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1. Huang Q, Wu H, Wang Z, Zhang Z, Jia H: [Diagnosis and treatment of lateral skull base tumors in pediatric]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi; 2008 Aug;22(16):734-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Diagnosis and treatment of lateral skull base tumors in pediatric].
  • OBJECTIVE: To explore the diagnosis and treatment of lateral skull base tumors in children.
  • METHOD: The clinical data of 8 patients with lateral skull base tumors were reviewed in a retrospective study.
  • Of 8 patients, one case was treated with chemotherapy.
  • The other 7 cases of benign or malignant tumors underwent surgery in different approaches.
  • Four patients had pre-and postoperative chemotherapy.
  • Three patients received postoperative chemotherapy.
  • One patient of chordoma died 5 months after surgery, the other 7 patients were alive at the time of analysis.
  • One patient developed hoarseness.
  • Two patients developed swallowing obstruction and healed 3-4 months after surgery.
  • CONCLUSION: Tumors in lateral skull base in children were rare, of which malignant tumors were more common compared to benign lesions.
  • CT and MRI are helpful in evaluating extent of disease and preoperative planning.
  • Surgery is the first choice of the treatment for lateral skull base tumors.
  • Radiation therapy and chemotherapy could be used for malignant tumors preoperatively and postoperatively.
  • Combined approach of temporal and infratemporal fossa is suitable for the surgery of those tumors involved temporal bone and middle or posterior cranial fossa as well as infratemporal fossa.
  • [MeSH-major] Skull Base Neoplasms / diagnosis. Skull Base Neoplasms / surgery

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  • (PMID = 18975775.001).
  • [ISSN] 1001-1781
  • [Journal-full-title] Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology, head, and neck surgery
  • [ISO-abbreviation] Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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2. Rivera-Luna R, López E, Rivera-Marquez H, Rivera-Ortegón F, Altamirano-Alvarez E, Mercado G, Covarrubias G, Rueda-Franco F, Marhx-Bracho A, Gutiérrez P: Survival of children under 3 years old with medulloblastoma: a study from the Mexican Cooperative Group for Childhood Malignancies (AMOHP). Childs Nerv Syst; 2002 Feb;18(1-2):38-42
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  • In 39 (79.6%) of these patients the tumors were staged as T3M0 or under, while 10 (20.4%) had metastasis at diagnosis.
  • For those who received radiotherapy the PFS was 62%, and in those not treated with radiotherapy PFS was nil ( P=0.0001).
  • When the children were divided into those who received surgical treatment plus chemotherapy and those who received surgery plus radiotherapy plus chemotherapy, the PFS was nil and 66%, respectively ( P=0.00001).
  • CONCLUSION: Because of the high morbidity of radiotherapy in children under 3 years old, surgery continues to be the basis of improved prognosis, followed by chemotherapy.
  • [MeSH-major] Cerebellar Neoplasms / drug therapy. Cerebellar Neoplasms / surgery. Medulloblastoma / drug therapy. Medulloblastoma / surgery
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Child, Preschool. Combined Modality Therapy. Cranial Fossa, Posterior. Female. Humans. Infant. Male. Neurosurgical Procedures. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 11935242.001).
  • [ISSN] 0256-7040
  • [Journal-full-title] Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
  • [ISO-abbreviation] Childs Nerv Syst
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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3. Nakamura T, Kanamori M, Sonoda Y, Watanabe M, Kumabe T, Tominaga T: [Primary yolk sac tumor in the cerebellar vermis. Case report]. No Shinkei Geka; 2009 Feb;37(2):173-7
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  • [Title] [Primary yolk sac tumor in the cerebellar vermis. Case report].
  • The tumor was totally resected, and the histological diagnosis was yolk sac tumor.
  • 18F-fluorodeoxyglucose-positron emission tomography, and thoracic, abdominal, and pelvic computed tomography showed no abnormal lesions, excluding the possibility of metastatic yolk sac tumor from an extracranial lesion.
  • The patient received chemotherapy consisting of ifosfamide, cisplatin, and etoposide, and had not relapsed at 6 months after resection.
  • Germ cell tumors rarely develop in the posterior fossa.
  • This case suggests that yolk sac tumor could develop in the cerebellar vermis.
  • [MeSH-major] Cerebellar Neoplasms / diagnosis. Endodermal Sinus Tumor / diagnosis
  • [MeSH-minor] Child, Preschool. Humans. Magnetic Resonance Imaging. Magnetic Resonance Spectroscopy. Male. Tomography, X-Ray Computed

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  • (PMID = 19227159.001).
  • [ISSN] 0301-2603
  • [Journal-full-title] No shinkei geka. Neurological surgery
  • [ISO-abbreviation] No Shinkei Geka
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] Japan
  • [Number-of-references] 17
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4. Xie J, Luo SQ, Ma ZY, Zhang YQ, Zeng HY, Qiu XG: [The clinical features and treatment of intracranial tumors in infants]. Zhonghua Yi Xue Za Zhi; 2004 Aug 2;84(15):1270-5
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  • [Title] [The clinical features and treatment of intracranial tumors in infants].
  • OBJECTIVE: To explore the treatment plan of intracranial tumors in infants.
  • METHODS: The clinical features and curative effect of 114 patients of intracranial tumors in infants who were admitted and performed microsurgery were analyzed retrospectively.
  • The total removal of tumor was 72.0%, subtotal removal 17.5%, partial removal 10.5%.
  • RESULTS: The tumor located at posterior fossa (37.7%), sella region (31.6%), hemisphere (19.3%) including in basal ganglia.
  • But 6 patients developed worse than the children of the same age.
  • CONCLUSION: Good prognosis can not be obtained for embryonal tumors and ependymoma through operation only.
  • Although radiotherapy is useful of inhibiting the growth of tumor, the dosage should be decreased for infants and the complications in long term also should be considered simultaneously.
  • It is a trend towards performing chemotherapy after operation.
  • It is not necessary to perform auxiliary therapy for astrocytoma, oligodendroglioma, and mixed glioma, because the prognosis is good after total removal of the tumor.
  • [MeSH-major] Brain Neoplasms / diagnosis. Brain Neoplasms / surgery. Microsurgery
  • [MeSH-minor] Astrocytoma / diagnosis. Astrocytoma / surgery. Cerebellar Neoplasms / diagnosis. Cerebellar Neoplasms / surgery. Child, Preschool. Cranial Fossa, Posterior. Female. Follow-Up Studies. Humans. Infant. Male. Medulloblastoma / diagnosis. Medulloblastoma / surgery. Retrospective Studies. Sella Turcica

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  • (PMID = 15387964.001).
  • [ISSN] 0376-2491
  • [Journal-full-title] Zhonghua yi xue za zhi
  • [ISO-abbreviation] Zhonghua Yi Xue Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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5. Germanwala AV, Mai JC, Tomycz ND, Niranjan A, Flickinger JC, Kondziolka D, Lunsford LD: Boost Gamma Knife surgery during multimodality management of adult medulloblastoma. J Neurosurg; 2008 Feb;108(2):204-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • METHODS: The authors performed a retrospective analysis of 12 adult patients with histologically proven medulloblastoma or supratentorial primitive neuroectodermal tumor who between February 1991 and December 2004 underwent >or=1 sessions of GKS for posttreatment residual or recurrent tumors (6 tumors in each group).
  • Nine patients also received systemic chemotherapy.
  • Stereotactic radiosurgery was applied to residual and recurrent posterior fossa tumor as well as to foci of intracranial medulloblastoma metastases.
  • The median time interval from initial diagnosis and resection to the first GKS treatment was 24 months (range 2-37 months).
  • The mean GKS-treated tumor volume was 9.4 cm3 (range 0.5-39 cm3).
  • RESULTS: Following adjunctive radiosurgery, 5 patients had no evidence of tumor on magnetic resonance (MR) imaging, 3 patients had stable tumor burden on MR imaging, and 4 patients had evidence of tumor progression locally with or without intracranial metastases.
  • All patients with tumor progression died.
  • The majority of patients who achieved tumor eradication (80%) and tumor stabilization (67%) after GKS had residual tumor as the reason for their referral for GKS.
  • The best outcomes were attained in patients with residual disease who were younger, had smaller tumor volumes, had no evidence of metastatic disease, and had received higher cumulative GKS doses.
  • CONCLUSIONS: Single or multiple GKS sessions were a well-tolerated, feasible, and effective adjunctive treatment for posterior fossa residual or recurrent medulloblastoma as well as intracranial metastatic medulloblastoma in adult patients.
  • [MeSH-major] Cerebellar Neoplasms / surgery. Medulloblastoma / surgery. Neoadjuvant Therapy. Radiosurgery / methods
  • [MeSH-minor] Adult. Age Factors. Chemotherapy, Adjuvant. Cranial Irradiation. Disease Progression. Female. Follow-Up Studies. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Neoplasm Recurrence, Local / radiotherapy. Neoplasm Recurrence, Local / surgery. Neoplasm, Residual. Neuroectodermal Tumors / radiotherapy. Neuroectodermal Tumors / surgery. Remission Induction. Retrospective Studies. Spine / radiation effects. Supratentorial Neoplasms / radiotherapy. Supratentorial Neoplasms / surgery. Survival Rate. Time Factors. Treatment Outcome

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  • (PMID = 18240913.001).
  • [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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6. Slampa P, Pavelka Z, Dusek L, Hynkova L, Sterba J, Ondrova B, Princ D, Novotny T, Kostakova S: Longterm treatment results of childhood medulloblastoma by craniospinal irradiation in supine position. Neoplasma; 2007;54(1):62-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Longterm treatment results of childhood medulloblastoma by craniospinal irradiation in supine position.
  • Medulloblastoma, a primitive neuroectodermal tumor growing in cerebellum, is one of the most sensitive to radiation therapy childhood brain tumors.
  • The radiotherapy is an essential method of treatment for these tumours, but the surgery is the primary treatment of choice in medulloblastoma.
  • I this study between January 1997 and March 2005 were post-operative irradiated a total number of 33 pediatric patients aged under 15 years (median age 8.7 years) with medulloblastoma.
  • All tumors were histologically proved and were localizated infratentorially in the posterior fossa.
  • All of the patients were irradiated with a dose of 24-36 Gy to the whole craniospinal axis and boost with conformal therapy restricted to the tumor bed to the total dose of 50-54 Gy (30-36 Gy "high risk", 24-30 Gy "standard risk" group).
  • Chemotherapy received 26 patients (78%).
  • Irradiation was performed using standard fractionation (5 fractions per week) with a single dose of 1.5-1.8 Gy for craniospinal axis by photon beam (6 MV) of the linear accelerator.
  • The median of disease-free survival was 20.6 months, 8 patients (24%) died.
  • In our study the statistical difference in survival rate between standard and high-risk patients with medulloblastoma was not shown.
  • No relationship was found between survival and age, sex or tumor size.
  • Endocrine deficits occurred in 45% (8 patients of the group were hypothyroid, 6 patients needed growth hormone replacement therapy, 1 patient had early puberty).
  • This results (results of overall and disease-free survival) and side-effects of technique of craniospinal axis irradiation in supine position are comparable with results of technique in prone position.
  • Further evaluation of the effectiveness of our therapy is not feasible due to the small number of patients.
  • [MeSH-major] Cerebellar Neoplasms / radiotherapy. Medulloblastoma / radiotherapy. Radiotherapy / methods. Supine Position
  • [MeSH-minor] Child. Child, Preschool. Combined Modality Therapy. Female. Humans. Kaplan-Meier Estimate. Male. Neoplasm Recurrence, Local. Radiotherapy Dosage. Time Factors. Treatment Outcome


7. Garrè ML, Tekautz T: Role of high-dose chemotherapy (HDCT) in treatment of atypical teratoid/rhabdoid tumors (AT/RTs). Pediatr Blood Cancer; 2010 Apr;54(4):647-8
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  • [Title] Role of high-dose chemotherapy (HDCT) in treatment of atypical teratoid/rhabdoid tumors (AT/RTs).
  • Atypical teratoid/rhabdoid tumors (AT/RTs) of the CNS have been recently characterized as a distinct clinicopathologic entity with an unusually poor prognosis and with the highest incidence in the first 2 years of life.
  • It often arises in the posterior fossa and its distinctive immunohistochemical (negative stain for INI-1) and cytogenetic features (monosomy or deletion of chromosome 22) permit an adequate diagnosis in most of cases.
  • AT/RT of the CNS is a usually fatal disease virtually unresponsive to chemotherapy (CT) and radiotherapy (RT).
  • Whether combined regimens including high-dose CT are able to prolong survival or change the natural history of this tumor are under evaluation.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Central Nervous System Neoplasms / drug therapy. Rhabdoid Tumor / drug therapy. Teratoma / drug therapy

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  • (PMID = 20146222.001).
  • [ISSN] 1545-5017
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 18
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8. Yağmurlu B, Akyürek S, Fitoz S, Demirkazik A: MRI of non-neoplastic cranial complications of malignant disorders. Diagn Interv Radiol; 2008 Jun;14(2):61-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • PURPOSE: To depict the well-known and atypical magnetic resonance imaging (MRI) findings of non-neoplastic central nervous system (CNS) complications of extra- CNS tumors and portray additional information from advanced techniques, such as diffusion and perfusion MRI.
  • MATERIALS AND METHODS: MRI scans of 92 patients were retrospectively evaluated based on the non-neoplastic effects induced by treatment or the remote effects of the tumor itself.
  • Patients with brain metastases and/or patients who had whole brain radiation therapy were excluded so as not to take the primary radiation effects into consideration.
  • RESULTS: Sixteen patients (9 females and 7 males; age range, 11-68 years; median age, 45 years) had positive findings other than brain metastases.
  • Six patients had posterior reversible encephalopathies, 3 patients had chemotherapy toxicity to the white matter, and 2 patients had acute strokes involving the posterior fossa and bilateral anterior circulation territory.
  • Three patients had bilateral radionecrosis of the temporal lobe due to radiotherapy given for the vicinal tumor (nasopharyngeal carcinoma).
  • CONCLUSION: One of the major and noteworthy complications of malignancies directly affecting survival is brain metastasis, but non-neoplastic complications are infrequently encountered and are thus underestimated, either due to the absence of a true diagnosis or the lack of information pertaining to the clinical outcome.
  • It is important for the radiologist to recognize these effects so as to help the clinician develop an optimal treatment strategy and avoid irreversible complications.
  • [MeSH-major] Brain / pathology. Central Nervous System Diseases / diagnosis. Central Nervous System Diseases / etiology. Magnetic Resonance Imaging / methods. Neoplasms / complications
  • [MeSH-minor] Adolescent. Adult. Aged. Central Nervous System Neoplasms / complications. Central Nervous System Neoplasms / diagnosis. Central Nervous System Neoplasms / secondary. Child. Diagnosis, Differential. Female. Humans. Male. Middle Aged. Retrospective Studies

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  • (PMID = 18553277.001).
  • [ISSN] 1305-3612
  • [Journal-full-title] Diagnostic and interventional radiology (Ankara, Turkey)
  • [ISO-abbreviation] Diagn Interv Radiol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Turkey
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9. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • 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.
  • 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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10. Massimino M, Giardini R, Cefalo G, Simonetti F, Pollo B, Giombini S, Tesoro-Tess JD, Ponzoni M, Patriarca C: Intravascular lymphomatosis (IL) in a child mimicking a posterior fossa tumor. J Neurooncol; 2001 Jan;51(1):47-50
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intravascular lymphomatosis (IL) in a child mimicking a posterior fossa tumor.
  • SS, a 13-year-old girl, was admitted to a Neurosurgery Unit because of endocranic hypertension, where, after CT and MRI documenting a IV ventricle 3 cm diameter tumor, she was submitted to complete tumor excision: extemporary diagnosis was suggestive of medulloblastoma.
  • Whole CNS MRI did not give evidence of residual or metastatic disease while CSF cytology showed only pleiocytosis.
  • Treatment was started according to our ongoing protocol for medulloblastoma with pre-radiation chemotherapy.
  • Before delivering radiotherapy (RT), upon review of histologic specimens, the definitive diagnosis of IL B-phenotype was made.
  • The girl was re-admitted and, after a complete re-staging, chemotherapy was intensified according to our schedule for high-grade B-cell lymphoma and CNS was irradiated up to a total dose of 25 Gy.
  • The case here reported is unique for age, tumor presentation, and, so far, favourable outcome, in spite of the delayed histological diagnosis.
  • [MeSH-major] Cerebellar Neoplasms / diagnosis. Lymphoma, B-Cell / diagnosis. Medulloblastoma / diagnosis. Vascular Neoplasms / diagnosis
  • [MeSH-minor] Adolescent. Cranial Fossa, Posterior. Female. Humans. Magnetic Resonance Imaging

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  • (PMID = 11349880.001).
  • [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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11. Hilden JM, Meerbaum S, Burger P, Finlay J, Janss A, Scheithauer BW, Walter AW, Rorke LB, Biegel JA: Central nervous system atypical teratoid/rhabdoid tumor: results of therapy in children enrolled in a registry. J Clin Oncol; 2004 Jul 15;22(14):2877-84
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Central nervous system atypical teratoid/rhabdoid tumor: results of therapy in children enrolled in a registry.
  • PURPOSE: Atypical teratoid/rhabdoid tumor (AT/RT) of the CNS is an extremely rare and aggressive tumor of early childhood.
  • The poor outcome with conventional infant brain tumor therapy has resulted in a lack of clear treatment guidelines.
  • A registry has been established to create an outcomes database and to facilitate biology studies for this tumor.
  • Nine patients (21%) had disseminated disease at diagnosis.
  • Sixteen tumors were infratentorial; 26 were supratentorial.
  • Primary therapy included chemotherapy in all patients, radiotherapy in 13 patients (31%), stem-cell rescue in 13 patients (31%), and intrathecal chemotherapy in 16 patients (38%).
  • Recurrent or progressive disease was reported in nine and 19 patients, respectively.
  • Twenty-seven patients (64%) are dead of disease (3 to 62 months from diagnosis) and one patient died of toxicity.
  • Fourteen patients (33%) show no evidence of disease (9.5 to 96 months from diagnosis).
  • CONCLUSION: Aggressive therapy has prolonged the natural history in a subset of children.
  • [MeSH-major] Central Nervous System Neoplasms / therapy. Registries. Rhabdoid Tumor / therapy. Teratoma / therapy
  • [MeSH-minor] Child. Child, Preschool. Combined Modality Therapy. Female. Humans. Infant. Male. Survival Analysis. Treatment Outcome

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  • (PMID = 15254056.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA 46274
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
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12. Viano JC, Herrera EJ, Suárez JC: Cerebellar astrocytomas: a 24-year experience. Childs Nerv Syst; 2001 Oct;17(10):607-10; discussion 611
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • INTRODUCTION: Cerebellar astrocytomas are the most benign tumors of the CNS.
  • METHODS AND RESULTS: We report on 38 children under 18 who had cerebellar astrocytoma in the posterior fossa and were treated by a multidisciplinary team in our Neurosurgical Department from January 1974 to December 1997.
  • Neither radiotherapy nor chemotherapy was indicated in patients with pilocytic or fibrillary astrocytomas.
  • These tumors were more frequently located in the right cerebellar hemisphere; increased intracranial pressure syndrome was the most frequent form of clinical presentation.
  • Total tumor resection was obtained in 29 (83%) cases and subtotal resection in 9 (17%).
  • In 6 (16%) cases, ventriculoperitoneal shunts were placed to control persistent hydrocephalus after tumor excision.
  • [MeSH-major] Astrocytoma. Cerebellar Neoplasms. Cerebellum / pathology. Neurosurgical Procedures
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Diagnosis, Differential. Female. Humans. Infant. Male. Prevalence. Retrospective Studies. Sex Distribution. Survival Analysis. Treatment Outcome

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  • (PMID = 11685523.001).
  • [ISSN] 0256-7040
  • [Journal-full-title] Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
  • [ISO-abbreviation] Childs Nerv Syst
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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13. Shankar A, Chacko G, Chacko AG: Intratumoral abscess: an unusual complication of ventriculoperitoneal shunt infection. Childs Nerv Syst; 2004 Mar;20(3):204-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • INTRODUCTION: Ventriculoperitoneal shunts were routinely used in the past in children with posterior fossa tumors and hydrocephalus.
  • CASE REPORT: This report highlights a previously unencountered phenomenon of a pyogenic abscess forming within a posterior fossa ependymoma as a result of shunt infection.
  • Only a partial excision of the tumor was possible, as the inflammatory response caused by the abscess had obliterated tissue planes.
  • [MeSH-major] Brain Abscess / diagnosis. Cerebellar Neoplasms / diagnosis. Ependymoma / diagnosis. Gram-Negative Bacterial Infections / diagnosis. Hydrocephalus / surgery. Postoperative Complications / diagnosis. Prosthesis-Related Infections / diagnosis. Skull Base Neoplasms / diagnosis. Ventriculoperitoneal Shunt / adverse effects
  • [MeSH-minor] Amikacin / therapeutic use. Cefotaxime / therapeutic use. Child, Preschool. Combined Modality Therapy. Cranial Fossa, Posterior / pathology. Cranial Fossa, Posterior / surgery. Cranial Irradiation. Drug Therapy, Combination / therapeutic use. Humans. Male. Neoplasm, Residual / diagnosis. Neoplasm, Residual / radiotherapy. Radiotherapy, Adjuvant

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  • (PMID = 14747956.001).
  • [ISSN] 0256-7040
  • [Journal-full-title] Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
  • [ISO-abbreviation] Childs Nerv Syst
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 84319SGC3C / Amikacin; N2GI8B1GK7 / Cefotaxime
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14. Szathmari A, Thiesse P, Galand-desmé S, Mottolese C, Bret P, Jouanneau E, Guyotat J, Lion-François L, Frappaz D: Correlation between pre- or postoperative MRI findings and cerebellar sequelae in patients with medulloblastomas. Pediatr Blood Cancer; 2010 Dec 15;55(7):1310-6
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  • We investigated whether pre-operative and delayed post-operative MRI may correlate with such sequelae.
  • MATERIAL AND METHODS: The data of 31 patients in continuous complete remission after removal of medulloblastoma, irradiation and chemotherapy, were retrospectively reviewed.
  • Magnetic Resonance Imaging (MRI) was analyzed for the following items: preoperative MRI (ratio of the surface of the tumor/posterior fossa, presence of ventricular dilatation or tonsilar hernia, involvement of the dentate nucleus) and delayed post-operative MRI (amount of cerebellar parenchyma removed, degree of cerebellar atrophy, presence of T1 hypointense regions in remaining cerebellar area and removal of region containing dentate nucleus).
  • RESULTS: On preoperative MRI, the ratio of the surface of the tumor/posterior fossa and the presence of tonsilar hernia were significantly correlated with long-term sequelae on speech (respectively P = 0.027 and P = 0.05).
  • Hypointense T1 territory in remaining cerebellar parenchyma significantly correlated with immediate post-operative cerebellar syndrome (P = 0.01) and showed a tendency for post-operative mutism (P = 0.087) but was not correlated with any long-term sequelae.
  • [MeSH-major] Cerebellar Neoplasms / surgery. Magnetic Resonance Imaging. Medulloblastoma / surgery. Postoperative Complications
  • [MeSH-minor] Adolescent. Adult. Atrophy. Cerebellum / pathology. Child. Child, Preschool. Combined Modality Therapy. Female. Humans. Infant. Intracranial Hypertension / etiology. Intracranial Hypertension / pathology. Male. Young Adult

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  • (PMID = 20981689.001).
  • [ISSN] 1545-5017
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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15. Sandberg DI, Crandall KM, Petito CK, Padgett KR, Landrum J, Babino D, He D, Solano J, Gonzalez-Brito M, Kuluz JW: Chemotherapy administration directly into the fourth ventricle in a new piglet model. Laboratory Investigation. J Neurosurg Pediatr; 2008 May;1(5):373-80
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  • [Title] Chemotherapy administration directly into the fourth ventricle in a new piglet model. Laboratory Investigation.
  • OBJECT: The authors hypothesized that chemotherapy infusions directly into the fourth ventricle may potentially play a role in treating malignant posterior fossa tumors.
  • METHODS: A closed-tip silicone lumbar drain catheter was inserted into the fourth ventricle via a posterior fossa craniectomy and 5 daily infusions of etoposide (0.5 mg in 5 animals) or normal saline (in 2 animals) were instilled.

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  • (PMID = 18447671.001).
  • [ISSN] 1933-0707
  • [Journal-full-title] Journal of neurosurgery. Pediatrics
  • [ISO-abbreviation] J Neurosurg Pediatr
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 6PLQ3CP4P3 / Etoposide
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16. 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.
  • The posterior fossa was not the most common site of recurrence, and delayed recurrence was not rare.
  • 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-major] Cerebellar Neoplasms / mortality. Medulloblastoma / mortality
  • [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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17. Gurol ME, St Louis EK: Treatment of cerebellar masses. Curr Treat Options Neurol; 2008 Mar;10(2):138-50
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  • [Title] Treatment of cerebellar masses.
  • Untreated lesions can be fatal in a few hours, but prompt and appropriate treatment of the mass effect can produce very good outcomes.
  • Medical measures to decrease brain edema should be taken, including elevation of the head of the bed and avoidance of hypo-osmolar solutions, hypercarbia, or hyperthermia.
  • However, medical measures should not delay surgical intervention, which should proceed as rapidly as possible when indicated.
  • Regardless of lesion size, neurologic deterioration and radiologic signs of obstructive hydrocephalus should call for emergency decompressive surgery with resection of hematoma or necrotic brain tissue.
  • Ventriculostomy should be considered as a bridge to surgical decompression, given the theoretical concern of upward herniation mediated by supratentorial drainage in the face of an underlying posterior fossa mass lesion.
  • Steroids are not indicated for cerebrovascular disease but should be used to treat vasogenic edema induced by tumor.
  • Specific treatments targeting the underlying pathology should be used aggressively: thrombolysis and endovascular interventions for eligible stroke patients, antibiotic therapy for abscesses, and radiotherapy, chemotherapy, or both for tumors.

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  • (PMID = 18334136.001).
  • [ISSN] 1092-8480
  • [Journal-full-title] Current treatment options in neurology
  • [ISO-abbreviation] Curr Treat Options Neurol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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18. Schoch B, Konczak J, Dimitrova A, Gizewski ER, Wieland R, Timmann D: Impact of surgery and adjuvant therapy on balance function in children and adolescents with cerebellar tumors. Neuropediatrics; 2006 Dec;37(6):350-8
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  • [Title] Impact of surgery and adjuvant therapy on balance function in children and adolescents with cerebellar tumors.
  • OBJECTIVES: This study examined the effects of posterior fossa tumor surgery and concomitant irradiation and/or chemotherapy on the long-term recovery of balance function in children and adolescent patients.
  • SUBJECTS AND METHODS: 22 patients, treated during childhood for a benign (n = 14) or malignant cerebellar tumor (n = 8), were examined in chronic state (mean latency between surgery and testing: 7.7 years, range 3 - 17 years).
  • RESULTS: Comparing the balance function of (i) children with or without affected cerebellar nuclei and (ii) children with and without adjuvant chemotherapy and/or radiotherapy revealed that damage to the cerebellar nuclei had more impact on neurological impairment than concomitant tumor therapy.
  • Chemotherapy with its neurological side effect was associated with enhanced postural sway in only two children with malignant tumors.
  • CONCLUSIONS: The study results indicate that the sparing of the deep cerebellar nuclei had the greatest impact on the recovery of balance function in pediatric patients treated for both a benign or malignant cerebellar tumor.
  • [MeSH-major] Cerebellar Neoplasms / surgery. Postural Balance
  • [MeSH-minor] Adolescent. Cerebellar Nuclei / drug effects. Cerebellar Nuclei / pathology. Cerebellar Nuclei / radiation effects. Cerebellar Nuclei / surgery. Cerebellum / drug effects. Cerebellum / radiation effects. Cerebellum / surgery. Chemotherapy, Adjuvant. Child. Child, Preschool. Combined Modality Therapy. Cranial Irradiation. Female. Follow-Up Studies. Humans. Image Processing, Computer-Assisted. Infant. Magnetic Resonance Imaging. Male. Neurologic Examination / drug effects. Postoperative Complications / diagnosis. Postoperative Complications / pathology. Radiotherapy, Adjuvant

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  • (PMID = 17357037.001).
  • [ISSN] 0174-304X
  • [Journal-full-title] Neuropediatrics
  • [ISO-abbreviation] Neuropediatrics
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
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19. Mazzola CA, Pollack IF: Medulloblastoma. Curr Treat Options Neurol; 2003 May;5(3):189-198
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  • Medulloblastomas, primitive neuroectodermal tumors of the cerebellum, comprise 20% of all pediatric brain tumors and are the most common solid neoplasm in children.
  • Primitive neuroectodermal tumors are believed to arise from cerebellar granule cell precursors.
  • The protein products of these genes function within the sonic hedgehog molecular signaling pathways, which are important in neural development and disease.
  • Age younger than 3 years, bulky residual disease postoperatively, and metastasis constitute adverse prognostic features and indicate patients who are considered "high risk" for recurrence with standard therapy using 3600 cGy craniospinal radiation in conjunction with a posterior fossa dose of 5400 cGy.
  • Chemotherapeutic trials have been developed to assess the safety and efficacy of various multi-agent therapies to improve the poor results of high-risk patients and to allow reduction in the dose of radiation needed to cure standard-risk patients, which may allow a decrease in late cognitive sequelae.
  • Currently, it is policy to evaluate all children with posterior fossa tumors characteristic of medulloblastoma with preoperative, staging neuroimaging studies of the craniospinal axis.
  • Postoperative neuroimaging studies are compared with preoperative studies to determine the amount of residual disease.
  • Children with tumor histopathology consistent with medulloblastoma are enrolled, when possible, in open clinical trials.
  • Chemotherapy and radiation are given as per protocol.
  • The goal of current treatment approaches is to tailor therapy based on clinical risk factors, with intensification of treatment for children with high-risk disease and reduction of radiation therapy for those with standard-risk disease.
  • Evaluation of biologic predictors of outcome, which may further refine treatment stratification, is in progress.

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  • (PMID = 12670407.001).
  • [ISSN] 1092-8480
  • [Journal-full-title] Current treatment options in neurology
  • [ISO-abbreviation] Curr Treat Options Neurol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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20. Spatola C, Privitera G: Recurrent intracranial hemangiopericytoma with extracranial and unusual multiple metastases: case report and review of the literature. Tumori; 2004 Mar-Apr;90(2):265-8
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  • Hemangiopericytoma is a rare tumor with uncommon location in the central nervous system.
  • It has only recently been included (WHO classification 1993) in a specific group of CNS tumors and subsequently (WHO classification 1997 and 2000) as a group by itself, while before it was confused with meningeal tumors.
  • We report on a case of a 48-year-old woman affected by this tumor.
  • The neoplasm was located in the posterior fossa.
  • The patient underwent primary surgery in 1990, not followed by any adjuvant therapy because of the histopathological diagnosis of meningioma.
  • After being free from disease for eight years she developed a local recurrence in 1998.
  • Subtotal excision of the tumor, which was finally identified as a hemangiopericytoma, was carried out, followed by adjuvant radiotherapy (64 Gy).
  • A radical metastasectomy was performed, followed by systemic chemotherapy.
  • One year later (2001) the tumor recurred again intracranially and a metastases was detected in the right breast, so the patient again underwent cranial irradiation (40 Gy) and second-line chemotherapy.
  • We may conclude that, despite the tumor's natural tendency to recur several times and the ability of intracranial hemangiopericytoma to spread outside the CNS, it is possible to ensure a long survival time.
  • [MeSH-major] Brain Neoplasms / pathology. Hemangiopericytoma / secondary. Hemangiopericytoma / therapy. Neoplasm Recurrence, Local
  • [MeSH-minor] Breast Neoplasms / secondary. Breast Neoplasms / therapy. Fatal Outcome. Female. Humans. Kidney Neoplasms / secondary. Kidney Neoplasms / therapy. Liver Neoplasms / secondary. Liver Neoplasms / therapy. Magnetic Resonance Imaging. Middle Aged

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  • (PMID = 15237597.001).
  • [ISSN] 0300-8916
  • [Journal-full-title] Tumori
  • [ISO-abbreviation] Tumori
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 15
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21. Inenaga C, Toyoshima Y, Mori H, Nishiyama K, Tanaka R, Takahashi H: A fourth ventricle atypical teratoid/rhabdoid tumor in an infant. Brain Tumor Pathol; 2003;20(2):47-52
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  • [Title] A fourth ventricle atypical teratoid/rhabdoid tumor in an infant.
  • Atypical teratoid/rhabdoid tumor (AT/RT), a recently established central nervous system tumor entity, occurs in children and is more malignant than medulloblastoma/primitive neuroectodermal tumors (PNET).
  • We report here a case of AT/RT in a male infant who was 9 months old at the time of diagnosis.
  • Magnetic resonance imaging revealed that the tumor occupied the fourth ventricle, and at surgery it was found to adhere to the floor of the fourth ventricle.
  • After subtotal removal of the tumor mass, chemotherapy and radiotherapy were performed, but the patient died about 8 months after the diagnosis following rapid regrowth of the residual tumor.
  • Light-microscopically, the tumor was composed mainly of nests of rhabdoid cells with fields of PNET.
  • Although it is well known that AT/RT often arises in the posterior fossa, detailed reports of cases affecting the fourth ventricle are rare.
  • In this case, the ultrastructural relationship between rhabdoid cells and the basal lamina, which has not so far been described in AT/RT, was of great interest when the nature of the rhabdoid cells was considered.
  • [MeSH-major] Brain Neoplasms / pathology. Fourth Ventricle / pathology. Rhabdoid Tumor / pathology

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  • (PMID = 14756440.001).
  • [ISSN] 1433-7398
  • [Journal-full-title] Brain tumor pathology
  • [ISO-abbreviation] Brain Tumor Pathol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
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22. Pascual Castroviejo I, Pascual Pascual S, Velázquez Fragua R, Viaño J, Garcia Segura JM: [Brain stem tumors associated with neurofibromatosis type 1. Presentation of 20 infantile patients]. Neurologia; 2007 Dec;22(10):846-52
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  • [Title] [Brain stem tumors associated with neurofibromatosis type 1. Presentation of 20 infantile patients].
  • [Transliterated title] Tumores de tronco cerebral asociados con neurofibromatosis tipo 1. Presentación de 20 pacientes infantiles.
  • OBJECTIVE: To describe the clinical and imaging findings of 20 patients (12 women and 8 men) with brain stem tumors associated with neurofibromatosis type 1 (NF1).
  • PATIENTS AND METHODS: All patients were first time studied before 11 years old.
  • Thirteen of the 20 patients (65 %) also had optic pathway tumor.
  • Brain stem tumor identification occurred at the same time as NF1 in the patients who were studied by MR at the time of the first consult.
  • RESULTS: Brain stem identification occurred at the same time as that of the NF1 in patients who were studied by MR from the beginning.
  • Diffuse or localized medullary enlargement was the most frequent MR imaging and appeared in 13 patients (65%), followed by the tumor that involved all brain stem (pontine and medullary areas) that appeared in 6 patients (30 %).
  • In the last group, one tumor showed extension through brain stem and medial cerebellar parts, another was located in the aqueduct and in the periaqueductal areas and showed slow progressive growth, and one third patient had a tumor with aggressive signs in the SMR study.
  • Another patient had an aggressive tumor that involved the left optic nerve, chiasm, mesencephalon and upper right pontine areas.
  • The histological study of the tumoral biopsic tissue of the two last patients showed astrocitoma degree 1 (benign tumor).
  • The two aggressive tumors were treated with radiotheraphy and chemotherapy and they are still alive 4 and 7 years respectively after treatment.
  • The rest of patients did not receive treatment.
  • Only one of the 20 patients died, although it was due to a malignant chiasmatic tumor, that had been treated twenty years before, and not by the brain stem tumor.
  • CONCLUSIONS: In NF1, brain stem tumors are the most frequent tumors of the posterior fossa and the second most frequent of the central nervous system (CNS).
  • MR and SMR are necessary to a correct identification of the tumor in some patients.
  • Most of these tumors are benign.
  • [MeSH-major] Brain Neoplasms / complications. Brain Neoplasms / diagnosis. Brain Stem. Magnetic Resonance Imaging. Magnetic Resonance Spectroscopy. Neurofibromatosis 1 / complications


23. Sainte-Rose C, Cinalli G, Roux FE, Maixner R, Chumas PD, Mansour M, Carpentier A, Bourgeois M, Zerah M, Pierre-Kahn A, Renier D: Management of hydrocephalus in pediatric patients with posterior fossa tumors: the role of endoscopic third ventriculostomy. J Neurosurg; 2001 Nov;95(5):791-7
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  • [Title] Management of hydrocephalus in pediatric patients with posterior fossa tumors: the role of endoscopic third ventriculostomy.
  • OBJECT: The authors undertook a study to evaluate the effectiveness of endoscopic third ventriculostomy in the management of hydrocephalus before and after surgical intervention for posterior fossa tumors in children.
  • METHODS: Between October 1, 1993, and December 31, 1997, a total of 206 consecutive children with posterior fossa tumors underwent surgery at Hĵpital Necker-Enfants Malades in Paris.
  • The medical records and neuroimaging studies of the remaining 196 patients were reviewed and categorized into three groups: Group A, 67 patients with hydrocephalus present on admission in whom endoscopic third ventriculostomy was performed prior to tumor removal; Group B, 82 patients with hydrocephalus who did not undergo preliminary third ventriculostomy but instead received conventional treatment; and Group C, 47 patients in whom no ventricular dilation was present on admission.
  • There were no significant differences between patients in Group A or B with respect to the following variables: age at presentation, evidence of metastatic disease, extent of tumor resection, or follow-up duration.
  • Ultimately, there were only four patients (6%) in Group A compared with 22 patients (26.8%) in Group B (p = 0.001) in whom progressive hydrocephalus required treatment following removal of the posterior fossa tumor.
  • The other six patients (7.3%) were treated by endoscopic third ventriculostomy after tumor resection.
  • In three patients who required placement of CSF shunts several episodes of shunt malfunction occurred that were ultimately managed by endoscopic third ventriculostomy and definitive removal of the shunt.
  • CONCLUSIONS: Third ventriculostomy is feasible even in the presence of posterior fossa tumors (including brainstem tumors).
  • When performed prior to posterior fossa surgery, it significantly reduces the incidence of postoperative hydrocephalus.
  • The procedure provides a valid alternative to placement of a permanent shunt in cases in which hydrocephalus develops following posterior fossa surgery, and it may negate the need for the shunt in cases in which the shunt malfunctions.
  • Furthermore, in patients in whom CSF has caused spread of the tumor at presentation, third ventriculostomy allows chemotherapy to be undertaken prior to tumor excision by controlling hydrocephalus.
  • Although the authors acknowledge that the routine application of third ventriculostomy in selected patients results in a proportion of patients undergoing an "unnecessary" procedure, they believe that because patients' postoperative courses are less complicated and because the incidence of morbidity is low and the success rate is high in those patients with severe hydrocephalus that further investigation of this protocol is warranted.
  • [MeSH-major] Brain Neoplasms / complications. Endoscopy. Hydrocephalus / etiology. Hydrocephalus / surgery. Third Ventricle / surgery. Ventriculostomy
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Cranial Fossa, Posterior. Humans. Infant. Postoperative Complications


24. Krishnamoorthy P, Freeman C, Bernstein ML, Lawrence S, Rodd C: Osteopenia in children who have undergone posterior fossa or craniospinal irradiation for brain tumors. Arch Pediatr Adolesc Med; 2004 May;158(5):491-6
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  • [Title] Osteopenia in children who have undergone posterior fossa or craniospinal irradiation for brain tumors.
  • OBJECTIVES: To determine lumbar spine and total body bone mineral density (BMD) in pediatric patients who have undergone cranial or craniospinal irradiation for posterior fossa tumors, specifically medulloblastoma and ependymoma and to analyze the association between degree of osteopenia and factors that may affect BMD.
  • All 19 underwent craniospinal radiotherapy plus a boost to the posterior fossa (mean +/- SD of 5410 +/- 130 rad [54.1 +/- 1.3 Gy] to the posterior fossa, mean +/- SD of 3470 +/- 460 rad [34.7 +/- 4.6 Gy] to the whole brain and spinal axis), and 8 of 19 underwent chemotherapy.
  • The remaining 5 patients had ependymoma and underwent irradiation to the posterior fossa only (mean +/- SD of 5680 +/- 720 rad [56.8 +/- 7.2 Gy]).
  • Therefore, there were 3 treatment groups: craniospinal irradiation and chemotherapy, only craniospinal irradiation, and only posterior fossa irradiation.
  • Bone mineral studies were performed a mean +/- SD of 5.42 +/- 3.23 years after therapy.
  • CONCLUSIONS: Children who have undergone irradiation for posterior fossa tumors have diminished total body and lumbar spine BMD, as compared with those of the general population.
  • This reduction was similar within all 3 treatment groups, which suggests that chemotherapy did not play a major role and that localized irradiation may have systemic effects.
  • [MeSH-major] Bone Density / radiation effects. Bone Diseases, Metabolic / etiology. Ependymoma / radiotherapy. Infratentorial Neoplasms / radiotherapy. Medulloblastoma / radiotherapy

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  • (PMID = 15123484.001).
  • [ISSN] 1072-4710
  • [Journal-full-title] Archives of pediatrics & adolescent medicine
  • [ISO-abbreviation] Arch Pediatr Adolesc Med
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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25. Bozić B, Rotim K, Kogler A, Broz R, Krpina H, Cupić H, Radić J: Cerebellar glioblastoma in the elderly--case report. Acta Clin Croat; 2009 Jun;48(2):175-8
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  • Computed tomography scan revealed a posterior fossa tumor of 34 x 33 x 52 mm in size, with hydrocephalus.
  • The patient presented with posterior fossa symptoms, ataxia, nausea and vomiting.
  • When the patient's condition improved, suboccipital median craniectomy was performed and the tumor was removed.
  • Postoperative treatment included radiotherapy and temozolomide chemotherapy.
  • [MeSH-major] Cerebellar Neoplasms. Glioblastoma

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  • (PMID = 19928418.001).
  • [ISSN] 0353-9466
  • [Journal-full-title] Acta clinica Croatica
  • [ISO-abbreviation] Acta Clin Croat
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Croatia
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26. McLean TW: Medulloblastomas and central nervous system primitive neuroectodermal tumors. Curr Treat Options Oncol; 2003 Dec;4(6):499-508
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  • [Title] Medulloblastomas and central nervous system primitive neuroectodermal tumors.
  • Significant advances in the treatment of medulloblastoma and primitive neuroectodermal tumors have been made in the past three decades.
  • Maximal surgical resection is a mainstay of therapy.
  • However, unlike many other central nervous system neoplasms, medulloblastoma and primitive neuroectodermal tumors are radiation and chemotherapy responsive.
  • Despite this response, the prognosis for patients with these tumors remains variable and is relatively poor in infants and patients with metastatic disease.
  • These tumors most commonly arise in children, thus most clinical trials emphasize the reduction of long-term sequelae, in addition to improving survival.
  • If a patient is ineligible or declines consent/assent for a clinical trial, the best current treatment approach is surgical resection, followed by radiation therapy (except for children younger than 3 years) with weekly vincristine.
  • For high-risk patients, 36 Gy of craniospinal irradiation should be delivered plus a boost of 19.8 Gy to the posterior fossa/primary tumor bed and sites of bulk metastatic disease.
  • For average-risk patients, the craniospinal irradiation dose may be lowered to 23.4 Gy plus 32.4 Gy to the posterior fossa/tumor bed.
  • After radiation therapy, intensive multimodal chemotherapy should be used for all patients.
  • [MeSH-major] Central Nervous System Neoplasms / therapy. Cerebellar Neoplasms / therapy. Medulloblastoma / therapy. Neuroectodermal Tumors, Primitive / therapy
  • [MeSH-minor] Antineoplastic Agents / administration & dosage. Antineoplastic Agents / therapeutic use. Cisplatin / administration & dosage. Cisplatin / therapeutic use. Cyclophosphamide / administration & dosage. Cyclophosphamide / therapeutic use. Emergency Medical Services. Etoposide / administration & dosage. Etoposide / therapeutic use. Humans. Life Style. Lomustine / administration & dosage. Lomustine / therapeutic use. Neurosurgical Procedures. Radiotherapy. Self-Help Groups. Social Support. Spinal Puncture. Vincristine / administration & dosage. Vincristine / therapeutic use

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  • (PMID = 14585230.001).
  • [ISSN] 1527-2729
  • [Journal-full-title] Current treatment options in oncology
  • [ISO-abbreviation] Curr Treat Options Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 7BRF0Z81KG / Lomustine; 8N3DW7272P / Cyclophosphamide; Q20Q21Q62J / Cisplatin
  • [Number-of-references] 38
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27. Douglas JG, Barker JL, Ellenbogen RG, Geyer JR: Concurrent chemotherapy and reduced-dose cranial spinal irradiation followed by conformal posterior fossa tumor bed boost for average-risk medulloblastoma: efficacy and patterns of failure. Int J Radiat Oncol Biol Phys; 2004 Mar 15;58(4):1161-4
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  • [Title] Concurrent chemotherapy and reduced-dose cranial spinal irradiation followed by conformal posterior fossa tumor bed boost for average-risk medulloblastoma: efficacy and patterns of failure.
  • PURPOSE: To review the efficacy and patterns of failure in average-risk medulloblastoma patients treated with concurrent chemotherapy and reduced-dose cranial spinal irradiation and a conformal tumor bed boost.
  • METHODS AND MATERIALS: Thirty-three patients with average risk (defined as < or =1.5 cm(2) of residual tumor after resection, age >3 years, and no involvement of the cerebrospinal fluid or spine [M0]) medulloblastoma were diagnosed at our institution between January 1994 and December 2001.
  • They were enrolled in an institutional pilot protocol consisting of concurrent chemotherapy (vincristine), reduced-dose cranial spinal irradiation (2340 cGy), a conformal primary tumor bed boost (3240 cGy), followed by eight cycles of chemotherapy (vincristine, cisplatin, and lomustine or cyclophosphamide).
  • RESULTS: The 5-year estimated disease-free survival rate, as determined by Kaplan-Meier plots, was 86% (+/-12.6%, 95% confidence interval).
  • The 5-year estimated disease-free posterior fossa control and primary tumor bed control rates were both 94% (+/-8.2%, 95% confidence interval).
  • The patterns of failure included 2 patients with distant central nervous system failure only, 1 patient who developed local primary tumor bed failure, posterior fossa failure, and diffuse leptomeningeal spread simultaneously, and 1 patient with failure in the high-dose, primary tumor bed field.
  • No patient experienced isolated posterior fossa failure outside the high-dose boost region.
  • CONCLUSION: The treatment of average-risk medulloblastoma with chemotherapy, reduced-dose cranial spinal irradiation, and a conformal tumor bed boost results in survival rates and local control rates comparable to those in contemporary studies.
  • A reduction in the amount of posterior fossa treated to the high dose is possible.
  • [MeSH-major] Infratentorial Neoplasms / drug therapy. Infratentorial Neoplasms / radiotherapy. Medulloblastoma / drug therapy. Medulloblastoma / radiotherapy. Radiotherapy, Conformal
  • [MeSH-minor] Adolescent. Adult. Child. Child, Preschool. Combined Modality Therapy. Confidence Intervals. Cranial Irradiation / methods. Female. Humans. Male. Pilot Projects

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  • (PMID = 15001259.001).
  • [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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28. Keene DL, Johnston DL, Grimard L, Michaud J, Vassilyadi M, Ventureyra E: Vascular complications of cranial radiation. Childs Nerv Syst; 2006 Jun;22(6):547-55
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  • OBJECTIVES: Cerebral vascular disease has been reported as a long-term complication of cranial radiotherapy.
  • The purpose of this study was to examine the frequency and risk factors associated with development of cerebral vascular disease in children after cranial radiation.
  • MATERIALS AND METHODS: A retrospective chart review of all cancer patients treated between 1985 and 2003 who were under the age of 18 years at the time of initial radiotherapy was performed.
  • Variables examined include diagnosis and site of malignancy, age at the time of radiotherapy, sex, total radiation dosage, number of fractions, duration, and whether the patient had proven cerebral vascular event.
  • One hundred and 13 cases involved tumors of the central nervous system.
  • The remaining patients had systemic neoplastic disease.
  • Post radiation cerebral vascular disease occurred in 11 (5%) patients, and all but one patient had a tumor involving the central nervous system (mainly in the posterior fossa and supratentorial midline).
  • CONCLUSION: There is an increased risk of cerebral vascular disease after radiation therapy in childhood, especially in children who received high dose radiation at the posterior fossa and supratentorial axial region.
  • [MeSH-major] Brain Neoplasms / radiotherapy. Cranial Irradiation / adverse effects. Drug-Related Side Effects and Adverse Reactions. Vascular Diseases / etiology


29. Maksoud YA, Hahn YS, Engelhard HH: Intracranial ependymoma. Neurosurg Focus; 2002 Sep 15;13(3):e4
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  • In this paper, the authors compiled a review of the pathological features, imaging characteristics, and treatment strategies related to this brain tumor.
  • The bibliographies of papers obtained were also checked for articles and chapters that could provide additional understanding of this tumor.
  • CONCLUSIONS: The posterior fossa is the most frequent site for an intracranial ependymoma.
  • Most authors recommend resecting as much of the tumor as is safely possible.
  • Microscopically, ependymal tumors show both epithelial and glial features.
  • Because ependymomas often recur despite surgical intervention, radiotherapy and/or radiosurgery may also play an important role in their treatment.
  • The use of chemotherapy in the treatment of these tumors, especially in the very young, is still being studied.
  • [MeSH-major] Brain Neoplasms / pathology. Brain Neoplasms / surgery. Ependymoma / pathology. Ependymoma / surgery

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  • (PMID = 15844876.001).
  • [ISSN] 1092-0684
  • [Journal-full-title] Neurosurgical focus
  • [ISO-abbreviation] Neurosurg Focus
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 31
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30. Ziewacz JE, Song JW, Blaivas M, Yang LJ: Radiation-induced meningeal osteosarcoma of tentorium cerebelli with intradural spinal metastases. Surg Neurol Int; 2010;1:14
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  • BACKGROUND: Primary meningeal osteosarcomas and radiation-induced extraosseous tumors are extremely rare.
  • CT and MRI studies revealed an extra-axial, dural-based mass in the posterior fossa arising from the tentorium cerebelli.
  • The patient underwent complete resection of the tumor with adjuvant chemotherapy.
  • Tumor recurrence was observed 9 months after initial diagnosis, and adjuvant radiation therapy was administered.
  • The intracranial disease stabilized; however, multiple cervico-thoracic spinal metastases were discovered 15 months after initial diagnosis.
  • CONCLUSION: Meningeal osteosarcomas are rare lesions that can metastasize and should be considered in the differential diagnosis for dural-based lesions, especially in the case of previous radiation therapy.

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  • (PMID = 20657695.001).
  • [ISSN] 2152-7806
  • [Journal-full-title] Surgical neurology international
  • [ISO-abbreviation] Surg Neurol Int
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] India
  • [Other-IDs] NLM/ PMC2908355
  • [Keywords] NOTNLM ; Meninges osteosarcoma / Radiation therapy / Spinal metastasis / Tentorium cerebelli
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31. Karami KJ, Poulik J, Rabah R, Krass J, Sood S: Simultaneous choroid plexus carcinoma and pilocytic astrocytoma in a pediatric patient. J Neurosurg Pediatr; 2010 Jan;5(1):104-12
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  • Simultaneous primary brain tumors in pediatric patients without prior chemotherapy or radiotherapy, phacomatosis, or known familial history are a rare occurrence.
  • Magnetic resonance imaging studies revealed diffuse heterogeneously enhancing left intraventricular and posterior fossa tumors initially believed most consistent with multicentric choroid plexus carcinomas.
  • A multiple staged resection was carried out for each tumor and gross-total resection was achieved.
  • Upon gross inspection intraoperatively as well as postoperative histological analysis, 2 distinct simultaneous tumors were identified: choroid plexus carcinoma and pilocytic astrocytoma.
  • To the authors' knowledge this is the first case report published identifying 2 distinct tumor types with similar radiological appearances in a pediatric patient with no prior history of radiotherapy, chemotherapy, or phacomatosis.
  • [MeSH-major] Astrocytoma / diagnosis. Astrocytoma / surgery. Cerebral Ventricle Neoplasms / diagnosis. Cerebral Ventricle Neoplasms / surgery. Choroid Plexus Neoplasms / diagnosis. Choroid Plexus Neoplasms / surgery. Fourth Ventricle / surgery. Lateral Ventricles / surgery. Magnetic Resonance Imaging. Neoplasms, Multiple Primary / diagnosis. Neoplasms, Multiple Primary / surgery. Neuronavigation. Thalamus / surgery. Tomography, X-Ray Computed


32. Tekautz TM, Fuller CE, Blaney S, Fouladi M, Broniscer A, Merchant TE, Krasin M, Dalton J, Hale G, Kun LE, Wallace D, Gilbertson RJ, Gajjar A: Atypical teratoid/rhabdoid tumors (ATRT): improved survival in children 3 years of age and older with radiation therapy and high-dose alkylator-based chemotherapy. J Clin Oncol; 2005 Mar 1;23(7):1491-9
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  • [Title] Atypical teratoid/rhabdoid tumors (ATRT): improved survival in children 3 years of age and older with radiation therapy and high-dose alkylator-based chemotherapy.
  • PURPOSE: To describe clinical features, therapeutic approaches, and prognostic factors in pediatric patients with atypical teratoid/rhabdoid tumors (ATRT) treated at St Jude Children's Research Hospital (SJCRH).
  • PATIENTS AND METHODS: Primary tumor samples from patients diagnosed with ATRT at SJCRH between July 1984 and June 2003 were identified.
  • Posterior fossa primary lesions and metastatic disease at diagnosis were more common in younger patients with ATRT.
  • All patients underwent surgical resection; 30 received subsequent chemotherapy.
  • Three of four patients 3 years or older with progressive disease were successfully rescued with ifosfamide, carboplatin, and etoposide therapy.
  • ATRT presenting in older patients can be cured using a combination of radiation and high-dose alkylating therapy.
  • Older patients with relapsed ATRT can have salvage treatment using ICE chemotherapy.
  • [MeSH-major] Central Nervous System Neoplasms / therapy. Neoplasms, Germ Cell and Embryonal / therapy. Rhabdoid Tumor / therapy. Teratoma / therapy
  • [MeSH-minor] Child, Preschool. Combined Modality Therapy. Humans. Immunohistochemistry. In Situ Hybridization, Fluorescence. Infant. Prognosis. Survival Rate. Transcription Factors / analysis

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  • (PMID = 15735125.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA 21765
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / SMARCC1 protein, human; 0 / Transcription Factors
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33. Carvi Y Nievas MN, Hoellerhage HG, Drahten C: White matter tract alterations assessed with diffusion tensor imaging and tractography in patients with solid posterior fossa tumors. Neurol India; 2010 Nov-Dec;58(6):914-21
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  • [Title] White matter tract alterations assessed with diffusion tensor imaging and tractography in patients with solid posterior fossa tumors.
  • BACKGROUND: This study assesses the tract alterations observed before and after resection of solid posterior fossa tumors (PFTs) using diffusion tensor imaging (DTI) and white matter tractography (WMT).
  • MATERIALS AND METHODS: Pre- and post-surgical DTI and WMT data were acquired in eight patients undergoing surgical resections of PFT.
  • RESULTS: In eight tumors (metastases (4), neurinomas (2) and meningiomas (2), the preoperative WMT revealed different tract alterations, including deviation (all cases), deformation (7 cases), thinning (8 cases) and apparent tract interruption (4 cases).
  • After tumor resection, the compromised white matter tracts showed a resolution (3 cases) or reduction (5 cases) of the deviation.
  • At this time (5 weeks post-surgery), several neurological functions had improved to different levels.
  • [MeSH-major] Brain Neoplasms / pathology. Diffusion Magnetic Resonance Imaging / methods. Infratentorial Neoplasms / pathology. Nerve Fibers, Myelinated / pathology. Pyramidal Tracts / pathology
  • [MeSH-minor] Adult. Aged. Brain Mapping. Female. Humans. Image Processing, Computer-Assisted / methods. Male. Middle Aged. Neurosurgery / methods. Treatment Outcome

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  • (PMID = 21150059.001).
  • [ISSN] 0028-3886
  • [Journal-full-title] Neurology India
  • [ISO-abbreviation] Neurol India
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] India
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34. Sandberg DI, Solano J, Petito CK, Mian A, Mou C, Koru-Sengul T, Gonzalez-Brito M, Padgett KR, Luqman A, Buitrago JC, Alam F, Wilkerson JR, Crandall KM, Kuluz JW: Safety and pharmacokinetic analysis of methotrexate administered directly into the fourth ventricle in a piglet model. J Neurooncol; 2010 Dec;100(3):397-406
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  • We have developed a piglet model to assess chemotherapy administration directly into the fourth ventricle as a potential treatment for medulloblastoma and other malignant posterior fossa tumors.
  • Safety was assessed by neurological examination, 4.7 T MRI, and post-mortem pathological analysis.
  • MTX levels in serum and cerebrospinal fluid (CSF) were measured, and area under the concentration-time curve (AUC) was calculated for CSF samples.
  • Statistically significant differences between fourth ventricle and lumbar AUC were detected at peaks (P = 0.01) and at all collection time points (P = 0.01) but not at troughs (P = 0.36).
  • [MeSH-major] Enzyme Inhibitors / administration & dosage. Enzyme Inhibitors / pharmacokinetics. Fourth Ventricle / drug effects. Methotrexate / administration & dosage. Methotrexate / pharmacokinetics
  • [MeSH-minor] Animals. Area Under Curve. Cell Count / methods. Magnetic Resonance Imaging / methods. Models, Animal. Swine. Time Factors

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  • (PMID = 20440538.001).
  • [ISSN] 1573-7373
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Enzyme Inhibitors; YL5FZ2Y5U1 / Methotrexate
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35. Wolfe-Christensen C, Mullins LL, Scott JG, McNall-Knapp RY: Persistent psychosocial problems in children who develop posterior fossa syndrome after medulloblastoma resection. Pediatr Blood Cancer; 2007 Oct 15;49(5):723-6
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  • [Title] Persistent psychosocial problems in children who develop posterior fossa syndrome after medulloblastoma resection.
  • PURPOSE: Posterior fossa syndrome (PFS) occurs in approximately 20% of patients after resection of a tumor from the posterior fossa.
  • We assessed whether the development of PFS is associated with increased risk for emotional, behavioral, and social problems after the cessation of cancer treatment.
  • All participants were survivors of childhood medulloblastoma and had been treated with surgical resection of the tumor, craniospinal radiation, +/- chemotherapy, and had comprehensive neuropsychological evaluations 1-2 years post-treatment.
  • RESULTS: Children who developed PFS were significantly more likely to exhibit obsessive-compulsive type (i.e., perfectionistic) behaviors, withdrawal behaviors, social problems, and internalizing problems (all P < 0.05) than those who did not develop PFS.
  • Additionally, children with PFS were more likely to evidence anxious-shy behaviors, attention problems, and somatic complaints, although these differences were not statistically significant.
  • CONCLUSION: Results from the current preliminary study suggest that PFS may place children at increased risk for emotional, behavioral, and social problems long after completion of their cancer treatment.
  • [MeSH-major] Brain Neoplasms / complications. Child Behavior Disorders / etiology. Medulloblastoma / surgery
  • [MeSH-minor] Adolescent. Child. Combined Modality Therapy. Data Collection. Humans. Postoperative Complications / psychology. Retrospective Studies. Survivors


36. Berrebi D, Lebras MN, Belarbi N, Couturier J, Fattet S, Faye A, Peuchmaur M, de Lagausie P: Bilateral adrenal neuroblastoma and nephroblastoma occurring synchronously in a child with Fanconi's anemia and VACTERL syndrome. J Pediatr Surg; 2006 Jan;41(1):e11-4
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  • The association between FA and solid pediatric tumors is extremely rare.
  • The authors report a rare case of VACTERL syndrome associated with FA and multiple solid pediatric tumors occurring in a very young girl.
  • At age of 11 months, she developed simultaneously a renal tumor in a horseshoe kidney and bilateral adrenal tumors.
  • We also evaluated the c-kit expression in these tumors to propose a therapeutic alternative to chemotherapy by oral agent STI-571 (Gleevec; Novartis, East Hanover, NJ).
  • Strong cytoplasmic immunostaining of c-kit was found in both tumors.
  • Unfortunately, she quickly developed a posterior cerebellar fossa tumor and died 1 month later.
  • This clinical situation is very rare but suggests that young patients with FA and solid pediatric tumors may belong to a particular subgroup of FA.
  • Further studies are necessary to test if STI-571 treatment could be efficient in such patients with pediatric tumors.
  • [MeSH-major] Adrenal Gland Neoplasms / pathology. Fanconi Anemia / complications. Kidney Neoplasms / pathology. Neuroblastoma / pathology. Wilms Tumor / pathology


37. Massimino M, Gandola L, Giangaspero F, Sandri A, Valagussa P, Perilongo G, Garrè ML, Ricardi U, Forni M, Genitori L, Scarzello G, Spreafico F, Barra S, Mascarin M, Pollo B, Gardiman M, Cama A, Navarria P, Brisigotti M, Collini P, Balter R, Fidani P, Stefanelli M, Burnelli R, Potepan P, Podda M, Sotti G, Madon E, AIEOP Pediatric Neuro-Oncology Group: Hyperfractionated radiotherapy and chemotherapy for childhood ependymoma: final results of the first prospective AIEOP (Associazione Italiana di Ematologia-Oncologia Pediatrica) study. Int J Radiat Oncol Biol Phys; 2004 Apr 1;58(5):1336-45
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  • [Title] Hyperfractionated radiotherapy and chemotherapy for childhood ependymoma: final results of the first prospective AIEOP (Associazione Italiana di Ematologia-Oncologia Pediatrica) study.
  • (1) focal hyperfractionated radiotherapy (HFRT) if with no evidence of disease (NED), or (2) 4 courses with VEC followed by HFRT for residual disease (ED).
  • HFRT dose was 70.4 Gy (1.1 Gy/fraction b.i.d.
  • RESULTS: Sixty-three consecutive children were enrolled: 46 NED, 17 ED; the tumor was infratentorial in 47 and supratentorial in 16, with spinal metastasis in 1.
  • Of NED patients, 35 of 46 have been treated with HFRT; 8 received conventionally fractionated radiotherapy, and 3 received no treatment.
  • Of the 17 ED patients, 9 received VEC + HFRT; violations due to postsurgical morbidity were as follows: HFRT only (2), conventionally fractionated radiotherapy (3) + VEC (2), and no therapy (1).
  • CONCLUSIONS: HFRT, despite the high total dose adopted, did not change the prognosis of childhood ependymoma as compared to historical series: New radiotherapeutic approaches are needed to improve local control.
  • Future ependymoma strategies should consider grading when stratifying treatment indications.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms / drug therapy. Brain Neoplasms / radiotherapy. Ependymoma / drug therapy. Ependymoma / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Chemotherapy, Adjuvant. Child. Child, Preschool. Cyclophosphamide / administration & dosage. Dose Fractionation. Etoposide / administration & dosage. Feasibility Studies. Humans. Infratentorial Neoplasms / drug therapy. Infratentorial Neoplasms / radiotherapy. Infratentorial Neoplasms / surgery. Patient Compliance. Prospective Studies. Radiotherapy, Adjuvant. Supratentorial Neoplasms / drug therapy. Supratentorial Neoplasms / radiotherapy. Supratentorial Neoplasms / surgery. Survival Analysis. Vincristine / administration & dosage

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  • (PMID = 15050308.001).
  • [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; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 8N3DW7272P / Cyclophosphamide
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38. Boguszewicz L, Blamek S, Sokół M: Pattern recognition methods in (1)H MRS monitoring in vivo of normal appearing cerebellar tissue after treatment of posterior fossa tumors. Acta Neurochir Suppl; 2010;106:171-5
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  • [Title] Pattern recognition methods in (1)H MRS monitoring in vivo of normal appearing cerebellar tissue after treatment of posterior fossa tumors.
  • The objective of this study was to investigate the metabolic responses of normal appearing cerebellar tissue after posterior fossa tumor treatment, and to identify characteristics of the particular treatment method.
  • Moreover, this work examined the metabolic alterations of normal appearing tissue induced by a particular tumor state including resection, stagnation, progression, and recurrence.
  • The studied group consisted of 29 patients treated for posterior fossa tumors.
  • All of them were irradiated with a total dose of 54 Gy at 1.8 Gy/fraction (median values).
  • In addition, 13 underwent chemotherapy, 25 underwent total tumor resection, 18 were tumor-free in control examinations, 5 had a stable disease, and tumor progression or recurrence was observed in 2 and 4 cases, respectively.
  • The 69 spectra, acquired using a MRI/MRS 2T system, were analyzed using Partial Least Squares Discriminant Analysis (PLS-DA) with orthogonal signal correction (OSC) spectral filtering.
  • Patients treated with chemotherapy showed an elevated band between 1.15-1.75 and 2.7-3.0 ppm and had decreases in the remaining parts of the spectra.
  • Increases in lactate and decreases in the remaining metabolites were characteristic for the tumor progression/recurrence group.
  • Pattern recognition methods coupled with MRS revealed significant treatment-dependent alterations in normal appearing cerebellar tissue, as well as metabolic changes induced by tumor progression/recurrence.
  • [MeSH-major] Cerebellum / pathology. Infratentorial Neoplasms / pathology. Infratentorial Neoplasms / physiopathology. Magnetic Resonance Spectroscopy / methods. Pattern Recognition, Physiological / physiology
  • [MeSH-minor] Adolescent. Combined Modality Therapy. Electrons. Female. Humans. Magnetic Resonance Imaging / methods. Male. Multivariate Analysis. Neuropsychological Tests. Radiotherapy Dosage

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  • (PMID = 19812943.001).
  • [ISSN] 0065-1419
  • [Journal-full-title] Acta neurochirurgica. Supplement
  • [ISO-abbreviation] Acta Neurochir. Suppl.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Austria
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39. Malheiros SM, Franco CM, Stávale JN, Santos AJ, Borges LR, Pelaez MP, Ferraz FA, Gabbai AA: Medulloblastoma in adults: a series from Brazil. J Neurooncol; 2002 Dec;60(3):247-53
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  • We retrospectively reviewed 15 adult patients (11 males, median age 34 years; range 23-48) who had been treated and followed in our Institution since 1991 from the time of diagnosis until death or last follow-up in December 2001.
  • The tumor was hemispheric in 11 patients.
  • CSF in 12 patients and craniospinal MRI in 6 did not show metastatic disease.
  • Two patients refused adjuvant treatment and died with progressive disease.
  • Thirteen patients received adjuvant craniospinal radiotherapy and 11 systemic chemotherapy.
  • After initial treatment only 2 of the 13 patients relapsed in the posterior fossa.
  • Recurrence was probably related to sub-optimal radiotherapy planning: inadequate low dose in the posterior fossa (37.5 Gy) and long delay in initiating treatment.
  • Two of the 13 patients that received adjuvant treatment died: one from meningitis, and one from recurrent disease.
  • Eleven patients remained alive, and disease-free with Karnofsky performance status ranging 80-100.
  • The median overall survival was not reached after a median follow-up of 5.6 years (range 0.7-10.8 years).
  • Adult medulloblastoma was predominant in males and the majority of patients had hemispheric tumors.
  • Long-term survival was not uncommon.
  • Although chemotherapy may be useful and well tolerated, radiotherapy remains the mainstay adjuvant treatment as suggested by our two recurrences associated with a delay or inadequate dose.
  • [MeSH-major] Cerebellar Neoplasms / mortality. Cerebellar Neoplasms / therapy. Medulloblastoma / mortality. Medulloblastoma / therapy
  • [MeSH-minor] Adult. Brazil. Chemotherapy, Adjuvant. Disease-Free Survival. Female. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Neoplasm Recurrence, Local. Prognosis. Radiotherapy, Adjuvant. Retrospective Studies. Survival Rate. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 12510776.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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40. de Tella OI Jr, Agner C, Aguiar PH, Herculano MA, Prandini MN, Stavile JN: Aggressive management of orbital meningeal melanocytoma. Acta Neurochir (Wien); 2003 Dec;145(12):1121-6
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  • OBJECTIVE: Meningeal melanocytoma generally occurs in the posterior fossa.
  • Computed tomography (CT) and Magnetic Resonance Imaging (MRI) of the brain showed an expansive intraconal mass lesion occupying the superior orbital compartment, the entire orbital apex, and the optic foramen.
  • Chemotherapy and irradiation followed the initial intervention.
  • A subfrontal tumor with massive edema was found on follow up CT scan.
  • INTERPRETATION: Meningeal melanocytomas are rare benign pigmented tumors of the central nervous system.
  • They are predominant in the posterior fossa and spinal cord and frequently mistaken for melanomas, especially on frozen sections.
  • [MeSH-major] Meningeal Neoplasms / surgery. Nevus / surgery. Orbital Neoplasms / surgery
  • [MeSH-minor] Adult. Antigens, Neoplasm. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biomarkers, Tumor / analysis. Chemotherapy, Adjuvant. Combined Modality Therapy. Craniotomy. Diagnosis, Differential. Follow-Up Studies. Humans. Male. Melanoma-Specific Antigens. Microsurgery. Neoplasm Proteins / analysis. Neoplasm Recurrence, Local / diagnosis. Orbit / pathology. Orbit / surgery. Postoperative Complications / diagnosis. Radiotherapy, Adjuvant. S100 Proteins / analysis. Tomography, X-Ray Computed

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  • (PMID = 14663571.001).
  • [ISSN] 0001-6268
  • [Journal-full-title] Acta neurochirurgica
  • [ISO-abbreviation] Acta Neurochir (Wien)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Austria
  • [Chemical-registry-number] 0 / Antigens, Neoplasm; 0 / Biomarkers, Tumor; 0 / Melanoma-Specific Antigens; 0 / Neoplasm Proteins; 0 / S100 Proteins
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41. Bertolone SJ, Yates AJ, Boyett JM, Wallace D, Finlay JL, Children's Cancer Group: Combined modality therapy for poorly differentiated gliomas of the posterior fossa in children: a Children's Cancer Group report. J Neurooncol; 2003 May;63(1):49-54
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  • [Title] Combined modality therapy for poorly differentiated gliomas of the posterior fossa in children: a Children's Cancer Group report.
  • PURPOSE: To study the effectiveness of combined chemotherapy and radiotherapy for children with high-grade astrocytomas of the posterior fossa.
  • Sixteen children were randomly assigned to one of two chemotherapy regimens, vincristine, lomustine, and prednisone or '8-in-1', using the same involved-field irradiation in both.
  • Six infants received 8-in-1 chemotherapy before involved-field irradiation.
  • RESULTS: Twenty-two patients with an institutional diagnosis high-grade posterior fossa tumors received chemotherapy and/or irradiation.
  • Overall survival for confirmed high-grade astrocytoma of the posterior fossa was approximately 36 +/- 13% at 5 years for the children (n = 11) and 25 +/- 15% at 5 years for the infants (n = 4).
  • CONCLUSIONS: Involved-field irradiation with chemotherapy appeared to prevent extraneural and subarachnoid metastases.
  • We also confirmed the rarity of the tumor (6% of patients registered).
  • Further Phase III trials are necessary to improve survival in this aggressive tumor.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Astrocytoma / drug therapy. Astrocytoma / radiotherapy. Cerebellar Neoplasms / drug therapy. Cerebellar Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Cell Differentiation / drug effects. Child. Child, Preschool. Combined Modality Therapy. Disease-Free Survival. Female. Humans. Infant. Lomustine / administration & dosage. Male. Neoplasm Recurrence, Local. Prednisone / administration & dosage. Survival Rate. Treatment Failure. Vincristine / administration & dosage

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  • (PMID = 12814254.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA21765
  • [Publication-type] Clinical Trial; Clinical Trial, Phase III; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 5J49Q6B70F / Vincristine; 7BRF0Z81KG / Lomustine; VB0R961HZT / Prednisone
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42. Raco A, Raimondi AJ, D'Alonzo A, Esposito V, Valentino V: Radiosurgery in the management of pediatric brain tumors. Childs Nerv Syst; 2000 May;16(5):287-95
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  • [Title] Radiosurgery in the management of pediatric brain tumors.
  • A total of 114 patients with benign and malignant intracranial tumors were treated by Valentino at the Flaminia Radiosurgical Center using a Philips 6-MeV linear accelerator between 1987 and 1995.
  • The tumor locations break down as follows: 36 in the cerebral hemispheres, 14 in the region of the hypothalamus/optic chiasm, 21 in the III ventricle/pineal region, 3 in the basal ganglia, 27 in the posterior fossa, 13 in the brain stem.
  • Seventy-nine patients had multivariate/combined treatment consisting of surgery or biopsy followed by chemotherapy, radiotherapy and/or radiosurgery.
  • Thirty-five were not operated on or biopsied but were treated primarily by radiosurgery, which was associated with chemotherapy and conventional radiotherapy.
  • The short- and long-term results were evaluated separately for each pathology in an attempt to derive guidelines for future treatment.
  • For tumors of the pineal region, we are of the opinion that radiosurgery is the treatment of choice in children and that more than one-third of patients can be cured by this means.
  • The remaining patients require surgery and/or chemotherapy in addition.
  • For medulloblastomas radiosurgery may be useful to control local recurrence if coupled with chemotherapy.
  • In the case of ependymomas, partly because of the extreme malignancy of the lesions in our series, radiosurgery did not succeed in controlling local recurrence.
  • We fear that limiting treatment to radiosurgery, rather than prescribing conventional radiotherapy when indicated, could permit CNS seeding.
  • In glial tumors radiosurgery helped either to "sterilize" the tumor bed after removal or to treat remnants of the lesions in critical areas; for diffuse brain stem gliomas it should be considered the treatment of choice.
  • [MeSH-major] Brain / surgery. Brain Neoplasms / pathology. Brain Neoplasms / surgery. Radiosurgery / methods
  • [MeSH-minor] Adolescent. Chemotherapy, Adjuvant. Child. Child, Preschool. Female. Follow-Up Studies. Humans. Infant. Karnofsky Performance Status. Male. Neoplasm Recurrence, Local. Neoplasm Seeding. Neoplasm, Residual / surgery. Prognosis. Radiotherapy. Reoperation. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 10883372.001).
  • [ISSN] 0256-7040
  • [Journal-full-title] Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
  • [ISO-abbreviation] Childs Nerv Syst
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] GERMANY
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43. Badhe PB, Chauhan PP, Mehta NK: Brainstem gliomas--a clinicopathological study of 45 cases with p53 immunohistochemistry. Indian J Cancer; 2004 Oct-Dec;41(4):170-4
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  • BACKGROUND: Brainstem tumors represent 10% of central nervous system tumors, accounting for 30% of pediatric posterior fossa tumors.
  • AIMS: The aim of this study was to clinicopathologically correlate 45 cases of brain stem gliomas and determine the occurrence and prognostic significance of p53 expression.
  • MATERIALS AND METHOD: 45 cases of brain stem gliomas encountered during a 19-year period.
  • The WHO brain tumor classification and Stroink's CT classification were applied.
  • Grade II astrocytomas were treated with excision and radiotherapy, while grade III and IV tumors were treated with radiotherapy and chemotherapy (CCNU).
  • The outcome was better in patients who were treated surgically. p53 is a frequently mutated gene in brain stem astrocytomas.
  • [MeSH-major] Biomarkers, Tumor / metabolism. Brain Stem Neoplasms / metabolism. Glioma / metabolism. Tumor Suppressor Protein p53 / metabolism

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  • (PMID = 15659871.001).
  • [ISSN] 0019-509X
  • [Journal-full-title] Indian journal of cancer
  • [ISO-abbreviation] Indian J Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] India
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Tumor Suppressor Protein p53
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44. Grill J, Le Deley MC, Gambarelli D, Raquin MA, Couanet D, Pierre-Kahn A, Habrand JL, Doz F, Frappaz D, Gentet JC, Edan C, Chastagner P, Kalifa C, French Society of Pediatric Oncology: Postoperative chemotherapy without irradiation for ependymoma in children under 5 years of age: a multicenter trial of the French Society of Pediatric Oncology. J Clin Oncol; 2001 Mar 01;19(5):1288-96
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  • [Title] Postoperative chemotherapy without irradiation for ependymoma in children under 5 years of age: a multicenter trial of the French Society of Pediatric Oncology.
  • PURPOSE: To evaluate a strategy that avoids radiotherapy in first-line treatment in children under 5 years of age with brain or posterior fossa ependymoma, by exclusively administering 16 months of adjuvant multiagent chemotherapy after surgery.
  • PATIENTS AND METHODS: Between June 1990 and October 1998, 73 children with ependymoma (82% with high-grade tumors) were enrolled onto this multicenter trial.
  • Children received adjuvant conventional chemotherapy after surgery consisting of seven cycles of three courses alternating two drugs at each course (procarbazine and carboplatin, etoposide and cisplatin, vincristine and cyclophosphamide) over a year and a half.
  • Systematic irradiation was not envisaged at the end of chemotherapy.
  • In the event of relapse or progression, salvage treatment consisted of a second surgical procedure followed by local irradiation with or without second-line chemotherapy.
  • RESULTS: Conventional chemotherapy was well tolerated and could be administered in outpatient clinics.
  • No radiologically documented response to chemotherapy more than 50% was observed.
  • Overall, 40% (95% CI, 29% to 51%) of the patients were alive having never received radiotherapy 2 years after the initiation of chemotherapy and 23% (95% CI, 14% to 35%) were still alive at 4 years without recourse to this modality.
  • In the multivariate analysis, the two factors associated with a favorable outcome were a supratentorial tumor location (P =.0004) and complete surgery (P =.0009).
  • CONCLUSION: A significant proportion of children with ependymoma can avoid radiotherapy with prolonged adjuvant chemotherapy.
  • Deferring irradiation at the time of relapse did not compromise overall survival of the entire patient population.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms / drug therapy. Ependymoma / drug therapy
  • [MeSH-minor] Carboplatin / administration & dosage. Chemotherapy, Adjuvant. Child, Preschool. Cisplatin / administration & dosage. Cyclophosphamide / administration & dosage. Disease-Free Survival. Etoposide / administration & dosage. Female. Humans. Infant. Male. Neoplasm Recurrence, Local. Procarbazine / administration & dosage. Prognosis. Treatment Outcome. Vincristine / administration & dosage

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  • (PMID = 11230470.001).
  • [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; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 35S93Y190K / Procarbazine; 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 8N3DW7272P / Cyclophosphamide; BG3F62OND5 / Carboplatin; Q20Q21Q62J / Cisplatin
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45. Sato I, Higuchi A, Yanagisawa T, Mukasa A, Ida K, Sawamura Y, Sugiyama K, Saito N, Kumabe T, Terasaki M, Nishikawa R, Ishida Y, Kamibeppu K: Development of the Japanese version of the Pediatric Quality of Life Inventory Brain Tumor Module. Health Qual Life Outcomes; 2010;8:38
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  • [Title] Development of the Japanese version of the Pediatric Quality of Life Inventory Brain Tumor Module.
  • The PedsQL Brain Tumor Module is comprised of six scales: Cognitive Problems, Pain and Hurt, Movement and Balance, Procedural Anxiety, Nausea, and Worry.
  • In the present study, we developed the Japanese version of the PedsQL Brain Tumor Module and investigated its feasibility, reliability, and validity among Japanese children and their parents.
  • Participants were recruited from 6 hospitals in Japan and the Children's Cancer Association of Japan, and questionnaires were completed by 137 children with brain tumors and 166 parents.
  • Feasibility of the questionnaire was determined based on the amount of time required to complete the form and the percentage of missing values.
  • Known-groups validity was described with regard to whole brain irradiation, developmental impairment, infratentorial tumors, paresis, and concurrent chemotherapy.
  • Evaluation of known-groups validity confirmed that the Cognitive Problems scale was sensitive for developmental impairment, the Movement and Balance scale for infratentorial tumors or paresis, and the Nausea scale for a patient currently undergoing chemotherapy.
  • CONCLUSIONS: The Japanese version of the PedsQL Brain Tumor Module is suitable for assessing health-related quality of life in children with brain tumors in clinical trials and research studies.
  • [MeSH-major] Brain Neoplasms. Quality of Life. Surveys and Questionnaires

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  • (PMID = 20398254.001).
  • [ISSN] 1477-7525
  • [Journal-full-title] Health and quality of life outcomes
  • [ISO-abbreviation] Health Qual Life Outcomes
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Validation Studies
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2873593
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46. Lutterbach J, Liegibel J, Koch D, Madlinger A, Frommhold H, Pagenstecher A: Atypical teratoid/rhabdoid tumors in adult patients: case report and review of the literature. J Neurooncol; 2001 Mar;52(1):49-56
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  • [Title] Atypical teratoid/rhabdoid tumors in adult patients: case report and review of the literature.
  • Atypical teratoid/rhabdoid tumors (AT/RT) of the central nervous system are rare and extremely aggressive malignancies of early childhood.
  • Magnetic resonance imaging revealed a posterior fossa mass.
  • Despite the dismal prognosis the patient decided not to undergo an abortion.
  • For this reason postoperative accelerated hyperfractionated radiotherapy was limited to the tumor region.
  • Despite a 6 week course of oral temozolomide, the tumor progressed and the patient died 11 months after diagnosis.
  • Oral chemotherapy was not effective in controlling diffuse tumor spread.
  • [MeSH-major] Brain Neoplasms / diagnosis. Dacarbazine / analogs & derivatives. Magnetic Resonance Imaging. Pregnancy Complications, Neoplastic / diagnosis. Rhabdoid Tumor / diagnosis. Teratoma / diagnosis
  • [MeSH-minor] Adult. Antineoplastic Agents, Alkylating / therapeutic use. Combined Modality Therapy. Delivery, Obstetric. Fatal Outcome. Female. Humans. Neoplasm Recurrence, Local. Pregnancy. Radiosurgery. Radiotherapy

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  • (PMID = 11451202.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; 7GR28W0FJI / Dacarbazine; YF1K15M17Y / temozolomide
  • [Number-of-references] 33
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47. Stavrou T, Bromley CM, Nicholson HS, Byrne J, Packer RJ, Goldstein AM, Reaman GH: Prognostic factors and secondary malignancies in childhood medulloblastoma. J Pediatr Hematol Oncol; 2001 Oct;23(7):431-6
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  • RESULTS: The median follow-up time was 92 months (range 6-257 months).
  • Univariate analysis showed that age at diagnosis, extent of surgical resection, presence of metastatic disease (M stage), ventriculoperitoneal shunt placement within 30 days from diagnosis, posterior fossa radiation therapy dose, and adjuvant chemotherapy significantly affected survival.
  • Although based on small numbers, the risk of second neoplasms was significantly increased in this cohort.
  • Multiple basal cell carcinomas developed in the areas of radiation therapy in two patients; these patients also had nevoid basal cell carcinoma syndrome (NBCCS) diagnosed.
  • One other patient died of glioblastoma multiforme 8 years after treatment of medulloblastoma.
  • A meningioma developed in another patient 10 years after radiation therapy.
  • CONCLUSION: As survival of medulloblastoma patients improves, increased surveillance regarding secondary malignancies is required, especially because radiation-induced tumors may occur many years after treatment.
  • In those patients, alternative therapy should be considered to minimize radiation therapy-related sequelae.
  • [MeSH-major] Carcinoma, Basal Cell / etiology. Cerebellar Neoplasms / diagnosis. Medulloblastoma / diagnosis. Neoplasms, Radiation-Induced / etiology. Skin Neoplasms / etiology
  • [MeSH-minor] Adolescent. Adult. Chemotherapy, Adjuvant. Child. Child, Preschool. Cohort Studies. Female. Humans. Infant. Male. Neoplasm Recurrence, Local. Prognosis. Radiotherapy. Retrospective Studies. Survival Rate


48. Massimino M, Gandola L, Spreafico F, Biassoni V, Luksch R, Collini P, Solero CN, Simonetti F, Pignoli E, Cefalo G, Poggi G, Modena P, Mariani L, Potepan P, Podda M, Casanova M, Pecori E, Acerno S, Ferrari A, Terenziani M, Meazza C, Polastri D, Ravagnani F, Fossati-Bellani F: No salvage using high-dose chemotherapy plus/minus reirradiation for relapsing previously irradiated medulloblastoma. Int J Radiat Oncol Biol Phys; 2009 Apr 1;73(5):1358-63
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  • [Title] No salvage using high-dose chemotherapy plus/minus reirradiation for relapsing previously irradiated medulloblastoma.
  • PURPOSE: Myeloablative regimens were frequently used for medulloblastoma relapsing after craniospinal irradiation (CSI): in 1997-2002, we used repeated surgery, standard-dose and myeloablative chemotherapy, and reirradiation.
  • Hematopoietic precursor mobilization followed high-dose etoposide or high-dose cyclophosphamide or cisplatin/etoposide therapy.
  • After the overall chemotherapy program, reirradiation was prescribed when possible.
  • RESULTS: Seventeen patients were treated: previous treatment included CSI of 19.5-36 Gy with posterior fossa/tumor boost and chemotherapy in 16 patients.
  • Relapse sites included leptomeninges in 9 patients, spine in 4 patients, posterior fossa in 3 patients, and brain in 1 patient.
  • Twelve of 14 patients with assessable tumor had an objective response after reinduction; 2 experienced progression and were not given the myeloablative courses.
  • Additional relapses appeared in 13 patients continuing the treatment.
  • CONCLUSIONS: Despite responses being obtained and ample use of surgery and reirradiation, second-line therapy with myeloablative schedules was not curative, barring a few exceptions.
  • A salvage therapy for medulloblastoma after CSI still needs to be sought.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cerebellar Neoplasms. Medulloblastoma. Neoplasm Recurrence, Local. Salvage Therapy
  • [MeSH-minor] Adolescent. Carboplatin / administration & dosage. Carboplatin / adverse effects. Child. Child, Preschool. Cisplatin / administration & dosage. Cisplatin / adverse effects. Combined Modality Therapy / methods. Cyclophosphamide / administration & dosage. Cyclophosphamide / adverse effects. Disease-Free Survival. Drug Administration Schedule. Etoposide / administration & dosage. Etoposide / adverse effects. Female. Granulocyte Colony-Stimulating Factor / administration & dosage. Humans. Male. Methotrexate / administration & dosage. Methotrexate / adverse effects. Radiotherapy Dosage. Remission Induction / methods. Thiotepa / administration & dosage. Thiotepa / adverse effects. Vincristine / administration & dosage. Vincristine / adverse effects. Young Adult

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  • (PMID = 19019566.001).
  • [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; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 143011-72-7 / Granulocyte Colony-Stimulating Factor; 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 8N3DW7272P / Cyclophosphamide; 905Z5W3GKH / Thiotepa; BG3F62OND5 / Carboplatin; Q20Q21Q62J / Cisplatin; YL5FZ2Y5U1 / Methotrexate
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49. Agaoglu FY, Ayan I, Dizdar Y, Kebudi R, Gorgun O, Darendeliler E: Ependymal tumors in childhood. Pediatr Blood Cancer; 2005 Sep;45(3):298-303
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  • [Title] Ependymal tumors in childhood.
  • BACKGROUND: Ependymal tumors are classified as ependymoma (benign or low grade) versus anaplastic ependymoma (malignant or high grade).
  • Ependymomas represent 5-10% of intracranial neoplasm in children.
  • In this study, demographic data and the treatment results of pediatric patients with ependymal tumors, treated in a single institute, is reported.
  • PATIENTS AND METHODS: Between 1989 and 2001, 40 (22 M/18 F) previously untreated patients with a median age of 5.5 years (3 months-15 years), of histologically proven ependymal tumors (except ependymoblastomas) were referred to the Institute of Oncology, University of Istanbul.
  • The localization was supratentorial in 18, infratentorial in 20, both supra and infratentorial in two patients.
  • Total tumor resection was performed in 20 patients (50%), subtotal in 18 patients (45%), and biopsy only in 2 patients (5%).
  • Postoperative treatment consisted of regional (8 patients) or craniospinal (CSI) (9 patients) radiotherapy (RT) in patients with ependymoma; regional (7 patients) or CSI RT (14 patients) with chemotherapy (ChT) in patients with anaplastic ependymoma; ChT only (1 patient) in patients less than 3 years of age.
  • The standard technique for posterior fossa irradiation was parallel-opposed lateral fields and total dose was 45-54 Gy.
  • Median time for progression or relapse was 24.3 months and there were 19 patients (43.6%) with relapse or progression.
  • CONCLUSIONS: The majority of complete responders were patients who had total tumor removal.
  • Treatment failure occurred mainly within the first 2 years, and outcome was dismal for patients who relapsed or had progressive disease.
  • [MeSH-major] Brain Neoplasms. Ependymoma
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Disease-Free Survival. Female. Humans. Infant. Male. Multivariate Analysis. Risk Factors. Survival Rate. Turkey / epidemiology

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  • [Copyright] (c) 2004 Wiley-Liss, Inc.
  • (PMID = 15770637.001).
  • [ISSN] 1545-5009
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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50. Deen HG, Miller DA, Kostick DA, Jaeckle KA: Removal of an orbital metallic foreign body to facilitate magnetic resonance imaging: technical case report. Neurosurgery; 2006 May;58(5):E999; discussion E999
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  • OBJECTIVE AND IMPORTANCE: Magnetic resonance imaging (MRI) is the imaging modality of choice for brain tumors and other lesions of the central nervous system.
  • However, this procedure is contraindicated in patients with orbital metallic foreign bodies.
  • CLINICAL PRESENTATION: Two patients, one with a posterior fossa mass and one with suspected central nervous system lymphoma, were seen at our institution.
  • The first patient underwent posterior fossa craniotomy and removal of the tumor, which proved to be a medulloblastoma.
  • The second patient was found to have evidence of lymphoma in the cranial base and meninges and was treated with radiotherapy and systemic and intrathecal chemotherapy.
  • CONCLUSION: Two patients with central nervous system tumors underwent removal of a metal fragment in the orbit for the specific purpose of facilitating MRI scans.
  • [MeSH-minor] Adult. Cerebellar Neoplasms / diagnosis. Humans. Male. Medulloblastoma / diagnosis. Meningeal Neoplasms / diagnosis. Middle Aged. Orbit / radiography. Orbit / surgery

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  • (PMID = 16639311.001).
  • [ISSN] 1524-4040
  • [Journal-full-title] Neurosurgery
  • [ISO-abbreviation] Neurosurgery
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Ferric Compounds; 1317-54-0 / ferrite
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51. Rønning C, Sundet K, Due-Tønnessen B, Lundar T, Helseth E: Persistent cognitive dysfunction secondary to cerebellar injury in patients treated for posterior fossa tumors in childhood. Pediatr Neurosurg; 2005 Jan-Feb;41(1):15-21
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  • [Title] Persistent cognitive dysfunction secondary to cerebellar injury in patients treated for posterior fossa tumors in childhood.
  • Traditionally, the cerebral hemispheres have been regarded as the region of the brain responsible for cognitive functions, while the cerebellum has been considered to be primarily involved in motor functions.
  • The aim of this study was to determine the neuropsychological profile of young adults treated for a posterior fossa tumor in childhood and look for possible support for the presence of the so-called 'cerebellar cognitive affective syndrome' in these patients.
  • The medulloblastoma group (n = 11) had been treated with surgery followed by radiotherapy and chemotherapy (mean age at surgery was 6.1 years and mean age at neuropsychological testing was 23.1 years).
  • No significant correlation between age at time of treatment and grade of neuropsychological impairment was found in the astrocytoma group, though there was a tendency that young age at time of treatment correlated with better outcome on IQ measures.
  • For this group, young age at time of treatment indicated a worse outcome.
  • CONCLUSIONS: Persistent cognitive dysfunction was detected in patients treated for posterior fossa medulloblastoma and cerebellar astrocytoma.
  • Follow-up of all patients treated for posterior fossa tumor in childhood should include an extensive neuropsychological testing at regular intervals.
  • [MeSH-major] Astrocytoma / surgery. Cerebellar Neoplasms / surgery. Cerebellum / physiopathology. Cerebellum / surgery. Cognition Disorders / etiology. Medulloblastoma / surgery

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  • [Copyright] Copyright 2005 S. Karger AG, Basel.
  • (PMID = 15886508.001).
  • [ISSN] 1016-2291
  • [Journal-full-title] Pediatric neurosurgery
  • [ISO-abbreviation] Pediatr Neurosurg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
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52. Smee RI, Williams JR: Medulloblastomas-primitive neuroectodermal tumours in the adult population. J Med Imaging Radiat Oncol; 2008 Feb;52(1):72-6
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  • Between 1977-2004 there were 11 patients referred, 1 with persistent disease and 10 were eligible, presenting with initial diagnosis.
  • All patients completed craniospinal radiotherapy (35-36 Gy at 1.8-2.0 Gy fractions) barring one patient, who died of surgical complications during his radiotherapy.
  • Chemotherapy was given in five of the nine patients postradiotherapy.
  • There were two posterior fossa recurrences, with associated supratentorial and extra central nervous system disease.
  • Of the 10 primary patients 7 are alive with no evidence of disease, 2 died because of disease, with 1 intercurrent death.
  • One patient developed a second malignancy.
  • Radiotherapy could control local disease even where complete resection was not achieved.
  • [MeSH-major] Cerebellar Neoplasms / epidemiology. Medulloblastoma / epidemiology. Neuroectodermal Tumors, Primitive / epidemiology
  • [MeSH-minor] Adolescent. Adult. Databases, Factual / statistics & numerical data. Female. Follow-Up Studies. Humans. Intracranial Pressure. Male. Neoplasm Recurrence, Local. Neurosurgical Procedures. New South Wales / epidemiology. Radiotherapy, Adjuvant. Rare Diseases. Retrospective Studies. Treatment Outcome

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  • (PMID = 18373831.001).
  • [ISSN] 1754-9477
  • [Journal-full-title] Journal of medical imaging and radiation oncology
  • [ISO-abbreviation] J Med Imaging Radiat Oncol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Australia
  • [Number-of-references] 29
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53. Yasuda K, Taguchi H, Sawamura Y, Ikeda J, Aoyama H, Fujieda K, Ishii N, Kashiwamura M, Iwasaki Y, Shirato H: Low-dose craniospinal irradiation and ifosfamide, cisplatin and etoposide for non-metastatic embryonal tumors in the central nervous system. Jpn J Clin Oncol; 2008 Jul;38(7):486-92
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  • [Title] Low-dose craniospinal irradiation and ifosfamide, cisplatin and etoposide for non-metastatic embryonal tumors in the central nervous system.
  • OBJECTIVE: The current study was conducted to evaluate the effects of low-dose craniospinal irradiation (CSI) combined with chemotherapy on non-metastatic embryonal tumors in the central nervous system (CNS), including medulloblastoma and supra-tentorial primitive neuroectodermal tumors (ST-PNET).
  • After surgery, the patients < or =5 years old received 18 Gy and the patients >5 years old received 24 Gy CSI.
  • The dose to the primary tumor bed was 39.6-54 Gy.
  • Chemotherapy consisted of ifosfamide, cisplatin and etoposide (ICE chemotherapy).
  • Both 5-year OAS and PFS were 100% for six average-risk patients (3 years or older, total resection and posterior fossa) and 70% for 10 poor-risk patients (others).
  • Eight patients received hormone replacement therapy.
  • CONCLUSION: Low-dose CSI and ICE chemotherapy may have a role as a treatment option for a subset of patients with non-metastatic embryonal tumors in the CNS.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Brain Neoplasms / therapy. Cranial Irradiation. Medulloblastoma / therapy. Neuroectodermal Tumors, Primitive / therapy
  • [MeSH-minor] Adolescent. Adult. Child. Child, Preschool. Cisplatin / administration & dosage. Combined Modality Therapy. Dose-Response Relationship, Radiation. Etoposide / administration & dosage. Female. Humans. Ifosfamide / administration & dosage. Infant. Male. Radiotherapy Dosage. Supratentorial Neoplasms / pathology. Supratentorial Neoplasms / therapy. Survival Analysis

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  • (PMID = 18573848.001).
  • [ISSN] 1465-3621
  • [Journal-full-title] Japanese journal of clinical oncology
  • [ISO-abbreviation] Jpn. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Japan
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide
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54. Mabbott DJ, Spiegler BJ, Greenberg ML, Rutka JT, Hyder DJ, Bouffet E: Serial evaluation of academic and behavioral outcome after treatment with cranial radiation in childhood. J Clin Oncol; 2005 Apr 1;23(10):2256-63
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  • [Title] Serial evaluation of academic and behavioral outcome after treatment with cranial radiation in childhood.
  • PURPOSE: To evaluate academic and behavioral outcome in radiated survivors of posterior fossa (PF) tumors.
  • PATIENTS AND METHODS: Fifty-three patients (36 males) treated for malignant PF tumors were seen for evaluation of academics and/or behavioral functioning.
  • Fourteen patients were treated with reduced-dose cranial radiation, and 34 patients were treated with standard-dose cranial radiation (dose was not available for four patients).
  • Standardized achievement tests and behavioral questionnaires were administered at different times after diagnosis for each child.
  • RESULTS: The presence of hydrocephalus was related to poorer academics, but outcome was not related to radiation dose, extent of surgery, or treatment with chemotherapy.
  • Behavioral functioning was generally not related to medical and demographic variables, and few clinically significant problems in externalizing behavior were evident.
  • Increases in social and attention problems emerged over time.
  • [MeSH-major] Child Behavior Disorders / etiology. Cognition Disorders / etiology. Ependymoma / radiotherapy. Infratentorial Neoplasms / radiotherapy. Medulloblastoma / radiotherapy. Radiation Injuries / psychology

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  • (PMID = 15800316.001).
  • [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
  • [Publication-country] United States
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55. 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.
  • 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).
  • No such association was seen in patients with infiltrating tumors.
  • In 102 total patient-years of follow-up (average follow-up period, 4.2 yr), 17 patients (six well-circumscribed and 11 infiltrating lesions) demonstrated complete response or stable disease and six patients (three well-circumscribed and three infiltrating lesions) demonstrated progressive disease or death.
  • Patients with well-circumscribed tumors and a bad outcome had significantly lower transverse eigenvalue measures in the corticospinal tracts compared with those with a more favorable clinical status (P < 0.05).
  • 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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56. Jaing TH, Wang HS, Tsay PK, Tseng CK, Jung SM, Lin KL, Lui TN: Multivariate analysis of clinical prognostic factors in children with intracranial ependymomas. J Neurooncol; 2004 Jul;68(3):255-61
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Our retrospective series included 15 with supratentorial and 28 with infratentorial tumors.
  • Radiotherapy was done in 31 patients and chemotherapy in 13.
  • The median survival time was 30 months, and 5-year overall survival and progression-free survival rates were 53.9% and 45.9%, respectively.
  • By tumor site: supratentorial, 56.6% and 50.9%; infratentorial, 52.3% and 42.5%.
  • Only one of 15 patients with supratentorial tumors developed isolated spinal metastasis.
  • [MeSH-major] Ependymoma / diagnosis. Infratentorial Neoplasms / diagnosis. Neoplasm Recurrence, Local / diagnosis. Supratentorial Neoplasms / diagnosis

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  • (PMID = 15332330.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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57. Metry DW, Hebert AA: Benign cutaneous vascular tumors of infancy: when to worry, what to do. Arch Dermatol; 2000 Jul;136(7):905-14
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  • [Title] Benign cutaneous vascular tumors of infancy: when to worry, what to do.
  • OBJECTIVES: To discuss the current knowledge regarding complicated hemangiomas (cervicofacial, periorbital, lumbosacral, and parotid), including the associated syndromes of diffuse neonatal hemangiomatosis and PHACES (posterior fossa malformations, most commonly of the Dandy-Walker variant; hemangiomas [especially large, plaquelike, facial lesions]; arterial anomalies; cardiac anomalies and coarctation of the aorta; eye abnormalities; and sternal cleft and/or supraumbilical raphe).
  • To discuss the risks and benefits of current treatment options, including the use of systemic corticosteroids and interferon in necessary situations.
  • Dermatologists should also be aware of available treatment options, including the use of systemic chemotherapy in life-threatening situations.
  • [MeSH-major] Hemangioma. Skin Neoplasms
  • [MeSH-minor] Abnormalities, Multiple. Hemangioendothelioma / congenital. Hemangioendothelioma / diagnosis. Hemangioendothelioma / pathology. Hemangioendothelioma / therapy. Humans. Infant. Infant, Newborn. Syndrome

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  • (PMID = 10890993.001).
  • [ISSN] 0003-987X
  • [Journal-full-title] Archives of dermatology
  • [ISO-abbreviation] Arch Dermatol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] UNITED STATES
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58. Hanbali F, Tabrizi P, Lang FF, DeMonte F: Tumors of the skull base in children and adolescents. J Neurosurg; 2004 Feb;100(2 Suppl Pediatrics):169-78
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  • [Title] Tumors of the skull base in children and adolescents.
  • OBJECT: Published data obtained in children with tumors of the skull base are sparse.
  • In the majority of the available reports, the authors focus on the technical application of skull base approaches, but they contribute a paucity of information on the management of specific tumors, especially malignant skull base lesions.
  • The purposes of this report are to increase the collective experience with the treatment of these tumors and to identify successful management paradigms.
  • METHODS: The authors retrospectively reviewed the clinical records, pathological reports, and diagnostic images obtained in 24 children (< or = 19 years of age) with tumors arising from the cranial base in whom resection was part of their management between 1992 and 2002.
  • Surgery-related complications and outcomes were analyzed with regard to tumor type and surgical approach.
  • Tumors involved the anterior skull base in eight (33%), the middle skull base in 10 (42%), both the anterior and middle skull base in four (17%), and the posterior skull base in two patients (8%).
  • Benign lesions were discovered in 11 patients (46%) and malignant neoplasms in 13 (54%).
  • The tumors were most commonly of mesenchymal origin (21 [87.5%] of 24 tumors).
  • A gross-total resection was achieved in 23 procedures (77%) and a subtotal resection in five (17%); a biopsy procedure was performed in one case; and the disease process could not be accessed in one case.
  • In nine patients (38%) the tumor recurred after a mean duration of 23 months.
  • CONCLUSIONS: Skull base tumors in children affect mainly the anterior and middle cranial fossa.
  • Sarcomas account for the majority of malignant tumors.
  • Treatment of skull base tumors in children and adolescents needs to be tailored to patient age, tumor location, and tumor type.
  • [MeSH-major] Craniotomy / methods. Postoperative Complications / etiology. Skull Base Neoplasms / surgery
  • [MeSH-minor] Adolescent. Chemotherapy, Adjuvant. Child. Child, Preschool. Combined Modality Therapy. Diagnostic Imaging. Female. Humans. Infant. Male. Neurologic Examination. Paranasal Sinus Neoplasms / diagnosis. Paranasal Sinus Neoplasms / drug therapy. Paranasal Sinus Neoplasms / radiotherapy. Paranasal Sinus Neoplasms / surgery. Radiotherapy, Adjuvant. Reoperation. Retrospective Studies. Sarcoma / diagnosis. Sarcoma / secondary. Sarcoma / surgery. Treatment Outcome

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  • (PMID = 14758945.001).
  • [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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59. Serowka K, Chiu Y, Gonzalez I, Gilles F, McComb G, Krieger M, Dhall G, Britt B, Ji L, Sposto R, Finlay JL: Central nervous system (CNS) tumors in the first six months of life: the Children's Hospital Los Angeles experience, 1979-2005. Pediatr Hematol Oncol; 2010 Mar;27(2):90-102
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  • [Title] Central nervous system (CNS) tumors in the first six months of life: the Children's Hospital Los Angeles experience, 1979-2005.
  • BACKGROUND: The authors report the experience at the Children's Hospital Los Angeles with brain tumors diagnosed before 6 months of age, describing the characteristics of the patients, their tumors, treatment strategies, and prognostic factors.
  • There were 11 gliomas, 9 choroid plexus tumors, 8 medulloblastomas and supratentorial primitive neuroectodermal tumors (PNET), 2 atypical teratoid/rhabdoid tumors (ATRT), and 1 each of ependymoma, craniopharyngioma, and immature teratoma.
  • Locations of primary tumors included 21 supratentorial (64%) and 7 posterior fossa, and 5 tumors involved both compartments.
  • The treatment strategies included 5 patients with biopsy only, 18 less than gross total resections (<GTRx), and 9 GTRx.
  • Fourteen children (42%) received chemotherapy.
  • [MeSH-major] Brain Neoplasms
  • [MeSH-minor] Female. Hospitals, Pediatric. Humans. Infant. Infant, Newborn. Los Angeles / epidemiology. Male. Prognosis. Survival Rate. Treatment Outcome

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  • (PMID = 20201690.001).
  • [ISSN] 1521-0669
  • [Journal-full-title] Pediatric hematology and oncology
  • [ISO-abbreviation] Pediatr Hematol Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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60. Ciurea AV, Coman T, Tascu A, Ionescu V: Intradural dermoid tumor of the posterior fossa in a child with diastematobulbia. Surg Neurol; 2005 Jun;63(6):571-5; discussion 575
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  • [Title] Intradural dermoid tumor of the posterior fossa in a child with diastematobulbia.
  • Dermoid tumors (DTs) are rare lesions and represent 0.3% of all intracranial tumors.
  • More than 50% of these tumors are diagnosed in childhood or early adolescence.
  • Authors report an intradural DT of the posterior fossa in a child aged 4 years, possibly originating in the brainstem in which the diastematobulbia was detected postoperatively.
  • The only curative treatment in DT is the total removal of the lesion.
  • The surgical intervention is particularly related to the DT type.
  • Diastematobulbia associated with DT and the origin of the DT in the brainstem is discussed based on the literature.
  • [MeSH-major] Brain Stem / abnormalities. Brain Stem / pathology. Brain Stem Neoplasms / complications. Dermoid Cyst / complications. Infratentorial Neoplasms / complications. Nervous System Malformations / complications. Neural Tube Defects / complications
  • [MeSH-minor] Cerebellar Diseases / etiology. Cerebellar Diseases / pathology. Cerebellar Diseases / radiography. Child, Preschool. Cranial Nerve Diseases / etiology. Cranial Nerve Diseases / pathology. Cranial Nerve Diseases / radiography. Headache / etiology. Headache / pathology. Headache / radiography. Humans. Magnetic Resonance Imaging. Male. Meningitis, Aseptic / etiology. Meningitis, Aseptic / pathology. Meningitis, Aseptic / radiography. Neurosurgical Procedures. Predictive Value of Tests. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 15936393.001).
  • [ISSN] 0090-3019
  • [Journal-full-title] Surgical neurology
  • [ISO-abbreviation] Surg Neurol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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61. Nazarov RV, Kondrat'ev AN: [Infectious safety in neurosurgical patients. The specific features of infectious complications in patients with subtentorial tumors, their diagnosis and treatment]. Anesteziol Reanimatol; 2009 May-Jun;(3):31-3
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  • [Title] [Infectious safety in neurosurgical patients. The specific features of infectious complications in patients with subtentorial tumors, their diagnosis and treatment].
  • The paper analyzes the incidence of the major infectious complications (regional and systemic) developing in neurosurgical patients (3630 patients with neurosurgical diseases and 872 with abnormalities of the posterior cranial fossa (PCF)) in the postoperative period after removal of subtentorial tumors.
  • Regional pyoseptic complications are shown to occur in patients with PCF abnormalities three times more frequently.
  • The basic diagnostic and therapeutic approaches to pyoseptic complications in neurosurgical patients are also considered.
  • [MeSH-major] Cerebellar Neoplasms / surgery. Infection. Neurosurgical Procedures. Postoperative Complications
  • [MeSH-minor] Brain Neoplasms / surgery. Humans. Medical Records. Meningitis / diagnosis. Meningitis / drug therapy. Meningitis / epidemiology. Retrospective Studies. Treatment Outcome

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  • (PMID = 19663219.001).
  • [ISSN] 0201-7563
  • [Journal-full-title] Anesteziologiia i reanimatologiia
  • [ISO-abbreviation] Anesteziol Reanimatol
  • [Language] rus
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Russia (Federation)
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62. Chung YN, Wang KC, Shin SH, Kim N, Chi JG, Min KS, Cho BK: Primary intracranial atypical teratoid/rhabdoid tumor in a child: a case report. J Korean Med Sci; 2002 Oct;17(5):723-6
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  • [Title] Primary intracranial atypical teratoid/rhabdoid tumor in a child: a case report.
  • Rhabdoid tumors of the central nervous system are rare malignancies.
  • Primary central nervous system atypical teratoid/rhabdoid tumors (ATT/RhTs) mostly occur during early childhood and are almost invariably fatal.
  • These tumors show similar histological and radiological features to primitive neuroectodermal tumormedulloblastoma (PNET-MB) but have different biological behaviors.
  • We report a case of primary intracranial ATT/RhT in the posterior cranial fossa of a child.
  • He was treated by surgical resection, chemotherapy, and radiotherapy.
  • Despite aggressive therapy, he died 19 months after diagnosis.
  • [MeSH-major] Brain Neoplasms / diagnosis. Rhabdoid Tumor / diagnosis. Teratoma / diagnosis
  • [MeSH-minor] Diagnosis, Differential. Humans. Infant. Magnetic Resonance Imaging. Male. Medulloblastoma / diagnosis. Neuroectodermal Tumors, Primitive / diagnosis. Tomography, X-Ray Computed

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  • (PMID = 12378033.001).
  • [ISSN] 1011-8934
  • [Journal-full-title] Journal of Korean medical science
  • [ISO-abbreviation] J. Korean Med. Sci.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Korea (South)
  • [Other-IDs] NLM/ PMC3054946
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63. Palmer SN, Meeske KA, Katz ER, Burwinkle TM, Varni JW: The PedsQL Brain Tumor Module: initial reliability and validity. Pediatr Blood Cancer; 2007 Sep;49(3):287-93
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  • [Title] The PedsQL Brain Tumor Module: initial reliability and validity.
  • BACKGROUND: Brain tumors (BT) are second only to acute lymphoblastic leukemia as the most prevalent form of pediatric cancer, with BT 5-year survival rates approaching 70%.
  • This investigation examines the internal consistency reliability and construct validity of the Pediatric Quality of Life Inventory (PedsQL) Brain Tumor Module.
  • METHODS: The PedsQL 4.0 Generic Core Scales, PedsQL Multidimensional Fatigue Scale, and PedsQL Brain Tumor Module were administered to 99 families.
  • The sample included children with tumors located in the posterior fossa/brainstem (N=62, 62.6%), supratentorial (N=15, 15.2%), and midline (N=22, 22.2%).
  • Children were on treatment (N=46, 46.5%), off treatment<12 months (N=19, 19.2%), or off treatment>12 months/long-term survivor (N=34, 34.3%).
  • Treatment included radiation (N=61, 61.6%), surgery (N=83, 83.8%), chemotherapy (N=87, 87.9%), and bone marrow transplant (N=5, 5.1%).
  • RESULTS: Internal consistency reliability was demonstrated for the 24-item PedsQL Brain Tumor Module (average alpha=0.78-0.92, parent proxy-report, n=99; average alpha=0.76-0.87, child self-report, n=51).
  • Construct validity for the PedsQL Brain Tumor Module was supported through an analysis of the intercorrelations with the Generic Core Scales and Fatigue Scale.
  • CONCLUSIONS: The findings provide support for the measurement properties of the PedsQL Brain Tumor Module.
  • [MeSH-major] Brain Neoplasms. Health Status. Quality of Life. Surveys and Questionnaires

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  • [Copyright] Copyright (c) 2006 Wiley-Liss, Inc.
  • (PMID = 16991131.001).
  • [ISSN] 1545-5009
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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64. Khalil EM: Treatment results of adults and children with medulloblastoma NCI, Cairo University experience. J Egypt Natl Canc Inst; 2008 Jun;20(2):175-86
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  • [Title] Treatment results of adults and children with medulloblastoma NCI, Cairo University experience.
  • PURPOSE: To evaluate treatment outcome and prognostic factors of adults and pediatric medulloblastoma patients treated by adjuvant postoperative craniospinal irradiation (CSI) and chemotherapy.
  • According to the Chang staging system; 50%-35% , 37.5%-47% and 12.5%-18% had T2, T3 and T4 tumors of adults and pediatric patient's population respectively.
  • All patients underwent primary surgical resection; near total resection in 25% , Subtotal resection in 61% ; with tumor residual < 1.5cm(2) in 49% compared to 51% with > 1.5cm(2) residual tumor and 14% , had biopsy only.
  • All patients were treated by craniospinal radiotherapy (RT); with a median dose of 34Gy to the whole brain, 54Gy to the posterior fossa and 32Gy to the spinal axis.
  • Thirty four pediatric patients (67% ) received concomitant chemotherapy, while 61% received adjuvant (postoperative) chemotherapy and 57% received sequential chemotherapy.
  • Only 33% of patients did not receive chemotherapy.
  • RESULTS: For the pediatric and adult patients, the 5- and 7-year overall and disease-free survival rates were 89% & 78% vs. 84% & 56% and 80% & 68% vs. 79% & 52% respectively.
  • Fourteen patients (21% ) relapsed (10 pediatric and 4 adults) at a median time of 11 months vs. 23 months and a median follow-up period of 8 and 12 months respectively; Neuro-axis was the most common site of relapse (11 patients).
  • Ninety percent (9/10) of the pediatric relapses were of the high risk group (8 received no chemotherapy) and took place within 2 years; similarly all adult relapses were of the high risk group; three relapses took place after 2 years.
  • In univariate analysis, T stages, M stages, extent of surgery, CSF seedling and risk category were significant prognostic factors for disease free survival for the pediatric age group.
  • At 5 years, 87% , 87% , 78% , 85% and 85% of T2, M0, near total resection, negative CSF seedling and low risk patients were estimated to be disease-free respectively, compared to none of the T4, M +, biopsy only, positive CSF seedling patients and only 41% of the high risk patients achieved 5 years without recurrence (p=0.001, <0.001, <0.001, <0.001, <0.001).
  • Patients who did not receive chemotherapy had a 69% 5-year DFS vs. 76% (p=0.286).
  • For adult patients; only the risk category was a significant prognostic factor with 5-year disease-free survival rate of 100% vs. 40% for low and high risk respectively (p=0.03).
  • On multivaiate analysis only the risk category and the T-stage were significant prognostic factors for disease free survival for the pediatric age group (p=0.042 and 0.031).
  • Late relapses, lateral tumor location and shorter median follow up were noted in adult patients.
  • Advanced tumor stage, metastases at presentation, limited tumor resection were powerful prognostic factors among the pediatric patients.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Cerebellar Neoplasms / therapy. Cranial Irradiation. Medulloblastoma / therapy
  • [MeSH-minor] Adolescent. Adult. Child. Child, Preschool. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Male. Neoplasm Recurrence, Local / diagnosis. Neoplasm Recurrence, Local / therapy. Neoplasm Staging. Prognosis. Radiotherapy Dosage. Radiotherapy, Adjuvant. Survival Rate. Treatment Outcome. Young Adult

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  • (PMID = 20029474.001).
  • [ISSN] 1110-0362
  • [Journal-full-title] Journal of the Egyptian National Cancer Institute
  • [ISO-abbreviation] J Egypt Natl Canc Inst
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Egypt
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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65. 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.
  • Those lesions specifically in the posterior fossa are even more difficult to assess, given the technical limitations of 2D CSI in the infratentorial compartment.
  • 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

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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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66. Berger A, Sadeh M, Tzur G, Shuper IA, Kornreich L, Inbar D, Cohen IJ, Michowiz S, Yaniv I, Constantini S, Vakil E: Motor and non-motor sequence learning in children and adolescents with cerebellar damage. J Int Neuropsychol Soc; 2005 Jul;11(4):482-7
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  • Cerebellar involvement in motor and non-motor sequence learning was examined with serial reaction time tasks (SRT).
  • Our sample consisted of 8 children and adolescents who had undergone surgical removal of a benign posterior fossa tumor (PFT) during childhood.
  • None of them had undergone chemotherapy or cranial radiation therapy (CRT).
  • The children were tested not earlier than 2.5 years after surgery (M = 5.9 years), enabling brain plasticity and recovery of functions.
  • The PFT group was not impaired in the implicit learning of sequences, as reflected in their performance in blocks with a repeated sequence, both before and after a random block.
  • [MeSH-major] Cerebellar Diseases / physiopathology. Psychomotor Performance / physiology. Reaction Time / physiology. Serial Learning / physiology
  • [MeSH-minor] Adolescent. Analysis of Variance. Child. Female. Functional Laterality / physiology. Humans. Magnetic Resonance Imaging / methods. Male. Neuropsychological Tests. Practice (Psychology). Recovery of Function. Time Factors

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  • (PMID = 16209429.001).
  • [ISSN] 1355-6177
  • [Journal-full-title] Journal of the International Neuropsychological Society : JINS
  • [ISO-abbreviation] J Int Neuropsychol Soc
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article
  • [Publication-country] England
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67. Greenberg HS, Chamberlain MC, Glantz MJ, Wang S: Adult medulloblastoma: multiagent chemotherapy. Neuro Oncol; 2001 01;3(1):29-34
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  • [Title] Adult medulloblastoma: multiagent chemotherapy.
  • In this study, the records of 17 adult patients with medulloblastoma treated with craniospinal radiation and 1 of 2 multiagent chemotherapy protocols were reviewed for progression-free survival, overall survival, and toxicity, and the patients were compared with each other and with similarly treated children and adults.
  • Seventeen medulloblastoma patients (11 female, 6 male) with a median age of 23 years (range, 18-47 years) were treated with surgery, craniospinal radiation (CSRT) plus local boost, and 1 of 2 adjuvant chemotherapy regimens.
  • All tumors were infratentorial (10 in 4th ventricle and 7 in left or right hemisphere).
  • Other relapse sites included the leptomeninges (5), bone (1), and brain (1).
  • Two patients relapsed during chemotherapy and 6 relapsed after completing all therapy at 18, 18, 26, 30, 40, and 48 months.
  • Toxicity during the Packer protocol was moderately severe, with only 1 of 10 patients able to complete all therapy.
  • Two patients had severe abdominal pain during CSRT + vincristine, and 5 had peripheral neuropathy during vincristine therapy.
  • The POG and Packer protocols did not have a statistically significant difference in relapse-free or overall survival because of the small sample size.
  • To know whether adding adjuvant chemotherapy to craniospinal radiation in adult therapy increases relapse-free and overall survival, we must await the results of a larger randomized controlled clinical trial.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Infratentorial Neoplasms / drug therapy. Medulloblastoma / drug therapy
  • [MeSH-minor] Abdominal Pain / chemically induced. Adolescent. Adult. Cerebrospinal Fluid Shunts. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Cisplatin / adverse effects. Combined Modality Therapy. Cranial Irradiation. Cyclophosphamide / administration & dosage. Cyclophosphamide / adverse effects. Disease-Free Survival. Etoposide / administration & dosage. Etoposide / adverse effects. Female. Gastrointestinal Diseases / chemically induced. Hearing Loss, Sensorineural / chemically induced. Hematologic Diseases / chemically induced. Humans. Life Tables. Lomustine / administration & dosage. Lomustine / adverse effects. Male. Neoplasm Invasiveness. Neoplasm Recurrence, Local. Peripheral Nervous System Diseases / chemically induced. Radiotherapy, Adjuvant. Retrospective Studies. Survival Analysis. Vincristine / administration & dosage. Vincristine / adverse effects

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  • (PMID = 11305414.001).
  • [ISSN] 1522-8517
  • [Journal-full-title] Neuro-oncology
  • [ISO-abbreviation] Neuro-oncology
  • [Language] eng
  • [Publication-type] Comparative Study; Evaluation Studies; Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 7BRF0Z81KG / Lomustine; 8N3DW7272P / Cyclophosphamide; Q20Q21Q62J / Cisplatin
  • [Number-of-references] 15
  • [Other-IDs] NLM/ PMC1920599
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68. Rueckriegel SM, Driever PH, Blankenburg F, Lüdemann L, Henze G, Bruhn H: Differences in supratentorial damage of white matter in pediatric survivors of posterior fossa tumors with and without adjuvant treatment as detected by magnetic resonance diffusion tensor imaging. Int J Radiat Oncol Biol Phys; 2010 Mar 1;76(3):859-66
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  • [Title] Differences in supratentorial damage of white matter in pediatric survivors of posterior fossa tumors with and without adjuvant treatment as detected by magnetic resonance diffusion tensor imaging.
  • PURPOSE: To elucidate morphologic correlates of brain dysfunction in pediatric survivors of posterior fossa tumors by using magnetic resonance diffusion tensor imaging (DTI) to examine neuroaxonal integrity in white matter.
  • PATIENTS AND METHODS: Seventeen medulloblastoma (MB) patients who had received surgery and adjuvant treatment, 13 pilocytic astrocytoma (PA) patients who had been treated only with surgery, and age-matched healthy control subjects underwent magnetic resonance imaging on a 3-Tesla system.
  • Fractional anisotropy (FA) maps were analyzed using tract-based spatial statistics, a part of the Functional MRI of the Brain Software Library.
  • Fractional anisotropy values of the PA patients were not only decreased in cerebellar hemispheric structures as expected, but also in supratentorial parts of the brain, with a distribution similar to that in MB patients.
  • However, the amount of significantly decreased FA was greater in MB than in PA patients, underscoring the aggravating neurotoxic effect of the adjuvant treatment.
  • CONCLUSIONS: Neurotoxic mechanisms that are present in PA patients (e.g., internal hydrocephalus and damaged cerebellar structures affecting neuronal circuits) contribute significantly to the alteration of supratentorial white matter in pediatric posterior fossa tumor patients.
  • [MeSH-major] Astrocytoma. Brain / pathology. Diffusion Magnetic Resonance Imaging / methods. Infratentorial Neoplasms. Medulloblastoma. Survivors
  • [MeSH-minor] Adolescent. Anisotropy. Axons. Case-Control Studies. Cerebellum / drug effects. Cerebellum / pathology. Cerebellum / radiation effects. Chemotherapy, Adjuvant / adverse effects. Child. Child, Preschool. Cranial Irradiation / adverse effects. Female. Humans. Leukoencephalopathies / etiology. Leukoencephalopathies / pathology. Male. Radiotherapy, Adjuvant / adverse effects

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  • [Copyright] Copyright (c) 2010 Elsevier Inc. All rights reserved.
  • (PMID = 19540067.001).
  • [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; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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69. Muirhead SE, Hsu E, Grimard L, Keene D: Endocrine complications of pediatric brain tumors: case series and literature review. Pediatr Neurol; 2002 Sep;27(3):165-70
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Endocrine complications of pediatric brain tumors: case series and literature review.
  • The survival rate for childhood cancer, including brain tumors, is increasing.
  • As a result, long-term sequelae of chemotherapy and radiotherapy are also increasing.
  • The purpose of this study was to determine the frequency of endocrine complications of therapy for brain tumors in pediatric patients.
  • Endocrinopathy was observed in 19 of 20 (95%) of patients with supratentorial midline tumors.
  • Fifty-seven patients with nonmidline tumors (22 supratentorial, 35 posterior fossa) were followed for a mean of 4.6 +/- 2.4 years.
  • Twenty-two endocrinopathies occurred in 16 patients treated as follows: one of 23 patients (0.4%) had surgery alone, zero of four (0%) had chemotherapy alone, eight of 18 (44%) had radiotherapy alone, and seven of 12 (58%) had both radiotherapy and chemotherapy.
  • Growth failure occurred in none of 23 patients who had surgery alone, in one of four patients who had chemotherapy (25%), in 11 of 18 patients who had radiotherapy (61%), in seven of 12 patients who received both radiotherapy and chemotherapy (58%), and in 12 of 18 patients who had craniospinal radiation (67%).
  • In conclusion, endocrine and growth disturbances are uncommon with surgery alone, although they occurred in 53 and 60%, respectively, of patients treated with cranial irradiation for a brain tumor.
  • This finding underscores the importance of routine endocrinology follow-up for all brain tumor patients receiving cranial irradiation.
  • [MeSH-major] Brain Neoplasms / diagnosis. Paraneoplastic Endocrine Syndromes / diagnosis
  • [MeSH-minor] Adolescent. Chemotherapy, Adjuvant / adverse effects. Child. Child, Preschool. Combined Modality Therapy. Cranial Irradiation / adverse effects. Craniotomy / adverse effects. Female. Follow-Up Studies. Human Growth Hormone / deficiency. Humans. Male. Postoperative Complications / diagnosis. Postoperative Complications / etiology. Postoperative Complications / mortality. Postoperative Complications / therapy. Retrospective Studies. Survival Rate

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  • (PMID = 12393125.001).
  • [ISSN] 0887-8994
  • [Journal-full-title] Pediatric neurology
  • [ISO-abbreviation] Pediatr. Neurol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone
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70. Marcus KJ, Goumnerova L, Billett AL, Lavally B, Scott RM, Bishop K, Xu R, Young Poussaint T, Kieran M, Kooy H, Pomeroy SL, Tarbell NJ: Stereotactic radiotherapy for localized low-grade gliomas in children: final results of a prospective trial. Int J Radiat Oncol Biol Phys; 2005 Feb 1;61(2):374-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • PURPOSE: To evaluate the efficacy of stereotactic radiotherapy (SRT) for small, localized, pediatric brain tumors and to determine the patterns of failure.
  • Of the 81 patients, 50 had low-grade astrocytoma, 23 had residual or recurrent craniopharyngioma, 4 had posterior fossa ependymoma, and 4 had other histologic types.
  • All patients underwent biopsy for diagnosis, with the exception of patients with neurofibromatosis and radiographic evidence of an optic system tumor.
  • The indications for treatment of patients with low-grade gliomas were progression during or after chemotherapy or progression after surgery alone.
  • CT and MRI fusion was used for treatment planning.
  • The target volume generally included the preoperative tumor plus a 2-mm margin for the planning target volume.
  • Three to nine arcs were used to deliver a mean total dose of 52.2 Gy in 1.8-Gy daily fractions.
  • Five patients, all with optic system/hypothalamic primary tumors, developed central nervous system dissemination 1.0-7.4 years after SRT.
  • One patient developed a presumed radiation-induced primitive neuroectodermal tumor 6 years after initial treatment.
  • Six patients died, three of dissemination, two of progression to higher grade tumors, and one of a secondary radiation-induced tumor.
  • All 6 cases of local progression were within the primary tumor bed at the time of progression and had received the full prescription dose.
  • CONCLUSION: Stereotactic radiotherapy provides excellent local control for children with small, localized low-grade glial tumors.
  • Marginal failures have not been observed, supporting the use of limited margins to minimize late sequelae using stereotactic immobilization and planning techniques.
  • [MeSH-major] Astrocytoma / surgery. Brain Neoplasms / surgery. Radiosurgery
  • [MeSH-minor] Adolescent. Adult. Child. Child, Preschool. Confidence Intervals. Disease Progression. Disease-Free Survival. Female. Humans. Male. Neoplasm Recurrence, Local / drug therapy. Prospective Studies. Radiotherapy Dosage

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  • (PMID = 15667955.001).
  • [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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71. Chen KS, Hung PC, Wang HS, Jung SM, Ng SH: Medulloblastoma or cerebellar dysplastic gangliocytoma (Lhermitte-Duclos disease)? Pediatr Neurol; 2002 Nov;27(5):404-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Medulloblastoma or cerebellar dysplastic gangliocytoma (Lhermitte-Duclos disease)?
  • Dysplastic cerebellar gangliocytoma is a rare benign tumor associated with specific neuroimaging findings of abnormal laminated or folial pattern in the posterior fossa.
  • In patients with a posterior fossa tumor suggestive of a dysplastic gangliocytoma on neuroimaging studies, a pathologic confirmation is necessary.
  • [MeSH-minor] Diagnosis, Differential. Drug Therapy. Gadolinium. Humans. Infant. Magnetic Resonance Imaging. Male. Neoplasm, Residual / surgery. Reoperation. Tomography, X-Ray Computed


72. Varan A, Akalan N, Söylemezoğlu F, Zorlu F, Yalçin B, Akyüz C, Kutluk T, Büyükpamukçu M: Central nervous system tumors in patients under three years of age: treatment results of a single institute. Pediatr Neurosurg; 2006;42(2):89-94
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Central nervous system tumors in patients under three years of age: treatment results of a single institute.
  • Eighty-six patients under 3 years of age with central nervous system tumors were retrospectively analyzed between 1972 and 2003.
  • Surgical resection was done in all patients except for those with optic glioma, pons glioma and pineal tumor.
  • Three different chemotherapy regimens were used in different time periods.
  • In 48 patients, the tumor was located in the posterior fossa, and 29 patients had a supratentorial tumor.
  • We had 32 (37.2%) patients with embryonic tumors (21 medulloblastoma, 4 ependymoblastoma, 5 with atypical teratoid rhabdoid and 2 with supratentorial primitive neuroectodermal tumors), 21 (24.4%) with ependymoma, 14 (16.3%) with optic glioma, 10 (11.6%) with astrocytoma, 3 (3.5%) with pons glioma and 6 (7.0%) with others.
  • OS rates according to the tumor localizations were 40.9 and 68.1% in the posterior fossa and supratentorial localizations, respectively (p=0.001).
  • OS rates were 33.7, 41.3 and 88.8% for the medulloblastoma+primitive neuroectodermal tumor groups, ependymoma and astrocytoma, respectively (p=0.0001).
  • Most of the patients had primitive embryonic tumors (37.2%).
  • The best prognostic factors were tumor localization and histology.
  • [MeSH-major] Central Nervous System Neoplasms / mortality. Central Nervous System Neoplasms / therapy. Neoplasms, Germ Cell and Embryonal / mortality. Neoplasms, Germ Cell and Embryonal / therapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Child, Preschool. Female. Humans. Infant. Infant, Newborn. Male. Prognosis. Retrospective Studies. Rhabdoid Tumor / mortality. Rhabdoid Tumor / pathology. Rhabdoid Tumor / therapy. Survival Rate

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  • [Copyright] Copyright (c) 2006 S. Karger AG, Basel.
  • (PMID = 16465077.001).
  • [ISSN] 1016-2291
  • [Journal-full-title] Pediatric neurosurgery
  • [ISO-abbreviation] Pediatr Neurosurg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
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73. Palmér L, Nordborg C, Steneryd K, Aman P, Kyllerman M: Large-cell medulloblastoma in Aicardi syndrome. Case report and literature review. Neuropediatrics; 2004 Oct;35(5):307-11
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • An eight-year-old girl with Aicardi syndrome (AIC) developed signs of increased intracranial pressure.
  • A clinical and radiological investigation revealed a tumor in the posterior fossa, which was resected.
  • Eight months later, she died of a local recurrence, despite treatment with chemotherapy and radiotherapy according to a PNET protocol.
  • In addition to the growth of a large-cell medulloblastoma at the location of the primary tumor and the meningeal spread of the tumor, the autopsy revealed major cortical and subcortical malformations of the brain.
  • Various benign (e.g., plexus papillomas) and malignant tumors (angiosarcoma, embryonic carcinoma, and hepatoblastoma) have been reported in connection with Aicardi syndrome.
  • A genetic analysis of AIC suggests that the mutation is localized on the distal part of the short arm of the X chromosome, an area that may be of importance for tumor development.
  • This is the first report of a primary malignant brain tumor -- large-cell medulloblastoma -- in a patient with Aicardi syndrome.
  • [MeSH-major] Agenesis of Corpus Callosum. Cerebellar Neoplasms / etiology. Choroid Diseases / complications. Medulloblastoma / etiology. Retinal Diseases / complications. Spasm / complications


74. Massimino M, Gandola L, Cefalo G, Lasio G, Riva D, Fossati-Bellani F, Gianni MC, Luksch R, Tesoro-Tess JD, Lombardi F: Management of medulloblastoma and ependymoma in infants: a single-institution long-term retrospective report. Childs Nerv Syst; 2000 Jan;16(1):15-20
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • To reduce the sequelae from CNS irradiation (RT), 16 children younger than 3 years with medulloblastoma-PNET (13 cases) and ependymoma (3 cases) were treated between 1987-1993 according to different postsurgical chemotherapy (CT) programs.
  • Eleven patients were rendered disease-free by surgery, while 5 had residual tumor.
  • Adjuvant therapy depended on patients' age, postsurgical status and parents' consent to radiotherapy (RT).
  • Nine of the 16 infants remained alive in continuous complete remission from the first neoplasm (median follow-up 7 years).
  • Three of them had been treated with CT alone and 6 with combined CT + RT (posterior fossa 4, whole CNS 2).
  • Seven patients relapsed a median of 13 months after diagnosis, and all 7 of them died of their disease.
  • One child in whom the entire CNS was irradiated developed glioblastoma multiforme 120 months after the first diagnosis of medulloblastoma.
  • [MeSH-major] Brain Neoplasms / surgery. Cerebellar Neoplasms / surgery. Ependymoma / surgery. Medulloblastoma / surgery. Neuroectodermal Tumors, Primitive / surgery
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Adjuvant. Child, Preschool. Combined Modality Therapy. Cranial Irradiation. Female. Follow-Up Studies. Humans. Infant. Male. Radiotherapy, Adjuvant. Retrospective Studies. Survival Rate


75. Wendland MM, Shrieve DC, Watson GA, Chin SS, Blumenthal DT: Extraneural metastatic medulloblastoma in an adult. J Neurooncol; 2006 Jun;78(2):191-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Medulloblastoma is a rare malignancy in adults, accounting for approximately 1% of all primary brain tumors.
  • Extraneural metastases have been reported in 10-30% of cases and most commonly involve bone; rarely lymph nodes, visceral organs and bone marrow may be involved with disease.
  • We report here our experience with a 26 year-old woman with medulloblastoma treated with gross total resection followed by radiation therapy to her craniospinal axis.
  • She subsequently developed widespread metastatic disease involving bone exclusive of the calvarium and spine for which multi-agent salvage chemotherapy was utilized with initial good clinical response.
  • She later relapsed within the lymph nodes and soft tissues of the pelvis and eventually suffered a local recurrence within the posterior fossa.
  • The treatment of medulloblastoma, particularly salvage therapy following disease recurrence, is reviewed.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bone Neoplasms / secondary. Brain Neoplasms / pathology. Medulloblastoma / secondary
  • [MeSH-minor] Adult. Combined Modality Therapy. Disease-Free Survival. Female. Humans. Lymphatic Metastasis. Radiotherapy Dosage. Salvage Therapy. Treatment Outcome

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  • (PMID = 16598430.001).
  • [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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76. Fouladi M, Hunt DL, Pollack IF, Dueckers G, Burger PC, Becker LE, Yates AJ, Gilles FH, Davis RL, Boyett JM, Finlay JL: Outcome of children with centrally reviewed low-grade gliomas treated with chemotherapy with or without radiotherapy on Children's Cancer Group high-grade glioma study CCG-945. Cancer; 2003 Sep 15;98(6):1243-52
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  • [Title] Outcome of children with centrally reviewed low-grade gliomas treated with chemotherapy with or without radiotherapy on Children's Cancer Group high-grade glioma study CCG-945.
  • BACKGROUND: The objectives of the current study were to determine the outcome of children who were treated with chemotherapy and radiotherapy on the Children's Cancer Group (CCG) high-grade glioma protocol (CCG-945) who were diagnosed with low-grade gliomas on post hoc central pathologic review and to identify clinical and biologic features associated with prognosis.
  • Patients older than 24 months with intracranial lesions were assigned randomly to receive either lomustine, vincristine, and prednisone (control regimen) or the 8-drugs-in-1-day regimen (experimental regimen); younger patients and those with primary spinal cord tumors were assigned nonrandomly to the experimental regimen.
  • Significantly poorer 5-year PFS was seen in children younger than 24 months, those with fibrillary astrocytoma, and those with posterior fossa tumors.
  • Patients demonstrated a modest improvement in PFS but no improvement in OS compared with children with low-grade gliomas who were treated with contemporary chemotherapy-alone approaches.
  • CONCLUSIONS: The current report calls attention to the importance of central pathologic review in large multiinstitutional trials of children with gliomas and suggests that aggressive front-line combined chemoradiotherapy does not confer a survival advantage in this highly selected population of patients.
  • [MeSH-major] Brain Neoplasms / therapy. Glioma / therapy
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Child. Child, Preschool. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Infant. Infant, Newborn. Lomustine / administration & dosage. Male. Prednisolone / administration & dosage. Prognosis. Treatment Outcome. Vincristine / administration & dosage

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  • [Copyright] Copyright 2003 American Cancer Society.DOI 10.1002/cncr.11637
  • (PMID = 12973849.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA13539; United States / NCI NIH HHS / CA / CA21765; United States / NINDS NIH HHS / NS / NS01810; United States / NINDS NIH HHS / NS / NS37704
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 5J49Q6B70F / Vincristine; 7BRF0Z81KG / Lomustine; 9PHQ9Y1OLM / Prednisolone
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77. López-Aguilar E, Sepúlveda-Vildósola AC, Rivera-Márquez H, Cerecedo-Díaz F, Hernández-Contreras I, Ramón-García G, Diegopérez-Ramírez J, Santacruz-Castillo E: Preirradiation ifosfamide, carboplatin, and etoposide for the treatment of anaplastic astrocytomas and glioblastoma multiforme: a phase II study. Arch Med Res; 2000 Mar-Apr;31(2):186-90
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  • [Title] Preirradiation ifosfamide, carboplatin, and etoposide for the treatment of anaplastic astrocytomas and glioblastoma multiforme: a phase II study.
  • BACKGROUND: Central nervous system (CNS) tumors are the second most common pediatric tumors.
  • Astrocytomas represent 35% of all CNS tumors in children.
  • Traditional treatment of anaplastic astrocytoma (AA) and glioblastoma multiforme (GM) consisting of surgery-radiotherapy-chemotherapy with nitrosoureas has resulted in a survival rate of 26% at 1 year.
  • Neoadjuvant chemotherapy has proven good results in the treatment of other solid tumors.
  • Chemotherapy with ifosfamide, carboplatin, and etoposide (ICE) permits synergism among the different drugs and sensitizes the tumor to radiotherapy.
  • Our objective was to evaluate the efficacy, security, and survival rate of postoperative chemotherapy with ICE in pediatric patients with AA or GM.
  • We evaluated 11 children with AA or GM who had received no prior treatment.
  • A magnetic resonance image (MRI) study of the tumor was made after surgery to evaluate residual tumor and routine laboratory analysis.
  • Chemotherapy with carboplatin, ifosfamide and etoposide was given every 3 weeks for four courses.
  • Each patient then received hyperfractionated radiotherapy and a final MRI was done at the end of the treatment.
  • Supratentorial and infratentorial tumors had a good response to chemotherapy.
  • Brainstem tumors had an initial response after two courses and then increased in size.
  • AA was the tumor with the greatest reduction of residual tumor after treatment.
  • CONCLUSIONS: Postoperative chemotherapy with ICE reduces the tumor size and increases the survival rate of pediatric patients with malignant astrocytomas with minimal toxicity.
  • Brainstem responded poorly to treatment.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Astrocytoma / drug therapy. Brain Neoplasms / drug therapy. Cranial Irradiation. Glioblastoma / drug therapy. Premedication. Radiotherapy, Adjuvant
  • [MeSH-minor] Adolescent. Carboplatin / administration & dosage. Child. Child, Preschool. Combined Modality Therapy. Disease-Free Survival. Etoposide / administration & dosage. Female. Humans. Ifosfamide / administration & dosage. Life Tables. Male. Mesna / administration & dosage. Prospective Studies. Survival Analysis. Survival Rate. Treatment Outcome

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  • (PMID = 10880725.001).
  • [ISSN] 0188-4409
  • [Journal-full-title] Archives of medical research
  • [ISO-abbreviation] Arch. Med. Res.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] MEXICO
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; BG3F62OND5 / Carboplatin; NR7O1405Q9 / Mesna; UM20QQM95Y / Ifosfamide; ICE protocol 5
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78. Kieffer-Renaux V, Viguier D, Raquin MA, Laurent-Vannier A, Habrand JL, Dellatolas G, Kalifa C, Hartmann O, Grill J: Therapeutic schedules influence the pattern of intellectual decline after irradiation of posterior fossa tumors. Pediatr Blood Cancer; 2005 Nov;45(6):814-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Therapeutic schedules influence the pattern of intellectual decline after irradiation of posterior fossa tumors.
  • BACKGROUND: To evaluate intellectual decline in children with posterior fossa (PF) tumors treated with different therapeutic protocols.
  • PROCEDURE: Forty children had a complete neuropsychological evaluation prospectively twice, at least 6 months year (y) after the end of their treatment.
  • Patients were classified into four groups according to treatment schedules: Group 1 (n = 7) PF radiotherapy (PFRT) alone at 50 Gy; Group 2 (n = 13) reduced-dose cranio-spinal irradiation (CSI) at 25 Gy with a PF boost; Group 3 (n = 9) standard CSI at 35 Gy and a PF boost; and Group 4 (n = 11) high-dose chemotherapy with stem cell support followed by PFRT at 50 Gy.
  • A FSIQ decline was observed in all treatment groups except Group 1 (P = 0.005).
  • The differences in FSIQ observed initially between the four treatment groups persisted at the second evaluation.
  • CONCLUSIONS: This study shows that FSIQ continues to decline more than 4 years after the diagnosis but this yearly decline seems to decrease with time from diagnosis.
  • Therapeutic schedules influence the magnitude of this decline.
  • [MeSH-major] Cognition Disorders / etiology. Infratentorial Neoplasms / complications. Infratentorial Neoplasms / radiotherapy. Intelligence / radiation effects. Radiotherapy / adverse effects
  • [MeSH-minor] Adolescent. Adult. Appointments and Schedules. Child. Child, Preschool. Combined Modality Therapy. Dose-Response Relationship, Radiation. Female. Follow-Up Studies. Humans. Infant. Intelligence Tests. Male. Time Factors

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  • [Copyright] (c) 2005 Wiley-Liss, Inc.
  • (PMID = 15924360.001).
  • [ISSN] 1545-5009
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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79. Quiñones-Hinojosa A, Friedlander RM, Boyer PJ, Batchelor TT, Chiocca EA: Solitary sciatic nerve lymphoma as an initial manifestation of diffuse neurolymphomatosis. Case report and review of the literature. J Neurosurg; 2000 Jan;92(1):165-9
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  • Magnetic resonance imaging studies revealed a solitary fusiform tumor, extending from the sciatic nerve, at the level of the lesser trochanter of the femur, into the posterior tibial nerve below the popliteal fossa.
  • Intraoperative gross examination found that the tumor diffusely expanded the nerve, but did not extend from or into surrounding muscle or tendons.
  • Postoperative staging did not reveal evidence of lymphomatous involvement of other organs, but additional chemo- and radiotherapies were administered.
  • The patient underwent intrathecal chemotherapy followed by systemic myelosuppressive chemotherapy with bone marrow rescue, but died of respiratory failure while still receiving treatment.
  • The aggressive biological characteristics of these tumors, their management, and pertinent literature are reviewed.
  • [MeSH-major] Lymphoma / diagnosis. Peripheral Nervous System Neoplasms / diagnosis. Sciatic Nerve

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  • (PMID = 10616097.001).
  • [ISSN] 0022-3085
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] UNITED STATES
  • [Number-of-references] 20
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80. 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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  • [Title] Incidence, risks, and sequelae of posterior fossa syndrome in pediatric medulloblastoma.
  • PURPOSE: To investigate the incidence, risks, severity, and sequelae of posterior fossa syndrome (PFS) in children with medulloblastoma.
  • 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.
  • Eleven patients had disseminated disease.
  • 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-major] Cerebellar Neoplasms / radiotherapy. Medulloblastoma / radiotherapy
  • [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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81. Zacharoulis S, Ji L, Pollack IF, Duffner P, Geyer R, Grill J, Schild S, Jaing TH, Massimino M, Finlay J, Sposto R: Metastatic ependymoma: a multi-institutional retrospective analysis of prognostic factors. Pediatr Blood Cancer; 2008 Feb;50(2):231-5
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  • PROCEDURE: Data regarding diagnosis, treatment and follow-up for 40 patients from eight institutional cohorts were collected.
  • RESULTS: Twenty-nine (72%) patients were less than 36 months of age at the time of diagnosis, 28% were females, and 90% of the patients had posterior fossa tumors.
  • Gross total resection (GTR) of the primary tumor was achieved in 16 patients (40%).
  • Adjuvant therapy was variable and included craniospinal irradiation (CSRT), chemotherapy, and chemotherapy with focal irradiation.
  • The 5-year event free survival (EFS) and overall survival (OS) from the time of diagnosis were 29% (+/-7%) and 43% (+/-8%), respectively.
  • Patients with GTR achieved a 5-year EFS of 35% and OS of 59%, compared to a 5-year EFS of 25% and OS of 32% for patients who did not achieve GTR (P = 0.12 for EFS, P = 0.03 for OS).
  • [MeSH-major] Brain Neoplasms / pathology. Ependymoma / pathology. Ependymoma / secondary
  • [MeSH-minor] Child. Child, Preschool. Disease-Free Survival. Female. Humans. Infant. Infant, Newborn. Kaplan-Meier Estimate. Male. Neoplasm Metastasis. Proportional Hazards Models. Retrospective Studies

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  • [Copyright] (c) 2007 Wiley-Liss, Inc.
  • (PMID = 17610266.001).
  • [ISSN] 1545-5017
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] United States
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82. Massimino M, Giangaspero F, Garrè ML, Genitori L, Perilongo G, Collini P, Riva D, Valentini L, Scarzello G, Poggi G, Spreafico F, Peretta P, Mascarin M, Modena P, Sozzi G, Bedini N, Biassoni V, Urgesi A, Balestrini MR, Finocchiaro G, Sandri A, Gandola L, AIEOP Neuro-Oncology Group: Salvage treatment for childhood ependymoma after surgery only: Pitfalls of omitting "at once" adjuvant treatment. Int J Radiat Oncol Biol Phys; 2006 Aug 1;65(5):1440-5
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  • [Title] Salvage treatment for childhood ependymoma after surgery only: Pitfalls of omitting "at once" adjuvant treatment.
  • PURPOSE: To discuss the results obtained by giving adjuvant treatment for childhood ependymoma (EPD) at relapse after complete surgery only.
  • METHODS AND MATERIALS: Between 1993 and 2002, 63 children older than 3 years old entered the first Italian Association for Pediatric Hematology and Oncology protocol for EPD (group A), and another 14 patients were referred after relapsing after more tumor excisions only (group B).
  • RESULTS: Mean time to first local progression in group B had been 14 months.
  • Tumors originated in the posterior fossa (PF) in 10 children and were supratentorial (ST) in 4; 11 had first been completely excised (NED) and 3 had residual disease (ED).
  • All received radiotherapy (RT) to tumor bed and 5 also had pre-RT chemotherapy.
  • Six of 14 patients (6/10 with PF tumors) had a further relapse a mean 6 months after the last surgery; 4 of 6 died: progression-free survival and overall survival at 4 years after referral were 54.4% and 77%, respectively.
  • Considering only PF tumors and setting time 0 as at the last surgery for group B, progression-free survival and overall survival were 32% and 50% for group B and 52% (p < 0.20)/70% (p < 0.29) for the 46 patients in group A with PF tumors.
  • CONCLUSIONS: Relapsers after surgery only, especially if with PF-EPD, do worse than those treated after first diagnosis; subsequent surgery for tumor relapse has severe neurologic sequelae.
  • [MeSH-major] Brain Neoplasms / radiotherapy. Ependymoma / radiotherapy. Salvage Therapy / methods
  • [MeSH-minor] Adolescent. Chemotherapy, Adjuvant. Child. Child, Preschool. Female. Humans. Neoplasm, Residual. Radiotherapy, Adjuvant. Treatment Outcome

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  • (PMID = 16863927.001).
  • [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
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83. Hong TS, Mehta MP, Boyett JM, Donahue B, Rorke LB, Zeltzer PM: Patterns of treatment failure in infants with primitive neuroectodermal tumors who were treated on CCG-921: a phase III combined modality study. Pediatr Blood Cancer; 2005 Oct 15;45(5):676-82
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  • [Title] Patterns of treatment failure in infants with primitive neuroectodermal tumors who were treated on CCG-921: a phase III combined modality study.
  • PURPOSE: To analyze patterns of treatment failure in infants with primitive neuroectodermal tumors (PNETs) who were treated primarily with chemotherapy in a large multi-institutional study.
  • MATERIALS AND METHODS: Sixty-five prospectively staged patients with PNET confirmed by central pathology review, who were 18 months or younger were treated on Children's Cancer Group Study 921 (CCG-921) primarily with chemotherapy.
  • Forty-six patients had posterior fossa (PF) primary tumors and 19 patients had supratentorial (ST) primaries.
  • Patterns of sites of initial treatment failure were analyzed and compared to failure patterns of 180 older children who had PF-PNETs, and 44 older children with ST-PNETs who were treated on the same protocol.
  • Cumulative 5-year relapse incidence (+/-SE) for younger patients with PF-PNETs was 64.5 +/- 8.9% for patients without metastases (M0) compared to 71.4 +/- 13.4% for patients with metastases (M+).
  • The overall treatment failure rate was significantly higher for younger compared to older patients with PF-PNET and ST-PNET.
  • There was no statistically significant difference in relapse patterns between patients with PF primary tumors and ST primaries when stratified by stage.
  • All patients had a high risk of recurrence at primary tumor site.
  • Younger patients who had PF primary tumors without metastasis at presentation were significantly more likely to relapse in PF than older patients.
  • CONCLUSIONS: Despite aggressive chemotherapy, younger children with PNETs have high rates of treatment failure and fare worse than high-risk, older patients with PF-PNETs, indicating the need to maximize local, regional, and systemic therapies.
  • [MeSH-major] Brain Neoplasms / therapy. Neuroectodermal Tumors, Primitive / therapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Clinical Trials, Phase III as Topic. Combined Modality Therapy. Disease Progression. Disease-Free Survival. Humans. Infant. Infratentorial Neoplasms / mortality. Infratentorial Neoplasms / pathology. Infratentorial Neoplasms / therapy. Neoplasm Recurrence, Local. Supratentorial Neoplasms / mortality. Supratentorial Neoplasms / pathology. Supratentorial Neoplasms / therapy. Survival Rate. Treatment Failure

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  • (PMID = 16007595.001).
  • [ISSN] 1545-5009
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA21765
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
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84. Cohen KJ, Broniscer A, Glod J: Pediatric glial tumors. Curr Treat Options Oncol; 2001 Dec;2(6):529-36
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  • [Title] Pediatric glial tumors.
  • Glial neoplasms in children comprise many heterogeneous tumors that include pilocytic and fibrillary astrocytomas, ependymomas, and the diffuse intrinsic pontine gliomas.
  • In contrast to adults, most of whom present with high-grade fibrillary neoplasms, alternate histologies represent most cases seen in the pediatric setting.
  • In addition, although most adult gliomas are supratentorial in location, in pediatrics infratentorial tumors (posterior fossa and brain stem) predominate.
  • We discuss three specific tumors: diffuse intrinsic pontine gliomas; pilocytic astrocytomas; and ependymomas.
  • Maximal surgical resection is the mainstay of therapy for both pilocytic astrocytomas and ependymomas.
  • Failure to achieve an optimal resection often results in progression and the need for further therapy for patients with pilocytic astrocytomas, and is ultimately fatal in most children with subtotally resected ependymomas.
  • Surgical resection has no role in the treatment of pontine gliomas.
  • Focal radiation therapy is included routinely in the treatment of ependymomas, and it has been shown to improve event-free survival.
  • This therapy also is used in the treatment of pontine gliomas because radiation treatment appears to slow inevitable tumor progression.
  • Radiation therapy in pilocytic astrocytomas is generally reserved for patients who progress after an initial surgical resection or for those patients with midline tumors; these patients are poor candidates for aggressive surgical resection.
  • The role of chemotherapy in these tumors is in evolution.
  • Chemotherapy for pilocytic astrocytomas, particularly in young children (for whom radiation therapy is avoided), appears to be effective in the treatment of a subset of patients.
  • Up-front chemotherapy is generally reserved for the youngest children who present with ependymoma.
  • In the recurrence setting, chemotherapy has shown some activity, although this approach is never curative.
  • Despite the application of various chemotherapeutics and other biologic agents, none of these therapies has improved the prognosis for patients with the uniformly lethal pontine glioma.
  • [MeSH-major] Brain Neoplasms / therapy. Glioma / therapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Astrocytoma / mortality. Astrocytoma / therapy. Cerebrospinal Fluid Shunts. Chemotherapy, Adjuvant. Child. Child, Preschool. Combined Modality Therapy. Cranial Irradiation. Craniotomy. Disease Progression. Ependymoma / mortality. Ependymoma / therapy. Epidemiologic Methods. Humans. Hydrocephalus / etiology. Hydrocephalus / surgery. Infant. Infratentorial Neoplasms / mortality. Infratentorial Neoplasms / therapy. Palliative Care. Pons. Prognosis. Radiotherapy, Adjuvant. Treatment Outcome

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  • (PMID = 12057098.001).
  • [ISSN] 1527-2729
  • [Journal-full-title] Current treatment options in oncology
  • [ISO-abbreviation] Curr Treat Options Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 30
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85. Yazigi-Rivard L, Masserot C, Lachenaud J, Diebold-Pressac I, Aprahamian A, Avran D, Doz F: [Childhood medulloblastoma]. Arch Pediatr; 2008 Dec;15(12):1794-804
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  • [Transliterated title] Le médulloblastome de l'enfant.
  • Medulloblastoma is one of the most common malignant childhood brain tumors.
  • It is a primitive neuroectodermal tumor (PNET) and predominantly arises in the cerebellum and 4th ventricle.
  • Most often intracranial hypertension reveals the disease typically with headache and vomiting.
  • However, the frequent atypical presentation should not delay neuroradiological investigations.
  • Brain and spinal MRI can establish the diagnosis of posterior fossa tumor and define the extent of the disease.
  • Histologic examination of the tumor confirms the diagnosis of medulloblastoma.
  • Patients are classified into 2 risk groups: standard-risk medulloblastoma, defined by nonmetastatic disease treated by total or subtotal tumor resection; and high-risk patients who have disseminated disease and/or residual disease.
  • Tumor molecular genetic findings allow the use of emerging prognostic factors and may ultimately contribute to the development of targeted therapy.
  • Current treatment in the oldest children combines surgical resection followed by radiotherapy and chemotherapy.
  • Treatment in younger patients is as much as possible restricted to surgery and chemotherapy.
  • However, long-term sequelae after treatment for medulloblastoma remain frequent and the detection and treatment of those sequelae is an essential part of the follow-up of the patients.
  • [MeSH-major] Cerebellar Neoplasms. Medulloblastoma
  • [MeSH-minor] Age Factors. Child. Child, Preschool. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Magnetic Resonance Imaging. Male. Meta-Analysis as Topic. Neoplasm Metastasis. Neoplasms, Second Primary / etiology. Prognosis. Prospective Studies. Radiotherapy / adverse effects. Radiotherapy Dosage. Randomized Controlled Trials as Topic. Risk Factors. Treatment Outcome

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  • (PMID = 18995998.001).
  • [ISSN] 0929-693X
  • [Journal-full-title] Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie
  • [ISO-abbreviation] Arch Pediatr
  • [Language] fre
  • [Publication-type] Comparative Study; English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Number-of-references] 52
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86. Koeller KK, Rushing EJ: From the archives of the AFIP: medulloblastoma: a comprehensive review with radiologic-pathologic correlation. Radiographics; 2003 Nov-Dec;23(6):1613-37
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  • Medulloblastoma is the most common pediatric central nervous system malignancy and the most common primary tumor of the posterior fossa in children.
  • This highly malignant neoplasm occurs more frequently in males and usually before 10 years of age.
  • Clinical symptoms and signs are generally brief, typically less than 3 months in duration, and reflect the strong predilection of this tumor to arise within the cerebellum, most often in the vermis.
  • Although much less common, the disease may also occur in adults, usually in the 3rd and 4th decades of life.
  • Surgical resection, radiation therapy, and chemotherapy have substantially lowered the mortality associated with this tumor, with 5-year survival rates now commonly well above 50%.
  • Still, both dissemination at the time of diagnosis and recurrence remain obstacles in achieving a cure.
  • The tumor has characteristic hyperattenuation on unenhanced computed tomographic scans that reflects the high nuclear-cytoplasmic ratio seen at histologic analysis.
  • The tumor typically appears heterogeneous on images, findings that are related to cyst formation, hemorrhage, and calcification and that are even more pronounced with magnetic resonance (MR) imaging.
  • Evidence of leptomeningeal metastatic spread is present in 33% of all cases at the time of diagnosis and is well evaluated with contrast-enhanced MR imaging of the brain and the spine.
  • With continued research, treatment of these common neoplasms should improve, perhaps even achieving a cure in the future.
  • [MeSH-major] Cerebellar Neoplasms / radiography. Magnetic Resonance Imaging. Medulloblastoma / radiography. Tomography, X-Ray Computed
  • [MeSH-minor] Adolescent. Adult. Aged. Child. Child, Preschool. Female. Humans. Infant. Male. Meninges / pathology. Middle Aged. Neoplasm Invasiveness. Prognosis. Survival Rate

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  • (PMID = 14615567.001).
  • [ISSN] 1527-1323
  • [Journal-full-title] Radiographics : a review publication of the Radiological Society of North America, Inc
  • [ISO-abbreviation] Radiographics
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 102
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87. Chen ML, McComb JG, Krieger MD: Atypical teratoid/rhabdoid tumors of the central nervous system: management and outcomes. Neurosurg Focus; 2005 Jun 15;18(6A):E8
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  • [Title] Atypical teratoid/rhabdoid tumors of the central nervous system: management and outcomes.
  • OBJECT: Atypical teratoid/rhabdoid tumors (ATRTs) represent a relatively newly categorized neoplastic entity.
  • They commonly present in childhood, and have a rapidly progressive clinical course with a survival time of less than 1 year.
  • Treatment regimens have been nonuniform.
  • In this retrospective review of patients with ATRTs who were treated at the authors' institution according to a uniform protocol, the goal was to assess the efficacy of the treatment and its outcome.
  • Tumor location was cortical in four patients, in the pineal region in four, in the posterior fossa in two, and spinal in one.
  • In one patient disseminated disease was revealed on the initial imaging study; seven patients had disseminated tumor subsequently.
  • Treatment consisted of chemotherapy in 11 patients, chemotherapy and local radiation in five, and chemotherapy and craniospinal radiation in three.
  • The mean time to death was 24 months, and ranged from 2 to 67 months.
  • The median time to progression was 3.5 months.
  • CONCLUSIONS: Atypical teratoid/rhabdoid tumors are malignant lesions with rapid progression.
  • Further study is necessary to determine the efficacy of therapy.
  • [MeSH-major] Central Nervous System Neoplasms / therapy. Rhabdoid Tumor / therapy. Teratoma / therapy
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Female. Follow-Up Studies. Humans. Infant. Magnetic Resonance Imaging / methods. Male. Retrospective Studies. Treatment Outcome

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  • (PMID = 16048294.001).
  • [ISSN] 1092-0684
  • [Journal-full-title] Neurosurgical focus
  • [ISO-abbreviation] Neurosurg Focus
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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88. Al-Hussain TO, Dababo MA: Posterior fossa tumor in a 2 year-old girl. Brain Pathol; 2009 Apr;19(2):343-6
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  • [Title] Posterior fossa tumor in a 2 year-old girl.
  • We report a case of a 2 year-old girl who presented with three weeks' history of deterioration of walking, then became unable to walk and later she developed projectile vomiting.
  • Radiological studies showed an enhancing mass in the posterior fossa extending from the cerebellum to the roof of the fourth ventricle.
  • The tumor was diagnosed as an embryonal tumor with abundant neuropil and true rosettes (ETANTR).
  • The tumor cells in the neuroblastic component were diffusely positive for synaptophysin and CD56, with scattered positive cells for glial fibrillary acidic protein.
  • Our patient developed recurrent disease 6 months after resection and chemotherapy.
  • ETANTR is a very rare aggressive embryonal CNS tumor that combines features of neuroblastoma and ependymoblastoma.
  • [MeSH-major] Infratentorial Neoplasms / pathology. Neoplasms, Germ Cell and Embryonal / pathology

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  • (PMID = 19291003.001).
  • [ISSN] 1750-3639
  • [Journal-full-title] Brain pathology (Zurich, Switzerland)
  • [ISO-abbreviation] Brain Pathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Switzerland
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89. Mendenhall WM, Morris CG, Amdur RJ, Hinerman RW, Mancuso AA: Parameters that predict local control after definitive radiotherapy for squamous cell carcinoma of the head and neck. Head Neck; 2003 Jul;25(7):535-42
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  • [Title] Parameters that predict local control after definitive radiotherapy for squamous cell carcinoma of the head and neck.
  • PURPOSE: To analyze parameters that may influence the likelihood of local control after definitive radiotherapy for head and neck cancer.
  • METHODS: Between April 1980 and January 2000, 404 patients were treated with definitive RT alone (358 patients) or combined with adjuvant chemotherapy (46 patients) at our institution and were followed up for 0.25 to 20.25 years (median, 3.5 years.
  • All patients had the primary tumor volume calculated on pretreatment CT.
  • Parameters evaluated in multivariate analyses of these end points included primary site, T stage, primary tumor volume, N stage, histologic differentiation, fractionation schedule, adjuvant chemotherapy, and gender.
  • RESULTS: The rates of local control and local control without a severe late complication after RT were significantly influenced by primary tumor volume for patients with cancer of the supraglottic larynx and true vocal cord.
  • In contrast, the rates of local control and local control without severe complications for patients with tumors of the oropharynx and hypopharynx were less influenced by tumor volume.
  • Multivariate analyses stratified by primary site revealed that tumor volume significantly influenced local control for patients with cancers of the supraglottis (p =.0220) and glottis (p =.0042) but not for those with lesions of the tonsillar fossa/posterior tonsillar pillar (p =.0892), base of tongue (p =.9493), anterior tonsillar pillar/soft palate (p =.5909), and hypopharynx (p =.2282).
  • Primary tumor volume also significantly influences the probability of local control in cancers of the supraglottis and glottis.
  • [MeSH-major] Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / radiotherapy. Head and Neck Neoplasms / pathology. Head and Neck Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Adjuvant. Cisplatin / therapeutic use. Female. Fluorouracil / therapeutic use. Humans. Male. Middle Aged. Multivariate Analysis. Neoplasm Staging. Predictive Value of Tests. Radiotherapy / adverse effects. Radiotherapy Dosage

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  • [Copyright] Copyright 2003 Wiley Periodicals, Inc. Head Neck 25: 535-542, 2003
  • (PMID = 12808656.001).
  • [ISSN] 1043-3074
  • [Journal-full-title] Head & neck
  • [ISO-abbreviation] Head Neck
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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90. Niizuma K, Saito M: [Case report of tuberculous retropharyngeal abscess]. Kekkaku; 2008 Apr;83(4):393-7
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  • With a test puncture to the neck tumor, acid-fast stained bacilli were detected from punctured pus and the patient was hospitalized immediately due to a suspicion of tuberculous retropharyngeal abscess.
  • Palpation revealed soft tumors of a ping-pong ball size without tenderness nor febrile sensation in the right submandibular region and left supraclavicular fossa in the neck.
  • In the cervical contrast enhanced CT images, an abscess was found in the hypopharyngeal posterior gap and was shown as LDA (low density area) surrounded by strongly contrasting walls.
  • The tumor was divided horizontally at the second cervical vertebra and shown strongly at the left cervical region as it goes downward, and in the region from the 6th cervical vertebra to the second thoracic vertebra, vertebral body destruction and numerous small abscesses in the vertebral anterior gap were found.
  • As the abscess punctured fluid was TB-PCR (+), she was diagnosed as tuberculous retropharyngeal abscess, and a treatment was started with HRS (combination of isoniazid, rifampicin and streptomycin).
  • Subsequently, since the symptoms have improved and retention of abscesses was not found, the patient was discharged from the hospital.
  • After the treatment for 9 months, no recurrence was reported.
  • [MeSH-major] Retropharyngeal Abscess / diagnosis. Retropharyngeal Abscess / therapy. Tuberculosis / diagnosis. Tuberculosis / microbiology
  • [MeSH-minor] Aged, 80 and over. Antitubercular Agents / administration & dosage. Drug Therapy, Combination. Female. Humans. Mycobacterium tuberculosis / isolation & purification. Polymerase Chain Reaction. Punctures / methods. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 18516903.001).
  • [ISSN] 0022-9776
  • [Journal-full-title] Kekkaku : [Tuberculosis]
  • [ISO-abbreviation] Kekkaku
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antitubercular Agents
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91. Modha A, Vassilyadi M, George A, Kuehn S, Hsu E, Ventureyra EC: Medulloblastoma in children--the Ottawa experience. Childs Nerv Syst; 2000 Jun;16(6):341-50
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  • Via a suboccipital approach, complete tumor resection was achieved in 75% and subtotal resection (>90%) in 25%, without any operative mortality.
  • The tumor was located in the vermis in 39% and in the cerebellar hemisphere in 11%; it occupied both locations in 50%.
  • Postoperatively, craniospinal radiation at 3600 cGy with a boost to the posterior fossa was administered.
  • Chemotherapy was used in 56%.
  • Chang's classification was used to grade the tumors.
  • T stage did not have an impact on survival, but M stage did.
  • There was no difference in survival in terms of tumor location, hydrocephalus or ventriculoperitoneal shunt.
  • Chemotherapy showed no survival benefit.
  • The mean follow-up time was 4.4+/-3.7 years, with a range of 2.5 months to 16.5 years.
  • Fourteen patients died, 5 were lost to follow-up, and 7 were transferred to adult care without persistent disease.
  • [MeSH-major] Cerebellar Neoplasms / radiotherapy. Cerebellar Neoplasms / surgery. Medulloblastoma / radiotherapy. Medulloblastoma / surgery
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Cognition Disorders / diagnosis. Female. Follow-Up Studies. Humans. Infant. Male. Neoplasm Recurrence, Local. Neoplasm Staging. Neuropsychological Tests. Ontario. Retrospective Studies. Survival Rate. Treatment Outcome

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  • (PMID = 10933229.001).
  • [ISSN] 0256-7040
  • [Journal-full-title] Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
  • [ISO-abbreviation] Childs Nerv Syst
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] GERMANY
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92. Wells EM, Walsh KS, Khademian ZP, Keating RF, Packer RJ: The cerebellar mutism syndrome and its relation to cerebellar cognitive function and the cerebellar cognitive affective disorder. Dev Disabil Res Rev; 2008;14(3):221-8
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  • The postoperative cerebellar mutism syndrome (CMS), consisting of diminished speech output, hypotonia, ataxia, and emotional lability, occurs after surgery in up to 25% of patients with medulloblastoma and occasionally after removal of other posterior fossa tumors.
  • [MeSH-major] Brain Damage, Chronic / etiology. Cerebellar Neoplasms / surgery. Cognition Disorders / etiology. Cranial Fossa, Posterior / surgery. Developmental Disabilities / etiology. Medulloblastoma / surgery. Mood Disorders / etiology. Mutism / etiology. Skull Base Neoplasms / surgery. Survivors / psychology


93. Puget S, Boddaert N, Viguier D, Kieffer V, Bulteau C, Garnett M, Callu D, Sainte-Rose C, Kalifa C, Dellatolas G, Grill J: Injuries to inferior vermis and dentate nuclei predict poor neurological and neuropsychological outcome in children with malignant posterior fossa tumors. Cancer; 2009 Mar 15;115(6):1338-47
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  • [Title] Injuries to inferior vermis and dentate nuclei predict poor neurological and neuropsychological outcome in children with malignant posterior fossa tumors.
  • BACKGROUND: Children treated for a malignant posterior fossa tumor (PFT) are at risk of intellectual impairment.
  • Its severity is not explained by age and radiotherapy alone.
  • METHODS: Sixty-one consecutive children (mean age, 6.0 years) treated for a malignant PFT with surgery, chemotherapy, and radiotherapy underwent a detailed neuropsychological evaluation, including a full-scale intelligence quotient (FSIQ), on average 5.6 years after the diagnosis.
  • The neurological examination was recorded 1 month after surgery and at the time of the neuropsychological evaluation.
  • Cerebellar and brain injuries were scored based on the magnetic resonance imaging (MRI).
  • [MeSH-major] Cerebellar Neoplasms / complications. Cerebellar Neoplasms / therapy. Cerebellar Nuclei / injuries. Cognition Disorders / etiology. Infratentorial Neoplasms / complications. Infratentorial Neoplasms / therapy. Intelligence. Motor Skills

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  • [Copyright] Copyright (c) 2009 American Cancer Society.
  • (PMID = 19195041.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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94. Peltier J, Vinchon M, Baroncini M, Kerdraon O, Dhellemmes P: Bifocal mixed germ-cell tumor with growing teratoma syndrome and metachronous mature metastases: case report. J Neurooncol; 2008 Oct;90(1):111-5
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  • [Title] Bifocal mixed germ-cell tumor with growing teratoma syndrome and metachronous mature metastases: case report.
  • The authors report the case of a 16-year-old male who presented with a bifocal diencephalic tumor arising both in the neurohypophysis and the pineal region with hydrocephalus.
  • MRI revealed an increase of the neoplasm during chemotherapy with recurrent obstructive hydrocephalus.
  • Subsequently, this patient developed metachronous cystic metastases in the cerebello-pontine angles, which were resected and identified as mature teratoma, then we observed a lesion of the brachium conjunctivum which stayed stable after 29 consecutive months.
  • To our knowledge, this is the fifth case of the growing teratoma syndrome located in the brain but the first case with simultaneously bifocal location and infratentorial disseminated metastasis.
  • Obviously surgical removal is the treatment of reference for teratomas.
  • Primary intracranial germ-cell tumors (CGT) arise in the midline of the brain and are located in the diencephalon.
  • Germ cell tumor (CGT) includes germinomas and non-germinomatous tumors, mature and immature teratomas account for 19.6 % [1].
  • Curiously, teratomas are able to grow during the first weeks of chemotherapy while serum markers remain normal.
  • This situation was originally described and designed as "the growing teratoma syndroma" (GTS) in primary testis tumors by Logothetis in 1982 [2].
  • Here we report the rare occurrence of a GTS in a teenager who presented metachronous cystic metastases located in posterior fossa which were histologically mature.
  • [MeSH-major] Brain Neoplasms / pathology. Teratoma / secondary
  • [MeSH-minor] Adolescent. Antineoplastic Agents / therapeutic use. Combined Modality Therapy. Humans. Magnetic Resonance Imaging. Male. Neurosurgical Procedures. Pineal Gland / pathology. Pineal Gland / physiopathology

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  • [CommentIn] J Neurooncol. 2009 Sep;94(3):449-50 [19347253.001]
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  • (PMID = 18574668.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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95. Papadakis V, Dunkel IJ, Cramer LD, Kramer E, Papadopoulos E, Goldman S, Packer RJ, Willoughby M, Baker D, Garvin J, Strandjord S, Coccia P, Kaplan AM, Klemperer M, Finlay JL: High-dose carmustine, thiotepa and etoposide followed by autologous bone marrow rescue for the treatment of high risk central nervous system tumors. Bone Marrow Transplant; 2000 Jul;26(2):153-60
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  • [Title] High-dose carmustine, thiotepa and etoposide followed by autologous bone marrow rescue for the treatment of high risk central nervous system tumors.
  • Forty-two patients (29 newly diagnosed) with high grade gliomas (n = 37), medulloblastoma (n = 2) or non-biopsied tumors (n = 3) with supratentorial (n = 24), brain stem (n = 11), posterior fossa (n = 5) or spinal (n = 2) location were eligible for this study with adequate organ function and no bone marrow tumor infiltration.
  • Twenty-one newly diagnosed patients received local irradiation (RT) post ABMR.
  • Of 25 evaluable newly diagnosed patients, 20% achieved complete remission (CR) and 4% partial remission (PR), while 28% remained in continuing complete remission (CCR) and 44% remained with stable disease prior to RT.
  • Of eight evaluable patients with recurrent disease, one achieved CR and two PR, while one remained in CCR and four with stable disease for 1 to 110.2 months.
  • Overall survival was 36%, 24% and 17% at 1, 2 and 3 years following ABMR, with three newly diagnosed patients and one patient treated for recurrent disease being alive, without disease progression 64.4, 67.0, 86.3 and 110.2 months after ABMR, respectively.
  • The combination of high-dose BCNU/ thiotepa/VP-16 has substantial toxicity but definite activity for high risk CNS tumors.
  • Similar protocols with lower toxicity merit further evaluation in both newly diagnosed and recurrent CNS tumors.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / toxicity. Bone Marrow Transplantation. Central Nervous System Neoplasms / complications. Central Nervous System Neoplasms / therapy
  • [MeSH-minor] Adolescent. Adult. Carmustine / administration & dosage. Carmustine / toxicity. Child. Child, Preschool. Combined Modality Therapy. Disease-Free Survival. Drug-Induced Liver Injury. Etoposide / administration & dosage. Etoposide / toxicity. Female. Graft Survival. Hematologic Diseases / chemically induced. Humans. Infant. Kidney Diseases / chemically induced. Lung Diseases / chemically induced. Male. Middle Aged. Multiple Organ Failure / chemically induced. Nervous System Diseases / chemically induced. Survival Rate. Thiotepa / administration & dosage. Thiotepa / toxicity. Transplantation, Autologous. Treatment Outcome

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  • (PMID = 10918425.001).
  • [ISSN] 0268-3369
  • [Journal-full-title] Bone marrow transplantation
  • [ISO-abbreviation] Bone Marrow Transplant.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] ENGLAND
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; 905Z5W3GKH / Thiotepa; U68WG3173Y / Carmustine
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96. Sandberg DI, Crandall KM, Koru-Sengul T, Padgett KR, Landrum J, Babino D, Petito CK, Solano J, Gonzalez-Brito M, Kuluz JW: Pharmacokinetic analysis of etoposide distribution after administration directly into the fourth ventricle in a piglet model. J Neurooncol; 2010 Mar;97(1):25-32
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • We hypothesize that infusion of chemotherapeutic agents directly into the fourth ventricle potentially may play a role in treating malignant posterior fossa brain tumors.
  • Accordingly, we used a piglet model developed in our laboratory to test the safety of etoposide infusions into the fourth ventricle and to study the pharmacokinetics associated with these infusions.
  • For CSF samples, area under the concentration-time curve (AUC) was calculated.
  • Piglets underwent daily neurological examinations, a 4.7 Tesla MRI scan, and then were sacrificed for post-mortem brain examination.
  • No neurological deficits or signs of meningitis were caused by intraventricular chemotherapy infusions.
  • MRI scans showed catheter placement within the fourth ventricle but no signal changes in the brain stem or cerebellum.
  • Statistically significant differences between fourth ventricle and lumbar AUC were noted at peaks (DeltaAUC = 3384196 ng h/ml with 95%CI: 1758625, 5009767, P = 0.0044) and at all collection time points (DeltaAUC = 1422977 ng h/ml with 95%CI: 732188, 2113766, P = 0.0046) but not at troughs (DeltaAUC = -29546 ng h/ml (95%CI: -147526, 88434.2, P = 0.5251).
  • Autopsy examination revealed ventriculitis and meningitis which did not have a clinical correlate.
  • Etoposide does not distribute evenly throughout CSF spaces after administration into the fourth ventricle, and higher peak CSF levels are observed in the fourth ventricle than in the lumbar cistern.
  • [MeSH-major] Antineoplastic Agents, Phytogenic / administration & dosage. Antineoplastic Agents, Phytogenic / pharmacokinetics. Etoposide / administration & dosage. Etoposide / pharmacokinetics. Fourth Ventricle / drug effects. Infratentorial Neoplasms / pathology
  • [MeSH-minor] Animals. Area Under Curve. Cell Count. Chromatography, High Pressure Liquid / methods. Confidence Intervals. Disease Models, Animal. Magnetic Resonance Imaging / methods. Neurologic Examination / methods. Swine. Time Factors

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  • (PMID = 19688296.001).
  • [ISSN] 1573-7373
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 6PLQ3CP4P3 / Etoposide
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97. Baussard B, Di Rocco F, Garnett MR, Boddaert N, Lellouch-Tubiana A, Grill J, Puget S, Roujeau T, Zerah M, Sainte-Rose C: Pediatric infratentorial gangliogliomas: a retrospective series. J Neurosurg; 2007 Oct;107(4 Suppl):286-91
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  • [Title] Pediatric infratentorial gangliogliomas: a retrospective series.
  • OBJECT: The aim of this study was to retrospectively review the clinical presentation, the roles of surgery and adjuvant therapy, and the treatment-related morbidity in children with a ganglioglioma in the posterior fossa and to try and determine the prognostic factors.
  • METHODS: Between 1991 and 2006, 10 children were treated for a posterior fossa ganglioglioma at the authors' institution.
  • RESULTS: The surgical procedure did not cause deterioration in the neurological condition in any of the children.
  • There was no recurrence in the child who underwent total macroscopic excision of the tumor, and there has been no tumor progression in three children, two of whom have had no evidence of enhancement of the postoperative residual tumor.
  • The tumor has progressed in six children, requiring further surgery in three, chemotherapy in four, and radiotherapy and second-line chemotherapy in one child to control the tumor.
  • CONCLUSIONS: The imaging of gangliogliomas in the posterior fossa showed patchy enhancement.
  • The patients in whom it was possible to achieve a radical resection, aimed at removing at least the enhancing portion of the tumor, have not required further treatment.
  • A second excision, for progressive tumors, is an effective adjuvant therapy.
  • [MeSH-major] Ganglioglioma / diagnosis. Ganglioglioma / therapy. Infratentorial Neoplasms / diagnosis. Infratentorial Neoplasms / therapy. Magnetic Resonance Imaging. Neurosurgical Procedures
  • [MeSH-minor] Adolescent. Chemotherapy, Adjuvant. Child. Child, Preschool. Cranial Fossa, Posterior. Disease Progression. Female. Follow-Up Studies. Humans. Male. Radiotherapy, Adjuvant. Retreatment. Retrospective Studies. Treatment Outcome

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  • (PMID = 17941492.001).
  • [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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98. Robertson PL, Muraszko KM, Holmes EJ, Sposto R, Packer RJ, Gajjar A, Dias MS, Allen JC, Children's Oncology Group: Incidence and severity of postoperative cerebellar mutism syndrome in children with medulloblastoma: a prospective study by the Children's Oncology Group. J Neurosurg; 2006 Dec;105(6 Suppl):444-51
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • OBJECT: Cerebellar mutism syndrome (CMS) is a unique postoperative syndrome typically arising 1 to 2 days after resection of a midline posterior fossa tumor; it consists of diminished speech progressing to mutism, emotional lability, hypotonia, and ataxia.
  • METHODS: The authors incorporated a CMS questionnaire in two large clinical trials (Children's Cancer Group [CCG] 9931, treatment for high-risk medulloblastoma/primitive neuroectodermal tumor; and CCG/Pediatric Oncology Group [POG] A9961, treatment for average-risk medulloblastoma) to prospectively survey for incidence, severity, and possible causes of CMS in children with newly diagnosed medulloblastoma.
  • CONCLUSIONS: Nearly one quarter of patients who underwent resection of a medulloblastoma developed symptoms of CMS, of which 92% were judged to be of moderate or severe intensity.
  • Brainstem invasion by tumor was the only risk factor that correlated positively with CMS occurrence; there was a negative correlation with cerebellar hemisphere tumor location.
  • [MeSH-major] Cerebellar Neoplasms / epidemiology. Cerebellar Neoplasms / surgery. Medulloblastoma / epidemiology. Medulloblastoma / surgery. Mutism / epidemiology. Postoperative Complications / epidemiology
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Child. Child, Preschool. Combined Modality Therapy. Female. Humans. Incidence. Infant. Male. Neuroectodermal Tumors, Primitive / drug therapy. Neuroectodermal Tumors, Primitive / epidemiology. Neuroectodermal Tumors, Primitive / surgery. Prognosis. Prospective Studies. Risk Factors. Severity of Illness Index

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  • [CommentIn] J Neurosurg Pediatr. 2008 Mar;1(3):262 [18352776.001]
  • (PMID = 17184075.001).
  • [ISSN] 0022-3085
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / U10 CA 98543
  • [Publication-type] Clinical Trial, Phase II; Clinical Trial, Phase III; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural
  • [Publication-country] United States
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99. Ris MD, Packer R, Goldwein J, Jones-Wallace D, Boyett JM: Intellectual outcome after reduced-dose radiation therapy plus adjuvant chemotherapy for medulloblastoma: a Children's Cancer Group study. J Clin Oncol; 2001 Aug 01;19(15):3470-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intellectual outcome after reduced-dose radiation therapy plus adjuvant chemotherapy for medulloblastoma: a Children's Cancer Group study.
  • PURPOSE: To investigate the intellectual outcomes of children with medulloblastomas/primitive neuroectodermal tumors (MB/PNET) treated with reduced-dose craniospinal radiotherapy (RT) plus adjuvant chemotherapy.
  • PATIENTS AND METHODS: Forty-three children with average-risk posterior fossa MB/PNETs underwent longitudinal intelligence testing.
  • All had been treated with a reduced-dose craniospinal RT regimen (23.4 Gy to the neuraxis, 32.4-Gy boost to the posterior fossa) and adjuvant chemotherapy.
  • CONCLUSION: This study represents the largest series of patients with average-risk MB/PNETs treated with a combination of reduced-dose RT and adjuvant chemotherapy whose intellectual development has been followed prospectively.
  • [MeSH-major] Brain Neoplasms / therapy. Intelligence / drug effects. Intelligence / radiation effects. Medulloblastoma / therapy. Neuroectodermal Tumors, Primitive / therapy
  • [MeSH-minor] Adolescent. Chemotherapy, Adjuvant / adverse effects. Child. Child, Preschool. Cranial Irradiation / adverse effects. Dose-Response Relationship, Radiation. Female. Humans. Intelligence Tests. Longitudinal Studies. Male. Radiotherapy / adverse effects


100. Mendenhall WM, Morris CG, Amdur RJ, Hinerman RW, Malyapa RS, Werning JW, Lansford CD, Villaret DB: Definitive radiotherapy for tonsillar squamous cell carcinoma. Am J Clin Oncol; 2006 Jun;29(3):290-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Definitive radiotherapy for tonsillar squamous cell carcinoma.
  • PURPOSE: The purpose of this study is to update our experience with definitive radiotherapy (RT) for carcinoma of the tonsillar area.
  • Of these, 198 patients underwent a planned neck dissection and 57 patients received induction (18 patients) or concomitant (39 patients) chemotherapy.
  • Local control after RT for early stage cancers was higher for tonsillar fossa/posterior pillar tumors than for those arising from the anterior tonsillar pillar.
  • CONCLUSION: Based on our data and a review of the literature, definitive RT provides cure rates that are as good as those after surgery, and is associated with a lower rate of severe complications.
  • Patients with lateralized tumors may be safely treated with ipsilateral field arrangements.
  • [MeSH-major] Carcinoma, Squamous Cell / radiotherapy. Tonsillar Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Follow-Up Studies. Humans. Incidence. Lymph Node Excision. Male. Middle Aged. Neoplasm Staging. Radiation Injuries / epidemiology. Survival Analysis. Treatment Outcome

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  • (PMID = 16755183.001).
  • [ISSN] 1537-453X
  • [Journal-full-title] American journal of clinical oncology
  • [ISO-abbreviation] Am. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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