Surgical approaches in pediatric neuro-oncology

Silva, Adikarige H D; Aquilina, Kristian

doi:10.1007/s10555-019-09832-2

Cited by 23 publications

(16 citation statements)

References 59 publications

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“…Besides, encasement of neurovascular structures in tumors and extensive bleeding in operation is also the signi cant obstacle preventing GTR. This situation occurred frequently in highly malignant tumors like CPC and AT/RT [16]. A 7-years-old boy was considered to have a choroid plexus tumor in lateral ventricles on MR image (Fig.…”

Section: Discussionmentioning

confidence: 99%

Giant pediatric intracranial tumor: Size feature and surgical strategy

Zhang¹,

Jing²,

Pang³

et al. 2021

Preprint

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Purpose: To quantify the size of the giant pediatric intracranial tumor (GPIT), analyze the character of GPIT and optimize the management of GPIT.Materials and methods: This study analyzes the clinical data of 36 cases of GPIT at a center from January 2015 to August 2020. The volume of GPITs were measured by 3D slicer software based on preoperative magnetic resonance imaging (MRI).Result: The mean volume of GPITs is 110.7ml, with the maximum volume 619.8ml and the minimum volume 27.3ml. Hemisphere held the largest mean volume of GPIT among all locations, including 7 cases whose volume is over 100ml. There is no statistical difference in volume of GPIT between sex. The most common sites of GPITs are hemisphere and cerebellum. Other locations include ventricle, sellar-parasellar region and cerebropontine angle. Medulloblastoma is the most common postoperative histopathological type, other types contain ependymoma, pilocytic astrocytoma, atypical teratoid rhabdoid tumor (AT/RT), choroid plexus carcinoma (CPC), choroid plexus papilloma（CPP）, oligodendroglioma, primitive neuroectoderm tumor (PNET), immature teratoma and yolk sac tumor. 28 cases achieved total resections while 4 cases only achieved subtotal resections. The patient with giant immature teratoma died during the operation because of bleeding. High-grade malignant tumors indicate poorer prognosis.Conclusion: GPIT is a common disease in children with unfavorable prognosis, especially in high-grade malignant tumors like CPC, PNET and AR/RT. Volume measurement based on MRI is an effective approach to access and compare the sizes of GPITs. Operation can expend the survival periods of the patients. Surgical strategies should be chosen according to the location and pathological feature of the tumors.

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Section: Discussionmentioning

confidence: 99%

Giant pediatric intracranial tumor: Size feature and surgical strategy

Zhang¹,

Jing²,

Pang³

et al. 2021

Preprint

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“…Brain tumors of children are usually large and more likely to arise in the posterior fossa [11], causing hydrocephalus and high intracranial pressure. Furthermore, emergency surgery is often required, and radical tumor resection is normally quite beneficial to the patients’ prognosis [12, 13]. However, infant patients with low body weight would confront a huge risk when undergoing giant intracranial tumors (> 5 cm in diameter) resection, due to the hypovolemia resulting from larger surface-weight ratio, higher total water content, limited renal ability to concentrate, and greater water loss from thin skin.…”

Section: Discussionmentioning

confidence: 99%

“…Pediatric brain tumors are considered the second most common pediatric neoplasm, and about 50% of them are nonmalignant [1]. Currently, the best strategy for most of these tumors is radical resection as soon as possible [2], due to the intracranial pressure elevation, brain nerve damage, and even life-threatening conditions resulting from intracranial tumors (> 5 cm in diameter) in children. However, the intraoperative mortality rate remains high [3], especially in children with low weight and life-threatening conditions such as blood loss and coagulopathy, which made it a great challenge for anesthesiologists.…”

Section: Introductionmentioning

confidence: 99%

Bioreactance-guided fluid therapy for excision of a giant brain tumor in an infant under general anesthesia: A case report and literature review

Chen

Fan

2021

Brain Science Advances

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Pediatric patients are more likely to suffer from brain tumors. Surgical resection is often the optimal treatment. Perioperative management of pediatric brain tumor resection brings great challenges to anesthesiologists, especially for fluid therapy. In this case, the infant-patient was only 69-day-old, weighed 6 kg，but she was facing a gaint brain tumor (7.9 cm × 8.1 cm × 6.7 cm) excision. The infant was at great risks such as hemorrhagic shock, cerebral edema, pulmonary edema, congestive heart failure, coagulation dysfunction, etc. However, we tried to use the parameters obtained by bioreactance-based NICOM® device (Cheetah Medical) to guide the infant’s intraoperative fluid therapy, and successfully avoided these complications and achieved a good prognosis.

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confidence: 99%

“…Solid tumors account for 60% of all pediatric malignant neoplasms, and the spectrum of tumor types observed in children is substantially different from that in adults regarding origin and histologic subtype, etiologic characteristics, responses to treatment, and clinical outcomes. 1,2 Pediatric malignancies are most commonly of primary central nervous system or hematopoietic origin. 2 Specifically, these comprise central nervous system tumors; neuroblastoma; softtissue sarcoma, including rhabdomyosarcoma and nonrhabdomyosarcoma soft tissue tumors; Wilms tumor; bone tumors such as osteosarcoma and Ewing sarcoma; retinoblastoma; and other miscellaneous tumors.…”

mentioning

confidence: 99%

Population Pharmacokinetics and Exposure‐Response Analysis of nab‐Paclitaxel in Pediatric Patients With Recurrent or Refractory Solid Tumors

Li¹,

Kassir²,

Chen³

et al. 2020

Clinical Pharm in Drug Dev

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Pediatric malignancies are most commonly of primary central nervous system or hematopoietic origin. The main reason for cancer death in pediatrics is refractory and relapsed disease, and improved therapeutic options are needed in the pediatric population. Nanoparticle albumin‐bound (nab)‐paclitaxel (Abraxane) is a human albumin‐stabilized formulation of paclitaxel and was designed to improve the chemotherapeutic effects of paclitaxel and to reduce toxicities. Although nab‐paclitaxel pharmacokinetics (PK) has been extensively studied in adults, no information is available on its PK in children. ABI‐007‐PST‐001 was the first nab‐paclitaxel clinical trial conducted in pediatrics, and the current analysis is the first study of nab‐paclitaxel PK in pediatrics. Our analyses suggested that ontogeny and maturation play a role in nab‐paclitaxel PK disposition, as demonstrated by the finding that both blood clearance and volume of distribution increased from younger to older pediatric age groups and from pediatrics to adults. A 3‐compartment population PK (PPK) model with saturable elimination was developed to describe the paclitaxel whole blood concentrations in pediatrics. The PPK model was customized by estimating the allometric function on PK parameters to take into account the ontogeny/maturation of patients. PPK estimates are consistent with the fast and deep distribution of paclitaxel that was previously observed in adults. Finally, the exposure‐safety analysis showed an increased probability of drug‐related adverse events (>grade 2) in cycle 1 and the first cycle of neutropenia (>grade 2) associated with higher doses. However, there is no statistically significant association between exposures (measured by area under the concentration‐time curve) and the probabilities of either safety event.

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Surgical approaches in pediatric neuro-oncology

Cited by 23 publications

References 59 publications

Giant pediatric intracranial tumor: Size feature and surgical strategy

Giant pediatric intracranial tumor: Size feature and surgical strategy

Bioreactance-guided fluid therapy for excision of a giant brain tumor in an infant under general anesthesia: A case report and literature review

Population Pharmacokinetics and Exposure‐Response Analysis of nab‐Paclitaxel in Pediatric Patients With Recurrent or Refractory Solid Tumors

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