Brain metastasis in children with sarcoma, neuroblastoma, and Wilms’ tumor

Prognostic factors in soft-tissue sarcomas: what have we learnt?

“…For example, synovial sarcoma, rhabdomyosarcoma and epithelioid sarcoma are known for their increased incidence of lymphatic spread [31,32]. Alveolar softpart sarcoma has a predilection for the brain [33][34][35]. It has "…10% of patients have metastatic disease at diagnosis, while a further 25% of patients with localized disease subsequently develop distant spread.…”

Role of post-operative radiation therapy in single brain metastasis from clear cell sarcoma in children: a case report with systemic review

“…In the series from Paulino et al, frontal lobe was the most common site of solitary metastasis, whereas cerebellar lesion was noted in only 2 cases (6%). In the two cases, the infratentorial metastasis was revealed by a cerebellar syndrome with loss of balance, incoordination and vomiting such as in our case [5].…”

“…However, in the cases of cranio-spinal irradiation the dose was 35 Gy in 14 fractions. Nevertheless, RT dose was not a significant prognostic factor for survival in the series reported by Paulino et al [5,8].…”

“…In Paulino et al report, the best prognosis was noted in patients with post-operative RT (median survival of 8 months), followed by that noted in patients who received RT alone or with chemotherapy (median survival ranged from 4 to 6 months). On multivariate analysis, only the use of RT was found to positively impact brain progression free survival (9 months with RT Vs 2 months without RT) [5].…”

Whole Neuraxis Irradiation to Address Central Nervous System Relapse in High-Risk Neuroblastoma

“…Consequently, there has been a shift in the pattern of relapse in these children with the emergence of metastases that involve or are isolated to the central nervous system (CNS) (1). Historically, reports of discrete neuraxis relapse (i.e., the parenchyma of the brain and spinal cord and the subarachnoid space) in children with NB have been rare and uniformly signified an ominous outcome (1)(2)(3)(4)(5)(6)(7)(8)(9). Initial attempts to treat CNS relapse with combinations of surgery, systemic chemotherapy, and/or focal radiotherapy (RT) were generally ineffective in preventing further progression of disease and ultimate death (1-3, 5, 6, 8, 9).…”