scholarly journals Childhood Malignant Brain Tumors: Balancing the Bench and Bedside

Cancers ◽  
2021 ◽  
Vol 13 (23) ◽  
pp. 6099
Author(s):  
Colin Thorbinson ◽  
John-Paul Kilday

Brain tumors are the leading cause of childhood cancer deaths in developed countries. They also represent the most common solid tumor in this age group, accounting for approximately one-quarter of all pediatric cancers. Developments in neuro-imaging, neurosurgical techniques, adjuvant therapy and supportive care have improved survival rates for certain tumors, allowing a future focus on optimizing cure, whilst minimizing long-term adverse effects. Recent times have witnessed a rapid evolution in the molecular characterization of several of the common pediatric brain tumors, allowing unique clinical and biological patient subgroups to be identified. However, a resulting paradigm shift in both translational therapy and subsequent survival for many of these tumors remains elusive, while recurrence remains a great clinical challenge. This review will provide an insight into the key molecular developments and global co-operative trial results for the most common malignant pediatric brain tumors (medulloblastoma, high-grade gliomas and ependymoma), highlighting potential future directions for management, including novel therapeutic options, and critical challenges that remain unsolved.

2016 ◽  
Vol 18 (suppl 3) ◽  
pp. iii142.3-iii142
Author(s):  
Sebastian Brabetz ◽  
Susanne N. Groebner ◽  
Huriye Seker-Cin ◽  
Norman L. Mack ◽  
Volker Hovestadt ◽  
...  

2004 ◽  
Vol 52 ◽  
pp. S172
Author(s):  
H. D. Hemmati ◽  
I. Nakano ◽  
M. Masterman-Smith ◽  
S. R. Bababeygy ◽  
B. Rafii ◽  
...  

2019 ◽  
Author(s):  
Enoch Uche ◽  
Nkechi Judith Uche ◽  
Obinna V Ajuzieogu ◽  
Dubem Amuta ◽  
ephraim Onyia ◽  
...  

Abstract Background: Pediatric brain tumors (PBT’s) from previous studies are associated with poor outcomes in our subregion. Methods. An 8 -year single center prospective study. All cases investigated with neuroimaging and treated were enrolled. Data was analyzed with SPSS (Inc) Chicago IL, USA version 23. Chi Square test, One-way Anova and confidence limits were used to evaluate associations using the 95% level of significance. Patients were followed up for a range of 1 to 7.5 years with a mean of 4.9 ±1.3years. Ethical approval was obtained for our study. Results: 95 patients were enrolled, 84 satisfied the study criteria. There were 45 males and 39 females, M: F=1.1. The mean age was 9.9±2.7 years 95%CI with a range of 9 months to 16 years. The most common symptom was headache for supratentorial lesions (73%) and gait disturbance (80.2%) for infratentorial lesions. More tumors were supratentorial in location (45(54.2%), while 33(37.1%) were infratentorial. Craniopharyngiomas (n=19), medulloblastomas(n=17) and astrocytomas (n=11) were the most common tumors. Hemoglobin genotype(AA and AS) had some influence on tumor phenotype, Odds ratio 8.9 and 3.3 for medulloblastoma and craniopharyngioma. 69 cases were microsurgically resected while 14 patients were treated with radiotherapy alone. The 30-day mortality for operated cases is 7.9±1.3%. Overall 1-year and 5-year survival was 67.9% and 53.6 % respectively. Survival rates varied among treatment groups (X2=8.9, P=0.017). Conclusion: Survival profile in this series suggests some improvement in comparison to previous studies from our region.


2015 ◽  
Vol 17 (suppl 3) ◽  
pp. iii33-iii33
Author(s):  
S. Brabetz ◽  
H. Seker-Cin ◽  
S. N. Grobner ◽  
V. Hovestadt ◽  
D. T. W. Jones ◽  
...  

2004 ◽  
Vol 52 (Suppl 1) ◽  
pp. S172.2-S172
Author(s):  
H. D. Hemmati ◽  
I. Nakano ◽  
M. Masterman-Smith ◽  
S. R. Bababeygy ◽  
B. Rafii ◽  
...  

Epilepsia ◽  
2015 ◽  
Vol 56 (10) ◽  
pp. 1599-1604 ◽  
Author(s):  
Nicole J. Ullrich ◽  
Scott L. Pomeroy ◽  
Kush Kapur ◽  
Peter E. Manley ◽  
Liliana C. Goumnerova ◽  
...  

2015 ◽  
Vol 16 (6) ◽  
pp. 675-680 ◽  
Author(s):  
Aria Fallah ◽  
Alexander G. Weil ◽  
Samir Sur ◽  
Ian Miller ◽  
Prasanna Jayakar ◽  
...  

OBJECT Pediatric brain tumors may be associated with medically intractable epilepsy for which surgery is indicated. The authors sought to evaluate the efficacy of epilepsy surgery for seizure control in pediatric patients with brain tumors. METHODS The authors performed a retrospective review of consecutive patients undergoing resective epilepsy surgery related to pediatric brain tumors at Miami Children’s Hospital between June 1986 and June 2014. Time-to-event analysis for seizure recurrence was performed; an “event” was defined as any seizures that occurred following resective epilepsy surgery, not including seizures and auras in the 1st postoperative week. The authors analyzed several preoperative variables to determine their suitability to predict seizure recurrence following surgery. RESULTS Eighty-four patients (47 males) with a mean age (± standard deviation) of 8.7 ± 5.5 years (range 0.5–21.6 years) were included. The study included 39 (46%) patients with gliomas, 20 (24%) with dysembryoplastic neuroepithelial tumors (DNETs), 14 (17%) with gangliogliomas, and 11 (13%) with other etiologies. Among the patients with gliomas, 18 were classified with low-grade glioma, 5 had oligodendroglioma, 6 had uncategorized astrocytoma, 3 had pilocytic astrocytoma, 3 had pleomorphic xanthoastrocytoma, 3 had glioblastoma, and 1 had gliomatosis cerebri. Seventy-nine (94.0%) resections were guided by intraoperative electrocorticography (ECoG). The mean time (± standard deviation) to seizure recurrence was 81.8 ± 6.3 months. Engel Class I outcome was achieved in 66 (78%) and 63 (75%) patients at 1 and 2 years’ follow-up, respectively. Patients with ganglioglioma demonstrated the highest probability of long-term seizure freedom, followed by patients with DNETs and gliomas. In univariate analyses, temporal location (HR 1.75, 95% CI 0.26–1.27, p = 0.171) and completeness of resection (HR 1.69, 95% CI 0.77–3.74, p = 0.191) demonstrated a trend toward a longer duration of seizure freedom. CONCLUSIONS ECoG-guided epilepsy surgery for pediatric patients with brain tumors is highly effective. Tumors located in the temporal lobe and those in which a complete ECoG-guided resection is performed may result in a greater likelihood of long-term seizure freedom.


2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9531-9531
Author(s):  
Tara M. Brinkman ◽  
Wei Liu ◽  
Gregory T. Armstrong ◽  
Amar J. Gajjar ◽  
Thomas E. Merchant ◽  
...  

9531 Background: Follow-up guidelines identify supratentorial tumor location as a risk factor for poor neurocognitive outcomes during childhood; yet few studies have systematically compared long-term cognitive outcomes between adult survivors of childhood infratentorial and supratentorial brain tumors. Methods: Neurocognitive functions were evaluated in 130 adult survivors of pediatric brain tumors (58 supratentorial and 72 infratentorial, mean [SD] current age = 27.4 years [5.2], age at diagnosis = 8.6 years [4.6], and time since diagnosis = 18.8 years [4.8]) participating in the SJLIFE long-term follow-up protocol. Age-adjusted standard scores for measures of intelligence, attention, memory, processing speed, and executive functioning were calculated, with clinical impairment defined as scores <10th percentile. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using multivariable logistic regression models to examine associations between neurocognitive functions and tumor location. Results: As a group, survivors performed below average across multiple neurocognitive domains, including full scale IQ (mean=88.1; SD=18.2), with 34% demonstrating impaired IQ. Survivors of infratentorial tumors were more likely to be impaired on measures of focused attention (OR=2.19, 95% CI=1.03-4.65) and fine motor dexterity (OR=2.62, 95% CI=1.21-5.66) compared to survivors of supratentorial tumors. After adjusting for sex, age at diagnosis, shunt placement and cranial radiation (yes/no), infratentorial tumor location was only associated with reduced performance on a task of visual abstract reasoning (OR=3.76, 95% CI=1.40-10.1). Cranial radiation therapy was independently associated with impaired short-term memory (OR=15.6, 95% CI=1.64-147.8) and processing speed (OR=3.86, 95% CI=1.15-13.0). Conclusions: Tumor location was not associated with neurocognitive impairment after adjusting for treatment exposures. To further delineate potential differences associated with tumor location, future studies will examine factors including radiation dose/volume, extent of surgical resection, and medical complications.


Sign in / Sign up

Export Citation Format

Share Document