Impact of induction chemotherapy, hyperfractionated accelerated radiotherapy and high‐dose thiotepa on brain volume loss and functional status of children with primitive neuroectodermal tumour

Abstract

Measurement of brain volume loss in patients treated with HART and high-dose thiotepa may not be sufficient to predict function. However, correlation of brain volume loss due to late neurotoxicity with performance decline may be more obvious over longer period of follow-up. The combination of HART and myeloablative courses of thiotepa is associated with severe neurotoxicity and subsequent decline in performance status in a significant proportion of patients.

Estimating brain volume loss after radiation therapy in children treated for posterior fossa tumors (Corpus callosum and whole brain volume changes following radiotherapy in children)

“…The CCV measurements have also been used in children with primitive neuroectodermal tumors treated with high-dose thiotepa after hyperfractionated accelerated craniospinal radiotherapy (HART), revealing mild to severe neuroparenchymal volume loss following intensive sequential high-dose therapy with thiotepa given after HART regimen. 5 This confirmed previous results from a similar study, but where a different method of estimating brain volume was used. 6 Linear increases in white matter volumes, occurring during normal maturation, have been documented in a largescale study of 145 healthy individuals aged between 4 and 20 years.…”

“…Various degrees of parenchymal volume loss and generalized white matter signal changes have been reported in children treated for medulloblastoma (MDL). [4][5][6][7] Most studies used a fully automated hybrid neural network segmentation as well as a classification method to quantitatively derive volumes of brain parenchyma from these images. 4,7,8 Volumes of the corpus callosum (CC) have also been advocated as a surrogate to quantify volumes of neuroparenchyma, because the nearly 180 million myelinated axons within this white matter commissure make it susceptible to radiation-induced damage.…”

“…4,7,8 Volumes of the corpus callosum (CC) have also been advocated as a surrogate to quantify volumes of neuroparenchyma, because the nearly 180 million myelinated axons within this white matter commissure make it susceptible to radiation-induced damage. 5,9 Nevertheless, a correlation between CC volume (CCV) and whole brain volume (WBV) has not been demonstrated. The purpose of this study, therefore, was to establish whether CCVs and WBVs are correlated and to determine the impact of low-vs highdose RT on brain parenchymal volume loss as assessed using each technique.…”

Holistic rehabilitation for children with cancer: The Chilean model

“…Increased survival in childhood cancer thanks to more effective but intense treatments is accompanied by physical, cognitive, psychological, and social sequelae, all of which can appear years after the end of treatment. 11 , 12 , 13 These sequelae have an impact on the quality of life (QOL) of the children, adolescents, and their families, altering their functionality, school performance, and social and labor inclusion. 9 , 13 , 14 , 15 Indeed, cancer survivors have been shown to be 43% less likely to graduate from high school, have 60% less chance of being employed, and 18% less chance of marrying.…”

Selective Neural Deletion of the Atg7 Gene Reduces Irradiation-Induced Cerebellar White Matter Injury in the Juvenile Mouse Brain by Ameliorating Oligodendrocyte Progenitor Cell Loss

“…High-energy radiotherapy has long been implicated in DNA damage and cell death, and late-onset radiation-induced changes are often progressive and irreversible. Such therapy often leads to diffuse white matter changes ranging from scattered focal white matter lesions to confluent lesions, and the type of lesion varies greatly, including mineralizing microangiopathy, diffuse cerebral atrophy, focal areas of frank radiation necrosis, and radiation-induced vasculopathy (Dietrich et al, 2001; Fouladi et al, 2004; Kralik et al, 2015, 2017; Szychot et al, 2017).…”