Transplantation of Zebrafish Pediatric Brain Tumors into Immune-competent Hosts for Long-term Study of Tumor Cell Behavior and Drug Response

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.

Download Full-text

Tumor location and neurocognitive impairment in adult survivors of pediatric brain tumors: A report from the St. Jude Lifetime Cohort (SJLIFE).

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.9531 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 9531-9531

Author(s):

Tara M. Brinkman ◽

Wei Liu ◽

Gregory T. Armstrong ◽

Amar J. Gajjar ◽

Thomas E. Merchant ◽

...

Keyword(s):

Brain Tumors ◽

Processing Speed ◽

Adult Survivors ◽

Pediatric Brain Tumors ◽

Tumor Location ◽

Age At Diagnosis ◽

Neurocognitive Functions ◽

Pediatric Brain

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.

Download Full-text

Short- and Long-Term Complications of Radiation Therapy for Pediatric Brain Tumors

Pediatric Neurosurgery ◽

10.1159/000120664 ◽

1992 ◽

Vol 18 (4) ◽

pp. 207-217 ◽

Cited By ~ 58

Author(s):

Bernadine Donahue

Keyword(s):

Radiation Therapy ◽

Brain Tumors ◽

Pediatric Brain Tumors ◽

Short And Long Term ◽

Pediatric Brain

Download Full-text

Management of pediatric brain tumors, strategies and long term outcome

Insights in Neurosurgery ◽

10.21767/2471-9633-c1-001 ◽

2017 ◽

Vol 02 (01) ◽

Author(s):

Abubakr Darrag Salim

Keyword(s):

Brain Tumors ◽

Pediatric Brain Tumors ◽

Term Outcome ◽

Long Term Outcome ◽

Pediatric Brain

Download Full-text

Management and Surveillance of Short- and Long-Term Sequelae of Radiation Therapy for the Treatment of Pediatric Brain Tumors

Journal of Pediatric Neurology ◽

10.1055/s-0040-1715501 ◽

2020 ◽

Vol 18 (06) ◽

pp. 307-312

Author(s):

Fred Chiu-Lai Lam ◽

Ekkehard M Kasper ◽

Anand Mahadevan

Keyword(s):

Radiation Therapy ◽

Brain Tumors ◽

Pediatric Brain Tumors ◽

Special Edition ◽

Long Term Effects ◽

Transition Into Adulthood ◽

Short And Long Term ◽

Pediatric Brain

AbstractRadiation therapy (RT) is a mainstay for the treatment of pediatric brain tumors. As improvements in and sophistication of this modality continue to increase the survival of patients, the long-term sequelae of RT pose significant challenges in the clinical management of this patient population as they transition into adulthood. In this special edition, we review the short- and long-term effects of RT for the treatment of pediatric brain tumors and the necessary surveillance required for follow-up.

Download Full-text

Long-term sequelae after pediatric brain tumors: Their effect on disability and quality of life

Medical and Pediatric Oncology ◽

10.1002/mpo.2950180410 ◽

1990 ◽

Vol 18 (4) ◽

pp. 304-310 ◽

Cited By ~ 157

Author(s):

Birgitta Lannering ◽

Ildiko Marky ◽

Anita Lundberg ◽

Elisabeth Olsson

Keyword(s):

Quality Of Life ◽

Brain Tumors ◽

Pediatric Brain Tumors ◽

Pediatric Brain

Download Full-text

Childhood Malignant Brain Tumors: Balancing the Bench and Bedside

Cancers ◽

10.3390/cancers13236099 ◽

2021 ◽

Vol 13 (23) ◽

pp. 6099

Author(s):

Colin Thorbinson ◽

John-Paul Kilday

Keyword(s):

Brain Tumors ◽

Survival Rates ◽

Rapid Evolution ◽

Developed Countries ◽

Pediatric Brain Tumors ◽

Neuro Imaging ◽

Pediatric Brain ◽

Translational Therapy

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.

Download Full-text