 years.
  • Questionnaires on quality of life and cognition showed high scores in favor of limited negative effects in the perception of mental and physical health after treatment.
  • Tumor recurrences should be treated with aggressive therapies as some patients may have sustained response.
  • Adjuvant chemotherapy should be given to high-risk patients, but its role in reducing recurrences, particularly distant ones, remains unclear in the standard-risk group.
  • [MeSH-minor] Adolescent. Adult. Disease-Free Survival. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging. Prognosis. Quality of Life. Sex Factors. Survival Rate

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  • (PMID = 19231932.001).
  • [ISSN] 0022-3085
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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14. Weber DC, Miller RC, Villà S, Hanssens P, Baumert BG, Castadot P, Varlet P, Abacioglu U, Igdem S, Szutowicz E, Nishioka H, Hofer S, Rutz HP, Ozsahin M, Taghian A, Mirimanoff RO: Outcome and prognostic factors in cerebellar glioblastoma multiforme in adults: a retrospective study from the Rare Cancer Network. Int J Radiat Oncol Biol Phys; 2006 Sep 1;66(1):179-86
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  • METHODS AND MATERIALS: Data from a series of 45 adult patients with cerebellar GBM were collected in a retrospective multicenter study.
  • Brainstem invasion was observed in 9 (20%) patients.
  • Radiotherapy (RT) was administered to 36 patients (with concomitant chemotherapy, 7 patients).
  • Adjuvant chemotherapy after RT was administered in 8 patients.
  • Median RT dose was 59.4 Gy.
  • RESULTS: The 1-year and 2-year actuarial overall survival rate was 37.8% and 14.7%, respectively, and was significantly influenced by salvage treatment (p = 0.048), tumor volume (p = 0.044), extent of neurosurgical resection (p = 0.019), brainstem invasion (p = 0.0013), additional treatment after surgery (p < 0.001), and completion of the initial treatment (p < 0.001) on univariate analysis.
  • The 1- and 2-year actuarial progression free survival was 25% and 10.7%, respectively, and was significantly influenced by brainstem invasion (p = 0.002), additional treatment after surgery (p = 0.0016), and completion of the initial treatment (p < 0.001).
  • On multivariate analysis, survival was negatively influenced by the extent of surgery (p = 0.03) and brainstem invasion (p = 0.02).
  • Brainstem invasion was observed in a substantial number of patients and was an adverse prognostic factor.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy / methods. Disease Progression. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local. Prognosis. Retrospective Studies. Survival Rate. Treatment Outcome

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  • (PMID = 16814953.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] United States
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15. Ferreri AJ, Blay JY, Reni M, Pasini F, Spina M, Ambrosetti A, Calderoni A, Rossi A, Vavassori V, Conconi A, Devizzi L, Berger F, Ponzoni M, Borisch B, Tinguely M, Cerati M, Milani M, Orvieto E, Sanchez J, Chevreau C, Dell'Oro S, Zucca E, Cavalli F: Prognostic scoring system for primary CNS lymphomas: the International Extranodal Lymphoma Study Group experience. J Clin Oncol; 2003 Jan 15;21(2):266-72
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  • PATIENTS AND METHODS: The prognostic role of patient-, lymphoma-, and treatment-related variables was analyzed in a multicenter series of 378 PCNSL patients treated at 23 cancer centers from five different countries.
  • RESULTS: Age more than 60 years, performance status (PS) more than 1, elevated lactate dehydrogenase (LDH) serum level, high CSF protein concentration, and involvement of deep regions of the brain (periventricular regions, basal ganglia, brainstem, and/or cerebellum) were significantly and independently associated with a worse survival.
  • The prognostic role of this score was confirmed by limiting analysis to assessable patients treated with high-dose methotrexate-based chemotherapy (2-year OS +/- SD: 85% +/- 8%, 57% +/- 8%, and 24% +/- 11%; P =.0004).
  • CONCLUSION: Age, PS, LDH serum level, CSF protein concentration, and involvement of deep structures of the brain were independent predictors of survival.
  • The proposed score and its relevance in therapeutic decision deserve to be validated in further studies.
  • [MeSH-minor] Adolescent. Adult. Age Distribution. Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols. Cerebrospinal Fluid / metabolism. Female. Humans. L-Lactate Dehydrogenase / metabolism. Male. Middle Aged. Neoplasm Staging. Prognosis. Remission Induction. Risk Factors. Surveys and Questionnaires. Survival Rate. Treatment Outcome

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  • (PMID = 12525518.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] United States
  • [Chemical-registry-number] EC 1.1.1.27 / L-Lactate Dehydrogenase
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16. Noël G, Boisserie G, Dessard-Diana B, Ferrand R, Hasboun D, Gasowski M, Desblancs CL, Simon JM, Baillet F, Mazeron JJ: [Comparison with dose-volume histograms of two conformal irradiation techniques used for the treatment of T2N0M0 nasopharyngeal cancer, one with association of photons and protons and another with photons alone]. Cancer Radiother; 2002 Dec;6(6):337-48

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Comparison with dose-volume histograms of two conformal irradiation techniques used for the treatment of T2N0M0 nasopharyngeal cancer, one with association of photons and protons and another with photons alone].
  • [Transliterated title] Comparaison par les histogrammes dose-volume de deux techniques d'irradiation conformationnelle des cancers du nasopharynx classés T4N0M0, l'une par photons et protons et l'autre par photons seuls.
  • That is why, in patients presenting with a locally advanced nasopharyngeal cancer, we compared the dose-volume distribution of irradiated tissues, obtained from two 3D conformal irradiation techniques.
  • Radiotherapy combined photons and protons beams and the platin-based chemotherapy was delivered in three intravenous injections at d1, 22, 43 of the irradiation.
  • The gross tumor volume (GTV) was delineated from the imagery, three clinical tumor volumes were defined, the CTV1 was the GTV and the whole nasopharynx, the CTV2 was the CTV plus a 10 mm-margin and the CTV3 was the CTV2 and the nodes areas (cervical and subclavicular).
  • Prophylactic dose within node areas was 44 Gy.
  • Prescribed doses within CTV2 and GTV or CTV1 were 54 Gy/CGE (Cobalt Gy Equivalent, for an EBR = 1,1) and 70 Gy/CGE, respectively.
  • Irradiation was delivered with fractions of 1.8 or 2.0 Gy/CGE, with 44 Gy or 54 Gy by photons and with 16 or 26 CGE by protons.
  • According to dose-volume histograms obtained from the dosimetry planning by protons and photons and from the theoretical dosimetry by photons lonely, for the different volumes of interest, GTV, CTV2, and organs at risk (optic nerves, chiasm, internal ears, brainstem, temporal lobes), we compared the averages of the maximum, minimum and mean doses and the averages of the volumes of organs of interest encompassed by different isodoses.Results- Calculated averages of minimum, maximum and mean doses delivered within GTV were superior for the treatment with combined photons and protons than with photons alone.
  • The average GTV encompassed by the 70 Gy/CGE isodose was larger by 65% with the association compared to photons alone.
  • The conformation ratio (tissue volume encompassed by the 95% isodose/GTV encompassed by the 95% isodose) was 3.1 with the association compared to 5.7 with photons alone.
  • Overall, 78% of the criteria were in favour of the association.Conclusion- For locally advanced nasopharyngeal cancer without clinical adenopathy, irradiation by photons and protons increases the tumor volume irradiated at the prescribed dose and decreases the volume or critical organs irradiated and the total dose delivered within them.
  • [MeSH-minor] Adult. Dose Fractionation. Female. Humans. Male. Neoplasm Staging. Photons / therapeutic use. Protons / therapeutic use

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  • (PMID = 12504770.001).
  • [ISSN] 1278-3218
  • [Journal-full-title] Cancer radiothérapie : journal de la Société française de radiothérapie oncologique
  • [ISO-abbreviation] Cancer Radiother
  • [Language] fre
  • [Publication-type] Case Reports; Comparative Study; English Abstract; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Protons
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17. Szkandera J, Ploner F, Bauernhofer T, Kasparek AK, Payer F, Balic M, Knechtel G, Gerger A, Gallè G, Samonigg H, Hofmann G: Paraneoplastic limbic encephalitis in a patient with extragonadal choriocarcinoma--significance of onconeural antibodies. Onkologie; 2010;33(8-9):452-4
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  • BACKGROUND: Paraneoplastic limbic or brainstem encephalitis is considered to be an autoimmune-mediated disorder of the nervous system associated with different types of cancer including germ cell tumors.
  • Neurologic tests, brain imaging, and blood chemistry tests failed to determine the cause of the symptoms.
  • Further examinations including ultrasound of the abdomen led to the detection of a retroperitoneal mass.
  • The patient underwent curative chemotherapy, but although the cancer therapy was successful, the neurologic disorders did not improve.
  • CONCLUSIONS: Patients with symptoms of limbic or brainstem encephalitis, especially young men, should be tested for anti-Ma2 antibodies in the serum to elucidate their origin.
  • The detection of these antibodies supports the diagnosis of a paraneoplastic syndrome, and may lead to the earlier identification of an otherwise hidden extragonadal germ cell tumor.
  • [MeSH-major] Antibodies, Neoplasm / immunology. Antigens, Neoplasm / immunology. Limbic Encephalitis / diagnosis. Limbic Encephalitis / immunology. Nerve Tissue Proteins / immunology. Peritoneal Neoplasms / diagnosis. Peritoneal Neoplasms / immunology
  • [MeSH-minor] Adult. Diagnosis, Differential. Humans. Male. Neoplasms, Gonadal Tissue

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  • [Copyright] Copyright © 2010 S. Karger AG, Basel.
  • (PMID = 20838061.001).
  • [ISSN] 1423-0240
  • [Journal-full-title] Onkologie
  • [ISO-abbreviation] Onkologie
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Antibodies, Neoplasm; 0 / Antigens, Neoplasm; 0 / Ma2 antigen; 0 / Nerve Tissue Proteins
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18. Hofmann MA, Coll SH, Küchler I, Kiecker F, Wurm R, Sterry W, Trefzer U: Prognostic factors and impact of treatment in melanoma brain metastases: better prognosis for women? Dermatology; 2007;215(1):10-6
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  • [Title] Prognostic factors and impact of treatment in melanoma brain metastases: better prognosis for women?
  • BACKGROUND: Brain metastases are a common consequence in patients with stage IV melanoma associated with a grim prognosis.
  • OBJECTIVE: The objective of this study was the examination of prognostic factors and the evaluation of different treatment options.
  • METHODS: A consecutive series of 133 patients with melanoma brain metastases with regard to prognostic factors and the impact on survival were analyzed.
  • RESULTS: 82 patients had involvement of only the cerebrum at the initial diagnosis, whereas in 7 patients only the cerebellum and the brainstem were involved.
  • The overall median survival time was 24 weeks (1-196) from diagnosis of brain metastases.
  • Multivariate analysis has established as significant prognostic factors: female gender, number of brain metastases, surgery, chemotherapy, radiotherapy and corticosteroid application.
  • CONCLUSION: With regard to the prognostic factors, an improved survival can be achieved in this patient group using more elective treatment options, also with emphasis on corticosteroids.
  • [MeSH-major] Brain Neoplasms / mortality. Brain Neoplasms / secondary. Cause of Death. Melanoma / secondary. Skin Neoplasms / pathology
  • [MeSH-minor] Adolescent. Adult. Age Distribution. Aged. Aged, 80 and over. Analysis of Variance. Cohort Studies. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Multivariate Analysis. Neoplasm Staging. Probability. Prognosis. Proportional Hazards Models. Retrospective Studies. Sex Distribution. Survival Analysis

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  • [Copyright] 2007 S. Karger AG, Basel
  • (PMID = 17587834.001).
  • [ISSN] 1421-9832
  • [Journal-full-title] Dermatology (Basel, Switzerland)
  • [ISO-abbreviation] Dermatology (Basel)
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Switzerland
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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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  • A dose of 59.4-60 Gy at 1.8-2.0 Gy per fraction was delivered.
  • Surgery consisted of biopsy only in 26% of the patients, and 80% received adjuvant chemotherapy.
  • The median progression-free survival time for anaplastic astrocytoma and glioblastoma histology was 5.6 and 2.5 months, respectively.
  • The overall survival time for anaplastic glioma and glioblastoma was 36 and 9 months, respectively.
  • A comparative dosimetric analysis revealed that regardless of tumor location, IMRT did not significantly improve target coverage compared with three-dimensional planning.
  • The mean brainstem dose also decreased by 7%.
  • Intensity-modulated radiotherapy delivered with a limited number of beams did not result in an increased dose to the normal brain.
  • [MeSH-major] Brain Neoplasms / radiotherapy. Glioma / radiotherapy. Radiotherapy, Intensity-Modulated
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Brain / radiation effects. Disease Progression. Female. Glioblastoma / radiotherapy. Humans. Male. Middle Aged. Neoplasm Recurrence, Local. Oligodendroglioma / radiotherapy. Radiotherapy Dosage. Retrospective Studies

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  • (PMID = 16458777.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] United States
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20. Korah MP, Esiashvili N, Mazewski CM, Hudgins RJ, Tighiouart M, Janss AJ, Schwaibold FP, Crocker IR, Curran WJ Jr, Marcus RB Jr: Incidence, risks, and sequelae of posterior fossa syndrome in pediatric medulloblastoma. Int J Radiat Oncol Biol Phys; 2010 May 1;77(1):106-12
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  • Five patients had <1.5-cm(2) residual tumor, 4 had >or=1.5-cm(2) residual tumor, and the remainder had no residual tumor.
  • Patients received craniospinal irradiation at a typical dose of 23.4 Gy or 36 Gy for standard- or high-risk disease, respectively.
  • The posterior fossa was given a total dose of 54 or 55.8 Gy.
  • Nearly all patients received chemotherapy following cooperative group protocols.
  • PFS developed in 18 patients (29%).
  • On univariate analysis, brainstem invasion, midline tumor location, younger age, and the absence of radiographic residual tumor were found to be predictors of PFS; the last two variables remained significant on multivariate analysis.
  • From 1990 to 2000 and from 2001 to 2007, the proportions of patients with no radiographic residual tumor were 77% and 94%, respectively.
  • Children with midline tumors exhibiting brainstem invasion are at increased risk.
  • With the increased incidence of PFS and the permanent morbidity in many patients, the risks and benefits of complete tumor removal in all patients need to be reexamined.
  • [MeSH-minor] Adolescent. Analysis of Variance. Ataxia / epidemiology. Ataxia / etiology. Child. Child, Preschool. Combined Modality Therapy / methods. Cranial Irradiation. Disease-Free Survival. Dysarthria / epidemiology. Dysarthria / etiology. Female. Follow-Up Studies. Humans. Incidence. Male. Muscle Hypotonia / epidemiology. Muscle Hypotonia / etiology. Mutism / epidemiology. Mutism / etiology. Neoplasm, Residual. Postoperative Complications / epidemiology. Radiotherapy Dosage. Retrospective Studies. Risk. Syndrome. Young Adult

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  • (PMID = 19695790.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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21. Hargrave D: Paediatric high and low grade glioma: the impact of tumour biology on current and future therapy. Br J Neurosurg; 2009 Aug;23(4):351-63
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  • [Title] Paediatric high and low grade glioma: the impact of tumour biology on current and future therapy.
  • Gliomas are the most common type of paediatric brain tumour and range from benign low grade gliomas which can be resected/observed to aggressive brainstem gliomas with dismal survival rates.
  • Current therapies rely on neurosurgery, radiotherapy, chemotherapy or combination of these conventional modalities and although histopathology helps to direct therapy, molecular pathology has so far not played a major role in the management of paediatric glioma.
  • However, increasing knowledge of glioma biology is starting to impact on drug development towards targeted therapies.
  • Pilocytic astrocytoma, the most common childhood low grade brain tumour, has recently been shown to harbour an activated BRAF/MAPK/ERK pathway in the majority of cases; this represents an attractive target for new agents.
  • The molecular biology of adult malignant glioma is now well described and targeted therapies against VEGFR are already playing a role in the management of glioblastoma.
  • However, selection for specific targeted therapy is unlikely to be based on, or restricted by, age but will require individual case by case testing for target presence in order to direct and maximise the efficacy of molecular therapy.
  • Brainstem glioma remains a tumour with a dismal prognosis but relatively little is known about the underlying biology and progress will require a concerted effort to collect tissue by biopsy and autopsy to allow appropriate analysis to identify and validate targets.
  • A new era of molecular based therapies offers the promise of major benefits in the management of paediatric glioma but translating this promise into reality will require further understanding of the biology driving these tumours.
  • [MeSH-major] Brain Neoplasms. Glioma / pathology
  • [MeSH-minor] Adolescent. Adult. Astrocytoma / genetics. Astrocytoma / pathology. Astrocytoma / therapy. Child. Child, Preschool. Combined Modality Therapy. Drug Delivery Systems. Genetic Predisposition to Disease. Genome-Wide Association Study. Hamartoma Syndrome, Multiple / genetics. Humans. Infant. Neoplasm Staging. Neurofibromatosis 1 / genetics. Prognosis. Tuberous Sclerosis / genetics


22. Hadjipanayis CG, Kondziolka D, Gardner P, Niranjan A, Dagam S, Flickinger JC, Lunsford LD: Stereotactic radiosurgery for pilocytic astrocytomas when multimodal therapy is necessary. J Neurosurg; 2002 Jul;97(1):56-64
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  • [Title] Stereotactic radiosurgery for pilocytic astrocytomas when multimodal therapy is necessary.
  • OBJECT: The goal of this study was to examine the role of stereotactic radiosurgery in the treatment of patients with recurrent or unresectable pilocytic astrocytomas.
  • METHODS: During a 13-year interval, 37 patients (median age 14 years) required multimodal treatment of recurrent or unresectable pilocytic astrocytomas.
  • Tumors involved the brainstem in 18 patients, cerebellum in three, thalamus in five, temporal lobe in four, and parietal lobe in two, as well as the hypothalamus, optic tract, corpus callosum, insular cortex, and third ventricle in one patient each.
  • Multimodal treatment included fractionated radiation therapy in 10 patients, stereotactic intracavitary irradiation of tumor in four, chemotherapy in two, cyst drainage in six, ventriculoperitoneal shunt placement in three, and additional cytoreductive surgery in four.
  • Tumor volumes varied from 0.42 to 25 cm3.
  • The median radiosurgical dose to the tumor margin was 15 Gy (range 9.6-22.5 Gy).
  • After radiosurgery, serial imaging demonstrated complete tumor resolution in 10 patients, reduced tumor volume in eight, stable tumor volume in seven, and delayed tumor progression in 12.
  • No procedure-related death was encountered.
  • Three patients died of local tumor progression.
  • Despite the favorable histological characteristics and prognosis usually associated with this neoplasm, an adverse location, recurrence, or progression of this disease requires alternative therapeutic approaches such as radiosurgery.
  • [MeSH-major] Astrocytoma / surgery. Astrocytoma / therapy. Brain Stem Neoplasms / surgery. Brain Stem Neoplasms / therapy. Radiosurgery
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Agents / administration & dosage. Antineoplastic Agents, Phytogenic / administration & dosage. Biopsy. Child. Child, Preschool. Cisplatin / administration & dosage. Combined Modality Therapy. Cysts / surgery. Female. Follow-Up Studies. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Prognosis. Radiotherapy / adverse effects. Retrospective Studies. Treatment Outcome. Vincristine / administration & dosage

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  • (PMID = 12134933.001).
  • [ISSN] 0022-3085
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Antineoplastic Agents, Phytogenic; 5J49Q6B70F / Vincristine; Q20Q21Q62J / Cisplatin
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23. Roser F, Nakamura M, Brandis A, Hans V, Vorkapic P, Samii M: Transition from meningeal melanocytoma to primary cerebral melanoma. Case report. J Neurosurg; 2004 Sep;101(3):528-31
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The authors describe the first case of an intracranial transition of a melanocytoma into a primary malignant melanoma within a short time.
  • A 37-year-old woman presented with progressive brainstem syndrome due to a tumor, originally diagnosed and treated 12 years earlier, that extended from the petroclival area to the anterior craniocervical junction.
  • The histological workup following subtotal tumor resection of the initial tumor had revealed the typical features of a fibrous melanocytic meningioma without increased proliferation.
  • Ten years after the patient had completed treatment for the melanocytic meningioma, control neuroimaging demonstrated growth of the residual tumor with compression of the brainstem.
  • Another neurosurgical intervention revealed a dark tumor of hard consistency.
  • At this time immunohistochemical examinations demonstrated melanocytic features (expression of vimentin, S100 protein, and melan A) of the lesion with focally increased proliferation (5% of Ki-67-positive cells) but no higher mitotic activity.
  • Clinical signs of deterioration along with imaging-confirmed tumor progression precipitated another operation within 7 months.
  • The patient's later clinical course consisted of a rapid diffuse meningeal spread of the lesion throughout the entire brain and spine.
  • Despite whole-brain and stereotactic radiation therapy as well as chemotherapy, the patient died 4 months after the last neuropathological diagnosis.
  • [MeSH-major] Cell Transformation, Neoplastic / pathology. Melanoma / pathology. Meningeal Neoplasms / pathology. Meningioma / pathology. Neoplasm, Residual / pathology. Nevus / pathology
  • [MeSH-minor] Adult. Brain Stem / pathology. Cell Division. Disease Progression. Fatal Outcome. Female. Follow-Up Studies. Humans. Magnetic Resonance Angiography. Meninges / pathology. Neoplasm Invasiveness / pathology. Reoperation

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  • (PMID = 15352613.001).
  • [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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24. Tapia-Perez H, Sanchez-Aguilar M, Torres-Corzo JG, Rodriguez-Leyva I, Gonzalez-Aguirre D, Gordillo-Moscoso A, Chalita-Williams C: Use of statins for the treatment of spontaneous intracerebral hemorrhage: results of a pilot study. Cent Eur Neurosurg; 2009 Feb;70(1):15-20
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  • [Title] Use of statins for the treatment of spontaneous intracerebral hemorrhage: results of a pilot study.
  • BACKGROUND AND STUDY AIMS: Spontaneous intracerebral hemorrhage (ICH) represents the most fatal kind of stroke, and there is still no treatment available that improves the outcome.
  • Exclusion criteria were a history of neoplasm, head injury four weeks before admission, non-hypertensive reasons, brainstem hemorrhage, steroid administration, cranial surgery, initial hydrocephalus, and NIHSS > or =30.
  • Further clinical trials are necessary to confirm a possible therapeutic effect and evaluate the toxicity of statins.
  • [MeSH-major] Cerebral Hemorrhage / drug therapy. Fluorobenzenes / therapeutic use. Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use. Pyrimidines / therapeutic use. Sulfonamides / therapeutic use
  • [MeSH-minor] Adult. Aged. Antihypertensive Agents / therapeutic use. Female. Glasgow Coma Scale. Hospital Mortality. Humans. Male. Middle Aged. Odds Ratio. Pilot Projects. Proportional Hazards Models. Prospective Studies. Retrospective Studies. Rosuvastatin Calcium. Sample Size. Stroke / drug therapy. Stroke / mortality. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 19197830.001).
  • [ISSN] 1868-4904
  • [Journal-full-title] Central European neurosurgery
  • [ISO-abbreviation] Cent Eur Neurosurg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antihypertensive Agents; 0 / Fluorobenzenes; 0 / Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0 / Pyrimidines; 0 / Sulfonamides; 83MVU38M7Q / Rosuvastatin Calcium
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25. Mulne AF, Ducore JM, Elterman RD, Friedman HS, Krischer JP, Kun LE, Shuster JJ, Kadota RP: Oral methotrexate for recurrent brain tumors in children: a Pediatric Oncology Group study. J Pediatr Hematol Oncol; 2000 Jan-Feb;22(1):41-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Oral methotrexate for recurrent brain tumors in children: a Pediatric Oncology Group study.
  • Patients in six different brain tumor strata were accrued.
  • RESULTS: The response rates (complete or partial responses) were as follows: astrocytoma 2 of 10, malignant glioma 1 of 19, medulloblastoma 0 of 18, brainstem tumor 0 of 12, ependymoma 1 of 7, and miscellaneous histologic types 0 of 12.
  • CONCLUSION: Low-dose oral MTX showed no significant activity against malignant glioma, medulloblastoma, brainstem tumors, and miscellaneous histologic types.
  • This regimen will not be recommended for front-line therapy.
  • [MeSH-major] Antimetabolites, Antineoplastic / therapeutic use. Brain Neoplasms / drug therapy. Methotrexate / therapeutic use. Neoplasm Recurrence, Local / drug therapy
  • [MeSH-minor] Administration, Oral. Adolescent. Adult. Child. Child, Preschool. Humans. Infant. Infant, Newborn

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  • (PMID = 10695820.001).
  • [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 / CA-03161; United States / NCI NIH HHS / CA / CA-29691; United States / NCI NIH HHS / CA / CA-69177; 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 / Antimetabolites, Antineoplastic; YL5FZ2Y5U1 / Methotrexate
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