Response to neoadjuvant chemotherapy in children with pineoblastoma

Ghim, Thad T.; Davis, Patricia C.; Seo, Joo Hee; Crocker, Ian; O'Brien, Mark S.; Krawiecki, Nicolas

doi:10.1002/1097-0142(19930901)72:5<1795::aid-cncr2820720546>3.0.co;2-n

Cited by 30 publications

(18 citation statements)

References 22 publications

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“…12,15,26) Current agents used for PNETs include cyclophosphamide, cisplatin, carboplatin, vincristine, ifosmide, and etoposide. 2,17) While our study did not show any impact of chemotherapy on survival, the power of our analysis was limited by the small number of patients who received chemotherapy (n ＝ 10, 29.4%) and the many different regimens used in these patients. Future studies should be directed towards the determination of the best chemotherapy regimen.…”

Section: Chemotherapymentioning

confidence: 65%

Management and Survival of Pineoblastoma: An Analysis of 34 Adults From the Brain Tumor Registry of Japan

Lee

Wakabayashi

Yoshida

2005

Neurol. Med. Chir.(Tokyo)

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Pineoblastoma is a rare tumor in adults, and factors influencing survival are poorly understood. Data from the Brain Tumor Registry of Japan (BTRJ) was analyzed to examine patient, tumor, and treatment characteristics associated with increased survival in adults with pineoblastomas. All pineoblastoma cases in adults aged 16 years or older were identified in the BTRJ. Data were extracted on demographics, presentation, tumor characteristics, treatments, and outcomes. Kaplan-Meier plots, the log rank method, and p value º0.15 was used to screen variables for inclusion in a multivariate Cox regression estimating survival. In the final Cox multivariate model, all variables with p values º0.05 were considered significant predictors of survival, and all variables with p values 0.05-0.099 were considered trends. The BTRJ contained 34 adults with pineoblastomas diagnosed from 1969-1998. The patients were predominantly male (22 patients), with a median age of 35 years (range 16-66 years). Median survival from diagnosis was 25.7 months, with a median follow up of 20.5 months. Median surgical resection was 75-94%, and five of the 34 patients had gross total resection. Twenty-nine of the 34 patients received cranial irradiation therapy with a median dose of 50 Gy (range 30-70 Gy). In the final multivariate model, cranial irradiation AE40 Gy (p ＝ 0.014) and gross total resection (p ＝ 0.034) were associated with improved survival. There was a trend towards improved survival for women (p ＝ 0.099). Adult pineoblastoma patients have poor survival prognosis. Cranial irradiation therapy using at least 40 Gy and complete surgical resection are associated with improved survival.

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Section: Chemotherapymentioning

confidence: 65%

Management and Survival of Pineoblastoma: An Analysis of 34 Adults From the Brain Tumor Registry of Japan

Lee

Wakabayashi

Yoshida

2005

Neurol. Med. Chir.(Tokyo)

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“…Our search resulted in 109 publications 1, 3, 4, 7, 10, 17‐61. amounting to 299 nonduplicated, diaggregated patients who were treated for pineoblastoma (see Fig.…”

Section: Resultsmentioning

confidence: 99%

The long‐term postsurgical prognosis of patients with pineoblastoma

Tate

Sughrue

Rutkowski

et al. 2011

Cancer

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BACKGROUND: For this report, the authors comprehensively summarized the existing literature on patients with pineoblastoma and identified the variables and treatments that had an impact patient on outcomes. METHODS: A comprehensive search identified 109 studies that collectively described the outcomes of patients with pineoblastoma. Individual patient data were classified based on treatment and were subjected to univariate comparisons. Cox regression analysis included comparisons of survival outcomes controlling for age, extent of resection, and treatment group, and between-group survival comparisons were performed using the Kendall tau (rank correlation) statistic. RESULTS: Two hundred ninety-nine patients met inclusion criteria. The overall survival rate was 54% (175 of 299 patients) at a mean follow-up of 31 AE 1.9 months (range, 1-159 months). The analyses demonstrated a markedly worse prognosis for children aged 5 years compared with older patients (5-year survival rate: 15% for children aged 5 years vs 57% for children aged !5 years; log-rank P < .00001). In addition, a graded increase in survival was observed with increasing degrees of resection (5-year survival rate: 84% for patients who underwent gross total resection vs 53% for patients who underwent subtotal resection vs 29% for patients who underwent debulking; logrank P < .0001). Multivariate analysis indicated that not achieving gross total resection markedly worsened patient survival (subtotal resection: hazard ratio, 6.47; 95% confidence interval, 2.3-19; P ¼ .001. debulking: hazard ratio, 9.27; 95% confidence interval, 3.2-27; P < .0001). CONCLUSIONS: The current findings emphasize the importance of aggressive surgical resection in the treatment of pineoblastoma. In addition, the authors conclude that clinical trials should not mix young patients with older patients or patients who undergo subtotal resection with patients who undergo gross total resection, because such heterogeneity may alter the variability of responses to treatment and reduce the likelihood of success. Cancer 2012;118:173-

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“…17 Phenytoin earlier was reported to inhibit microtubular polymerization, 33,34 an activity that has been postulated to be the cause of its teratogenic action. 16,18 Mareel and coworkers 36 demonstrated a fairly complete inhibition of invasion of malignant murine cells into embryonic chick heart fragments at 1 g VCR/ml. 17 The addition of a noncytostatic drug to a chemotherapeutic agent not only is an attractive concept, in terms of augmentation of the antiproliferative activity with fewer side effects, but also promises further insight into the functional mechanisms of tumor control.…”

Section: Vinca Alkaloids Dph and Microtubulesmentioning

confidence: 96%

Differential effects of vincristine and phenytoin on the proliferation, migration, and invasion of human glioma cell lines

Tonn¹,

Haugland²,

Saraste³

et al. 1995

Journal of Neurosurgery

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The aim of this study was to investigate the antimigratory and antiinvasive potential of vincristine sulfate (VCR) on human glioma cells and to analyze whether phenytoin (5,5-diphenylhydantoin; DPH) might act synergistically with VCR. Vincristine affects the cytoplasmic microtubules; DPH has been reported to enhance VCR cytotoxicity in murine cells. In two human glioma cell lines, GaMG and D-37MG, we found VCR to reduce monolayer growth and colony formation in a dose-dependent fashion at concentrations of 10 ng/ml and above. Phenytoin increased the cytotoxic and cytostatic effects of VCR in monolayer cells but not in spheroids. Multicellular spheroids were used to investigate directional migration. A coculture system of GaMG and D-37MG spheroids with fetal rat brain aggregates was used to analyze and quantify tumor cell invasion. A dose-dependent inhibition of migration and invasion by VCR was observed in both cell lines without further enhancement by DPH. Immunofluorescence microscopy with antibodies against alpha-tubulin revealed dose-dependent morphological alterations in the microtubules when the cells were exposed to VCR but not after incubation with DPH. Based on the combination of standardized in vitro model systems currently in use and the present data, the authors strongly suggest that VCR inhibits migration and invasion of human glioma cells. This is not altered by DPH, which inhibits cell proliferation in combination with VCR.

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Response to neoadjuvant chemotherapy in children with pineoblastoma

Cited by 30 publications

References 22 publications

Management and Survival of Pineoblastoma: An Analysis of 34 Adults From the Brain Tumor Registry of Japan

Management and Survival of Pineoblastoma: An Analysis of 34 Adults From the Brain Tumor Registry of Japan

The long‐term postsurgical prognosis of patients with pineoblastoma

Differential effects of vincristine and phenytoin on the proliferation, migration, and invasion of human glioma cell lines

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