Radiation therapy for brain stem tumor with special reference to CT feature and prognosis correlations

Shibamoto, Yuta; Takahashi, Masaji; Dokoh, Shigeharu; Tanabe, Masaya; Ishida, Tetsuya; Abe, Mitsuyuki

doi:10.1016/0360-3016(89)90372-6

Cited by 22 publications

(7 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In other respects, they are similar notwithstanding the exclusion of cervicomedullary tumours. Our 5-year survival ® gures are also similar to those from other paediatric centres, 8,12 although there are differences when comparison is made with adult series, 10 suggesting that the behaviour of pontine tumours, the commonest site of involvement, may be more benign in adults than in children.…”

Section: Discussionsupporting

confidence: 81%

Intrinsic brainstem tumours in childhood: a report of 35 children followed for a minimum of 5 years

Chitnavis

Phipps²,

Harkness³

et al. 1997

British Journal of Neurosurgery

View full text Add to dashboard Cite

The presentation, pathology and outcome of 35 children with intrinsic brainstem tumours treated at our institution between 1980 and 1990 have been reviewed. Eight children remain alive. There were 19 girls and 16 boys. Mean age at diagnosis was 5 years. The mean duration of symptoms prior to diagnosis was 5 months. The diagnosis was made by computed tomography (CT) in all children and magnetic resonance imaging (MRI), in addition, for 24 children. Twenty-seven tumours (77%) were diffuse, three (8.6%) were predominantly cystic, three (8.6%) were exophytic and two (5.7%) were focal. Cervicomedullary tumours were not included in this study. Definitive histology was obtained in 13 children (37.1%), eight (22.9%) by biopsy alone and five (14.3%) after surgery to debulk the tumours. Eleven of these cases were astrocytomas and two were primitive neuroectodermal tumours (PNET). Twelve children (34.3%) required shunt placement for hydrocephalus. Twenty-eight children (80%) were irradiated using conventionally fractionated radiotherapy to a total dose between 50 and 55 Gy. Six children (17.1%) also received chemotherapy. The overall mean survival time was 10 months, but five of six children who had their tumours debulked survived free of progressive disease for more than 5 years following their diagnosis. The prognosis for brainstem tumours in children remains poor with only a minority falling into the surgically resectable (good prognosis) group.

show abstract

Section: Discussionsupporting

confidence: 81%

Intrinsic brainstem tumours in childhood: a report of 35 children followed for a minimum of 5 years

Chitnavis

Phipps²,

Harkness³

et al. 1997

British Journal of Neurosurgery

View full text Add to dashboard Cite

show abstract

“…The exophytic nature of these lesions and their 'lowgrade' histology suggest the potential benefit of primary surgical intervention [3]. The availability of tissue from such patients leads to the potential for meaningful clinicopathologic and imaging correlations in this uncommon group of tumors [4,7,9], Our observations suggest that these DEBSGs have the histologic and diagnostic imaging features of juvenile pilocytic astrocytomas. These well-circumscribed tumors do not appear to be associated with intrinsic brain stem pathology as reflected in their generally benign clinical course and normal brain stem auditory-evoked poten tials.…”

Section: Introductionmentioning

confidence: 82%

“…Brain stem tumors are uniquely identified by anatomic location in trating lesions of the pons, the characteristic clinical and MRI appearance generally obviates the need for histologic confirmation. Even when biopsies are obtained, they are of limited prognostic value; these lesions almost uniform ly show a malignant clinical course with little suggestion of more favorable outcome in the 33-83% of such cases which demonstrate low-grade histology [2,[4][5][6][7], Dorsally exophytic brain stem gliomas (DEBSGs) have been identified as minimally invasive tumors generally associated with prolonged survival [8], Although these lesions have been reported to be 'low-grade' astrocytic tumors, their histology has not been well characterized. The exophytic nature of these lesions and their 'lowgrade' histology suggest the potential benefit of primary surgical intervention [3].…”

Section: Introductionmentioning

confidence: 99%

Predominance of Pilocytic Histology in Dorsally Exophytic Brain Stem Tumors

et al. 1994

View full text Add to dashboard Cite

We report the magnetic resonance imaging (MRI) and clinicohistologic characterization of dorsally exophytic brain stem gliomas (DEBSGs). Between 1983 and 1991, 12 of 51 patients evaluated for the diagnosis of brain stem glioma were found to have DEBSGs emanating from the pons, pontomedulla-ry junction or medulla. Eleven of the 12 patients had classic juvenile pilocytic astrocytomas. Unlike most other brain stem tumors, these patients were young (median 38 months, range 17-75), had a relatively long duration of symptoms (median 7 months, range 2-24) and displayed signs of increased intracranial pressure with limited cranial nerve paresis, absence of pyramidal tract findings, and near normal brain stem auditory-evoked potentials. MRI characteristically showed sharply demarcated lesions with decreased signal intensity on T1, and increased intensity on T2 sequences. Except for cystic areas, these tumors showed bright, uniform enhancement after gadolinium-DTPA. In all patients, 50-100% of the tumor volume could be resected. Three of 10 patients who received no immediate postoperative treatment eventually demonstrated disease progression, and 2 patients with subtotal resections who were treated with radiation and/or chemotherapy postoperatively remain disease-free for extended periods of time. The only death occurred in the 1 patient treated with chemotherapy who died of secondary leukemia. The overall and progression-free survival of these patients at 2 years is 100 and 67% as compared to 18 and 21 %, respectively, for other concomitantly treated non-exophytic brain stem gliomas. The excellent prognosis for this unusual group of brain stem tumors may be associated with the generally benign biology of pilocytic tumors and the ability to achieve significant degrees of resection.

show abstract

“…Studies have shown that more prolonged exposure to paclitaxel enables better response rates in vitro [5] than more brief exposures to greater drug concentrations. The concentration of paclitaxel required for maximal synergy (1±10 nM) [2] is well below peak levels achieved with routine systemic doses (800±1500 nM) [3]. Maximum radiosensitization is associated with the accumulation of cells at the junction of phases G2 and M, the relatively more radiosensitive point in the cell cycle.…”

Section: Introductionmentioning

confidence: 99%

“…

INTRODUCTIONAdults and children with high-grade astrocytic malignant brain tumors and those with brain stem gliomas have a grim prognosis [1,2]. Neither hyperfractionated radiotherapy alone nor the addition of several chemotherapeutic agents has impacted on survival [3].

…”

mentioning

confidence: 99%

A phase I study of cranial radiation therapy with concomitant continuous infusion paclitaxel in children with brain tumors

Liu

Vapiwala

Munoz

et al. 2001

Med. Pediatr. Oncol.

View full text Add to dashboard Cite

show abstract

Radiation therapy for brain stem tumor with special reference to CT feature and prognosis correlations

Cited by 22 publications

References 30 publications

Intrinsic brainstem tumours in childhood: a report of 35 children followed for a minimum of 5 years

Intrinsic brainstem tumours in childhood: a report of 35 children followed for a minimum of 5 years

Predominance of Pilocytic Histology in Dorsally Exophytic Brain Stem Tumors

A phase I study of cranial radiation therapy with concomitant continuous infusion paclitaxel in children with brain tumors

Contact Info

Product

Resources

About