scholarly journals Neurogenesis, Exercise, and Cognitive Late Effects of Pediatric Radiotherapy

2013 ◽  
Vol 2013 ◽  
pp. 1-12 ◽  
Author(s):  
Shaefali P. Rodgers ◽  
Melissa Trevino ◽  
Janice A. Zawaski ◽  
M. Waleed Gaber ◽  
J. Leigh Leasure
Keyword(s):  
Cell Proliferation ◽  
Brain Cancer ◽  
Late Effects ◽  
Raw Materials ◽  
Survival Rates ◽  
Common Type ◽  
Potential Treatment ◽  
The Brain ◽  
Tumor Eradication

Brain cancer is a common type of childhood malignancy, and radiotherapy (RT) is a mainstay of treatment. RT is effective for tumor eradication, and survival rates are high. However, RT damages the brain and disrupts ongoing developmental processes, resulting in debilitating cognitive “late” effects that may take years to fully manifest. These late effects likely derive from a long-term decrement in cell proliferation, combined with a neural environment that is hostile to plasticity, both of which are induced by RT. Long-term suppression of cell proliferation deprives the brain of the raw materials needed for optimum cognitive performance (such as new neurons in the hippocampus and new glia in frontal cortex), while chronic inflammation and dearth of trophic substances (such as growth hormone) limit neuroplastic potential in existing circuitry. Potential treatments for cognitive late effects should address both of these conditions. Exercise represents one such potential treatment, since it has the capacity to enhance cell proliferation, as well as to promote a neural milieu permissive for plasticity. Here, we review the evidence that cognitive late effects can be traced to RT-induced suppression of cell proliferation and hostile environmental conditions, as well as emerging evidence that exercise may be effective as an independent or adjuvant therapy.

Herbal Medicine for Glioblastoma: Current and Future Prospects

2020 ◽  
Vol 16 (8) ◽  
pp. 1022-1043
Author(s):  
Imran Khan ◽  
Sadaf Mahfooz ◽  
Mustafa A. Hatiboglu
Keyword(s):  
Cell Proliferation ◽  
Survival Rates ◽  
Standard Of Care ◽  
Natural Compounds ◽  
Treatment Modalities ◽  
Normal Brain ◽  
The Central Nervous System ◽  
Cycle Regulation ◽  
Immense Potential

Background: Glioblastoma is one of the most aggressive and devastating tumours of the central nervous system with short survival time. Glioblastoma usually shows fast cell proliferation and invasion of normal brain tissue causing poor prognosis. The present standard of care in patients with glioblastoma includes surgery followed by radiotherapy and temozolomide (TMZ) based chemotherapy. Unfortunately, these approaches are not sufficient to lead a favorable prognosis and survival rates. As the current approaches do not provide a long-term benefit in those patients, new alternative treatments including natural compounds, have drawn attention. Due to their natural origin, they are associated with minimum cellular toxicity towards normal cells and it has become one of the most attractive approaches to treat tumours by natural compounds or phytochemicals. Objective: In the present review, the role of natural compounds or phytochemicals in the treatment of glioblastoma describing their efficacy on various aspects of glioblastoma pathophysiology such as cell proliferation, apoptosis, cell cycle regulation, cellular signaling pathways, chemoresistance and their role in combinatorial therapeutic approaches was described. Methods: Peer-reviewed literature was extracted using Pubmed, EMBASE Ovid and Google Scholar to be reviewed in the present article. Conclusion: Preclinical data available in the literature suggest that phytochemicals hold immense potential to be translated into treatment modalities. However, further clinical studies with conclusive results are required to implement phytochemicals in treatment modalities.

scholarly journals Late Effects and Survivorship Issues in Patients with Neuroblastoma

Children ◽  
2018 ◽  
Vol 5 (8) ◽  
pp. 107 ◽  
Author(s):  
Danielle Friedman ◽  
Tara Henderson
Keyword(s):  
Late Effects ◽  
Survival Rates ◽  
Premature Mortality ◽  
The Past ◽  
Excess Morbidity ◽  
Related Risk ◽  
Impaired Quality ◽  
Made In

Over the past two decades, marked progress has been made in understanding the biology of neuroblastoma; this has led to refined risk stratification and treatment modifications with resultant increasing 5-year survival rates for children with neuroblastoma. Survivors, however, remain at risk for a wide variety of potential treatment-related complications, or “late effects”, which may lead to excess morbidity and premature mortality in this cohort. This review summarizes the existing survivorship literature on long-term health outcomes for survivors of neuroblastoma, focusing specifically on potential injury to the endocrine, sensory, cardiovascular, pulmonary, and renal systems, as well as survivors’ treatment-related risk for subsequent neoplasms and impaired quality of life. Additional work is needed to assess the potential late effects of newer multimodality therapies with the aim of optimizing long-term medical and psychosocial outcomes for all survivors of neuroblastoma.

Pediatric Cancer Survivorship: Research and Clinical Care

2006 ◽  
Vol 24 (32) ◽  
pp. 5160-5165 ◽  
Author(s):  
Anna T. Meadows
Keyword(s):  
Pediatric Cancer ◽  
Late Effects ◽  
Clinical Care ◽  
Survival Rates ◽  
The United States ◽  
Term Survival ◽  
Pediatric Cancer Survivors ◽  
Effects Of Aging

Regardless of how one defines survivorship, more than 10 million individuals in the United States have been treated for a malignant disease; about 250,000 were younger than 21 years of age at diagnosis. Thirty years ago, pediatric oncologists recognized that children with cancer might be cured by adding chemotherapy to surgery and radiation. Studies were then begun of complications that could reduce survival or the quality of survival, and that might be associated with previous therapy. The complications were termed late effects, and studies focused on patients who were likely to be cured, or less likely to succumb to the original cancer than they were to experience disabilities. Clinical trials tested whether changes in therapy to reduce complications could maintain the same excellent survival rates. During the last 20 years, articles detailing late effects and the relationship between therapy and outcome have been published. This article reviews the progress made in understanding the outcomes reported and the efforts made to improve the quality of long-term survival for children and adolescents. Several questions remain regarding the long-term complications of therapy. Clinicians need more data regarding the effects of aging to guide them in managing former patients. Caregivers and pediatric cancer survivors who are now adults seek the optimal venue in which to receive care as independent adults. In addition, medical oncologists need to determine whether the models for research and clinical care of survivors created in pediatric oncology can be applied to survivors of adult-onset cancer.

Possible Considerations for the Management of Turcot’s Syndrome?

2019 ◽  
Vol 15 (2) ◽  
pp. 146-154
Author(s):  
Alexandrina Nikova ◽  
Dimitar Ganchev ◽  
Theodossios Birbilis
Keyword(s):  
Mortality Rate ◽  
Rare Disease ◽  
High Mortality ◽  
Brain Cancer ◽  
Search Engines ◽  
Common Type ◽  
Genetic Mutations ◽  
Published Data ◽  
Turcot's Syndrome ◽  
The Brain

Background: Turcot’s syndrome (TS) is a rare disease with known incidence of about 1-2 cases per year. It is, however, linked to high mortality due to the brain cancer. And because of this, we propose recommendations, aimed at preventing the mortality of the patients and to minimize the risk of undiagnosed Turcot’s syndrome. Methods: The authors collected the worldwide published data on TS, from the year of its definition till 2018, all of which was published on the search engines, such as Medline, Medknow, Cohraine and Wiley. Results: We included 97 patients, 57 from which are females and 40 males with median age of 22 years. The most common type of cancer is medulloblastoma, followed by glioblastoma and astrocytoma. We further divided the patients into two categories based on the first symptom of the disease and we made an algorithm of approaching these patients. Conclusion: TS is a disease that affects mostly members of families with multiple genetic mutations and types of cancers. And because of the unknown mechanisms of inheritance, it is useful to establish guidelines for the approach of those patients, in order to minimize the high mortality rate.

scholarly journals New Agents, Emerging Late Effects, and the Development of Precision Survivorship

2018 ◽  
Vol 36 (21) ◽  
pp. 2231-2240 ◽  
Author(s):  
Eric J. Chow ◽  
Zoltan Antal ◽  
Louis S. Constine ◽  
Rebecca Gardner ◽  
W. Hamish Wallace ◽  
...  
Keyword(s):  
Late Effects ◽  
Treatment Options ◽  
Survival Rates ◽  
Surgical Techniques ◽  
Adaptive Immune System ◽  
Host Susceptibility ◽  
Cell Surface Antigens ◽  
New Agents

Incremental improvements in the treatment of children and adolescents with cancer have led to 5-year survival rates reaching nearly 85%. In the past decade, impressive progress has been made in understanding the biology of many pediatric cancers. With that understanding, multiple new agents have become available that offer the promise of more-effective and less-toxic treatment. These include agents that target various cell surface antigens and engage the adaptive immune system, as well as those that interfere with key signaling pathways involved in tumor development and growth. For local control, surgery and radiation techniques also have evolved, becoming less invasive or featuring new techniques and particles that more precisely target the tumor and limit the dose to normal tissue. Nevertheless, targeted agents, like conventional chemotherapy, radiotherapy, and surgery, may have off-target effects and deserve long-term follow-up of their safety and efficacy. These include injury to the endocrine, cardiovascular, and immunologic systems. New radiation and surgical techniques that theoretically reduce morbidity and improve long-term quality of life must also be validated with actual patient outcomes. Finally, with advances in genomics, information on host susceptibility to late effects is beginning to emerge. Such knowledge, coupled with improved metrics that better describe the spectrum of potential late effects across the entire lifespan, can lead to the development of decision models that project the potential long-term health outcomes associated with various treatment and follow-up strategies. These developments will help extend the current focus on precision medicine to precision survivorship, where clinicians, patients, and families will have a better grasp of the potential risks, benefits, and tradeoffs associated with the growing number of cancer treatment options.

scholarly journals Recent Advances in Liquid Biopsy of Brain Cancers

2021 ◽  
Vol 12 ◽  
Author(s):  
Yunyun An ◽  
Fei Fan ◽  
Xiaobing Jiang ◽  
Kun Sun
Keyword(s):  
Cerebrospinal Fluid ◽  
Early Diagnosis ◽  
Cancer Patients ◽  
Brain Cancer ◽  
Liquid Biopsy ◽  
Causes Of Death ◽  
Survival Rates ◽  
Relapse Prediction ◽  
Clinical Benefits ◽  
The Brain

Brain cancers are among the top causes of death worldwide. Although, the survival rates vary widely depending on the type of the tumor, early diagnosis could generally benefit in better prognosis outcomes of the brain cancer patients. Conventionally, neuroimaging and biopsy are the most widely used approaches in diagnosis, subtyping, and prognosis monitoring of brain cancers, while emerging liquid biopsy assays using peripheral blood or cerebrospinal fluid have demonstrated many favorable characteristics in this task, especially due to their minimally invasive and easiness in sampling nature. Here, we review the recent studies in the liquid biopsy of brain cancers. We discuss the methodologies and performances of various assays on diagnosis, tumor subtyping, relapse prediction as well as prognosis monitoring in brain cancers, which approaches have made a big step toward clinical benefits of brain cancer patients.

scholarly journals Pediatric Hodgkin lymphoma: trade-offs between short- and long-term mortality risks

Blood ◽  
2012 ◽  
Vol 120 (11) ◽  
pp. 2195-2202 ◽  
Author(s):  
Jennifer M. Yeh ◽  
Lisa Diller
Keyword(s):  
Life Expectancy ◽  
Hodgkin Lymphoma ◽  
Late Effects ◽  
Survival Rates ◽  
Treatment Strategies ◽  
Careful Consideration ◽  
Term Survival ◽  
Pediatric Hodgkin Lymphoma ◽  
Trade Offs

Abstract As pediatric Hodgkin lymphoma (HL) survival rates approach > 95%, treatment decisions are increasingly based on minimizing late effects. Using a model-based approach, we explored whether the addition of radiotherapy contributes to improved overall long-term survival. We developed a state-transition model to simulate the lifetime HL clinical course, and we compared 2 treatment strategies: chemotherapy alone (CT) and chemoradiotherapy (CRT). Data on HL relapse, late recurrence, and excess second cancer and cardiac late-effects mortality were estimated from the published literature and databases. Outcomes included conditional life expectancy, cause-specific mortality, and proportion alive at age 50. For a hypothetical cohort of HL patients (diagnosis age 15), conditional life expectancy was 57.2 years with CT compared with 56.4 years with CRT. Estimated lifetime HL mortality risk was 3.6% with CT versus 2.2% with CRT. In contrast, combined risk of excess late-effects mortality was lower for CT (1.8% vs 7.4% with CRT). Among those alive at age 50, only 9.2% of those initially treated with CT were at risk for radiation-related late effects (100% for CRT). Initial treatment with CT may be associated with longer average per-person life expectancy. These results support the need for careful consideration of the risk-benefit profile of radiation as frontline therapy in pediatric patients.

scholarly journals Late Effects of Acute Lymphoblastic Leukemia Therapy in Patients Diagnosed at 0-20 Years of Age

Hematology ◽  
2011 ◽  
Vol 2011 (1) ◽  
pp. 238-242 ◽  
Author(s):  
Leslie L. Robison
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Late Effects ◽  
Lymphoblastic Leukemia ◽  
Survival Rates ◽  
Adverse Outcomes ◽  
Number Of Children ◽  
Second Neoplasms ◽  
Increased Risk ◽  
Late Morbidity

Abstract Survival rates for children with acute lymphoblastic leukemia (ALL) have increased dramatically over the past 4 decades, with 5-year survival rates of > 90% in recent trials. With the increasing number of children and adolescents cured of ALL, identifying and characterizing the occurrence of long-term adverse late effects has become increasingly important. In this young population, successful treatment of ALL is associated with increased risk of adverse outcomes such as late mortality, second neoplasms, chronic health conditions, endocrine dysfunction, and psychological function. Research efforts conducted through large survivor cohorts, such as the Childhood Cancer Survivor Study, are providing new and important insights into the very long-term consequences of ALL therapy, while providing direction for screening recommendations and intervention-based approaches for reducing late morbidity and mortality.

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