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1. Bowers DC, Weprin BE: Intramedullary Spinal Cord Tumors. Curr Treat Options Neurol; 2003 May;5(3):207-212
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intramedullary Spinal Cord Tumors.
  • The three most common types of intramedullary spinal cord tumors are low-grade astrocytomas, ependymomas, and high-grade astrocytomas.
  • Surgical extirpation is the necessary and sufficient primary treatment for most intramedullary spinal cord tumors.
  • Radiation therapy may also have a role in the management of persistent, recurrent, or progressive low-grade astrocytomas and ependymomas.
  • The current treatment of spinal cord high-grade astrocytomas, which includes surgical debulking, radiation therapy, and possibly chemotherapy, is clearly inadequate.
  • Chemotherapy may have a potential role for certain progressive spinal cord tumors, but the role is undefined at present.
  • Recent reports have described the use of stereotactic radiosurgery for extramedullary spinal tumors, and stereotactic radiosurgery may someday be useful in the management of intramedullary spinal cord tumors.
  • Rehabilitation programs are an important component of the multidisciplinary care of patients with spinal cord tumors.
  • Finally, more work, especially the inclusion of adults and children with intramedullary spinal cord tumors into prospective clinical trials, is needed to improve the therapy of intramedullary spinal cord tumors and rehabilitation after diagnosis of a spinal cord tumor.

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  • (PMID = 12670409.001).
  • [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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2. Spencer SA, Harris J, Wheeler RH, Machtay M, Schultz C, Spanos W, Rotman M, Meredith R: RTOG 96-10: reirradiation with concurrent hydroxyurea and 5-fluorouracil in patients with squamous cell cancer of the head and neck. Int J Radiat Oncol Biol Phys; 2001 Dec 1;51(5):1299-304
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • PURPOSE: Patients with recurrent squamous cell cancer of the head and neck (SCH&N) are generally treated with systemic chemotherapy.
  • This study was undertaken to explore the feasibility and toxicity, and estimate the therapeutic impact of, reirradiation (RRT) with concurrent hydroxyurea and 5-fluorouracil.
  • METHODS AND MATERIALS: The eligibility requirements included SCH&N presenting as a second primary or recurrence > or =6 months after definitive RT to > or =45 Gy, with > or =75% of the tumor volume within the previous field.
  • The cumulative spinal cord dose was limited to 50 Gy, and measurable disease was required.
  • A cycle consisted of 5 days, Monday through Friday, of 1.5-Gy twice-daily repeated RT, with the fractions separated by > or =6 h, with 1.5 g of hydroxyurea given 2 h and 300 mg/m2 of a 5-fluorouracil IV bolus given 30 min before each second daily fraction.
  • The median prior radiation dose was 61.2 Gy.
  • Six patients died of treatment-related toxicity.
  • Two died of hemorrhage from the tumor site without thrombocytopenia.
  • CONCLUSION: Repeated RT with concurrent chemotherapy as given in this study is a feasible approach for selected, previously irradiated patients with SCH&N and may produce increased median and 1-year survival rates compared with systemic chemotherapy trials reported in the literature.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Carcinoma, Squamous Cell / radiotherapy. Fluorouracil / therapeutic use. Head and Neck Neoplasms / radiotherapy. Hydroxyurea / therapeutic use
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Survival Rate

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  • (PMID = 11728690.001).
  • [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] Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; U3P01618RT / Fluorouracil; X6Q56QN5QC / Hydroxyurea
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3. Kuba H, Inamura T, Nishio S, Fukui M: Metastatic spinal intramedullary germinoma with elevated cerebrospinal fluid chorionic gonadotropin: a case report. Clin Neurol Neurosurg; 2000 Mar;102(1):44-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Metastatic spinal intramedullary germinoma with elevated cerebrospinal fluid chorionic gonadotropin: a case report.
  • We treated a patient whose unusual recurrent germinoma illustrates the diagnostic value of measuring human chorionic gonadotropin beta subunit (HCG-beta) in cerebrospinal fluid (CSF) and serum.
  • A 25-year-old man with a suprasellar germinoma and ventricular dissemination was treated successfully with systemic chemotherapy and cranial irradiation.
  • Six years later he developed progressive numbness and weakness in both upper extremities.
  • Magnetic resonance imaging (MRI) disclosed an intramedullary spinal cord tumor in the cervical region.
  • After completion of systemic chemotherapy and spinal irradiation, symptoms subsided and the tumor was no longer evident on MRI.
  • Based on the patient's history and the rapid response of the tumor to treatment, the spinal cord tumor was considered a metastatic intramedullary spinal germinoma representing CSF dissemination via the central canal.
  • [MeSH-major] Chorionic Gonadotropin, beta Subunit, Human / cerebrospinal fluid. Germinoma / cerebrospinal fluid. Germinoma / secondary. Spinal Cord Neoplasms / cerebrospinal fluid. Spinal Cord Neoplasms / secondary
  • [MeSH-minor] Adult. Brain / pathology. Humans. Magnetic Resonance Imaging. Male. Tomography, X-Ray Computed

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  • (PMID = 10717404.001).
  • [ISSN] 0303-8467
  • [Journal-full-title] Clinical neurology and neurosurgery
  • [ISO-abbreviation] Clin Neurol Neurosurg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] NETHERLANDS
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin, beta Subunit, Human
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4. Yone K, Ijiri K, Hayashi K, Yokouchi M, Takenouchi T, Manago K, Nerome Y, Ijichi O, Ikarimoto N, Komiya S: Primary malignant peripheral nerve sheath tumor of the cauda equina in a child case report. Spinal Cord; 2004 Mar;42(3):199-203
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Primary malignant peripheral nerve sheath tumor of the cauda equina in a child case report.
  • STUDY DESIGN: A case report of primary malignant peripheral nerve sheath tumor (MPNST) of the cauda equina in a child is presented, and the literature is reviewed.
  • OBJECTIVE: To discuss the problems involved in the treatment of primary intradural MPNSTs.
  • MRI revealed an intradural tumor at L3-L5 level.
  • Following laminectomy of L3, L4 and L5, the tumor was removed en bloc.
  • Based on pathological and immunohistological findings, the tumor was diagnosed as an MPNST.
  • RESULTS: Although adjuvant chemotherapy was administered local recurrence and cerebral and spinal metastases of the tumor were found 6 months after the operation.
  • Following additional incomplete removal of the recurrent tumor, radiation therapy was administered.
  • Although recurrent and metastatic tumors disappeared or diminished in size by radiation, tumors increased in size thereafter, despite additional adjuvant chemotherapy.
  • Although no gold standard for the treatment of tumors has been established yet, surgical removal of tumors combined with postoperative high-dose radiation may be recommended.
  • [MeSH-minor] Brain Neoplasms / secondary. Child, Preschool. Fatal Outcome. Humans. Magnetic Resonance Imaging. Male. Spinal Neoplasms / secondary

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  • (PMID = 15001982.001).
  • [ISSN] 1362-4393
  • [Journal-full-title] Spinal cord
  • [ISO-abbreviation] Spinal Cord
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
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5. Kurisu K, Hida K, Yano S, Yamaguchi S, Motegi H, Kubota K, Iwasaki Y: [Case of a large intra and extra medullary abscess of the spinal cord due to dermal sinus]. No Shinkei Geka; 2008 Dec;36(12):1127-32
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Case of a large intra and extra medullary abscess of the spinal cord due to dermal sinus].
  • The patient underwent irrigation of purulent material in the intraspinal abscess including on intramedullary lesion, removal of dermoid tumor, and the resection of the dermal sinus.
  • After that, he was treated with 8 weeks of antibiotic therapy.
  • Prophylactic surgery is indicated to prevent dangerous and recurrent infections of the central nervous system.
  • [MeSH-minor] Anti-Bacterial Agents / administration & dosage. Diagnostic Imaging. Drug Therapy, Combination. Humans. Infant. Laminectomy. Male

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  • (PMID = 19086444.001).
  • [ISSN] 0301-2603
  • [Journal-full-title] No shinkei geka. Neurological surgery
  • [ISO-abbreviation] No Shinkei Geka
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Anti-Bacterial Agents
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6. Chowdhary S, Green MR, Chamberlain M: Ependymomas. Curr Treat Options Neurol; 2006 Jul;8(4):309-18
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  • The role of craniospinal irradiation in patients with local disease and no evidence of metastasis is controversial because most tumor recurrences are local and at the site of the primary tumor.
  • No clear role for adjuvant chemotherapy has been demonstrated.
  • When used, chemotherapy for ependymomas has been administered primarily to children aged younger than 3 years as adjuvant therapy and to patients with recurrent disease who are not considered surgical candidates as salvage therapy.
  • Recurrent ependymomas are managed by reoperation of tumors that are surgically accessible, by radiotherapy if not previously administered, and by salvage chemotherapy.
  • Because salvage chemotherapy is not curative, no standard therapy exists, and a variety of chemotherapy agents and drug schedules have been investigated.

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  • (PMID = 16942674.001).
  • [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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7. Dhermain F, de Crevoisier R, Parker F, Cioloca C, Kaliski A, Beaudre A, Lefkopoulos D, Armand JP, Haie-Meder C: [Role of radiotherapy in recurrent gliomas]. Bull Cancer; 2004 Nov;91(11):883-9
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  • [Title] [Role of radiotherapy in recurrent gliomas].
  • Their increasing incidence and the weak impact of treatments on the prognosis justify all the efforts expended to improve results.
  • Surgery, radiation therapy (RT) and chemotherapy are proposed as first-line therapy, according to indications and modalities that remain controversial.
  • Finally, after a very variable duration of local control depending on the histologic type, recurrence is virtually inevitable, with mainly local progression.
  • After or in the absence of surgery, different chemotherapy schedules are proposed according to the histologic type and the patient's general status and objective response rates are very limited, except in the case of oligodendrogliomas.
  • Re-irradiation has a rather bad reputation: even as first-line therapy, total doses never exceed 60 Gy in 30 fractions of 2 Gy over six weeks (conventional fractionation).
  • In addition, studies on primates demonstrated that the spinal cord was capable of repairing, at least partially, RT-induced injury.
  • Treatment efficacy and toxicity endpoints were very heterogeneous.
  • Nevertheless, with a clearly defined prospective assessment, re-irradiation seems possible without any unacceptable clinical neurotoxicity under the following conditions: a good general status (WHO 0-1); at least a one-year disease-free interval; an initial WHO grade 2 or 3 histology with a maximal tumor diameter not exceeding 3 cm.
  • In this very selective setting, re-irradiation is possible at a dose of 30 to 40 Gy, if possible in stereotactic mode, with a hypofractionated schedule (less than 4 Gy/fraction).
  • [MeSH-major] Brain Neoplasms / radiotherapy. Glioma / radiotherapy. Neoplasm Recurrence, Local / radiotherapy

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  • (PMID = 15582893.001).
  • [ISSN] 1769-6917
  • [Journal-full-title] Bulletin du cancer
  • [ISO-abbreviation] Bull Cancer
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Number-of-references] 44
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8. Hurwitz CA, Strauss LC, Kepner J, Kretschmar C, Harris MB, Friedman H, Kun L, Kadota R: Paclitaxel for the treatment of progressive or recurrent childhood brain tumors: a pediatric oncology phase II study. J Pediatr Hematol Oncol; 2001 Jun-Jul;23(5):277-81
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Paclitaxel for the treatment of progressive or recurrent childhood brain tumors: a pediatric oncology phase II study.
  • PURPOSE: To assess the efficacy and define the toxicity of paclitaxel given at a dosage of 350 mg/m2 every 3 weeks as a 24-hour continuous infusion to children with recurrent or progressive primary brain tumors.
  • PATIENTS AND METHODS: Seventy-three eligible patients, ages 4 months to 19 years, with progressive or recurrent primary brain tumors were treated according to a Pediatric Oncology Group (POG) phase II protocol with paclitaxel (POG 9330).
  • Tumor histologic strata included: astrocytoma (n = 4), malignant glioma (n = 13), medulloblastoma (n = 16), brain stem glioma (n = 15), ependymoma (n = 13), and miscellaneous histologies (n = 12).
  • All patients had previous histologic confirmation of a primary intracranial or spinal cord tumor with magnetic resonance imaging or computed tomography documentation of unequivocally measurable progressive or recurrent disease.
  • All patients had received previous therapy including surgery, radiation therapy, and/or chemotherapy, but no patient had been previously treated on more than one phase II trial.
  • Patients were allowed to continue therapy for a total of 18 cycles in the absence of progressive disease or unacceptable toxicity.
  • RESULTS: Seventy-five patients were enrolled onto the POG 9330 protocol; two ineligible patients were removed from the study before receiving any therapy.
  • CONCLUSION: Paclitaxel is well tolerated in children with recurrent or progressive brain tumors at this dosage and schedule and may result in short-term disease stabilization in this patient population.
  • [MeSH-major] Antineoplastic Agents, Phytogenic / therapeutic use. Brain Neoplasms / drug therapy. Paclitaxel / therapeutic use
  • [MeSH-minor] Adolescent. Astrocytoma / drug therapy. Astrocytoma / pathology. Child. Child, Preschool. Dexamethasone / therapeutic use. Disease Progression. Drug Hypersensitivity / prevention & control. Ependymoma / drug therapy. Ependymoma / pathology. Female. Glioma / drug therapy. Glioma / pathology. Humans. Immunosuppressive Agents / therapeutic use. Infant. Infratentorial Neoplasms / drug therapy. Infratentorial Neoplasms / pathology. Infusions, Intravenous. Male. Medulloblastoma / drug therapy. Medulloblastoma / pathology. Nausea / chemically induced. Neoplasm Recurrence, Local. Neutropenia / chemically induced. Remission Induction. Salvage Therapy. Treatment Failure

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  • (PMID = 11464982.001).
  • [ISSN] 1077-4114
  • [Journal-full-title] Journal of pediatric hematology/oncology
  • [ISO-abbreviation] J. Pediatr. Hematol. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA03161; United States / NCI NIH HHS / CA / CA07431; United States / NCI NIH HHS / CA / CA15525; etc
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 0 / Immunosuppressive Agents; 7S5I7G3JQL / Dexamethasone; P88XT4IS4D / Paclitaxel
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9. Guiu S, Guiu B, Feutray S, Chauffert B: Direct intratumoral chemotherapy with carboplatin and epinephrine in a recurrent cervical chordoma: case report. Neurosurgery; 2009 Sep;65(3):E629-30; discussion E630
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  • [Title] Direct intratumoral chemotherapy with carboplatin and epinephrine in a recurrent cervical chordoma: case report.
  • OBJECTIVE: Chordomas are rare primary bone tumors for which surgery is classically the first-line treatment.
  • Because radiation therapy and systemic chemotherapy show limited effectiveness, we report the use of direct intratumoral chemotherapy (IC) to treat recurrent chordoma.
  • CLINICAL PRESENTATION: A 46-year-old man presented with a recurrent cervical chordoma after surgery and radiation therapy.
  • This recurrence manifested as C4-C5 spinal cord compression.
  • TECHNIQUE: Three 22-gauge needles were inserted at the upper, middle, and lower parts of the tumor and advanced under computed tomographic guidance while injecting local anesthetic.
  • Eleven intratumoral treatments were performed during an 18-month period.
  • CONCLUSION: A marked clinical response with regression of the spinal cord compression was observed, without specific toxicity.
  • A good partial response was obtained with a 42% decrease in tumor volume (from 69 to 40 cm3).
  • Moreover, the central part of the tumor showed tumor necrosis, as confirmed by histological examination.
  • Thus, in patients with this rare tumor, intratumoral chemotherapy may be a valid treatment option when surgery and radiation therapy fail.
  • Furthermore, intratumoral chemotherapy in combination with surgical treatment should be considered to improve the local control rate.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Carboplatin / therapeutic use. Chordoma / drug therapy. Epinephrine / therapeutic use. Spinal Neoplasms / drug therapy. Sympathomimetics / therapeutic use
  • [MeSH-minor] Combined Modality Therapy. Follow-Up Studies. Humans. Magnetic Resonance Imaging / methods. Male. Middle Aged. Neoplasm Recurrence, Local / diagnosis. Neoplasm Recurrence, Local / drug therapy

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  • (PMID = 19687674.001).
  • [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 / Antineoplastic Agents; 0 / Sympathomimetics; BG3F62OND5 / Carboplatin; YKH834O4BH / Epinephrine
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10. Wei F, Liu X, Liu Z, Jiang L, Dang G, Ma Q, Dang L: Interferon alfa-2b for recurrent and metastatic giant cell tumor of the spine: report of two cases. Spine (Phila Pa 1976); 2010 Nov 15;35(24):E1418-22
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  • [Title] Interferon alfa-2b for recurrent and metastatic giant cell tumor of the spine: report of two cases.
  • OBJECTIVE: To demonstrate that interferon alfa-2b is a therapeutic option for obtaining long-term control of recurrent and metastatic giant cell tumor of spine.
  • SUMMARY OF BACKGROUND DATA: Interferon alfa served as angiogenesis inhibitor and has been successfully used to treat giant cell tumor of long bones and facial bones.
  • Up to date, no report is found with regard to the use of interferon as a stand-alone treatment for unresectable, recurrent, and metastatic giant cell tumor originated from the spine.
  • METHODS: A 29-year-old woman with C1 and C2 giant cell tumor was treated by radiotherapy, intralesional curet, and chemotherapy orderly.
  • Tumor recurred after 2 years.
  • Tumor recurred second time and caused severe spinal cord compression.
  • A 24-year-old man with recurrent giant cell tumor of T5 and T6 was treated by spondylectomy of T5 and T6.
  • Six months later, a giant metastatic lesion was found in sacrococcygeal region, which was excised and proved to be giant cell tumor of bone.
  • Four months later, 2 recurrent lesions were found beside the rectum.
  • CONCLUSION: Interferon therapy may be an effective and safe treatment for spine giant cell tumor recurrence and metastasis in soft tissue.
  • The effectiveness may be time and dosage dependent.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Giant Cell Tumor of Bone / drug therapy. Interferon-alpha / therapeutic use. Neoplasm Recurrence, Local. Spinal Neoplasms / drug therapy
  • [MeSH-minor] Adult. Biopsy. Female. Humans. Magnetic Resonance Imaging. Male. Recombinant Proteins. Tomography, X-Ray Computed. Treatment Outcome. Young Adult

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  • (PMID = 21030898.001).
  • [ISSN] 1528-1159
  • [Journal-full-title] Spine
  • [ISO-abbreviation] Spine
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Interferon-alpha; 0 / Recombinant Proteins; 99210-65-8 / interferon alfa-2b
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11. Abel TJ, Chowdhary A, Thapa M, Rutledge JC, Geyer JR, Ojemann J, Avellino AM: Spinal cord pilocytic astrocytoma with leptomeningeal dissemination to the brain. Case report and review of the literature. J Neurosurg; 2006 Dec;105(6 Suppl):508-14
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  • [Title] Spinal cord pilocytic astrocytoma with leptomeningeal dissemination to the brain. Case report and review of the literature.
  • Leptomeningeal dissemination of low-grade spinal cord gliomas is an uncommon event.
  • The authors report a unique case of leptomeningeal dissemination of a spinal cord pilocytic astrocytoma (PCA) to the intracranial cerebral subarachnoid spaces in a child.
  • An intradural intramedullary spinal cord tumor was identified, and the lesion was subtotally resected and diagnosed by the pathology department to be a PCA.
  • Subsequently, the patient had recurrences of the intradural intramedullary tumor at 6 months and 2 years after his original presentation.
  • He underwent a repeated resection of the recurrent tumor and fenestration of an associated syrinx on both occasions.
  • The pathological characteristics of the reresected tumor remained consistent with those of a PCA.
  • The patient then underwent chemotherapy, and total spine magnetic resonance (MR) imaging 2 months later demonstrated stability in the size of the spinal cord tumor and a decrease in the associated syrinx.
  • However, an MR image of the head demonstrated two new areas of supratentorial subarachnoid leptomeningeal spread of the primary spinal cord tumor at the 2-month follow-up examination.
  • This case illustrates a unique instance of supratentorial leptomeningeal dissemination of an intramedullary spinal cord PCA in a child.
  • [MeSH-major] Astrocytoma / secondary. Brain Neoplasms / secondary. Meningeal Neoplasms / secondary. Spinal Cord Neoplasms / pathology
  • [MeSH-minor] Child, Preschool. Humans. Magnetic Resonance Imaging. Male. Neoplasm Recurrence, Local / pathology. Neoplasm Recurrence, Local / surgery


12. Grimm S, Chamberlain MC: Adult primary spinal cord tumors. Expert Rev Neurother; 2009 Oct;9(10):1487-95
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  • [Title] Adult primary spinal cord tumors.
  • Primary spinal cord tumors represent 2-4% of all neoplasms of the CNS.
  • Primary spinal cord tumors are anatomically separable into two broad categories: intradural intramedullary and intradural extramedullary.
  • Resective surgery can usually be accomplished with spinal ependymomas owing to separation of tumor from spinal cord and, when complete, require no further therapy.
  • By contrast, spinal cord gliomas infiltrate the myelon and, consequently, surgery is nearly always incomplete.
  • Chemotherapy is administered for recurrent primary spinal cord tumors without other options, that is, reoperation or re-irradiation.
  • Problematic, however, is the lack of clinical trials in general for these CNS tumors and for spinal cord tumors in particular.
  • Consequently, treatment is similar to that for intracranial tumors with a similar histology.
  • Early recognition of the signs and symptoms of primary spinal cord tumors allows for early treatment, potentially minimizes neurologic morbidity and improves outcome.
  • Primary treatment is surgery in essentially all spinal cord tumors, and predictors of outcome include preoperative functional status, histological grade of tumor and extent of surgical resection.
  • [MeSH-major] Spinal Cord Neoplasms / classification. Spinal Cord Neoplasms / therapy
  • [MeSH-minor] Adult. Combined Modality Therapy. Humans. Neurosurgical Procedures. Young Adult

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  • (PMID = 19831838.001).
  • [ISSN] 1744-8360
  • [Journal-full-title] Expert review of neurotherapeutics
  • [ISO-abbreviation] Expert Rev Neurother
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 82
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13. Tsukagoshi S, Ikeda M, Tano S, Obayashi K, Fujita Y, Okamoto K: [Case of recurrent delayed radiation myelopathy with 5-year remission interval]. Rinsho Shinkeigaku; 2010 Jun;50(6):393-8
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  • [Title] [Case of recurrent delayed radiation myelopathy with 5-year remission interval].
  • We report a 47-year-old woman with relapsed delayed radiation myelopathy (DRM), occurring 5 years and 10 years after radiation therapy for nasopharyngeal carcinoma at 37 years old.
  • MRI showed Gadolinium-enhanced lesion as a ring-like-enhancement of the spinal cord at C1-2 on T1-weighted image (T1WI), with high signal area and swelling of the spinal cord at the upper C1 to C6 areas on T2-weighted image.
  • We diagnosed her as having DRM after considering the differential diagnosis, e.g., multiple sclerosis, spinal tumor and other neurological diseases.
  • Her sensory symptoms quickly improved following therapy with prednisolone and warfarin.
  • At this time, MRI demonstrated Gadolinium-enhanced lesion as a ring-like enhancement of the spinal cord at C2 on T1WI. but the area also differed from that of previous lesion; a high signal area and swelling of the spinal cord was also seen on FLAIR image of the medulla and upper C1 to C6.
  • Thereafter, the patient recovered and the spinal cord lesion on MRI decreased markedly.
  • [MeSH-major] Radiation Injuries / etiology. Radiotherapy / adverse effects. Spinal Cord Diseases / etiology
  • [MeSH-minor] Drug Therapy, Combination. Female. Humans. Magnetic Resonance Imaging. Methylprednisolone / administration & dosage. Middle Aged. Prednisolone / administration & dosage. Pulse Therapy, Drug. Recurrence. Remission Induction. Spinal Cord / pathology. Time Factors. Treatment Outcome. Warfarin / administration & dosage

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  • (PMID = 20593664.001).
  • [ISSN] 0009-918X
  • [Journal-full-title] Rinshō shinkeigaku = Clinical neurology
  • [ISO-abbreviation] Rinsho Shinkeigaku
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 5Q7ZVV76EI / Warfarin; 9PHQ9Y1OLM / Prednisolone; X4W7ZR7023 / Methylprednisolone
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14. Shono T, Natori Y, Morioka T, Torisu R, Mizoguchi M, Nagata S, Suzuki SO, Iwaki T, Inamura T, Fukui M, Oka K, Sasaki T: Results of a long-term follow-up after neuroendoscopic biopsy procedure and third ventriculostomy in patients with intracranial germinomas. J Neurosurg; 2007 Sep;107(3 Suppl):193-8
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  • [Title] Results of a long-term follow-up after neuroendoscopic biopsy procedure and third ventriculostomy in patients with intracranial germinomas.
  • OBJECT: The authors report the results of long-term follow-ups in 12 patients with intracranial germinomas who underwent neuroendoscopic procedures before chemotherapy and radiotherapy, and discuss the usefulness and safety of these procedures.
  • All patients received chemotherapy and radiotherapy postoperatively, according to the regimen promulgated by the Japanese Pediatric Brain Tumor Study Group.
  • A complete response to postoperative chemotherapy and radiotherapy was achieved in all cases.
  • Only one patient had a recurrent lesion in the spinal cord 6 years after the initial treatment; however, this patient had undergone only the neuroendoscopic biopsy procedure without ETV.
  • The risk of tumor dissemination due to the neuroendoscopic procedures appears to be minimal when the appropriate chemotherapy and radiotherapy are provided postoperatively.
  • [MeSH-minor] Adolescent. Adult. Biopsy. Combined Modality Therapy. Endoscopy. Female. Follow-Up Studies. Humans. Hydrocephalus / pathology. Hydrocephalus / surgery. Magnetic Resonance Imaging. Male. Neoplasm Seeding. Postoperative Complications. Retrospective Studies. Third Ventricle / pathology. Third Ventricle / surgery. Treatment Outcome

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  • (PMID = 17918523.001).
  • [ISSN] 0022-3085
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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15. Amini E, Roffidal T, Lee A, Fuller GN, Mahajan A, Ketonen L, Kobrinsky N, Cairo MS, Wells RJ, Wolff JE: Central neurocytoma responsive to topotecan, ifosfamide, carboplatin. Pediatr Blood Cancer; 2008 Jul;51(1):137-40
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  • A 5-year-old male presented with spinal cord drop metastasis from a recurrent neurocytoma.
  • The complete response of central neurocytoma to chemotherapy only reported here should be helpful to those caring for patients with this rare tumor.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Neurocytoma / drug therapy

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  • [Copyright] (c) 2008 Wiley-Liss, Inc.
  • (PMID = 18338396.001).
  • [ISSN] 1545-5017
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 7M7YKX2N15 / Topotecan; BG3F62OND5 / Carboplatin; UM20QQM95Y / Ifosfamide
  • [Number-of-references] 18
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16. Milker-Zabel S, Zabel A, Thilmann C, Schlegel W, Wannenmacher M, Debus J: Clinical results of retreatment of vertebral bone metastases by stereotactic conformal radiotherapy and intensity-modulated radiotherapy. Int J Radiat Oncol Biol Phys; 2003 Jan 1;55(1):162-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • PURPOSE: Reirradiation of spinal tumors is limited by the tolerance of the spinal cord.
  • We evaluated local control, pain relief, neurologic improvement, side effects, and survival rates after fractionated conformal radiotherapy (FCRT) and intensity-modulated RT (IMRT) of recurrent spinal metastases.
  • METHODS AND MATERIALS: Eighteen patients with 19 radiologic manifestations were retreated for recurrent spinal metastases using FCRT (n = 5) or IMRT (n = 14).
  • All patients had previously undergone conventional RT (median dose 38 Gy).
  • The indication for reirradiation was tumor progression associated with pain (n = 16) or neurologic symptoms (n = 12).
  • The median time to recurrence was 17.7 months.
  • The median total dose for reirradiation was 39.6 Gy.
  • Tumor size remained unchanged in 84.2%.
  • One patient had local tumor progression 9.5 months after reirradiation.
  • Six patients received chemotherapy after reirradiation because of progressive distant metastases.
  • CONCLUSION: These data demonstrate that FCRT and IMRT are effective and safe in recurrent spinal tumors and can be offered to patients to achieve local control, as well as pain relief.
  • [MeSH-major] Radiotherapy, Conformal / methods. Spinal Neoplasms / radiotherapy. Spinal Neoplasms / secondary

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  • (PMID = 12504049.001).
  • [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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17. Mut M, Schiff D, Shaffrey ME: Metastasis to nervous system: spinal epidural and intramedullary metastases. J Neurooncol; 2005 Oct;75(1):43-56
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  • [Title] Metastasis to nervous system: spinal epidural and intramedullary metastases.
  • Spinal cord epidural metastasis (SEM) is a common complication of systemic cancer with an increasing incidence.
  • Pathophysiologically, vascular insufficiency is more important than direct spinal cord compression.
  • Radiotherapy has an important role, particularly in treatment of radiosensitive tumors and in patients who are not candidates for surgery.
  • Novel approaches such as stereotactic radiosurgery are promising; however, response to chemotherapy depends on inherent properties of primary tumor.
  • Recurrent SEM is a substantial problem for which surgery or repeat radiotherapy may be options.
  • The prognosis is usually poor and preferred modality of treatment is radiotherapy.
  • [MeSH-major] Epidural Neoplasms / secondary. Spinal Cord Neoplasms / secondary

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  • (PMID = 16215815.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 125
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18. Fakhrai N, Neophytou P, Dieckmann K, Nemeth A, Prayer D, Hainfellner J, Marosi C: Recurrent spinal ependymoma showing partial remission under Imatimib. Acta Neurochir (Wien); 2004 Nov;146(11):1255-8
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  • [Title] Recurrent spinal ependymoma showing partial remission under Imatimib.
  • BACKGROUND: There are few treatment options for recurrent spinal ependymoma after surgery and radiation therapy.
  • CLINICAL PRESENTATION: We present a patient with recurrent spinal ependymoma who received radiation therapy after laminectomy and partial tumor resection.
  • Months later, the patient developed gait paresis.
  • MRT showed tumor recurrence and partial resection was again performed.
  • Oral cytotoxic chemotherapy with Temozolomide was initiated.
  • As the tumor had stained positively for platelet derived growth factor (PDGF) receptor, treatment with Imatimib was initiated.
  • FINDINGS: The patient experienced improvement in neurological symptoms and the following MRT revealed slight tumor regression.
  • CONCLUSION: Imatimib should be considered a potential therapeutic option in recurrent ependymomas expressing PDGF receptor.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Ependymoma / drug therapy. Neoplasm Recurrence, Local / drug therapy. Piperazines / therapeutic use. Pyrimidines / therapeutic use. Spinal Cord Neoplasms / drug therapy

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  • (PMID = 15365794.001).
  • [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 / Antineoplastic Agents; 0 / Benzamides; 0 / Piperazines; 0 / Pyrimidines; 8A1O1M485B / Imatinib Mesylate; EC 2.7.10.1 / Receptors, Platelet-Derived Growth Factor
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19. Arnold PM, Habib A, Newell K, Anderson KK: Esthesioneuroblastoma metastatic to the thoracic intradural and extradural space. Spine J; 2009 May;9(5):e1-5
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  • BACKGROUND CONTEXT: Ethesioneuroblastoma (ENB) is a rare tumor of the olfactory epithelium that has been shown to metastasize mostly to the cervical lymphatics, with only infrequent spread to other locations.
  • PURPOSE: To report a rare case of recurrent ENB metastatic to the thoracic intradural and extradural space.
  • METHODS: A 64-year-old man with recurrent ENB presented with chronic pain in the neck, shoulder, and back.
  • Computed tomography of the chest showed no pulmonary metastasis and a high-attenuation spinal canal mass at T8 was noted on magnetic resonance imaging.
  • A tumor was seen penetrating through the dura, and a midline durotomy was performed for resection of a large intradural mass.
  • RESULTS: The postoperative period was uneventful, and included pain management and physical therapy, followed by chemotherapy and radiation.
  • The patient remains free of spinal recurrence 2 years after surgery.
  • CONCLUSIONS: Metastasis of ENB to the spinal column is rare, and of those instances, 80% are localized to the cauda equina.
  • Recurrent ENB metastatic to the thoracic intradural and extradural space is extremely rare, and was successfully treated with surgical resection.
  • [MeSH-major] Epidural Space / pathology. Esthesioneuroblastoma, Olfactory / secondary. Nasal Cavity / pathology. Nose Neoplasms / pathology. Spinal Cord Neoplasms / secondary
  • [MeSH-minor] Dura Mater / pathology. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / pathology. Thoracic Vertebrae

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  • (PMID = 18805062.001).
  • [ISSN] 1878-1632
  • [Journal-full-title] The spine journal : official journal of the North American Spine Society
  • [ISO-abbreviation] Spine J
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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20. Hukin J, Siffert J, Velasquez L, Zagzag D, Allen J: Leptomeningeal dissemination in children with progressive low-grade neuroepithelial tumors. Neuro Oncol; 2002 10;4(4):253-60
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  • Our purpose is to describe the incidence and clinical features of leptomeningeal dissemination (LM) in children with progressive low-grade neuroepithelial tumor (LGN).
  • Satisfactorily followed data were obtained on 427 of the 588 patients with localized LGN at diagnosis between 1986 and 1998, 177 (42%) of whom developed progressive or recurrent disease.
  • The primary tumor sites were diencephalon (6), brainstem (3), cerebellum (2), cerebrum (1), and spinal cord (1).
  • Management included chemotherapy (2) or radiotherapy (3) or both (7); 1 patient received only radical resections of symptomatic lesions.
  • We strongly urge that for optimum treatment planning all patients with recurrent LGN be staged with an enhanced spine and brain MRI before adjuvant therapy is initiated.
  • [MeSH-minor] Adolescent. Adult. Child. Child, Preschool. Combined Modality Therapy. Disease Progression. Female. Humans. Infant. Magnetic Resonance Imaging. Male. Neoplasm Recurrence, Local / epidemiology. Neoplasm Recurrence, Local / therapy. Survival Analysis. Treatment Outcome

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  • (PMID = 12356355.001).
  • [ISSN] 1522-8517
  • [Journal-full-title] Neuro-oncology
  • [ISO-abbreviation] Neuro-oncology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC1920666
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21. Corapcioglu F, Dillioğlugil O, Sarper N, Akansel G, Calişkan M, Arisoy AE: Spinal cord compression and lung metastasis of Wilms' tumor in a pregnant adolescent. Urology; 2004 Oct;64(4):807-10
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  • [Title] Spinal cord compression and lung metastasis of Wilms' tumor in a pregnant adolescent.
  • Wilms' tumor in adults is rare, and no treatment guidelines have been established.
  • Spinal cord compression has also been rarely reported in all age groups.
  • In this case report, we present a 19-year-old adolescent with recurrent Wilms' tumor, a paraspinal dumbbell mass, metastatic involvement of the vertebral bodies, lung metastasis, and pregnancy.
  • To our knowledge, this is the first report of a pregnant patient with Wilms' tumor who had to undergo immediate chemotherapy with vincristine and actinomycin-D owing to spinal cord compression at 25 weeks of pregnancy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Kidney Neoplasms / complications. Kidney Neoplasms / drug therapy. Lung Neoplasms / secondary. Neoplasm Recurrence, Local / drug therapy. Polyradiculopathy / etiology. Pregnancy Complications, Neoplastic / drug therapy. Spinal Cord Compression / etiology. Wilms Tumor / complications. Wilms Tumor / drug therapy
  • [MeSH-minor] Abdominal Pain / etiology. Adolescent. Bone Neoplasms / drug therapy. Bone Neoplasms / radiotherapy. Bone Neoplasms / secondary. Carboplatin / administration & dosage. Combined Modality Therapy. Cyclophosphamide / administration & dosage. Dactinomycin / administration & dosage. Dactinomycin / adverse effects. Dexamethasone / administration & dosage. Etoposide / administration & dosage. Female. Fetus / drug effects. Humans. Ifosfamide / administration & dosage. Infant, Newborn. Lumbar Vertebrae. Patient Dropouts. Pregnancy. Remission Induction. Vincristine / administration & dosage. Vincristine / adverse effects


22. Chamberlain MC: Temozolomide for recurrent low-grade spinal cord gliomas in adults. Cancer; 2008 Sep 1;113(5):1019-24
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  • [Title] Temozolomide for recurrent low-grade spinal cord gliomas in adults.
  • BACKGROUND: There is no standard therapy for surgery- and radiotherapy-resistant, recurrent, low-grade spinal cord gliomas.
  • Therefore, a retrospective study of temozolomide (TMZ) in adults with recurrent low-grade spinal cord gliomas with a primary objective of determining progression-free survival (PFS) was performed.
  • METHODS: Twenty-two patients (11 men and 11 women) aged 20 years to 55 years (median, 35 years) with recurrent spinal cord gliomas (World Health Organization grade 2 astrocytoma in 19 patients and oligoastrocytoma in 3 patients) were treated.
  • All patients were chemotherapy-naive.
  • Time to tumor progression ranged from 2 months to 28 months (median, 14.5 months).
  • CONCLUSIONS: TMZ demonstrated modest efficacy with acceptable toxicity in this cohort of adult patients with recurrent low-grade spinal cord gliomas.
  • [MeSH-major] Antineoplastic Agents, Alkylating / therapeutic use. Dacarbazine / analogs & derivatives. Glioma / drug therapy. Spinal Cord Neoplasms / drug therapy
  • [MeSH-minor] Adult. Disease-Free Survival. Drug Administration Schedule. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / drug therapy. Retrospective Studies

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  • [Copyright] (c) 2008 American Cancer Society.
  • (PMID = 18615600.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; 7GR28W0FJI / Dacarbazine; 85622-93-1 / temozolomide
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23. Ewelt C, Stummer W, Klink B, Felsberg J, Steiger HJ, Sabel M: Cordectomy as final treatment option for diffuse intramedullary malignant glioma using 5-ALA fluorescence-guided resection. Clin Neurol Neurosurg; 2010 May;112(4):357-61
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cordectomy as final treatment option for diffuse intramedullary malignant glioma using 5-ALA fluorescence-guided resection.
  • BACKGROUND: We present a case of an anaplastic astrocytoma (WHO-grade III, AA III) in a 27-year-old woman treated by spinal cordectomy.
  • The patient was pretreated by surgery, radiation therapy and temozolomide chemotherapy and repeat surgery at recurrence.
  • Later on, she developed paraplegia and a diffuse severe pain syndrome.
  • To assess tumor invasion intraoperatively, we used tumor fluorescence derived from 5-aminolevulinic acid (5-ALA).
  • PATIENTS COURSE: The spinal cord was amputated caudally to the root entry zones of the T10 sensory roots.
  • Additional cordectomy was performed because of tumor infiltration at the cut end to T9 as identified by intraoperative tumor fluorescence, and as verified histologically.
  • The final transected level was between T8 and T9, and the cut end did not reveal any tumor invasion intraoperatively by tumor fluorescence and postoperatively by MRI and with regard to the pathological result.
  • She refused additional adjuvant therapy.
  • CONCLUSION: Our observation suggests 5-ALA fluorescence-guided resections to be useful in the context of malignant spinal cord gliomas.
  • Furthermore, our particular case indicates that palliative spinal cordectomy with a wide margin and intraoperative resection using fluorescence guidance may be a final option for patients with recurrent spinal malignant glioma presenting with complete deficit below the lesion.
  • [MeSH-major] Aminolevulinic Acid. Astrocytoma / surgery. Cordotomy / methods. Neurosurgical Procedures / methods. Spinal Cord Neoplasms / surgery. Surgery, Computer-Assisted / methods
  • [MeSH-minor] Adult. Female. Humans. Magnetic Resonance Imaging. Pain / drug therapy. Pain / etiology. Paraplegia / etiology. Spine / pathology

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  • [Copyright] Copyright 2010 Elsevier B.V. All rights reserved.
  • (PMID = 20061079.001).
  • [ISSN] 1872-6968
  • [Journal-full-title] Clinical neurology and neurosurgery
  • [ISO-abbreviation] Clin Neurol Neurosurg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 88755TAZ87 / Aminolevulinic Acid
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24. DeLaney TF, Liebsch NJ, Pedlow FX, Adams J, Dean S, Yeap BY, McManus P, Rosenberg AE, Nielsen GP, Harmon DC, Spiro IJ, Raskin KA, Suit HD, Yoon SS, Hornicek FJ: Phase II study of high-dose photon/proton radiotherapy in the management of spine sarcomas. Int J Radiat Oncol Biol Phys; 2009 Jul 1;74(3):732-9
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  • PURPOSE: Radiotherapy (XRT) for spine sarcomas is constrained by spinal cord, nerve, and viscera tolerance.
  • Negative surgical margins are uncommon; hence, doses of >or=66 Gy are recommended.
  • Treatment included pre- and/or postoperative photon/proton XRT with or without radical resection; patients with osteosarcoma and Ewing's sarcoma received chemotherapy.
  • Shrinking fields delivered 50.4 cobalt Gray equivalent (Gy RBE) to subclinical disease, 70.2 Gy RBE to microscopic disease in the tumor bed, and 77.4 Gy RBE to gross disease at 1.8 Gy RBE qd.
  • Spinal cord dose was limited to 63/54 Gy RBE to surface/center.
  • Intraoperative boost doses of 7.5 to 10 Gy could be given by dural plaque.
  • Two of 36 (5.6%) patients treated for primary versus 7/14 (50%) for recurrent tumor developed local recurrence (p < 0.001).
  • Five patients developed late radiation-associated complications; no myelopathy developed but three sacral neuropathies appeared after 77.12 to 77.4 Gy RBE.
  • CONCLUSIONS: Local control with this treatment is high in patients radiated at the time of primary presentation.
  • Spinal cord dose constraints appear to be safe.
  • Sacral nerves receiving 77.12-77.4 Gy RBE are at risk for late toxicity.

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  • (PMID = 19095372.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / P01 CA021239; United States / NCI NIH HHS / CA / CA021239-27; United States / NCI NIH HHS / CA / CA021239-28; United States / NCI NIH HHS / CA / P01CA021239; United States / NCI NIH HHS / CA / P01 CA021239-27; United States / NCI NIH HHS / CA / P01 CA021239-28
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Protons
  • [Other-IDs] NLM/ NIHMS121640; NLM/ PMC2734911
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