Adjuvant chemotherapy for medulloblastoma: The first multi-centre control trial of the International Society of Paediatric Oncology (SIOP I)

Tait, Diana; Thornton‐Jones, Helen; Bloom, H. J. G.; Lemerle, J; Morris‐Jones, P. H.

doi:10.1016/0277-5379(90)90017-n

Cited by 319 publications

(198 citation statements)

References 20 publications

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“…Conflicting results have emerged from studies of clinical prognostic indicators for PNET (Hubbard et al, 1989;Tait et al, 1990;Zerbini et al, 1993;Geyer et al, 1994;Bailey et al, 1995), but the presence of metastases at the time of diagnosis has featured consistently as an indicator of poor prognosis, and is supported by our findings. Prognosis has previously been linked to histological variant (Hubbard et al, 1989), with desmoplastic variants tending to have a more favourable outcome than classic medulloblastomas, but this has not been found to be the case in all reports (Choux et al, 1983) and, while our series showed a similar trend, it did not reach significance with the number of cases involved.…”

Section: Discussionsupporting

confidence: 80%

Comparative genomic hybridization and histological variation in primitive neuroectodermal tumours

et al. 1999

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SummaryThe objective of this study was to test the hypothesis that chromosomal imbalances in central nervous system primitive neuroectodermal tumours (PNETs) reflect site and histology. We used comparative genomic hybridization to study 37 cases of PNET, of which four were cerebral and 31 were medulloblastomas classified histologically as classic (n = 17) or nodular/desmoplastic (n = 14). Tumour immunophenotype was characterized with antibodies to neuroglial, mesenchymal and epithelial markers. Chromosomal imbalances were detected in 28 medulloblastomas (90%), and significant associations between tumour variants and genetic abnormalities were demonstrated. Aberrations suggesting isochromosome 17q were present in eight (26%) medulloblastomas, of which seven were classic variants. None of these cases, or a further six with gain of 17q, showed immunoreactivity for glial fibrillary acidic protein. Loss on 9q was found in six cases (19%), five of them nodular/desmoplastic. Loss of 22 occurred in four (13%), all classic medulloblastomas in young patients with a poor outcome and immunoreactivity for more than one epithelial or mesenchymal marker. Different patterns of imbalance were found in the cerebral PNETs. There were no abnormalities of chromosome 17, but all three cases with imbalance showed losses of 3p12.3-p14.

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Section: Discussionsupporting

confidence: 80%

Comparative genomic hybridization and histological variation in primitive neuroectodermal tumours

et al. 1999

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“…It is reasonable to assume that the results from the randomized trials Original Article performed in the 1980s and 1990s, leading to the standardization of treatment (including radiotherapy and chemotherapy), have played a major role in this improvement in survival rates. [4][5][6]32 However, it should be noted that overlapping error bars during the 1985 and 1987 time period in children indicate that an improvement of this magnitude may be caused by random error and should be interpreted cautiously. Nonetheless, there is an overall improvement in survival noted throughout the entire study period, and it is possible that the greatest strides were made during the late 1980s.…”

Section: Longitudinal Cumulative Relative Survivalmentioning

confidence: 99%

Relative survival of childhood and adult medulloblastomas and primitive neuroectodermal tumors (PNETs)

Smoll

2011

Cancer

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BACKGROUND: Medulloblastomas are 1 of the most common brain tumors in children but can affect individuals of all ages. For this report, the author investigated the impact of medulloblastomas/primitive neuroectodermal tumors (PNETs) on the US population with a focus on age differences. METHODS: Data from the Surveillance, Epidemiology, and End Results (SEER) database were used to describe cumulative relative survival (CRS) using crude, period, and longitudinal period approaches for patients diagnosed with all medulloblastoma subtypes and PNETs. CRS estimates were obtained using SEER expected mortality data and the Ederer II method for expected survival estimation. These data were applied to the construction of rational follow-up scheduling protocols. RESULTS: The 5-year period CRS for all patients who were followed between 2001 and 2006 was 69%. Adults had a worse overall prognosis, but this difference in excess hazard rates appeared only after 4 years of follow-up. Furthermore, the 5-year and 10-year CRS has improved a minimum of 11% in children, adolescents, and adults over the past 25 years. CONCLUSIONS: The survival difference between children, adolescents, and adults with medulloblastomas and PNETs depended on the length of follow-up, which was described in this report as an age-by-follow-up interaction and observed as a ''fork'' on Kaplan-Meier curves. Differences in survival between children and adults emerged only 4 years after diagnosis, and adults fared worse. There has been significant improvement in survival from medulloblastomas/PNETs since the late 1970s and early 1980s. Cancer 2012;118:1313-

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“…They develop most frequently in the cerebellum when they are usually known as medulloblastomas. Although fatal if untreated, current treatment regimens achieve 50-60% 5-year survival rates for medulloblastomas (Tait et al, 1990). At the present time neither clinical nor histopathological features in medulloblastomas reliably identify which tumours will recur (Caputy et al, 1987), making it difficult to develop new therapeutic strategies.…”

mentioning

confidence: 98%

p53 protein overexpression identifies a group of central primitive neuroectodermal tumours with poor prognosis

Jaros

Lunec²,

Perry³

et al. 1993

Br J Cancer

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Summary Primitive neuroectodermal tumours (PNET's) or medulloblastomas are common primary brain tumours of childhood. Current treatment protocols achieve 50-60% cures. However, it has proved difficult to develop better treatment for the remaining patients because prognostic factors are not established. We have investigated the prognostic value of p53 protein expression in 87 PNET's using immunohistochemistry with DO-7 and CM-1 antibodies on biopsy paraffin sections. Eight patients (9%) had intensely reactive tumour cell nuclei, and a significantly reduced survival (P = 0.002); only one survives and this with a recurrent tumour 50 months following diagnosis. Sixty eight per cent of patients had faintly reactive tumour cell nuclei, a reduced survival up to 4 years but a long term survival not significantly different (P = 0.41) from 23% of patients with p53 negative PNET's; the 10 year survival rates were 37% and 40%, respectively. Males had a reduced survival (P = 0.04) with a 2-fold relative risk of death compared to females. Multivariate analysis showed that intense overexpression of p53 protein identifies a group of PNET patients with a 7-fold relative risk of death compared to all other cases, irrespective of sex. This marked difference suggests the involvement of p53 in the pathogenesis of PNET's which have a particularly poor response to treatment, and should help to develop new therapies for this group of patients.

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Adjuvant chemotherapy for medulloblastoma: The first multi-centre control trial of the International Society of Paediatric Oncology (SIOP I)

Cited by 319 publications

References 20 publications

Comparative genomic hybridization and histological variation in primitive neuroectodermal tumours

Comparative genomic hybridization and histological variation in primitive neuroectodermal tumours

Relative survival of childhood and adult medulloblastomas and primitive neuroectodermal tumors (PNETs)

p53 protein overexpression identifies a group of central primitive neuroectodermal tumours with poor prognosis

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