Treatment of infants with malignant gliomas: The Pediatric Oncology Group Experience

Duffner, Patricia K.; Krischer, Jeffrey; Burger, Peter C.; Cohen, Michael E.; Backstrom, James; Horowitz, Marc E.; Sanford, Robert A.; Friedman, Henry S.; Kun, Larry E.

doi:10.1007/bf00250203

Cited by 93 publications

(64 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Among children with supratentorial high-grade astrocytomas, TP53 mutations and protein overexpression are less prevalent in children younger than 4 years of age than they are in those older than 4 years of age [8]. Young children with supratentorial high-grade astrocytomas often undergo maximal surgical resection and chemotherapy, but do not receive radiation therapy (RT) unless there is tumor recurrence or progression [9,10]. Still, their 3-year event-free survival (EFS) rate ranges between 31% and 43% with this approach.…”

Section: Known Genetic and Molecular Alterationsmentioning

confidence: 99%

“…Two of the largest studies in this population were conducted by cooperative groups in North America, and both used maximal surgical resection followed by combination chemotherapy for 1-2 years [9,10]. The first study treated the infants with 10 cycles of 8-in-1 chemotherapy; the second used cyclophosphamide and vincristine alternated with cisplatin and etoposide.…”

Section: Patients With Newly Diagnosed Diseasementioning

confidence: 99%

See 1 more Smart Citation

Supratentorial High-Grade Astrocytoma and Diffuse Brainstem Glioma: Two Challenges for the Pediatric Oncologist

2004

View full text Add to dashboard Cite

Pediatric high-grade gliomas represent a heterogeneous group of tumors that accounts for 15%-20% of all pediatric central nervous system tumors. These neoplasms predominantly involve the supratentorial hemispheres or the pons, in which case the tumors are usually called diffuse brainstem gliomas. The diagnosis of supratentorial neoplasms is dependent on their histologic appearance. The maximum possible surgical resection is always attempted since the degree of surgical resection is the main prognostic factor for these patients. Older children (>3 years) with supratentorial neoplasms undergo a multimodality treatment comprised of surgical resection, radiation therapy, and chemotherapy. The addition of chemotherapy seems to improve the survival of a subset of these children, particularly those with glioblastoma multiforme. However, 2-year survival rates remain poor for children with supratentorial neoplasms, ranging from 10%-30%.The diagnosis of a diffuse brainstem glioma is based upon typical imaging, dispensing with the need for surgery in the majority of cases. Radiation therapy is the mainstay of treatment for children with diffuse brainstem gliomas. The role of chemotherapy for these children is not clear, and it is, in general, employed in the context of an investigational study. Less than 10% of children with diffuse brainstem gliomas survive 2 years. Hematology-Oncology, St. Jude Children's Research Hospital, 332 North Lauderdale Room C-6066 Mail Stop 260, Memphis, Tennessee 38105, USA. Telephone: 901-495-4925; Fax: 901-521-9005; e-mail: alberto.broniscer@stjude.org Received July 15, 2003; accepted for publication November 19, 2003. ©AlphaMed Press 1083-7159/2004 The Oncologist ® Pediatric Oncology The Oncologist LEARNING OBJECTIVESAfter completing this course, the reader will be able to:1. Describe the known genetic alterations associated with pediatric supratentorial high-grade astrocytomas and diffuse brainstem gliomas.2. Discuss the clinical and biologic prognostic factors for children with supratentorial high-grade astrocytomas and diffuse brainstem gliomas.3. Explain the roles played by surgery, radiation therapy, and chemotherapy in the treatment of children with supratentorial high-grade astrocytomas and diffuse brainstem gliomas.Access and take the CME test online and receive one hour of AMA PRA category 1 credit at CME.TheOncologist.com CME CMEThis material is protected by U.S.

show abstract

Section: Known Genetic and Molecular Alterationsmentioning

confidence: 99%

Section: Patients With Newly Diagnosed Diseasementioning

confidence: 99%

Supratentorial High-Grade Astrocytoma and Diffuse Brainstem Glioma: Two Challenges for the Pediatric Oncologist

2004

View full text Add to dashboard Cite

show abstract

“…5,6,10,12,17,18,21,[24][25][26]28,31,[33][34][35][36]41,42 From these publications, there were 29 cases of GBM that met our inclusion criteria. The patients underwent either CT scans or MRI based on the patient's age and the clinical presentation.…”

Section: Resultsmentioning

confidence: 99%

Radiological features of infantile glioblastoma and desmoplastic infantile tumors: British Columbia’s Children’s Hospital experience

Bader¹,

Heran²,

Dunham

et al. 2015

PED

View full text Add to dashboard Cite

OBJECT Two of the more common infantile brain tumors, glioblastoma multiforme (GBM) and desmoplastic infantile tumors (DITs), can be difficult to distinguish on MRI. Both tumors occur in the supratentorial compartment and both have solid and cystic components. Differentiating between the 2 on MRI studies could assist the surgeon in discussions with family and child management. The authors report on their institutional experience with both tumors, focusing on radio-graphic features, especially the diffusion studies, which might be useful in distinguishing between infantile GBM and DIT. METHODS A retrospective review was undertaken of all infantile brain tumors treated at British Columbia’s Children’s Hospital between 1982 and 2012, and cases of GBM and DIT were recorded. Only cases that had imaging were included in the study. A literature review was completed to identify reported cases of infantile GBM and DIT. Only reports that described or included radiological studies (particularly MRI) of the tumors were included. Certain radiographic features of the tumors were reviewed, including location, size, consistency, pattern of enhancement, and features on MR diffusion studies. RESULTS Of 70 cases of infantile brain tumors, 2 GBM cases and 3 DIT cases (all 3 of which were desmoplastic infantile gangliogliomas [DIGs]) met the inclusion criteria. The radiological studies obtained in all 5 cases were reviewed by a neuroradiologist. All 5 patients had supratentorial tumors with cystic-solid consistency. Diffusion MRI studies showed restricted diffusion in the 2 GBM cases, but no evidence of restricted diffusion in the DIG tumors. The GBM tumors were heterogeneously enhancing, and the DIG tumors showed avid and homogeneous enhancement. The literature review revealed 29 cases of infantile GBM and 32 cases of DIG/DIT that met the inclusion criteria. The tumors were large in both groups. The tumors were cystic-solid in consistency in 10 of 30 (33%) of GBM cases and 28 of 32 (87.5%) of DIT cases. The contrast enhancement was heterogeneous in 9 of 30 (30%) GBM cases, and it was homogeneous and avid in 27 of 32 (84%) of DIT cases. Diffusion studies were recorded in 2 published infantile GBM cases, and in both of them diffusion was restricted. The authors only found 1 report that discussed DIG tumor features on MR diffusion studies, but the interpretation was difficult and unclear. CONCLUSIONS Magnetic resonance imaging, especially diffusion-weighted imaging, may be a useful aid in distinguishing between infantile GBM and DIT tumors, with infantile GBM demonstrating restricted diffusion.

show abstract

“…They have been reported to bear a more favorable prognosis in infants than in older children despite the lack of radiation used in treatment. OS rates in prospective studies are in the range of 50%-66% [30,[112][113][114]. As is true with older children, these results need to be interpreted in light of the welldescribed discordance among neuropathologists when diagnosing HGG.…”

Section: Hggmentioning

confidence: 94%

Current Treatment Approaches for Infants with Malignant Central Nervous System Tumors

Lafay‐Cousin

Strother

2009

The Oncologist

View full text Add to dashboard Cite

DisclosuresLucie Lafay-Cousin: None; Douglas Strother: None.Section editors Susan M. Blaney and Ross Pinkerton have disclosed no financial relationships relevant to the content of this article.The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. LEARNING OBJECTIVES1. Evaluate the challenges of identifying very young children with brain tumors so that they can be enrolled in clinical trials.2. Identify prognostic factors for children with certain brain tumors and assess the influence of these factors on current therapeutic strategies.3. Outline factors affecting survival and neurocognitive outcome of children with malignant brain tumors.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACT

show abstract

Treatment of infants with malignant gliomas: The Pediatric Oncology Group Experience

Cited by 93 publications

References 24 publications

Supratentorial High-Grade Astrocytoma and Diffuse Brainstem Glioma: Two Challenges for the Pediatric Oncologist

Supratentorial High-Grade Astrocytoma and Diffuse Brainstem Glioma: Two Challenges for the Pediatric Oncologist

Radiological features of infantile glioblastoma and desmoplastic infantile tumors: British Columbia’s Children’s Hospital experience

Current Treatment Approaches for Infants with Malignant Central Nervous System Tumors

Contact Info

Product

Resources

About