Prognosticating survival of pineal parenchymal tumors of intermediate differentiation (PPTID) by grade

Lu, Victor M.; Luther, Evan; Eichberg, Daniel G.; Morell, Alexis A.; Shah, Ashish H.; Komotar, Ricardo J.; Ivan, Michael E.

doi:10.1007/s11060-021-03863-y

Cited by 11 publications

(14 citation statements)

References 22 publications

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“…A more contemporary review of 103 PPTID patients in the National Cancer Database (NCDB) found that surgery with GTR was the only treatment-related prognostic factor, with chemotherapy and RT having no impact on survival. 5 However, the authors of the review do acknowledge that the use of RT should not be ruled out given newer evidence showing an impact on progression-free survival (PFS). 5 Interestingly, the authors also presented 3 patients that had been treated at their institution with adjuvant RT (2 with STR and 1 with GTR), and all 3 were alive without recurrence with follow-up times ranging from 4.1 to 6.3 years.…”

Section: Literature Review/discussionmentioning

confidence: 99%

“… 5 However, the authors of the review do acknowledge that the use of RT should not be ruled out given newer evidence showing an impact on progression-free survival (PFS). 5 Interestingly, the authors also presented 3 patients that had been treated at their institution with adjuvant RT (2 with STR and 1 with GTR), and all 3 were alive without recurrence with follow-up times ranging from 4.1 to 6.3 years. 5 Contrary to the previous works, in 1 of the largest metanalyses heretofore conducted incorporating 29 studies and 127 PPTID patients, Mallick et al found that adjuvant RT significantly improved overall survival (OS) to 252 months compared to 168 months for patients who underwent surgery alone.…”

Section: Literature Review/discussionmentioning

confidence: 99%

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Radiation therapy for pineal parenchymal tumor of intermediate differentiation: A case series and literature review

Liu

Carmicheal

Baine

et al. 2023

J Cent Nerv Syst Dis

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Pineal parenchymal tumor of intermediate differentiation (PPTID) is a rare, primary tumor of the pineal gland. Due to its rarity, there is no consensus on optimal therapeutic strategies or standard characterization of the tumor’s behavior. Here, we report 2 new cases of PPTID and an extensive review of the literature involving the use and extent of radiation therapy. Patient 1 is a 54-year-old male who presented with PPTID and drop metastases in the spinal cord, received cranial spinal irradiation (CSI), and experienced recurrence 3.5 years after treatment. Stereotactic body radiation therapy (SBRT) helped the patient into remission for 9 months. Patient 2 is a 32-year-old male with a local PPTID at presentation who went on to receive surgical resection followed by focused adjuvant radiation therapy to the pineal tumor bed. He then presented 6 years after treatment with extensive disseminated recurrence and died due to leptomeningeal disease (LMD) about 4 years after recurrence. The available literature on PPTID is limited and reported cases of LMD with ongoing follow-up in PPTID are scarce. Our report adds to the current known PPTID cases, contributing to the information available regarding prognosis and treatment response. Although an optimal therapeutic strategy for PPTID still cannot be determined, data from the literature suggest that utilizing radiation therapy in patients with low-risk disease and gross total resections as well as the use of upfront CSI have the potential to improve patient progression and survival outcomes.

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Section: Literature Review/discussionmentioning

confidence: 99%

Section: Literature Review/discussionmentioning

confidence: 99%

Radiation therapy for pineal parenchymal tumor of intermediate differentiation: A case series and literature review

Liu

Carmicheal

Baine

et al. 2023

J Cent Nerv Syst Dis

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“…PPTIDs present a challenging diagnosis due to the absence of stringent histopathologic criteria for their classification and the presence of histological features spanning from well-differentiated PCs to high-grade PBs [ 7 , 10 ]. PPTID accounts for nearly 40–45% of all primary parenchymal pineal tumors.…”

Section: Pathological and Molecular Featuresmentioning

confidence: 99%

“…The KBTBD4 in-frame insertion is a frequent molecular alteration in PPTID. In contrast, DICER1 and DROSHA mutations were limited to PBs and may aid in differential diagnosis [ 7 , 13 ]. ATRX mutations associated with protein loss have also been reported [ 14 ].…”

Section: Pathological and Molecular Featuresmentioning

confidence: 99%

“…Lymphomas, atypical teratoid rhabdoid tumor (ATRT), and metastases may also occur in this region, though they are uncommon (see Figure 1 ) [ 4 , 5 , 6 ]. Pineal parenchymal tumors and germ cell tumors together make up more than 70% of all pineal region tumors [ 7 ]. Treatment options range from biopsy and surgery to radiotherapy and chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

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Diagnosis and Treatment of Pineal Region Tumors in Adults: A EURACAN Overview

Lombardi

Poliani

Manara

et al. 2022

Cancers

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Pineal region tumors are rare intracranial tumors, accounting for less than 1% of all adult intracranial tumor lesions. These lesions represent a histologically heterogeneous group of tumors. Among these tumors, pineal parenchymal tumors and germ cell tumors (GCT) represent the most frequent types of lesions. According to the new WHO 2021 classification, pineal parenchymal tumors include five distinct histotypes: pineocytoma (PC), pineal parenchymal tumors of intermediate differentiation (PPTID), papillary tumor of the pineal region (PTPR), pinealoblastoma (PB), and desmoplastic myxoid tumor of the pineal region, SMARCB1-mutant; GCTs include germinoma, embryonal carcinoma, yolk sac tumor, choriocarcinoma, teratoma, mixed GCTs. Neuroradiological assessment has a pivotal role in the diagnostic work-up, surgical planning, and follow-up of patients with pineal masses. Surgery can represent the mainstay of treatment, ranging from biopsy to gross total resection, yet pineal region tumors associated with obstructive hydrocephalus may be surgically managed via ventricular internal shunt or endoscopic third ventriculostomy. Radiotherapy remains an essential component of the multidisciplinary treatment approach for most pineal region tumors; however, treatment volumes depend on the histological subtypes, grading, extent of disease, and the combination with chemotherapy. For localized germinoma, the current standard of care is chemotherapy followed by reduced-dose whole ventricular irradiation plus a boost to the primary tumor. For pinealoblastoma patients, postoperative radiation has been associated with higher overall survival. For the other pineal tumors, the role of radiotherapy remains poorly studied and it is usually reserved for aggressive (grade 3) or recurrent tumors. The use of systemic treatments mainly depends on histology and prognostic factors such as residual disease and metastases. For pinealoblastoma patients, chemotherapy protocols are based on various alkylating or platinum-based agents, vincristine, etoposide, cyclophosphamide and are used in association with radiotherapy. About GCTs, their chemosensitivity is well known and is based on cisplatin or carboplatin and may include etoposide, cyclophosphamide, or ifosfamide prior to irradiation. Similar regimens containing platinum derivatives are also used for non-germinomatous GCTs with very encouraging results. However, due to a greater understanding of the biology of the disease’s various molecular subtypes, new agents based on targeted therapy are expected in the future. On behalf of the EURACAN domain 10 group, we reviewed the most important and recent developments in histopathological characteristics, neuro-radiological assessments, and treatments for pineal region tumors.

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Genetical and epigenetical profiling identifies two subgroups of pineal parenchymal tumors of intermediate differentiation (PPTID) with distinct molecular, histological and clinical characteristics

Rahmanzade,

Pfaff,

Banan

et al. 2023

Acta Neuropathol

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Prognosticating survival of pineal parenchymal tumors of intermediate differentiation (PPTID) by grade

Cited by 11 publications

References 22 publications

Radiation therapy for pineal parenchymal tumor of intermediate differentiation: A case series and literature review

Radiation therapy for pineal parenchymal tumor of intermediate differentiation: A case series and literature review

Diagnosis and Treatment of Pineal Region Tumors in Adults: A EURACAN Overview

Genetical and epigenetical profiling identifies two subgroups of pineal parenchymal tumors of intermediate differentiation (PPTID) with distinct molecular, histological and clinical characteristics

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