“Treatment of Early Childhood Medulloblastoma by Postoperative Chemotherapy Alone”

Rutkowski, Stefan; Bode, Udo; Deinlein, Frank

doi:10.1097/01.cot.0000289241.40357.f1

Cited by 146 publications

(268 citation statements)

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“…Most frequent in children between the ages 0 and 9, this aggressive tumor can occur at any age (Louis et al 2007). Histopathological variants also exist and are associated with different outcomes (Rutkowski et al 2005;Ellison et al 2011b). Most recently, transcriptional profiling identified four major MB subgroups: two associated with pathogenic abnormalities in the Wingless (WNT) and Sonic Hedgehog (SHH) developmental signaling pathways (the WNT and SHH subgroups), and two that are less well molecularly characterized and referred to as group 3 and group 4 tumors.…”

mentioning

confidence: 99%

Role of MYC in Medulloblastoma

Roussel

Robinson

2013

Cold Spring Harbor Perspectives in Medicine

126

107

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Since its discovery as an oncogene carried by the avian acute leukemia virus MC29 in myelocytomatosis (Roussel et al. 1979) and its cloning (Vennstrom et al. 1982), c-MYC (MYC), as well as its paralogs MYCN and MYCL1, has been shown to play essential roles in cycling progenitor cells born from proliferating zones during embryonic development, and in all proliferating cells after birth. MYC deletion induces cell-cycle exit or cell death, depending on the cell type and milieu, whereas MYC and MYCN amplification or overexpression promotes cell proliferation and occurs in many cancers. Here, we review the relationship of MYC family proteins to the four molecularly distinct medulloblastoma subgroups, discuss the possible roles MYC plays in each of these subgroups and in the developing cells of the posterior fossa, and speculate on possible therapeutic strategies targeting MYC.

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mentioning

confidence: 99%

Role of MYC in Medulloblastoma

Roussel

Robinson

2013

Cold Spring Harbor Perspectives in Medicine

126

107

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“…The 5-year progression-free and OS rates were 82 and 93 % for the 17 patients who had complete resection, 50 and 56 % for those with residual tumor in the postoperative bed and 33 % and 38 % for those with macroscopic metastasis. A surprising finding in the study is the better outcome of patients with desmoplastic compared with classic medulloblastoma [9].…”

Section: Omitting or Delaying Rt In The Very Youngmentioning

confidence: 81%

Treatment strategies to reduce radiotherapy late effects in children

Paulino

2012

J Radiat Oncol

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Late effects of treatment are an important cause of morbidity and mortality in childhood cancer survivors. The use of radiotherapy has been implicated as a risk factor for the development of many late complications. Several strategies have been employed in pediatric oncology to minimize the late effects of radiotherapy. These have included (1) omitting or delaying radiotherapy until the child is older, (2) decreasing radiotherapy doses and volumes by incorporating chemotherapy in the treatment regimen, (3) alteration of radiotherapy fractionation, (4) use of novel techniques to spare or minimize radiation dose to surrounding normal tissues, and (5) elimination of radiotherapy in favorable subsets of patients. In infants with brain tumors, delaying radiotherapy and giving chemotherapy until the child is 3 years old was a popular approach three to four decades ago with limited success with respect to tumor control. With the advent of modern radiotherapy technology, younger patients are now able to be treated with conformal techniques and reasonable neurotoxicity. Using chemotherapy to reduce doses of radiation therapy has been employed in standard-risk medulloblastoma, intracranial germinoma, Hodgkin lymphoma, and Wilms' tumor. Likewise, the use of chemotherapy to reduce radiotherapy volumes has been employed in intracranial germinoma, Hodgkin lymphoma, and neuroblastoma and for the boost portion of treatments for rhabdomyosarcoma and Ewing sarcoma. There are a few phase III trials comparing conventional and hyperfractionated radiotherapy, but none of them have shown superiority of one over the other in terms of tumor control and late effects. Current protocols are testing the omission of radiotherapy in the most favorable subset of patients with Hodgkin lymphoma and Wilms' tumor. Intensity-modulated radiation therapy is currently used in many children in developed nations. Proton therapy is available in a few centers; clinical results of treatment are accumulating regarding the effectiveness and longterm toxicity of this radiation modality.

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“…These results are encouraging, although the number of patients studied was low. Rutkowski et al 19 reported the results of a HIT-SKK'92 study in which intraventricular chemotherapy was introduced as a substitute for RT. In their study, treatment was completed without RT in children who achieved CR after 6 months of intensive chemotherapy, including high-dose MTX and intraventricular MTX.…”

Section: Discussionmentioning

confidence: 99%

Tandem high-dose chemotherapy and auto-SCT for malignant brain tumors in children under 3 years of age

et al. 2013

Bone Marrow Transplant

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In an effort to improve survival and reduce late adverse effects of radiation therapy (RT), 25 children o3 years of age with malignant brain tumors received tandem high-dose chemotherapy (HDCT) and auto-SCT following six cycles of induction chemotherapy. RT was either not given or deferred until 3 years of age if the patient was in CR after tandem HDCT/auto-SCT. Tumors relapsed or progressed in nine patients (five during induction treatment), and two of these patients survived after receiving salvage treatment, including RT. Two patients died due to toxicities during tandem HDCT/auto-SCT. A total of 16 patients survived to a median follow-up period of 52 months (range 18-96) from the time of diagnosis. Four of these patients did not receive RT, two received local RT (L-RT), three received craniospinal RT (CSRT), and seven received both L-RT and CSRT. The 5-year OS and EFS rates were 67.8 ± 9.4% and 55.5 ± 10.0%, respectively. Neuroendocrine and neurocognitive functions evaluated 3 years after tandem HDCT/auto-SCT were acceptable. Our results indicate that tandem HDCT/auto-SCT may improve survival in young children with malignant brain tumors with an acceptable level of risk of long-term toxicity.

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“Treatment of Early Childhood Medulloblastoma by Postoperative Chemotherapy Alone”

Cited by 146 publications

References 0 publications

Role of MYC in Medulloblastoma

Role of MYC in Medulloblastoma

Treatment strategies to reduce radiotherapy late effects in children

Tandem high-dose chemotherapy and auto-SCT for malignant brain tumors in children under 3 years of age

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