Primary postoperative chemotherapy without radiotherapy for treatment of brain tumours other than ependymoma in children under 3 years: Results of the first UKCCSG/SIOP CNS 9204 trial

Grundy, Richard G.; Wilne, Sophie; Robinson, K. L.; Ironside, James W.; Cox, Tim; Chong, WK; Michalski, Antony; Campbell, R. H. A.; Bailey, C C; Thorp, Nicky; Pizer, Barry; Punt, Jonathan; Walker, David; Ellison, David W.; Machin, David

doi:10.1016/j.ejca.2009.09.013

Cited by 106 publications

(74 citation statements)

References 25 publications

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“…The patient was treated for 27 weeks in total with chemotherapy (protocol modified from proposed International Society of Paediatric Oncology Infant HGG study and based on the HIT-SKK study) [6,7]. This consisted of cyclophosphamide, vincristine, carboplatin, etoposide and high-dose methotrexate.…”

Section: Case Reportmentioning

confidence: 99%

Congenital Glioblastoma Multiforme: Complete Resection with Long-Term Survival and a Novel Technique of Contralateral Cystoventriculostomy

et al. 2012

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Congenital glioblastomas are rare primary tumours of the central nervous system with poor prognosis if left untreated. We report the case of a 4-week-old infant with such a tumour treated by surgical excision and a course of postoperative chemotherapy. After the chemotherapy, the patient displayed a neurological deterioration and follow-up magnetic resonance imaging (MRI) scans revealed no signs of recurrence, but showed entrapment and significant distension of the right lateral ventricle. A novel technique of contralateral cystoventriculostomy was performed to attempt to decompress the cyst and improve the infant's neurological status. After surgery there was a significant neurological improvement, and 30 months after resection the child is alive, with mild hemiparesis and no signs of recurrence on follow-up MRI scan. The cystoventriculostomy is patent and continues to decompress the encapsulated ventricle.

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Section: Case Reportmentioning

confidence: 99%

Congenital Glioblastoma Multiforme: Complete Resection with Long-Term Survival and a Novel Technique of Contralateral Cystoventriculostomy

et al. 2012

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“…Treatment with conventional postoperative chemotherapy alone results in less than 20% survival. [104][105][106] Small cohorts of patients treated with regimens designed specifically for ATRT have achieved survival rates greater than 50%.…”

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confidence: 99%

Pediatric Brain Tumors: Innovative Genomic Information Is Transforming the Diagnostic and Clinical Landscape

Gajjar

Bowers

Karajannis

et al. 2015

JCO

197

132

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Pediatric neuro-oncology has undergone an exciting and dramatic transformation during the past 5 years. This article summarizes data from collaborative group and institutional trials that have advanced the science of pediatric brain tumors and survival of patients with these tumors. Advanced genomic analysis of the entire spectrum of pediatric brain tumors has heralded an era in which stakeholders in the pediatric neuro-oncology community are being challenged to reconsider their current research and diagnostic and treatment strategies. The incorporation of this new information into the next-generation treatment protocols will unleash new challenges. This review succinctly summarizes the key advances in our understanding of the common pediatric brain tumors (ie, medulloblastoma, low- and high-grade gliomas, diffuse intrinsic pontine glioma, and ependymoma) and some selected rare tumors (ie, atypical teratoid/rhabdoid tumor and CNS primitive neuroectodermal tumor). The potential impact of this new information on future clinical protocols also is discussed. Cutting-edge genomics technologies and the information gained from such studies are facilitating the identification of molecularly defined subgroups within patients with particular pediatric brain tumors. The number of evaluable patients in each subgroup is small, particularly in the subgroups of rare diseases. Therefore, international collaboration will be crucial to draw meaningful conclusions about novel approaches to treating pediatric brain tumors.

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“…After 4 cycles of treatment, the response was poor, and the patient continued to lose weight, which decreased to 5.7 kg (23.3 SDS); hence, chemotherapy was changed to the United Kingdom Cancer Children Study Group (UKCCSG)/International Society of Pediatric Oncology (SIOP) protocol. 8 In the following months, tumor growth stopped, and weight loss reversed with a high-calorie diet (120-150 kcal/kg per day) administered by continuous enteral night feeding through a percutaneous gastrostomy.…”

Section: Patient Presentationmentioning

confidence: 99%

The Role of Leptin in Diencephalic Syndrome

Velasco¹,

Clemente

Lorite

et al. 2014

Pediatrics

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Diencephalic syndrome is a rare condition associated with central nervous system tumors. The most common presentation is secondary failure to thrive with proper caloric intake and no statural impairment. Despite the importance of this syndrome, little is known of its pathophysiology. Some reports have documented changes in human growth hormone and insulin levels at the onset, whereas others have described endocrine disorders of hypothalamic insufficiency resulting from surgery of the tumor. It has been suggested that the hormonal changes described, such as increased human growth hormone and ghrelin or decreased insulin and leptin levels, are related to a patient’s BMI. These findings support the role of these 4 hormones as indicators of the patient’s nutritional status but not as mediators or potential therapeutic targets of the disease. We report the case of an infant who initially presented with tumor progression and, after chemotherapy, progressive weight gain and reduced tumor size. Because he presented no hormonal deficiencies or obesity after therapy, we were able to analyze his hormonal status uninfluenced by effects of metabolic treatment or excess weight. Although ghrelin and leptin levels have been related to nutritional status, our patient’s leptin levels fell when tumor size decreased and weight increased: an extraordinary finding because leptin concentration is expected to increase with weight gain. This paradoxical response suggests that leptin may be dysregulated in diencephalic syndrome or that the diencephalic astrocytoma may have had an effect on leptin secretion.

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Primary postoperative chemotherapy without radiotherapy for treatment of brain tumours other than ependymoma in children under 3 years: Results of the first UKCCSG/SIOP CNS 9204 trial

Cited by 106 publications

References 25 publications

Congenital Glioblastoma Multiforme: Complete Resection with Long-Term Survival and a Novel Technique of Contralateral Cystoventriculostomy

Congenital Glioblastoma Multiforme: Complete Resection with Long-Term Survival and a Novel Technique of Contralateral Cystoventriculostomy

Pediatric Brain Tumors: Innovative Genomic Information Is Transforming the Diagnostic and Clinical Landscape

The Role of Leptin in Diencephalic Syndrome

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