Treatment of Early Childhood Medulloblastoma by Postoperative Chemotherapy Alone

Rutkowski, Stefan; Bode, Udo; Deinlein, Frank; Ottensmeier, Holger; Warmuth‐Metz, Monika; Soerensen, Niels; Graf, Norbert; Emser, Angela; Pietsch, Torsten; Wolff, Johannes; Kortmann, Rolf Dieter; Kuehl, Joachim

doi:10.1056/nejmoa042176

Cited by 652 publications

(209 citation statements)

References 25 publications

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“…Over the past decades, there has been progressive improvement in treating children with primary malignant brain tumors, particularly medulloblastomas and low-grade astrocytomas [1, 12, 14,19,20,21]. Reasons include advances in imaging studies, neurosurgical techniques, radiotherapy, adjuvant chemotherapy, and postoperative care [1, 3,19,20,21].…”

Section: Discussionmentioning

confidence: 99%

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Survival Analysis of Children with Primary Malignant Brain Tumors in England and Wales: A Population-Based Study

Tseng

Tseng²

2006

Pediatr Neurosurg

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Primary malignant brain tumor is the second most common cancer in children. To investigate factors affecting children’s survival at a population level, data of 3,169 patients (age <15 years) from the Cancer Registry in England and Wales were used. They were diagnosed during 1971–1990 and followed up until 1995. Variables including age, gender, morphology, WHO grade, tumor site, socioeconomic status, geographical region, and period of diagnosis were available for analysis using the Kaplan-Meier method and the Cox hazards ratio (HR) regression. Results showed that the median survival and the 1-, 5-, and 10-year crude survival rate for this population were 8.7 years, 72.4, 54.0, and 49.2% respectively. Survival was influenced by age (HR 0.88/5 years), morphology (ependymoma HR 2.43), WHO grades (HR 1.42/grade), tumor sites (brain stem HR 2.11), and periods of diagnosis (HR 0.88/5 years). Gender, socioeconomic status, and geographical region did not affect their survival. Results from this population-based data are very helpful for comparison with other hospital-based studies and for public health purposes.

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Section: Discussionmentioning

confidence: 99%

“…Reasons include advances in imaging studies, neurosurgical techniques, radiotherapy, adjuvant chemotherapy, and postoperative care [1, 3,19,20,21]. Other explanations include better publicity on the availability of screening programs and early medical advice, more vigilance of general practitioners and prompt referral [2].…”

Section: Discussionmentioning

confidence: 99%

Survival Analysis of Children with Primary Malignant Brain Tumors in England and Wales: A Population-Based Study

Tseng

Tseng²

2006

Pediatr Neurosurg

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“…In order to ensure the safety of these measures, such treatment should necessarily be embedded in a complex, multidisciplinary and structured aftercare scheme. There are also promising, new primary treatment modalities being investigated, which show that postoperative chemotherapy alone may, in the future, possibly lead to a decrease in the degree of growth impairment in many of these children, and, in some cases, may prevent the occurrence of growth impairment [43]. …”

Section: Discussionmentioning

confidence: 99%

Final Height in Children with Medulloblastoma Treated with Growth Hormone

et al. 2005

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Background: Medulloblastoma is the most frequent primary solid central nervous system tumour in children. The 5-year survival rate is at present at about 60%. Height in general is severely compromised in survivors. The present study is an extension of the investigation by the author’s group of the effect of exogenous growth hormone (GH) among medulloblastoma patients. Methods: A total of 113 patients with medulloblastoma (out of 682 cases documented in KIGS, Pfizer International Growth Database) were treated with GH till final height was achieved. At the start of GH therapy (median dose 0.18 mg/kg/week), patients were 8.9 years old and had a median height SDS of –1.6. Results: After 6.8 years of GH, final height SDS was –1.9, reflecting an overall loss in height of 0.3 SDS. This contrasted with an age-matched group of patients with idiopathic growth hormone deficiency (iGHD, n = 1,986), whose gain in height was 1.6 SDS on the same dose. The index of responsiveness averaged –0.9 during the first prepubertal year and –2.0 during total pubertal growth, thus indicating a major impairment in responsiveness to GH as compared to iGHD. Height at GH start, which correlated positively with the age at disease onset, was found to be the major determinant of final height. Conclusions: Our findings show that attempts to improve the height outcome in medulloblastoma must involve earlier recognition and treatment with higher-than-replacement doses of GH; additionally, modifications in cancer treatment programs need to be considered, such as lowering the dose of craniospinal irradiation or avoiding it as far as possible.

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“…вного мозга и составляет 20-25% в структуре ново-Несмотря на улучшение результатов лечения, смерт-образований центральной нервной системы у детей ность достаточно высока, особенно в группе высокого [1][2][3]. В разных странах частота выявления медуллоб-риска, у выживших пациентов часто возникают ластом различна и составляет в среднем 2-6 случаев неврологические, эндокринные нарушения и соци-на 1 млн.…”

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“…Влияние дополнительных этиологических моложе 3-5 лет используют схему лечения, пре-факторов на индукцию и рост медуллобластом еще дусматривающую увеличение максимальной про-предстоит выяснить, а сами эти факторы иденти-должительности жизни без применения облучения фицировать. [3,5]. Взрослым пациентам назначают различные В последние десятилетия актуальным является схемы лечения в зависимости от степени резекции вопрос о роли вирусов в возникновении опухолей опухоли и наличия метастазирования.…”

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Presence of оnсо- and herpes viruses in medulloblastomas and gliomas (review of the literature and our own observations)

Lisianyi¹,

Потапова²,

Гудков³

et al. 2012

Ukr Neurosurg J

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Содержание онко-и герпесвирусов в медуллобластомах и глиомах головного мозга (обзор литературы и собственные наблюдения) Вступление. В настоящее время широко изучаются роль вирусной контаминации опухолей головного мозга и возможности противовирусной противоопухолевой терапии.Материалы и методы. С применением цепной реакции с полимеразой изучено содержание онко-и герпесвирусов в ткани медуллобластом и глиом головного мозга.Результаты. При исследовании 61 образца опухоли контаминация различными вирусами выявлена в 47,5%, наиболее часто -в медуллобластомах (в 51%), реже -в глиобластомах (в 22%). Чаще всего выяв-ляли вирус герпеса VII типа (в 16,3%) и полиомавирусы (в 10%). Наиболее короткий безрецидивный период отмечен у пациентов при наличии медуллобластомы при контаминации полиомавирусом SV-40.Обсуждение. Перспективным является изучение роли вирусов в онкогенезе опухолей, их прогности-ческое значение, а также возможность использования противовирусной терапии для лечения опухолей головного мозга.Ключевые слова : медуллобластома, глиома, полиомавирус, цитомегаловирус, вирус герпеса VII типа.

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Treatment of Early Childhood Medulloblastoma by Postoperative Chemotherapy Alone

Abstract: Postoperative chemotherapy alone is a promising treatment for medulloblastoma in young children without metastases.

Cited by 652 publications

References 25 publications

Survival Analysis of Children with Primary Malignant Brain Tumors in England and Wales: A Population-Based Study

Survival Analysis of Children with Primary Malignant Brain Tumors in England and Wales: A Population-Based Study

Final Height in Children with Medulloblastoma Treated with Growth Hormone

Presence of оnсо- and herpes viruses in medulloblastomas and gliomas (review of the literature and our own observations)

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