Preradiation chemotherapy of children and young adults with malignant brain tumors: Results of the german pilot trial HIT'88/'89.

Kühl, Joachim; Müller, Horst; Berthold, Frank; Kortmann, Rolf‐Dieter; Deinlein, Frank; Maaß, Eberhard; Graf, Norbert; Gnekow, Astrid; Scheurlen, Wolfram; Göbel, U.; Wolff, Johannes; Bamberg, M.; Kaatsch, Peter; Kleihues, Paul; Rating, D.; Sörensen, N.; Wiestler, Otmar D.

doi:10.1055/s-2008-1043883

Cited by 92 publications

(45 citation statements)

References 7 publications

(11 reference statements)

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“…Postoperative therapy before the late 1980s consisted of "empirical" non-trialbased treatment. From then onward, trial-based therapy was adopted, including a combination of craniospinal radiation and chemotherapy according to standard protocols (32,33). Radiation therapy of MB consisted of doses of 50 -55 Gy and 35 Gy to the posterior fossa and craniospinal axis, respectively.…”

Section: Methodsmentioning

confidence: 99%

“…The key survival results are summarized in Table 3. Patients receiving a combination of standard chemotherapy and radiotherapy (32,33) showed a significantly improved survival (log-rank test, P Ͻ 0.001). The survival was found to be reduced in patients younger than 3 years of age at diagnosis and in patients with evidence of metastatic disease at diagnosis.…”

Section: Prognosis Of Patients With Classical Mb With Regard To Clinimentioning

confidence: 99%

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Expression of Matrix Metalloproteinases and Their Inhibitors in Medulloblastomas and Their Prognostic Relevance

Özen

Krebs

Hemmerlein³

et al. 2004

Clinical Cancer Research

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Purpose and Experimental Design:The cellular mechanisms leading to metastatic disease in medulloblastoma (MB), the most common malignant brain tumor in childhood, are mainly unknown. Recently, however, the involvement of matrix metalloproteinases (MMPs) has been suggested. We examined the expression and localization of four MMPs-MMP-2 and -9, membrane-type 1 and 2 MMP (MT1-and MT2-MMP)-and correlated the data with those for their main inhibitors, tissue inhibitors of metalloproteinases (TIMP-1, -2, and -3), in 83 classical and 18 desmoplastic MBs.Results: Independent of the histological subtype, MMP-2 expression was found in a small percentage of tumors, whereas MMP-9 and MT1-or MT2-MMP were expressed in >75% of tumor samples. The expression of TIMP-1, -2, and -3, on the other hand, was found to depend on the histological subtype: TIMP-3 was often found in classical MB, whereas TIMP-2 was often expressed in desmoplastic MB (P ‫؍‬ 0.007-0.001). In addition, both TIMP-3 and -2 correlated significantly with the expression of all studied metalloproteinases except MMP-2. TIMP-1, detected only in classical MB in a low percentage, was the only TIMP that correlated with the expression of MMP-2. Kaplan-Meier estimation revealed significantly reduced long-term survival of patients with strong MMP expression in tumor samples. In multivariate logistic regression analysis, however, the prognosis was significantly determined only by clinical parameters.Conclusions: TIMP-3 and -2 expression is highly correlated with histological subtypes of MBs and strongly associated with the expression of certain MMPs. The expression of TIMPs and MMPs, however, does not determine prognosis independently of clinical parameters.

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Section: Methodsmentioning

confidence: 99%

Section: Prognosis Of Patients With Classical Mb With Regard To Clinimentioning

confidence: 99%

Expression of Matrix Metalloproteinases and Their Inhibitors in Medulloblastomas and Their Prognostic Relevance

Özen

Krebs

Hemmerlein³

et al. 2004

Clinical Cancer Research

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show abstract

“…In addition to the radiation, chemotherapy was given in 16 patients. Three patients received carboplatinum/vincristine, one patient was treated according to the CCNU/vincristine/cisplatinum chemotherapy protocol (Packer et al, , 1999, four patients were treated according to an intense chemotherapeutic protocol designed for medulloblastoma, using cisplatinum, Ara-C, etoposide, iphosphamide, and high dose methotrexate (Kuhl et al, 1998), and six patients received various types of other institutional chemotherapeutic protocols. Ten patients did not receive any chemotherapy, and chemotherapy was not documented in one patient.…”

Section: Clinicalmentioning

confidence: 99%

Treatment of paediatric pontine glioma with oral trophosphamide and etoposide

Wolff¹,

Westphal²,

Mölenkamp

et al. 2002

Br J Cancer

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To evaluate the overall survival of paediatric patients with pontine gliomas treated with oral trophosphamide and etoposide. Patients between 3 and 17 years of age with either typical diffuse pontine glioma on MRI or histologically proven anaplastic astrocytoma/glioblastoma multiforme located in the pons, were eligible. Treatment consisted of oral trophosphamide 100 mg m 72 day 71 combined with oral etoposide at 25 mg m 72 day 71 starting simultaneously with conventional radiation. Twenty patients were enrolled (median age 6 years, male : female=9 : 11). Surgical procedures included: no surgery: five, open biopsy: three, stereotactic biopsy: six, partial resection: three, and sub-total resection: three. Histological diagnoses included pilocytic astrocytoma: one, astrocytoma with no other specification: three, anaplastic astrocytoma: three, glioblastoma multiforme: eight, no histology: five. The most frequent side effects were haematologic and gastrointestinal. There was no toxic death. The response to combined treatment in 12 evaluable patients was: complete response: 0, partial response: three, stable disease: four, and progressive disease: five. All tumours progressed locally and all patients died. The overall median survival was 8 months. The overall survival rates at 1 and 4 years were: 0.4 and 0.05 respectively. This was not different from a control group of patients documented in the same population. Oral trophosphamide in combination with etoposide did not improve survival of pontine glioma patients. The treatment was well tolerated and should be evaluated for more chemoresponsive paediatric malignancies.

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“…Medulloblostom için günümüzde kabul gören tedavi şeması 3 yaşın üzerindeki çocuklarda maksimum cerrahi rezeksiyon, KSRT ve kemoterapidir (11,16). Üç yaş altındaki hastalarda radyoterapi (RT) uygulaması beyin gelişimi henüz tamamlanmadığı için 3 yaş sonrasına geciktirilir.…”

Section: Tedavi Yaklaşımıunclassified

Current Treatment of Medulloblastoma

Or¹,

Güney²,

Dizman³

et al. 2013

Acta Oncol Tur.

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ÖZETMedulloblastom çocukluk çağının ikinci en sık görülen ve en malign beyin tümörüdür. Yetişkinlerde ise oldukça nadir rastlanır. Medulloblastom tanılı hastalar tedavi öncesi standart risk ve yüksek riskli olmak üzere iki gruba ayrılır. Cerrahi rezeksiyonu takiben kraniospinal radyoterapi tedavinin temelini oluşturur. Günümüzde tedaviye kemoterapinin eklenmesi sağkalımın artmasına katkıda bulunmuştur. Ayrıca kemoterapinin eklenmesi ile total radyoterapi dozu da düşürülmüştür. Tedavide yeni kemoterapik ajanların geliştirilmesi ve yeni radyoterapi teknikleri hastaların uyumunu arttırmıştır. Anahtar Kelimeler: Medulloblastom; Kraniospinal ışınlama; Radyoterapi ABSTRACT Medulloblastoma is the second most common and most malignant brain tumor in children. But in adults medulloblastomas occur rarely. The patients with medulloblastoma are stratified two groups before treatment: avarage risk and high risk. Surgical resection followed by craniospinal irradiation has been the mainstay of medulloblastoma therapy. In recent years, chemotherapy has been introduced to reduce the total dose of radiation and increase the survival rate. The new radiotherapy techniques and chemotherapy agents increase compliance to treatment.

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Preradiation chemotherapy of children and young adults with malignant brain tumors: Results of the german pilot trial HIT'88/'89.

Cited by 92 publications

References 7 publications

Expression of Matrix Metalloproteinases and Their Inhibitors in Medulloblastomas and Their Prognostic Relevance

Expression of Matrix Metalloproteinases and Their Inhibitors in Medulloblastomas and Their Prognostic Relevance

Treatment of paediatric pontine glioma with oral trophosphamide and etoposide

Current Treatment of Medulloblastoma

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