Long-term outcomes in children with glioblastoma

2010 ◽  
Vol 6 (2) ◽  
pp. 145-149 ◽  
Author(s):  
Kyung Sun Song ◽  
Ji Hoon Phi ◽  
Byung-Kyu Cho ◽  
Kyu-Chang Wang ◽  
Ji Yeoun Lee ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Progression Free Survival ◽  
Radical Resection ◽  
Tumor Location ◽  
Recurrent Glioblastoma ◽  
Subtotal Resection ◽  
Long Term Outcomes ◽  
Term Outcome ◽  
Long Term Outcome

Object Glioblastoma is the most common primary malignant brain tumor; however, glioblastoma in children is less common than in adults, and little is known about its clinical outcome in children. The authors evaluated the long-term outcome of glioblastoma in children. Methods Twenty-seven children were confirmed to have harbored a glioblastoma between 1985 and 2007. The clinical features and treatment outcomes were reviewed retrospectively. All patients underwent resection; complete resection was performed in 12 patients (44%), subtotal resection in 12 patients (44%), and biopsy in 3 patients (11%). Twenty-four patients (89%) had radiation therapy, and 14 (52%) patients received chemotherapy plus radiation therapy. Among the latter, 5 patients had radiation therapy concurrent with temozolomide chemotherapy. Four patients with small-size recurrent glioblastoma received stereotactic radiosurgery. Results The median overall survival (OS) was 43 months, and the median progression-free survival was 12 months. The OS rate was 67% at 1 year, 52% at 2 years, and 40% at 5 years. The median OS was significantly associated with tumor location (52 months for superficially located tumors vs 7 months for deeply located tumors; p = 0.017) and extent of removal (106 months for completely resected tumors vs 11 months for incompletely resected tumors; p < 0.0001). Conclusions The prognosis of glioblastoma is better in children than in adults. Radical resection followed by concurrent chemoradiation therapy may be the initial treatment of choice.

Spinal dumbbell tumors: Long-term outcome and risk factors

2019 ◽  
Author(s):  
Xin Wang ◽  
Yongning Li ◽  
Shiyuan Han ◽  
Jun Gao
Keyword(s):  
Univariate Analysis ◽  
Japanese Orthopaedic Association ◽  
Progression Free Survival ◽  
Tumor Location ◽  
Subtotal Resection ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Free Survival ◽  
Functional Preservation

Abstract Objective There is limited literature on long-term outcomes after resection of intraspinal dumbbell tumors. To identify the progression-free survival (PFS) and outcomes associated with these tumors, we retrospectively reviewed data from 74 patients. Methods From 2007 to 2016, data from 74 patients who underwent surgical treatment for dumbbell tumors were reviewed. Patient outcomes were determined with the Japanese Orthopaedic Association (JOA) score. The median follow-up time was 7.3 years Results Gross total resection (GTR) was performed in 39 patients (52.70%) and subtotal resection (STR) in 35 patients (47.30%). The progression-free survival (PFS) at 11 years was 82.43%. A good outcome was observed in 85.13% of patients based on the JOA. Moreover, the univariate analysis showed that surgical recession was related to tumor recurrence, and that tumor location and multiplicity were associated with tumor prognosis. However, the multivariate regression analyses showed that no factors were associated with poor prognosis and recurrence. Conclusion The general standard treatment for spinal dumbbell tumors is complete resection, but the surgery needs to protect nerve function as much as possible. Thus, our principle is to maximize tumor removal with functional preservation.

NCOG-10. RADIATION THERAPY CAN BE SAFELY DEFERRED IN OLIGODENDROGLIOMAS

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi153-vi154
Author(s):  
Alexis Demopoulos ◽  
Jonathan Knisely
Keyword(s):  
Radiation Therapy ◽  
Management Practice ◽  
Young Patients ◽  
Memory Loss ◽  
Progression Free Survival ◽  
Long Term Results ◽  
Term Outcome ◽  
Long Term Outcome

Abstract Deferring multimodal aggressive therapies in young patients to delay treatment-induced toxicity without jeopardizing long-term outcome would be of great benefit to our patients. After IRB approval, we retrospectively reviewed 80 confirmed IDH mutant and 1p19q codeleted oligodendrogliomas treated at one institution between 2005 and 2020. Median follow-up was 5 (range 1-26) years. All patients underwent maximal safe resection, followed by observation with routine imaging (n=28), chemotherapy alone (n=27), or radiation with chemotherapy (n=25) as initial upfront therapy. Median progression free survival was 36 (range 1-203), 54 (range 1-306), and 57 (range 4-281) months, respectively. Median overall survival was not reached, with 85% (67/80) alive, 8 on treatment and 59 stable off therapy. Among 35 patients who died or were followed for 10 years, median PFS was 12, 15, and 10 years for observation (n=9), chemotherapy (n=11) and chemoradiotherapy (n=15), with deaths or KPS below 50 in 3, 6, and 8, respectively. Three deaths in the observation group occurred 12, 12 and 17 years after diagnosis; one at 95 years old and another tumor-unrelated. Among 44 patients eventually receiving radiation, 15 suffered toxicity, including pathologically proven necrosis (n=6), cognitive decline with KPS&lt; 50 (n=5), memory loss with KPS &gt; 50 (n=3), and optic neuropathy (n=1). Myelosuppression from PCV was more pronounced after chemoradiation than in the upfront setting. Temozolomide after PCV chemotherapy was well tolerated. Long term follow-up of oligodendroglioma patients is challenging, but essential in determining late toxicities and treatment efficacy. Long-term results of European and North American multicenter cooperative group trials contradicted earlier publications reporting no benefit from early chemotherapy. Some management practice guidelines established a half-century ago persist (i.e., administer radiation therapy early), despite potentially crippling late effects. Deferring upfront radiation therapy is safe, less toxic, and equally efficacious in codeleted oligodendrogliomas.

Chemotherapy Alone for Localized Non-Bulky Hodgkin Lymphoma

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 2591-2591 ◽  
Author(s):  
George P. Canellos
Keyword(s):  
Radiation Therapy ◽  
Massachusetts General Hospital ◽  
Combined Modality Therapy ◽  
Progression Free Survival ◽  
Multiple Series ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Combined Modality ◽  
Asymptomatic Patients

Abstract Combined modality therapy with radiation and chemotherapy has been the standard treatment for limited-stage HL. Long-term toxicities, including cardiac and disease and secondary cancers, s have been reported in multiple series with long follow-up. Lower doses and smaller fields may be less toxic, but mediastinal/cardiac radiation is unavoidable in most cases. The Dana-Farber Cancer Institute and Massachusetts General Hospital lymphoma teams have now treated 74 patients with localized, non-bulky classical HL with chemotherapy as the only therapy. The median age of the series was 29 years (17–42). The M/F ratio was 33/41. The clinical stages were IA (10), IIA (56), IIB (9). The treatment consisted of ABVD × 6 cycles (70 pts), ABVD × 4 cycles (3 pts), and variants of ABVD (2 pts). The median F/U is 48+ months (4+–174+). One patient had primary refractory disease. Seven patients (median age 30, range 20–38) have relapsed (6, 10, 10, 11, 14, 20 and 63 months) whose original stage was IA (1), IIA (3), IIB (3). The progression-free survival at 4 years is 91%. All patients are alive. Six of seven patients received salvage RT and autologous stem cell transplantation, and only one has relapsed to date. In retrospect, all seven patients who relapsed from CR or CRu were FDG-PET negative at mid-cycle. Thus far, there has been no long-term, chemotherapy-related toxicity in the patients who remain in remission. 94% (62/66) asymptomatic patients remain in remission compared to 6/9 (67%) IIB patients. Conclusion: In young adults with non-bulky, localized HL chemotherapy alone with ABVD can achieve excellent progression-free and overall survival, especially those asymptomatic at diagnosis. These data and previously published results indicate an equivalent long-term outcome when compared to combined modality trials but without the long-term risks of radiation therapy. Avoidance of radiation therapy may be even more important in the pediatric age group.

scholarly journals Focal Midbrain Glioma: Long Term Survival in a Cohort of 16 Patients and the Implications for Management

1996 ◽  
Vol 23 (3) ◽  
pp. 204-207 ◽  
Author(s):  
Mark G. Hamilton ◽  
Carl Lauryssen ◽  
Neil Hagen
Keyword(s):  
Radiation Therapy ◽  
Treatment Effectiveness ◽  
Symptom Control ◽  
Mass Effect ◽  
Tumor Location ◽  
Limited Information ◽  
Term Outcome ◽  
Term Survival ◽  
Long Term Outcome

AbstractBackground: Focal gliomas involving the midbrain tectum and tegmentum have been identified as having a better prognosis than diffuse tumors affecting the brain stem. However, only limited information is available concerning treatment effectiveness and long term outcome for these patients. Methods: A retrospective, population-based cancer registry survey was performed to assess the clinical features and treatment courses of patients with focal midbrain tumors. Results: Sixteen patients with midbrain gliomas were identified; eight had tectal gliomas and eight tegmental gliomas. Thirteen patients presented with symptoms related to hydrocephalus, and 12 required a ventriculoperitoneal shunt. Seven patients underwent surgery directed at the tumor. Eight patients underwent initial radiation therapy and none had initial chemotherapy. One patient diagnosed at age 18 months had a rapidly growing tumor after 14 months of follow up which has responded to chemotherapy. The mean survival of this patient population was 84 months (range 3-280 months) after diagnosis, with only one tumor related death occurring (280 months after diagnosis). Survival was not affected by tumor location within the midbrain (tegmental or tectal) or by whether radiation therapy was or was not administered. Conclusions: Patients with focal midbrain gliomas require symptom control aimed at treatment of hydrocephalus, or mass effect from the tumor. However the extended survival of this population suggests that routine aggressive surgical debulking is often not required. Furthermore, the routine use of radiation therapy or chemotherapy for all such patients is questioned.

scholarly journals Long-Term Outcome after Asphyxia and Therapeutic Hypothermia in Late Preterm Infants: A Pilot Study

Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 994
Author(s):  
Hanne Lademann ◽  
Karl Abshagen ◽  
Anna Janning ◽  
Jan Däbritz ◽  
Dirk Olbertz
Keyword(s):  
Pilot Study ◽  
Preterm Infants ◽  
Perinatal Asphyxia ◽  
Psychomotor Development ◽  
Long Term Outcomes ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Developmental Index ◽  
Mental Developmental Index

Therapeutic hypothermia (THT) is the recommended treatment for neuroprotection in (near) term newborns that experience perinatal asphyxia with hypoxic-ischemic encephalopathy. The benefit of THT in preterm newborns is unknown. This pilot study aims to investigate long-term outcomes of late preterm asphyctic infants with and without THT compared to term infants. The single-center, retrospective analysis examined medical charts of infants with perinatal asphyxia born between 2008 and 2015. Long-term outcome was assessed using the Bayley Scales of Infant Development 2 at the age of (corrected) 24 months. Term (n = 31) and preterm (n = 8) infants with THT showed no differences regarding their long-term outcomes of psychomotor development (Psychomotor Developmental Index 101 ± 16 vs. 105 ± 11, p = 0.570), whereas preterm infants had a better mental outcome (Mental Developmental Index 105 ± 13 vs. 93 ± 18, p = 0.048). Preterm infants with and without (n = 69) THT showed a similar mental and psychomotor development (Mental Developmental Index 105 ± 13 vs. 96 ± 20, p = 0.527; Psychomotor Developmental Index 105 ± 11 vs. 105 ± 15, p = 0.927). The study highlights the importance of studying THT in asphyctic preterm infants. However, this study shows limitations and should not be used as a basis for decision-making in the clinical context. Results of a multicenter trial of THT for preterm infants (ID No.: CN-01540535) have to be awaited.

scholarly journals LGG-06. LONG-TERM OUTCOME OF NEWLY DIAGNOSED LOW GRADE GLIOMA

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii367-iii367
Author(s):  
Nongnuch Sirachainan ◽  
Attaporn Boongerd ◽  
Samart Pakakasama ◽  
Usanarat Anurathapan ◽  
Ake Hansasuta ◽  
...  
Keyword(s):  
Surgical Management ◽  
Progression Free Survival ◽  
Low Grade Glioma ◽  
Low Grade ◽  
Newly Diagnosed ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Common Location ◽  
Suprasellar Region

Abstract INTRODUCTION Low grade glioma (LGG) is the most common central nervous system (CNS) tumor in children accounted for 30–50%. Regarding benign characteristic of disease, surgical management remains the mainstay of treatment. However, surgical approach is limited in some conditions such as location at brainstem or infiltrative tumor. Chemotherapy and radiation treatments have been included in order to control tumor progression. The 5-years survival rate is approach 90% especially in patients who receive complete resection. However, the outcome of children with LGG in low to middle income is limited. Therefore, the aim of the study was to determine long-term outcome of children with newly diagnosed LGG. METHODS A retrospective study enrolled children aged &lt;18 years who were newly diagnosed LGG during January 2006- December 2019. Diagnosis of LGG was confirmed by histological findings of grade I and II according to WHO criteria. RESULTS A total of 40 patients, female to male ratio was 1:1.35 and mean (SD) for age was 6.7 (4.0) years. The most common location was optic chiasmatic pathway (42.5%), followed by suprasellar region (25.0%). Sixty percent of patients received at least partial tumor removal. Chemotherapy and radiation had been used in 70% and 10.0% respectively. The 10-year progression free survival was 74.1±11.4% and overall survival was 96.2±3.8%. SUMMARY: Treatment of Pediatric LGG mainly required surgical management, however, chemotherapy and radiation had been used in progressive disease. The outcome was excellent.

scholarly journals An update of the long-term outcome of patients with nonspecific pleurisy at medical thoracoscopy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yan-Xia Yu ◽  
Yuan Yang ◽  
Yan-Bing Wu ◽  
Xiao-Juan Wang ◽  
Li-Li Xu ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Malignant Disease ◽  
Long Term Outcomes ◽  
Benign Diseases ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Medical Thoracoscopy ◽  
One Year

Abstract Background Medical thoracoscopy (MT) is recommended in patients with undiagnosed exudative pleural effusion and offers a degree of diagnostic sensitivity for pleural malignancy. However, not all patients who undergo MT receive an exact diagnosis. Our previous investigation from 2014 summarized the long-term outcomes of these patients with nonspecific pleurisy (NSP); now, we offer updated data with the goal of refining our conclusions. Methods Between July 2005 and August 2018, MT with pleural biopsies were performed in a total of 1,254 patients with undiagnosed pleural effusions. One hundred fifty-four patients diagnosed with NSP with available follow-up data were included in the present study, and their medical records were reviewed. Results A total of 154 patients were included in this study with a mean follow-up duration of 61.5 ± 43.7 months (range: 1–180 months). No specific diagnosis was established in 67 (43.5%) of the patients. Nineteen patients (12.3%) were subsequently diagnosed with pleural malignancies. Sixty-eight patients (44.2%) were diagnosed with benign diseases. Findings of pleural nodules or plaques during MT and the recurrence of pleural effusion were associated with malignant disease. Conclusions Although most NSP patients received a diagnosis of a benign disease, malignant disease was still a possibility, especially in those patients with nodules or plaques as noted on the MT and a recurrence of pleural effusion. One year of clinical follow-up for NSP patients is likely sufficient. These updated results further confirm our previous study’s conclusions.

scholarly journals Hyperglycemia in the Posttransplant Period: NODAT vs Posttransplant Diabetes Mellitus

2018 ◽  
Vol 2 (11) ◽  
pp. 1314-1319 ◽  
Author(s):  
Suruchi Gupta ◽  
Teresa Pollack ◽  
Candice Fulkerson ◽  
Kathleen Schmidt ◽  
Diana Johnson Oakes ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Liver Transplant ◽  
Controlled Trial ◽  
Organ Transplant ◽  
Long Term Outcomes ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Persistent Hyperglycemia

Abstract Objective To characterize the types of hyperglycemia that occur up to 1 year following liver transplant and to clarify the nomenclature for posttransplant hyperglycemia. Design We analyzed 1-year glycemic follow-up data in 164 patients who underwent liver transplant and who had been enrolled in a randomized controlled trial comparing moderate to intensive insulin therapy to determine if patients had preexisting known diabetes, transient hyperglycemia, persistent hyperglycemia, or new-onset diabetes after transplantation (NODAT). Results Of 119 patients with posttransplant hyperglycemia following hospital discharge, 49 had preexisting diabetes, 5 had insufficient data for analysis, 48 had transient hyperglycemia (16 resolved within 30 days and 32 resolved between 30 days and 1 year), 13 remained persistently hyperglycemic out to 1 year and most likely had preexisting diabetes that had not been diagnosed or insulin resistance/insulinopenia prior to transplant, and 4 had NODAT (i.e., patients with transient hyperglycemia after transplant that resolved but then later truly developed sustained hyperglycemia, meeting criteria for diabetes). Conclusions Distinct categories of patients with hyperglycemia following organ transplant include known preexisting diabetes, persistent hyperglycemia (most likely unknown preexisting diabetes or insulin resistance/insulinopenia), transient hyperglycemia, and NODAT. Those with preexisting diabetes for many years prior to transplant may well have very different long-term outcomes compared with those with true NODAT. Therefore, it would be prudent to classify patients more carefully. Long-term outcome studies are needed to determine if patients with true NODAT have the same poor prognosis as patients with preexisting diabetes (diagnosed and undiagnosed) undergoing transplant.

Sign in / Sign up

Export Citation Format

Share Document