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1. Yang DT, Rozen WM, Rickert CH, Lo PA: Primary pontomedullary germinoma in a 12 year old boy. J Clin Neurosci; 2009 Feb;16(2):321-5
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  • [Title] Primary pontomedullary germinoma in a 12 year old boy.
  • Primary intracranial germinomas are rare tumors, accounting for approximately 1-4% of all intracranial tumors.
  • Intracranial germinomas are more commonly found in the suprasellar and pineal midline structures of the brain.
  • Brainstem and posterior fossa germinomas are rarer still, with few reported cases in the literature, and little discussion of their presentation, management and clinical outcome.
  • Only six previous cases of lower brainstem germinoma have been reported, with varying modes of presentation and a lack of definitive management guidelines.
  • We report the first case of a lower brainstem germinoma in a male without known genetic abnormality.
  • Tumor remission was achieved with partial surgical resection, chemotherapy and radiotherapy.
  • [MeSH-major] Brain Stem Neoplasms. Germinoma

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  • (PMID = 19091568.001).
  • [ISSN] 0967-5868
  • [Journal-full-title] Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
  • [ISO-abbreviation] J Clin Neurosci
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Scotland
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2. Packer RJ, Krailo M, Mehta M, Warren K, Allen J, Jakacki R, Villablanca JG, Chiba A, Reaman G: A Phase I study of concurrent RMP-7 and carboplatin with radiation therapy for children with newly diagnosed brainstem gliomas. Cancer; 2005 Nov 1;104(9):1968-74
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  • [Title] A Phase I study of concurrent RMP-7 and carboplatin with radiation therapy for children with newly diagnosed brainstem gliomas.
  • BACKGROUND: Ninety percent of children with diffuse, intrinsic brainstem tumors will die within 18 months of diagnosis.
  • Carboplatin is antineoplastic and radiosensitizing; however, its delivery to the primary tumor site is problematic.
  • RMP-7 is a bradykinin analog that causes selective permeability of the blood-brain-tumor interface.
  • The objective of this Phase I study was to determine the toxicity and feasibility of delivering RMP-7 and carboplatin for 5 successive days during radiotherapy to children with newly diagnosed, diffuse, intrinsic brainstem gliomas.
  • Local radiotherapy, in dose fractions of 180 centigrays (cGy) per day (to a total dose of 5940 cGy), was given within 4 hours of completion of drug delivery.
  • Duration of treatment was escalated in a stepwise, weekly fashion in cohorts of 3 patients, until there was treatment-limiting toxicity or until radiotherapy was completed.
  • RESULTS: One child died early during treatment of progressive disease and was not assessable for toxicity.
  • Treatment for 3 weeks, 4 weeks, and 5 weeks was tolerated well, with mild flushing, tachycardia, nausea, emesis, dizziness, and abdominal pain.
  • One of 3 children treated at the full duration of therapy (33 doses over 7 weeks) developed dose-limiting hepatotoxicity and neutropenia.
  • The estimated median survival was 328 days, and 1 patient remained free of disease progression for > 400 days after the initiation of treatment.
  • CONCLUSIONS: The results of this study confirmed the feasibility of giving RMP-7 and carboplatin daily during radiotherapy to children with brainstem tumors.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bradykinin / analogs & derivatives. Brain Stem Neoplasms / drug therapy. Brain Stem Neoplasms / radiotherapy. Carboplatin / therapeutic use. Glioma / drug therapy. Glioma / radiotherapy
  • [MeSH-minor] Child. Child, Preschool. Combined Modality Therapy. Drug Administration Schedule. Feasibility Studies. Female. Humans. Male. Radiotherapy / adverse effects. Radiotherapy Dosage. Survival Rate. Treatment Outcome

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  • [Copyright] (c) 2005 American Cancer Society.
  • (PMID = 16177987.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase I; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 159768-75-9 / RMP 7; BG3F62OND5 / Carboplatin; S8TIM42R2W / Bradykinin
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3. 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


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4. Hukin J, Siffert J, Cohen H, Velasquez L, Zagzag D, Allen J: Leptomeningeal dissemination at diagnosis of pediatric low-grade neuroepithelial tumors. Neuro Oncol; 2003 07;5(3):188-96
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  • The charts were reviewed and patients contacted to validate the demographic data, treatment, and clinical status.
  • The distribution of LM patients by primary tumor site was diencephalon, 5; cerebrum, 2; spinal cord, 3; brainstem, 2; and cerebellum, 1.
  • Six of 8 patients with LM had durable objective responses to chemotherapy.
  • We suggest that staging be considered in the following circumstances: diencephalic primary site, unexplained hydrocephalus, clinical features suggestive of LM, and before adjuvant therapy is initiated.
  • The prognosis for children with LM at diagnosis is favorable, and its identification alters therapeutic strategies.
  • [MeSH-major] Central Nervous System Neoplasms / diagnosis. Meningeal Neoplasms / diagnosis. Neoplasms, Neuroepithelial / diagnosis

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  • (PMID = 12816725.001).
  • [ISSN] 1522-8517
  • [Journal-full-title] Neuro-oncology
  • [ISO-abbreviation] Neuro-oncology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC1920691
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5. Hofman R, Rosingh HJ: Unilateral hearing loss as primary symptom of craniopharyngioma in a six-year-old girl. J Laryngol Otol; 2008 Mar;122(3):e10
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  • [Title] Unilateral hearing loss as primary symptom of craniopharyngioma in a six-year-old girl.
  • Magnetic resonance scanning revealed a massive, cystic craniopharyngioma exerting pressure on the patient's ventricular system and brainstem and also invading the internal acoustic canal.
  • The patient's hearing loss completely recovered, and she experienced no neurological or endocrinological side effects of the treatment.
  • [MeSH-major] Craniopharyngioma / complications. Hearing Loss, Unilateral / etiology. Pituitary Neoplasms / complications
  • [MeSH-minor] Child. Craniotomy / methods. Female. Humans. Reflex, Babinski / drug therapy. Treatment Outcome

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  • (PMID = 18252012.001).
  • [ISSN] 1748-5460
  • [Journal-full-title] The Journal of laryngology and otology
  • [ISO-abbreviation] J Laryngol Otol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 6
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6. Nagashima T, Mizutani Y, Kawahara H, Maguchi S, Terayama Y, Shinohara T, Orba Y, Chuma T, Mano Y, Itoh T, Sawa H, Sakai K, Motomura M, Nagashima K: Anti-Hu paraneoplastic syndrome presenting with brainstem-cerebellar symptoms and Lambert-Eaton myasthenic syndrome. Neuropathology; 2003 Sep;23(3):230-8
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  • [Title] Anti-Hu paraneoplastic syndrome presenting with brainstem-cerebellar symptoms and Lambert-Eaton myasthenic syndrome.
  • Two cycles of combined chemotherapy resulted in shrinkage of the lung tumor together with complete recovery of neurological symptoms and disappearance of anti-Hu antibody.
  • Relapse of SCLC 4 months later with re-appearance of anti-Hu antibody required additional chemotherapy and irradiation.
  • Eight months later, when multiple liver metastasis of SCLC was noticed, muscular weakness with positive waxing phenomenon compatible with Lambert-Eaton myasthenic syndrome (LEMS) developed.
  • Postmortem examinations revealed residual SCLC in the primary lung, and massive liver metastasis with generalized lymph node involvement, but no tumors in the CNS.
  • The present PNS was unique in that the relapse of SCLC was accompanied by the appearance of anti-Hu antibody, and that initial signs of brainstem-cerebellar symptoms, encephalopathy and autonomic failure were replaced by LEMS coinciding with the tumor recurrence.
  • [MeSH-major] Carcinoma, Small Cell / complications. Lambert-Eaton Myasthenic Syndrome / etiology. Lung Neoplasms / complications. Neoplasm Recurrence, Local / immunology. RNA-Binding Proteins / immunology
  • [MeSH-minor] Autoantibodies / blood. Autoantibodies / cerebrospinal fluid. Blotting, Western. Brain Stem / pathology. Cerebellum / pathology. ELAV Proteins. Humans. Immunohistochemistry. Liver Neoplasms / secondary. Male. Middle Aged. Paraneoplastic Cerebellar Degeneration / pathology

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  • (PMID = 14570293.001).
  • [ISSN] 0919-6544
  • [Journal-full-title] Neuropathology : official journal of the Japanese Society of Neuropathology
  • [ISO-abbreviation] Neuropathology
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Australia
  • [Chemical-registry-number] 0 / Autoantibodies; 0 / ELAV Proteins; 0 / RNA-Binding Proteins
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7. Bowers DC, Krause TP, Aronson LJ, Barzi A, Burger PC, Carson BS, Weingart JD, Wharam MD, Melhem ER, Cohen KJ: Second surgery for recurrent pilocytic astrocytoma in children. Pediatr Neurosurg; 2001 May;34(5):229-34
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  • Pilocytic astrocytoma (PA) is the most common childhood brain tumor.
  • In cases where the tumor progresses or recurs following primary surgical resection, the appropriate treatment is unclear.
  • Options include chemotherapy, radiation therapy, surgical resection or a combination thereof.
  • Patients were excluded if they received adjuvant chemotherapy or radiation therapy.
  • Tumor locations included: cerebral hemisphere (3), cerebellum (7), optic pathway/hypothalamus (5), thalamus (1) and brainstem (4).
  • The indication for 4 surgeries included an enlarging tumor-associated cyst.
  • Surgery for tumors located in the cerebral hemispheres or cerebellum resulted in GTR or NTR in all cases and can result in long periods of progression-free survival without further adjuvant treatment.
  • [MeSH-major] Astrocytoma / surgery. Brain / surgery. Brain Neoplasms / surgery. Neoplasm Recurrence, Local / surgery
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Humans. Infant. Reoperation / adverse effects. Retrospective Studies. Treatment Outcome


8. Hansen EK, Bucci MK, Quivey JM, Weinberg V, Xia P: Repeat CT imaging and replanning during the course of IMRT for head-and-neck cancer. Int J Radiat Oncol Biol Phys; 2006 Feb 1;64(2):355-62
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  • PURPOSE: Many patients with head-and-neck (H&N) cancer have tumor shrinkage and/or weight loss during the course of radiotherapy.
  • We conducted this retrospective study to determine the dosimetric effects of repeat computed tomography (CT) imaging and replanning during the course of intensity-modulated radiotherapy (IMRT) on both normal tissues and target volumes.
  • The first IMRT plan for each patient was generated based on the original planning CT scan acquired before the start of treatment.
  • Because of tumor shrinkage or weight loss during radiotherapy, a second CT scan was acquired, and a new plan was generated and used to complete the course of IMRT.
  • RESULTS: All patients had locally advanced, nonmetastatic Stage III or IV disease, including 6 nasopharynx, 6 oropharynx, and 1 unknown primary site.
  • All patients were treated with concurrent platinum-based chemotherapy.
  • The doses to 95% (D95) of the planning target volumes of the gross tumor volume (PTVGTV) and the clinical target volume (PTVCTV) were reduced in 92% of patients, by 0.8-6.3 Gy (p=0.02) and 0.2-7.4 Gy (p=0.003), respectively.
  • The maximum dose (Dmax) to the spinal cord increased in all patients (range, 0.2-15.4 Gy; p=0.003) and the brainstem Dmax increased in 85% of patients without replanning (range, 0.6-8.1 Gy; p=0.007).
  • CONCLUSIONS: Repeat CT imaging and replanning during the course of IMRT for selected patients with H&N cancer is essential to identify dosimetric changes and to ensure adequate doses to target volumes and safe doses to normal tissues.
  • [MeSH-major] Head and Neck Neoplasms / radiography. Head and Neck Neoplasms / radiotherapy. Radiotherapy, Intensity-Modulated / methods. Tomography, X-Ray Computed / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Analysis of Variance. Brain Stem. Female. Humans. Male. Middle Aged. Nasopharyngeal Neoplasms / radiography. Nasopharyngeal Neoplasms / radiotherapy. Oropharyngeal Neoplasms / radiography. Oropharyngeal Neoplasms / radiotherapy. Radiotherapy Dosage. Radiotherapy Planning, Computer-Assisted. Retrospective Studies. Spinal Cord. Statistics, Nonparametric. Weight Loss

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  • (PMID = 16256277.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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9. Fouladi M, Nicholson HS, Zhou T, Laningham F, Helton KJ, Holmes E, Cohen K, Speights RA, Wright J, Pollack IF, Children's Oncology Group: A phase II study of the farnesyl transferase inhibitor, tipifarnib, in children with recurrent or progressive high-grade glioma, medulloblastoma/primitive neuroectodermal tumor, or brainstem glioma: a Children's Oncology Group study. Cancer; 2007 Dec 1;110(11):2535-41
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  • [Title] A phase II study of the farnesyl transferase inhibitor, tipifarnib, in children with recurrent or progressive high-grade glioma, medulloblastoma/primitive neuroectodermal tumor, or brainstem glioma: a Children's Oncology Group study.
  • BACKGROUND: An open-label Phase II study of tipifarnib was conducted to evaluate its safety and efficacy in children with recurrent or refractory medulloblastoma (MB)/primitive neuroectodermal tumor (PNET), high-grade glioma (HGG), and diffuse intrinsic brainstem glioma (BSG).
  • The primary objective was to estimate the sustained response rate in all strata.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Brain Neoplasms / drug therapy. Brain Stem Neoplasms / drug therapy. Glioma / drug therapy. Medulloblastoma / drug therapy. Quinolones / therapeutic use
  • [MeSH-minor] Adolescent. Adult. Child. Child, Preschool. Disease Progression. Female. Humans. Male. Neuroectodermal Tumors / drug therapy. Treatment Outcome


10. Lui YW, Law M, Chacko-Mathew J, Babb JS, Tuvia K, Allen JC, Zagzag D, Johnson G: Brainstem corticospinal tract diffusion tensor imaging in patients with primary posterior fossa neoplasms stratified by tumor type: a study of association with motor weakness and outcome. Neurosurgery; 2007 Dec;61(6):1199-207; discussion 1207-8
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  • [Title] Brainstem corticospinal tract diffusion tensor imaging in patients with primary posterior fossa neoplasms stratified by tumor type: a study of association with motor weakness and outcome.
  • OBJECTIVE: Diffusion tensor imaging (DTI) allows in vivo delineation of brainstem white matter tracts.
  • The purpose of this study was to determine whether or not abnormalities of DTI metrics and fiber tractography correlate with neurological deficits and clinical status in patients with primary posterior fossa tumors.
  • METHODS: A review of patients with primary posterior fossa tumors who underwent magnetic resonance imaging with DTI was performed.
  • Patients were stratified by tumor type (well-circumscribed or infiltrating lesions).
  • Fractional anisotropy (FA) color maps were used to localize the corticospinal tracts within the brainstem.
  • CONCLUSION: In patients with well-circumscribed primary posterior fossa masses, higher mean diffusivity and lower FA in the brainstem corticospinal tract are associated with contralateral motor deficits; lower transverse eigenvalue may be observed with an unfavorable clinical outcome.
  • [MeSH-major] Brain Neoplasms / pathology. Brain Neoplasms / physiopathology. Diffusion Magnetic Resonance Imaging. Infratentorial Neoplasms / pathology. Infratentorial Neoplasms / physiopathology. Pyramidal Tracts / pathology

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  • (PMID = 18162899.001).
  • [ISSN] 1524-4040
  • [Journal-full-title] Neurosurgery
  • [ISO-abbreviation] Neurosurgery
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / R01 CA093992
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
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11. Ohno M, Natsume A, Fujii M, Ito M, Wakabayashi T: Interferon-beta, MCNU, and conventional radiotherapy for pediatric patients with brainstem glioma. Pediatr Blood Cancer; 2009 Jul;53(1):37-41
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  • [Title] Interferon-beta, MCNU, and conventional radiotherapy for pediatric patients with brainstem glioma.
  • BACKGROUND: Most children with brainstem glioma die within 2 years of diagnosis, and the median survival time for patients with this condition is less than 1 year.
  • The role of chemotherapy in the treatment of children with brainstem glioma is not well defined.
  • The primary aim of this study is to evaluate the effects of treatment with interferon-beta (IFN-beta), ranimustine (MCNU), and radiotherapy (IMR therapy) administered to brainstem glioma patients treated at our institution.
  • We also determined patient response to IMR therapy by evaluating O(6)-methylguanine-DNA methyltransferase (MGMT) promoter methylation in serum DNA.
  • PROCEDURES: We retrospectively reviewed 15 patients who were newly diagnosed to have brainstem tumors and were administered IFN-beta (1-2 MIU/day, days 1-7; 0.5-1 MIU/day, days 8-14) and MCNU (80 mg/m(2) on day 2) concurrently with conventional radiotherapy.
  • The median overall survival time and the median progression-free survival time were 14.7 and 4.6 months, respectively.
  • The MGMT promoter methylation status in the serum appeared to correlate with a positive response to IMR therapy.
  • CONCLUSIONS: The IMR combination therapy is well tolerated and may be a promising treatment for brainstem glioma.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Stem Neoplasms / drug therapy. Brain Stem Neoplasms / radiotherapy. Glioma / drug therapy. Glioma / radiotherapy
  • [MeSH-minor] Adolescent. Carboplatin / administration & dosage. Child. Child, Preschool. DNA Methylation / drug effects. Dacarbazine / administration & dosage. Dacarbazine / analogs & derivatives. Disease-Free Survival. Etoposide / administration & dosage. Female. Humans. Interferon-beta / administration & dosage. Magnetic Resonance Imaging. Male. Nitrosourea Compounds / administration & dosage. Retrospective Studies. Treatment Outcome

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  • [Copyright] Copyright 2009 Wiley-Liss, Inc.
  • (PMID = 19260101.001).
  • [ISSN] 1545-5017
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Nitrosourea Compounds; 6PLQ3CP4P3 / Etoposide; 77238-31-4 / Interferon-beta; 7GR28W0FJI / Dacarbazine; 85622-93-1 / temozolomide; BG3F62OND5 / Carboplatin; RYH2T97J77 / ranimustine
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12. Jennings MT, Sposto R, Boyett JM, Vezina LG, Holmes E, Berger MS, Bruggers CS, Bruner JM, Chan KW, Dusenbery KE, Ettinger LJ, Fitz CR, Lafond D, Mandelbaum DE, Massey V, McGuire W, McNeely L, Moulton T, Pollack IF, Shen V: Preradiation chemotherapy in primary high-risk brainstem tumors: phase II study CCG-9941 of the Children's Cancer Group. J Clin Oncol; 2002 Aug 15;20(16):3431-7
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  • [Title] Preradiation chemotherapy in primary high-risk brainstem tumors: phase II study CCG-9941 of the Children's Cancer Group.
  • PURPOSE: This Children's Cancer Group group-wide phase II trial evaluated the efficacy and toxicity of two chemotherapy arms administered before hyperfractionated external-beam radiotherapy (HFEBRT).
  • PATIENTS AND METHODS: Thirty-two patients with newly diagnosed brainstem gliomas were randomly assigned to regimen A and 31 to regimen B.
  • Patients were evaluated by magnetic resonance imaging after induction chemotherapy and HFEBRT at a dose of 72 Gy.
  • RESULTS: Ten percent +/- 5% of regimen A patients objectively responded to chemotherapy.
  • The neuroradiographic response rate for regimen B was 19% +/- 8% for chemotherapy and 23% +/- 9% after HFEBRT.
  • Response rates were not statistically significant between regimens after induction or chemotherapy/HFEBRT.
  • Event-free survival was 17% +/- 5% (estimate +/- SE) at 1 year and 6% +/- 3% at 2 years.
  • Survival was significantly longer among patients who responded to chemotherapy (P <.05).
  • CONCLUSION: Neither chemotherapy regimen meaningfully improved response rate, event-free survival, or overall survival relative to previous series of patients with brainstem gliomas who received radiotherapy with or without chemotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Stem Neoplasms / drug therapy. Glioma / drug therapy
  • [MeSH-minor] Adolescent. Analysis of Variance. Carboplatin / administration & dosage. Child. Child, Preschool. Cisplatin / administration & dosage. Cyclophosphamide / administration & dosage. Disease-Free Survival. Etoposide / administration & dosage. Female. Humans. Male. Neoadjuvant Therapy. Survival Rate. Vincristine / administration & dosage

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  • (PMID = 12177103.001).
  • [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] Clinical Trial; Clinical Trial, Phase II; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 8N3DW7272P / Cyclophosphamide; BG3F62OND5 / Carboplatin; Q20Q21Q62J / Cisplatin
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13. Hukin J, Siffert J, Velasquez L, Zagzag D, Allen J: Leptomeningeal dissemination in children with progressive low-grade neuroepithelial tumors. Neuro Oncol; 2002 10;4(4):253-60
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  • Our purpose is to describe the incidence and clinical features of leptomeningeal dissemination (LM) in children with progressive low-grade neuroepithelial tumor (LGN).
  • We have continuously tracked all patients with primary CNS tumors since 1986.
  • Satisfactorily followed data were obtained on 427 of the 588 patients with localized LGN at diagnosis between 1986 and 1998, 177 (42%) of whom developed progressive or recurrent disease.
  • The primary tumor sites were diencephalon (6), brainstem (3), cerebellum (2), cerebrum (1), and spinal cord (1).
  • 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-major] Central Nervous System Neoplasms / pathology. Meningeal Neoplasms / secondary. Neoplasms, Neuroepithelial / secondary
  • [MeSH-minor] Adolescent. Adult. Child. Child, Preschool. Combined Modality Therapy. Disease Progression. Female. Humans. Infant. Magnetic Resonance Imaging. Male. Neoplasm Recurrence, Local / epidemiology. Neoplasm Recurrence, Local / therapy. Survival Analysis. Treatment Outcome

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  • (PMID = 12356355.001).
  • [ISSN] 1522-8517
  • [Journal-full-title] Neuro-oncology
  • [ISO-abbreviation] Neuro-oncology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC1920666
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14. 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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15. 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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16. Li N, Kim JH, Glusac EJ: Brainstem involvement by mycosis fungoides in a patient with large-cell transformation: a case report and review of literature. J Cutan Pathol; 2003 May;30(5):326-31
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  • [Title] Brainstem involvement by mycosis fungoides in a patient with large-cell transformation: a case report and review of literature.
  • RESULTS: A 71-year-old female with long-standing MF developed lymphomatous CNS involvement 10 years after the diagnosis of tumor stage MF.
  • At this time, the patient presented with a transient episode of garbled speech followed by generalized weakness.
  • Computerized tomography scan (CT scan) and magnetic resonance imaging scan (MRI scan) of the head revealed a subcortical lesion in the left temporo-frontal lobe.
  • Cerebrospinal fluid (CSF) examination showed atypical T cells, and brain biopsy confirmed parenchymal involvement by T-cell lymphoma.
  • No lymph node or other systemic involvement was noted at this time, and the patient was treated with chemotherapy.
  • Twelve months later, the patient developed recurrent CNS lymphoma with multiple organ involvement and expired soon thereafter.
  • [MeSH-major] Brain Neoplasms / pathology. Cell Transformation, Neoplastic / pathology. Lymphoma, Large-Cell, Anaplastic / pathology. Mycosis Fungoides / pathology. Neoplasms, Second Primary / pathology. Skin Neoplasms / pathology


17. Laigle-Donadey F, Iraqi W, Straus C, Martin-Duverneuil N, FĂ©nelon G, Hoang-Xuan K: [Primary central nervous system lymphoma presenting with central neurogenic hyperventilation. A case report and review of the literature]. Rev Neurol (Paris); 2005 Oct;161(10):940-8
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  • [Title] [Primary central nervous system lymphoma presenting with central neurogenic hyperventilation. A case report and review of the literature].
  • OBSERVATION: We report here a 54-year-old patient who developed central neurogenic hyperventilation as the initial presentation of a primary central nervous system lymphoma located in the brainstem.
  • CONCLUSION: The patient's hyperventilation resolved completely with chemotherapy for primary CNS lymphoma.
  • Most of the cases reported in the literature are related to a diffuse tumor of the brainstem with an intriguing overrepresentation of primary CNS lymphoma.
  • [MeSH-major] Brain Stem Neoplasms / complications. Hyperventilation / etiology. Lymphoma, B-Cell / complications

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  • (PMID = 16365623.001).
  • [ISSN] 0035-3787
  • [Journal-full-title] Revue neurologique
  • [ISO-abbreviation] Rev. Neurol. (Paris)
  • [Language] fre
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Number-of-references] 41
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18. Blaney S, Berg SL, Pratt C, Weitman S, Sullivan J, Luchtman-Jones L, Bernstein M: A phase I study of irinotecan in pediatric patients: a pediatric oncology group study. Clin Cancer Res; 2001 Jan;7(1):32-7
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  • An MTD was defined in heavily pretreated and less-heavily pretreated (i.e., two prior chemotherapy regimens, no prior bone marrow transplantation, and no radiation to the spine, skull, ribs, or pelvic bones) patients.
  • Myelosuppression was the primary DLT in heavily pretreated patients, and diarrhea was the DLT in less-heavily pretreated patients.
  • Stable disease (4-20 cycles) was observed in seven patients with a variety of malignancies including neuroblastoma, pineoblastoma, glioblastoma, brainstem glioma, osteosarcoma, hepatoblastoma, and a central nervous system rhabdoid tumor.
  • [MeSH-major] Antineoplastic Agents, Phytogenic / therapeutic use. Camptothecin / analogs & derivatives. Camptothecin / therapeutic use. Enzyme Inhibitors / therapeutic use. Neoplasms / drug therapy. Topoisomerase I Inhibitors
  • [MeSH-minor] Adolescent. Adult. Child. Child, Preschool. Dose-Response Relationship, Drug. Drug Administration Schedule. Female. Hematologic Tests. Humans. Infant. Infusions, Intravenous. Male. Toxicity Tests. Treatment Outcome

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  • (PMID = 11205914.001).
  • [ISSN] 1078-0432
  • [Journal-full-title] Clinical cancer research : an official journal of the American Association for Cancer Research
  • [ISO-abbreviation] Clin. Cancer Res.
  • [Language] eng
  • [Grant] United States / NCRR NIH HHS / RR / MO1RR00188; United States / NCI NIH HHS / CA / U01CA57745
  • [Publication-type] Clinical Trial; Clinical Trial, Phase I; Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 0 / Enzyme Inhibitors; 0 / Topoisomerase I Inhibitors; 7673326042 / irinotecan; XT3Z54Z28A / Camptothecin
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19. Packer RJ, Krailo M, Mehta M, Warren K, Allen J, Jakacki R, Villablanca JG, Chiba A, Reaman G: Phase 1 study of concurrent RMP-7 and carboplatin with radiotherapy for children with newly diagnosed brainstem gliomas. Cancer; 2005 Sep 15;104(6):1281-7
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  • [Title] Phase 1 study of concurrent RMP-7 and carboplatin with radiotherapy for children with newly diagnosed brainstem gliomas.
  • BACKGROUND: Ninety percent of children with diffuse intrinsic brainstem tumors will die within 18 months of diagnosis.
  • However, delivery to the primary tumor site is problematic.
  • RMP-7 is a bradykinin analog that causes selective permeability of the blood-brain-tumor interface.
  • Local radiotherapy (5940 centigrays) was given within 4 hours of completion of drug delivery.
  • Duration of treatment was escalated in a stepwise, weekly fashion, in cohorts of 3, until there was treatment-limiting toxicity or until radiotherapy was completed.
  • RESULTS: One child died early in treatment of progressive disease and was not assessable for toxicity.
  • Treatment for 3, 4, or 5 weeks was tolerated well, with mild flushing, tachycardia, nausea, emesis, dizziness, and abdominal pain.
  • Of 3 children treated at the full duration of therapy (33 doses over 7 wks), 1 developed dose-limiting hepatotoxicity and neutropenia.
  • The estimated median survival period was 328 days, and 1 patient remained disease progression free > 400 days from initiation of treatment.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Stem Neoplasms / therapy. Carboplatin / administration & dosage. Glioma / therapy
  • [MeSH-minor] Adolescent. Bradykinin / administration & dosage. Bradykinin / adverse effects. Bradykinin / analogs & derivatives. Child. Child, Preschool. Combined Modality Therapy. Humans

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  • [Copyright] Copyright 2005 American Cancer Society.
  • (PMID = 16078267.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase I; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 159768-75-9 / RMP 7; BG3F62OND5 / Carboplatin; S8TIM42R2W / Bradykinin
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20. Contopoulos-Ioannidis DG, Giotis ND, Baliatsa DV, Ioannidis JP: Extended-interval aminoglycoside administration for children: a meta-analysis. Pediatrics; 2004 Jul;114(1):e111-8
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  • These include concentration-dependent bactericidal activity; postantibiotic effect, which allows continued efficacy even when serum concentrations fall below expected minimum inhibitory concentrations; decreased risk of adaptive resistance; and diminished accumulation in renal tubules and inner ear.
  • (4) primary nephrotoxicity, ie, any rise in serum creatinine or decrease in creatinine clearance with thresholds as defined in each study;.
  • (5) secondary nephrotoxicity, ie, urinary excretion of proteins or phospholipids; and (6) ototoxicity based on pure tone audiometry, brainstem auditory evoked responses, or otoacoustic emissions for neonates and infants, vestibular testing, clinical impression, or any other method.
  • All of the efficacy and toxicity outcomes were evaluated at the end of therapy.
  • NEPHROTOXICITY: There was no significant difference between ODD and MDD in the primary nephrotoxicity outcomes.
  • The pooled primary nephrotoxicity rates were 1.6% (15 of 955 cases) in the ODD arms and 1.6% (15 of 923 cases) in the MDD arms.
  • Results were consistent across types of clinical settings and aminoglycosides.
  • OTOTOXICITY: There was no significant difference between ODD and MDD in the primary ototoxicity outcomes.
  • SUBGROUP AND BIAS ANALYSES: We detected no statistically significant differences between ODD and MDD in any of the examined subgroups (neonatal intensive care unit, cystic fibrosis, cancer, or urinary tract infection), with respect to combined clinical or microbiologic failure outcomes, primary nephrotoxicity outcomes, or ototoxicity (based on auditory testing), when sufficient data were available.
  • In our meta-analysis, we were not able to show any reduction in the risk of primary nephrotoxicity outcomes with ODD.
  • This approach minimizes cost, simplifies administration, and provides similar or even potentially improved efficacy and safety, compared with MDD of these drugs.
  • [MeSH-major] Aminoglycosides / administration & dosage. Anti-Bacterial Agents / administration & dosage. Bacterial Infections / drug therapy
  • [MeSH-minor] Child. Cystic Fibrosis / drug therapy. Drug Administration Schedule. Hearing / drug effects. Humans. Infant, Newborn. Kidney / drug effects. Neoplasms / drug therapy. Randomized Controlled Trials as Topic. Risk. Treatment Outcome. Urinary Tract Infections / drug therapy

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  • [CommentIn] J Urol. 2005 Apr;173(4):1192 [15758741.001]
  • [CommentIn] Pediatrics. 2005 Mar;115(3):827-8; author reply 828 [15741401.001]
  • (PMID = 15231982.001).
  • [ISSN] 1098-4275
  • [Journal-full-title] Pediatrics
  • [ISO-abbreviation] Pediatrics
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Meta-Analysis
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Aminoglycosides; 0 / Anti-Bacterial Agents
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21. Grundy RG, Wilne SH, Robinson KJ, Ironside JW, Cox T, Chong WK, Michalski A, Campbell RH, Bailey CC, Thorp N, Pizer B, Punt J, Walker DA, Ellison DW, Machin D, Children's Cancer and Leukaemia Group (formerly UKCCSG) Brain Tumour Committee: Primary postoperative chemotherapy without radiotherapy for treatment of brain tumours other than ependymoma in children under 3 years: results of the first UKCCSG/SIOP CNS 9204 trial. Eur J Cancer; 2010 Jan;46(1):120-33
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  • [Title] Primary postoperative chemotherapy without radiotherapy for treatment of brain tumours other than ependymoma in children under 3 years: results of the first UKCCSG/SIOP CNS 9204 trial.
  • BACKGROUND: Radiotherapy is an effective adjuvant treatment for brain tumours arising in very young children, but it has the potential to damage the child's developing nervous system at a crucial time - with a resultant reduction in IQ leading to cognitive impairment, associated endocrinopathy and risk of second malignancy.
  • We aimed to assess the role of a primary chemotherapy strategy in avoiding or delaying radiotherapy in children younger than 3 years with malignant brain tumours other than ependymoma, the results of which have already been published.
  • Following maximal surgical resection, chemotherapy was delivered every 14 d for 1 year or until disease progression.
  • FINDINGS: Over all diagnostic groups the cumulative progression rate was 80.9% at 5 years while the corresponding need-for-radiotherapy rate for progression was 54.6%, but both rates varied by tumour type.
  • There was no clear relationship between chemotherapy dose intensity and outcome.
  • The 5-year EFS for non-brainstem high-grade gliomas [HGGs] was 13.0% (CI: 2.2-33.4) and the OS was 30.9% (CI: 11.5-52.8).
  • This treatment strategy was less effective for AT/RT with 3-year OS of 16.7% (CI: 0.8-51.7) and CNS PNET with 1-year OS of 9.1% (CI: 0.5-33.3).
  • INTERPRETATION: The outcome for very young children with brain tumours is dictated by degree of surgical resection and histological tumour type and underlying biology as an indicator of treatment sensitivity.
  • Desmoplastic/nodular sub-type of medulloblastoma has a better prognosis than classic histology, despite traditional adverse clinical features of metastatic disease and incomplete surgical resection.
  • This study highlights the differing therapeutic challenges presented by the malignant brain tumours of early childhood, the importance of surgical approaches and the need to explore individualised brain sparing approaches to the range of malignant brain tumours that present in early childhood.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms / drug therapy
  • [MeSH-minor] Astrocytoma / drug therapy. Astrocytoma / radiotherapy. Astrocytoma / surgery. Child, Preschool. Choroid Plexus Neoplasms / drug therapy. Choroid Plexus Neoplasms / radiotherapy. Choroid Plexus Neoplasms / surgery. Disease Progression. Drug Administration Schedule. Female. Follow-Up Studies. Humans. Infant. Male. Medulloblastoma / drug therapy. Medulloblastoma / radiotherapy. Medulloblastoma / surgery. Neuroectodermal Tumors, Primitive / drug therapy. Neuroectodermal Tumors, Primitive / radiotherapy. Neuroectodermal Tumors, Primitive / surgery. Radiotherapy, Adjuvant / methods. Survival Analysis. Teratoma / drug therapy. Teratoma / radiotherapy. Teratoma / surgery. Treatment Outcome

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  • (PMID = 19818598.001).
  • [ISSN] 1879-0852
  • [Journal-full-title] European journal of cancer (Oxford, England : 1990)
  • [ISO-abbreviation] Eur. J. Cancer
  • [Language] eng
  • [Grant] United Kingdom / Cancer Research UK / /
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] England
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22. 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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  • [Title] Prognostic scoring system for primary CNS lymphomas: the International Extranodal Lymphoma Study Group experience.
  • PURPOSE: To identify survival predictors and to design a prognostic score useful for distinguishing risk groups in immunocompetent patients with primary CNS lymphomas (PCNSL).
  • 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-major] Central Nervous System Neoplasms / diagnosis. Lymphoma / diagnosis
  • [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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23. Fuentes S, Delsanti C, Metellus P, Peragut JC, Grisoli F, Regis J: Brainstem metastases: management using gamma knife radiosurgery. Neurosurgery; 2006 Jan;58(1):37-42; discussion 37-42
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  • [Title] Brainstem metastases: management using gamma knife radiosurgery.
  • OBJECTIVE: Brainstem metastasis is an uncommon complication of systemic cancer, generally considered to have a highly unfavorable prognosis.
  • Surgical risks are high and standard radiation or chemotherapy have little effect.
  • The purpose of this study is to evaluate our experience using Gamma Knife radiosurgery (GKRS) for the management of brainstem metastasis.
  • METHODS: Between July 1992 and March 2001, we treated 28 patients with brainstem metastasis using GKRS.
  • At time of the radiosurgery, eight patients presented with another supratentorial metastasis.
  • The most frequent primary tumor site was the lung (13 cases) followed by the melanoma in four cases, the kidney in two, and other locations in six.
  • Only six patients underwent fractionated whole-brain radiation therapy.
  • Mean marginal radiation dose for GKRS was 19.6 Gy (range, 11-30).
  • Local tumor control was achieved in 92% of patients.
  • Death was related to the progression of the brainstem lesion in two cases.
  • CONCLUSION: The results of this small series demonstrate that GKRS can be a valuable modality for safe and effective management of brain stem metastasis.
  • Owing to the high risk of surgical resection and low efficacy of medical treatment, radiosurgery can be proposed upfront.
  • [MeSH-major] Brain Neoplasms / secondary. Brain Neoplasms / surgery. Brain Stem. Radiosurgery
  • [MeSH-minor] Adult. Aged. Disease Progression. Female. Follow-Up Studies. Humans. Kidney Neoplasms / secondary. Lung Neoplasms / secondary. Male. Medulla Oblongata. Melanoma / secondary. Mesencephalon. Middle Aged. Pons. Survival Analysis. Treatment Outcome

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  • (PMID = 16385327.001).
  • [ISSN] 1524-4040
  • [Journal-full-title] Neurosurgery
  • [ISO-abbreviation] Neurosurgery
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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24. Gilmer-Hill HS, Ellis WG, Imbesi SG, Boggan JE: Spinal oligodendroglioma with gliomatosis in a child. Case report. J Neurosurg; 2000 Jan;92(1 Suppl):109-13
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  • The authors present a rare case of oligodendrogliomatosis in a child, which they believe originated from a primary spinal cord tumor.
  • At 2.5 years of age this boy developed poor balance, neck stiffness, and a regression in developmental milestones.
  • A computerized tomography (CT) scan of the head initially revealed ventriculomegaly and multiple cystic cerebellar lesions.
  • A CT scan of the head and an MR image obtained 3 years later demonstrated diffuse small cysts on the surface of the brainstem, cerebellum, medial temporal and inferior frontal cortices, subcortical white matter, and corpus callosum suggestive of leptomeningeal tumor spread.
  • The cells appeared to migrate along the subpial space but no tumor cells were present in the subarachnoid space.
  • Despite having a complicated course, chemotherapy with carboplatin has provided the patient with long-term palliation and a high quality of life.
  • This case may represent the fifth report in the literature of oligodendrogliomatosis occurring in a child but only the third occurring with a spinal primary tumor.
  • [MeSH-major] Brain Neoplasms / pathology. Glioma / pathology. Neoplasms, Multiple Primary / pathology. Oligodendroglioma / pathology. Spinal Cord Neoplasms / pathology
  • [MeSH-minor] Child, Preschool. Combined Modality Therapy. Humans. Magnetic Resonance Imaging. Male. Palliative Care. Photomicrography. Tomography, X-Ray Computed


25. Uchino M, Haga D, Mito T, Kuramitsu T, Nakamura N: Primary midbrain cystic germinoma mimicking glioma: a case with neuroendoscopic biopsy. J Neurooncol; 2006 Sep;79(3):255-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Primary midbrain cystic germinoma mimicking glioma: a case with neuroendoscopic biopsy.
  • The preoperative diagnosis included brain stem glioma, metastasis, and neuroepithelial cyst.
  • The patient responded well to chemotherapy and radiotherapy.
  • The case illustrates the diagnostic value of neuroendoscopic biopsy in the differential diagnosis of brainstem lesions in adult.
  • [MeSH-major] Brain Stem Neoplasms / pathology. Germinoma / pathology. Glioma / pathology
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biopsy. Diagnosis, Differential. Diplopia / etiology. Endoscopy. Headache / etiology. Humans. Magnetic Resonance Imaging. Male

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  • (PMID = 16557347.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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26. 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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  • [Title] Transition from meningeal melanocytoma to primary cerebral melanoma. Case report.
  • 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.
  • Pleomorphic changes and a focal high mitotic activity led to the diagnosis of a primary cerebral malignant melanoma.
  • 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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