Stereotactic techniques in managing pediatric brain tumors

Black, Peter McL.; Tarbell, Nancy J.; Alexander, Eben; Rockoff, Mark A.; Zhan, Min-Shu; Loeffler, Jay S.

doi:10.1007/bf00302038

Cited by 13 publications

(7 citation statements)

References 24 publications

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“…Good local control with little toxicity has been reported for treat ment of primary and recurrent brain tumors in children [6,8,9]. In our series the local control of high-grade gliomas was disappointing.…”

Section: Neoplasmsmentioning

confidence: 54%

“…The use of stereotactic radiosurgery among pediatric patients had been slower in its implementation but in gen eral has paralleled the application in adults [6][7][8][9], One reason for the lag is concern regarding potential CNS tox icity in pediatric patients treated with radiation. Most studies have demonstrated a relationship between dose, fraction size, volume of tissue irradiated, patient age and the incidence of late CNS toxicity with standard external beam radiotherapy [16][17][18].…”

Section: Discussionmentioning

confidence: 99%

“…The technique and results of radiosurgery in the treatment of arteriovenous malformations (AVMs) and intracranial malignancies in adults has been well documented [2][3][4][5]. More recently, the use of stereotactic radiosurgery has been applied to pediatric populations [6][7][8][9], In this paper we describe our experience treating pediatric patients with gamma knife radiosurgery at the University of California, San Francis co (UCSF).…”

Section: Introductionmentioning

confidence: 99%

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Gamma Knife Radiosurgery in Children

Baumann¹,

Wara²,

Larson³

et al. 1996

Pediatr Neurosurg

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52 pediatric patients were treated with radiosurgery at the University of California, San Francisco. Arteriovenous malformations were treated in 27 patients. Complete obliteration was noted in 4 of 12 patients imaged more than 2 years after radiosurgery. Arteriovenous malformation rebleed was noted in 1 patient. Symptomatic T2 changes were noted in 2 patients. Among 29 neoplasms treated in 25 patients, local control was noted in 5 of 7 low-grade gliomas, 5 of 14 high-grade gliomas, 4 of 5 craniopharyngiomas and 3 of 3 sarcomas. Three patients treated for neoplasms developed necrosis after radiosurgery.

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Section: Neoplasmsmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Gamma Knife Radiosurgery in Children

Baumann¹,

Wara²,

Larson³

et al. 1996

Pediatr Neurosurg

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“…About 50% of cerebral tumors in children are low-grade gliomas, about 30% anaplastic gliomas or glioblastomas, and the rest a variety of less common tumors, such as primitive neuroectodermal tumor (PNET), choroid plexus carcinoma, and meningiomas. The characteristics of specific tumors and their management have been described in a number of publications [4,6,10,20,21,22,28,45,53,55,63,68].…”

Section: Introductionmentioning

confidence: 99%

The present and future of cerebral tumor surgery in children

Black

2000

Child's Nerv Syst

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Cerebral hemisphere tumors are less common than posterior fossa tumors in children, but are still important among childhood tumors. At the present time, many are low grade and can be treated satisfactorily with modern surgical techniques. These techniques include image-guided surgery in the conventional operating room, brain mapping, and surgery in the intraoperative MRI. Technical sophistication is the chief characteristic of present approaches to cerebral cortical tumors. In the future, surgery for these tumors will require both technical and biological sophistication. Malignant cerebral tumors are invasive and heterogeneous and require new understandings of biology to develop effective treatments. These biological understandings will be added to sophisticated surgical techniques for surgical resection, perhaps with local delivery methods.

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“…These strategies, already used extensively in the treatment of adult brain tumors, have recently been applied to the pediatric population [4, 5, 6]. However, there are some drawbacks.…”

Section: Introductionmentioning

confidence: 99%

Permanent Low-Activity <sup>125</sup>I Seed Placement for the Treatment of Pediatric Brain Tumors: Preliminary Experience

Rostomily¹,

Halligan

Geyer

et al. 2001

Pediatr Neurosurg

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Although external beam radiation therapy is effective in the treatment of many pediatric brain neoplasms its use in this patient population has been associated with the development of significant cognitive and endocrine dysfunction and is severely limited as an option in previously irradiated patients. Therefore, we have adopted a strategy for management of residual microscopic disease by implantation of low-activity ¹²⁵I seeds in the tumor bed at the time of surgery. Six patients aged 2–14 years with recurrent tumors including two supratentorial primitive neuroectodermal tumors (n = 2), one medulloblastoma, one malignant ependymoma (n = 1), glioblastoma (n = 1) and one pleomorphic xanthoastrocytoma were implanted at the time of reoperation. A total of 11–126 seeds were implanted resulting in total doses of 16–21.8 Gy (after theoretical infinite time) at a depth of 5 mm from the implanted resection bed. Five patients had prior external beam radiation while the other patient (2 years old at initial diagnosis) progressed after surgery and chemotherapy. Two patients had lasting local tumor control. One patient is alive at 390 weeks of follow-up and another who died of distant failure at 366 weeks had no recurrence on MRI at 333 weeks’ follow-up. Only 2 patients had first local failures. These results suggest that the use of permanent low-activity ¹²⁵I seeds as an adjunct to surgery can provide good local tumor control and is a suitable treatment option for pediatric patients.

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Stereotactic techniques in managing pediatric brain tumors

Cited by 13 publications

References 24 publications

Gamma Knife Radiosurgery in Children

Gamma Knife Radiosurgery in Children

The present and future of cerebral tumor surgery in children

Permanent Low-Activity <sup>125</sup>I Seed Placement for the Treatment of Pediatric Brain Tumors: Preliminary Experience

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