Rechute frontale du médulloblastome

Kochbati, L.; Ghorbel, Imen; Chaari, Néila; Besbes, M.; Maâlej, M.

doi:10.1016/j.canrad.2008.04.008

Cited by 8 publications

(2 citation statements)

References 10 publications

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“…The patient used to undergo three-dimensional conformal radiotherapy or two-dimensional conformal radiotherapy/conventional radiography which could not cover the cribriform plate with sufficient dose due to technical limitations. The disadvantage of the standard conformal X-ray technique is inadequate target coverage, mainly of the cribriform plate, when certain organs at risk such as the parotid glands, the inner ears, or the lenses are to be spared ( 52 , 53 ). For the recent and sequenced cases (case 1 and case 2), intensity-modulated radiation was delivered, but irritation dosage had not been adequately modulated to the cribriform plate (2000–3420 Gy) in our retrospective review.…”

Section: Discussionmentioning

confidence: 99%

Molecular characterization of sub-frontal recurrent medulloblastomas reveals potential clinical relevance

Chen¹,

Yang²,

Wang³

et al. 2023

Front. Neurol.

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BackgroundSingle recurrence in the sub-frontal region after cerebellar medulloblastoma (MB) resection is rare and the underlying molecular characteristics have not been specifically addressed.MethodsWe summarized two such cases in our center. All five samples were molecularly profiled for their genome and transcriptome signatures.ResultsThe recurrent tumors displayed genomic and transcriptomic divergence. Pathway analysis of recurrent tumors showed functional convergence in metabolism, cancer, neuroactive ligand–receptor interaction, and PI3K-AKT signaling pathways. Notably, the sub-frontal recurrent tumors had a much higher proportion (50–86%) of acquired driver mutations than that reported in other recurrent locations. The acquired putative driver genes in the sub-frontal recurrent tumors functionally enriched for chromatin remodeler-associated genes, such as KDM6B, SPEN, CHD4, and CHD7. Furthermore, the germline mutations of our cases showed a significant functional convergence in focal adhesion, cell adhesion molecules, and ECM–receptor interaction. Evolutionary analysis showed that the recurrence could be derived from a single primary tumor lineage or had an intermediate phylogenetic similarity to the matched primary one.ConclusionRare single sub-frontal recurrent MBs presented specific mutation signatures that might be related to the under-dose radiation. Particular attention should be paid to optimally covering the sub-frontal cribriform plate during postoperative radiotherapy targeting.

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Section: Discussionmentioning

confidence: 99%

Molecular characterization of sub-frontal recurrent medulloblastomas reveals potential clinical relevance

Chen¹,

Yang²,

Wang³

et al. 2023

Front. Neurol.

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“…Conventional contrasted MRI does not adequately distinguish MB recurrence from radionecrosis or radiation-induced tumors 4 . Table 1 shows the characteristics of conventional contrasted MRI from seven reports of MB recurrence in the literature [6][7][8][9][10][11][12] and only one case in which the findings were described with advanced techniques (DWI and PWI MRI) 1. Aboain et al 2 characterized recurrence on 3.0T and 1.5T MRI in a study of 21 patients.…”

Section: Discussionmentioning

confidence: 99%

Advanced MRI findings of supratentorial medulloblastoma recurrence in a young adult: a case report and literature review

Guerrero-Gomez,

Ramos-Sanchez,

Casares-Cruz

et al. 2023

JMEXFRI

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Conventional contrasted magnetic resonance imaging (MRI) poorly differentiates medulloblastoma (MB) recurrence from radiation-induced tumors or radionecrosis. Herein, we demonstrate the usefulness of advanced diffusion-weighted-imaging (DWI) and perfusion-weighted imaging (PWI) MRI techniques for the diagnosis of supratentorial MB recurrence in a 27-yearold patient with leptomeningeal carcinomatosis and the subsequent appearance of two supratentorial intraaxial masses.Significant diffusion restriction with ADC values for the right lesion of 448 x 10 -6 mm 2 /s and 492 x 10 -6 mm 2 /s for the left lesion were found. These values were low compared with the healthy brain parenchyma of 707 x 10 -6 mm 2 /s. The DSC-PWI analysis showed increased quantitatively measured relative cerebral blood volume (rCBV) with an rCBV index of 4. 89 and 4.34 (right and left, respectively) compared with 1.05 of healthy white matter. Supratentorial MB recurrence was diagnosed in a patient with masses in the temporal poles based on DWI and PWI MRI sequences, typical of highly cellular tumors with blood-brain barrier alterations and increased angiogenesis. This case report is the first from Mexico that characterizes MB recurrence with advanced MRI techniques.

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Evaluating the positional uncertainty of intrafraction, adjacent fields, and daily setup with the BrainLAB ExacTrac system in patients who are receiving craniospinal irradiation

Duan

Zhou

Dai

et al. 2020

J Applied Clin Med Phys

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Purpose: To investigate the daily setup, interfraction motion, variability in the junction areas, and dosimetric effect in craniospinal irradiation (CSI) patients. Methods: Fifteen CSI patients who had undergone split-field IMRT were followed in the study. Previous, middle, and posttreatment, each target volume position was evaluated using the ExacTrac system. Interfraction and intrafraction motions, the margin of the junction in adjacent targets volumes, and the dosimetric effect of the longitudinal residual error were analyzed. Results: The lowest attainment rate within the tolerance of the initial setup error was 66.79% in six directions. The values of the initial error were within 15 mm (SD 4.5 mm) in the translation direction and 5°(SD 1.3°) in the rotation direction after the transposition of the treatment isocenter. With the guidance of the ExacTrac system, the interfraction and intrafraction residual errors were almost within the tolerance after correction, the margin of CTV-to-PCTV was in the range of target expansion criteria. The residual longitudinal errors resulted in only slight changes in the mean doses of PGTV and PCTV, while the maximum dose of the spinal cord increased by 16.1%. The patients did not exhibit any side-effects by the overall treatment during the follow-up period. Conclusions: Position correction is necessary after setup and the transposition of the treatment isocenter. Intra-fraction motion in the lateral direction should be monitored throughout treatment. The position errors in junction areas are almost within the tolerance after correction. The patients did not exhibit any side-effects by the overall treatment.

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Rechute frontale du médulloblastome

Cited by 8 publications

References 10 publications

Molecular characterization of sub-frontal recurrent medulloblastomas reveals potential clinical relevance

Molecular characterization of sub-frontal recurrent medulloblastomas reveals potential clinical relevance

Advanced MRI findings of supratentorial medulloblastoma recurrence in a young adult: a case report and literature review

Evaluating the positional uncertainty of intrafraction, adjacent fields, and daily setup with the BrainLAB ExacTrac system in patients who are receiving craniospinal irradiation

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