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Bennett J, Yeo KK, Tabori U, Hawkins C, Lim-Fat MJ. Pediatric-type low-grade gliomas in adolescents and young adults-challenges and emerging paradigms. Childs Nerv Syst 2024:10.1007/s00381-024-06449-x. [PMID: 38761264 DOI: 10.1007/s00381-024-06449-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 05/09/2024] [Indexed: 05/20/2024]
Abstract
Pediatric-type low-grade glioma (PLGG) encompasses a heterogeneous group of WHO grade 1 or 2 tumors and is the most common central nervous system tumor found in children. PLGG extends beyond pediatrics, into adolescents and young adults (AYA, ages 15-40). PLGG represents 25% of all gliomas diagnosed in AYA with differences in tumor location and molecular alterations compared to children, resulting in improved outcome for AYAs. Long-term outcome is excellent, though patients may suffer significant morbidity depending on tumor location. There are differences in treatment practices with radiation used to treat PLGG in AYAs more often than in children. Most PLGG in AYA harbor an alteration in the RAS/MAPK pathway, with limited insight into response to targeted therapy in this age group. This review discusses the epidemiology, current therapeutic approaches, and challenges in the management of PLGG in AYA.
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Affiliation(s)
- Julie Bennett
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada.
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada.
- Arthur and Sonia Labbatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON, Canada.
| | - Kee Kiat Yeo
- Department of Pediatric Oncology, Dana-Farber / Boston Children's Cancer and Blood Disorder Center, Boston, MA, USA
| | - Uri Tabori
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
- Arthur and Sonia Labbatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON, Canada
| | - Cynthia Hawkins
- Arthur and Sonia Labbatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON, Canada
| | - Mary Jane Lim-Fat
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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Depond CC, Zouaoui S, Darlix A, Rigau V, Mathieu-Daudé H, Bauchet F, Khettab M, Trétarre B, Figarella-Branger D, Taillandier L, Boetto J, Pallud J, Zemmoura I, Roche PH, Bauchet L. Descriptive epidemiology of 30,223 histopathologically confirmed meningiomas in France: 2006-2015. Acta Neurochir (Wien) 2024; 166:214. [PMID: 38740641 DOI: 10.1007/s00701-024-06093-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 04/13/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND AND OBJECTIVES Meningioma is one of the most common neoplasm of the central nervous system. To describe the epidemiology of meningioma operated in France and, to assess grading and histopathological variability among the different neurosurgical centres. METHODS We processed the French Brain Tumour Database (FBTDB) to conduct a nationwide population-based study of all histopathologically confirmed meningiomas between 2006 and 2015. RESULTS 30,223 meningiomas cases were operated on 28,424 patients, in 61 centres. The average number of meningioma operated per year in France was 3,022 (SD ± 122). Meningioma was 3 times more common in women (74.1% vs. 25.9%). The incidence of meningioma increased with age and, mean age at surgery was 58.5 ± 13.9 years. Grade 1, 2, and 3 meningiomas accounted for 83.9%, 13.91% and, 2.19% respectively. There was a significant variability of meningioma grading by institutions, especially for grade 2 which spanned from 5.1% up to 22.4% (p < 0.001). Moreover, the proportion of grade 2 significantly grew over the study period (p < 0.001). There was also a significant variation in grade 1 subtypes diagnosis among the institutions (p < 0.001). 89.05% of the patients had solely one meningioma surgery, 8.52% two and, 2.43% three or more. The number of surgeries was associated to the grade of malignancy (p < 0.001). CONCLUSION The incidence of meningioma surgery increased with age and, peaked at 58.5 years. They were predominantly benign with meningothelial subtype being the most common. However, there was a significant variation of grade 1 subtypes diagnosis among the centres involved. The proportion of grade 2 meningioma significantly grew over the study time, on contrary to malignant meningioma proportion, which remained rare and, stable over time around 2%. Likewise, there was a significant variability of grade 2 meningioma rate among the institutions.
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Affiliation(s)
- Charles Champeaux Depond
- Department of Neurosurgery, Hôpital Privé Clairval - Ramsay Santé, 317 Bd de Redon, 13009, Marseille, France.
| | - Sonia Zouaoui
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 34295, Montpellier cedex 5, France
- Institut de Génomique Fonctionnelle (IGF), University of Montpellier, CNRS, INSERM, 34094, Montpellier, France
| | - Amélie Darlix
- Institut de Génomique Fonctionnelle (IGF), University of Montpellier, CNRS, INSERM, 34094, Montpellier, France
- Medical Oncology Department, Institut du Cancer de Montpellier, University of Montpellier, 34298, Montpellier, France
| | - Valérie Rigau
- Institut de Génomique Fonctionnelle (IGF), University of Montpellier, CNRS, INSERM, 34094, Montpellier, France
- Department of Pathology, Gui-de-Chauliac Hospital, Montpellier University Medical Center, 34295, Montpellier cedex 5, France
| | - Hélène Mathieu-Daudé
- Department of Epidemiology, French Brain Tumour Database, GNOLR, Registre Des Tumeurs de L'Hérault, ICM, 34298, Montpellier cedex 5, France
| | - Fabienne Bauchet
- Department of Epidemiology, French Brain Tumour Database, GNOLR, Registre Des Tumeurs de L'Hérault, ICM, 34298, Montpellier cedex 5, France
| | - Mohamed Khettab
- Institut de Génomique Fonctionnelle (IGF), University of Montpellier, CNRS, INSERM, 34094, Montpellier, France
- Medical Oncology Unit, CHU de La Réunion, Université de La Réunion, 97410, Saint Pierre, France
| | - Brigitte Trétarre
- Registre Des Tumeurs de L'Hérault, ICM, 34298, Montpellier cedex 5, France
| | - Dominique Figarella-Branger
- Institut de Neurophysiopathologie, Service d'Anatomie Pathologique Et de Neuropathologie, Aix-Marseille University, APHM, CNRS, INP, CHU Timone, 13005, Marseille, France
| | - Luc Taillandier
- Department of Neurology, University Hospital of Nancy, Nancy, France
| | - Julien Boetto
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 34295, Montpellier cedex 5, France
- Institut de Génomique Fonctionnelle (IGF), University of Montpellier, CNRS, INSERM, 34094, Montpellier, France
- Paris Brain Institute, Sorbonne Université, CRICM INSERM U1127 CNRS UMR 7225, 75013, Paris, France
| | - Johan Pallud
- Service de Neurochirurgie, GHU Paris Psychiatrie Et Neurosciences, Site Sainte Anne, 75014, Paris, France
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris, INSERM U1266, 75014, Paris, France
| | - Ilyess Zemmoura
- Neurosurgery Department, CHRU de Tours, Tours, France
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Pierre-Hugues Roche
- Neurosurgery Department, CHRU de Tours, Tours, France
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
- Service de Neurochirurgie de L'hôpital Nord, APHM - AMU, Marseille, France
| | - Luc Bauchet
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 34295, Montpellier cedex 5, France
- Institut de Génomique Fonctionnelle (IGF), University of Montpellier, CNRS, INSERM, 34094, Montpellier, France
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Ng S, Duffau H. Brain Plasticity Profiling as a Key Support to Therapeutic Decision-Making in Low-Grade Glioma Oncological Strategies. Cancers (Basel) 2023; 15:3698. [PMID: 37509359 PMCID: PMC10378506 DOI: 10.3390/cancers15143698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/13/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
The ability of neural circuits to compensate for damage to the central nervous system is called postlesional plasticity. In diffuse low-grade gliomas (LGGs), a crosstalk between the brain and the tumor activates modulations of plasticity, as well as tumor proliferation and migration, by means of paracrine and electrical intercommunications. Such adaptative mechanisms have a major impact on the benefits and risks of oncological treatments but are still disregarded by current neuro-oncological guidelines. In this review, the authors first aimed to highlight clinical, radiological, and oncological markers that robustly reflect the plasticity potentials and limitations in LGG patients, including the location of the tumor and the degree of critical white matter tract infiltration, the velocity of tumor expansion, and the reactional changes of neuropsychological performances over time. Second, the interactions between the potential/limitations of cerebral plasticity and the efficacy/tolerance of treatment options (i.e., surgery, chemotherapy, and radiotherapy) are reviewed. Finally, a longitudinal and multimodal treatment approach accounting for the evolutive profiles of brain plasticity is proposed. Such an approach integrates personalized predictive models of plasticity potentials with a step-by-step therapeutic decision making and supports onco-functional balanced strategies in patients with LGG, with the ultimate aim of optimizing overall survival and quality of life.
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Affiliation(s)
- Sam Ng
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 34295 Montpellier, France
- Institute of Functional Genomics, University of Montpellier, Centre National de le Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale 1191, 34094 Montpellier, France
| | - Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 34295 Montpellier, France
- Institute of Functional Genomics, University of Montpellier, Centre National de le Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale 1191, 34094 Montpellier, France
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National Brain Tumour Registry of China (NBTRC) statistical report of primary brain tumours diagnosed in China in years 2019–2020. THE LANCET REGIONAL HEALTH - WESTERN PACIFIC 2023. [DOI: 10.1016/j.lanwpc.2023.100715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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Molecular Characterization of Adult Tumors Diagnosed as Cerebellar Glioblastomas Identifies Subgroups Associated With Prognosis. Am J Surg Pathol 2023; 47:131-144. [PMID: 36418240 DOI: 10.1097/pas.0000000000001996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Adult tumors diagnosed as cerebellar glioblastoma (cGBM) are rare and their optimal classification remains to be determined. The aim of this study was to identify subgroups of cGBM based on targeted molecular analysis. cGBM diagnosed between 2003 and 2017 were identified from the French Brain Tumor Database and reviewed according to the WHO 2021 classification. The following molecular alterations were studied: IDH1/2 , H3F3A , FGFR1 , BRAF , TERT promoter mutations, EGFR amplification, MGMT promoter methylation, and alternative lengthening of telomere status. DNA methylation profile was assessed in a subset of cases. Eighty-three cGBM were included and could be classified into 6 mutually exclusive subgroups associated with median age at diagnosis (MA) and prognosis: TERT -mutant and/or EGFR -amplified tumors (n=22, 26.5%, MA=62 y, median overall survival [OS]=4 mo), H3K27M-mutant tumors (n=15, 18.1%, MA=48 y, median OS=8 mo), mitogen-activated protein kinases (MAPK) pathway-activated tumors ( FGFR1 , BRAF mutation, or occurring in neurofibromatosis type I patients, n=15, 18.1%, MA=48 y, median OS=57 mo), radiation-associated tumors (n=5, 6%, MA=47 y, median OS=5 mo), IDH-mutant tumors (n=1), and unclassified tumors (n=25, 30.1%, MA=63 y, median OS=17 mo). Most MAPK pathway-activated tumors corresponded to high-grade astrocytomas with piloid features based on DNA methylation profiling. In multivariate analysis, MAPK pathway-activating alterations, ATRX loss of expression, and alternative lengthening of telomere positivity were independently associated with a better outcome and TERT / EGFR alterations with a worse outcome. cGBM display an important intertumoral heterogeneity. Targeted molecular analysis enables to classify the majority of tumors diagnosed as cGBM into mutually exclusive and clinically relevant subgroups. The presence of MAPK pathway alterations is associated with a much better prognosis.
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Xue C, Liu C, Yun X, Zou X, Li X, Wang P, Li F, Ge Y, Zhang Q, Xie X, Li X, Luo B. Knockdown of hsa_circ_0008922 inhibits the progression of glioma. PeerJ 2022; 10:e14552. [PMID: 36570001 PMCID: PMC9784332 DOI: 10.7717/peerj.14552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 11/20/2022] [Indexed: 12/24/2022] Open
Abstract
Background A glioma is a tumor originating from glial cells in the central nervous system. Although significant progress has been made in diagnosis and treatment, most high-grade glioma patients are prone to recurrence. Therefore, molecular targeted therapy may become a new direction for adjuvant therapy in glioma. In recent years, many studies have revealed that circular RNA (circRNA) may play an important role in the occurrence and development of many tumors including gliomas. Our previous study found that the expression of hsa_circ_0008922 was up-regulated in glioma tissues upon RNA sequencing. The biological mechanism of circ_0008922 is still unreported in gliomas. Therefore, in this study, we preliminarily outlined the expression of hsa_circ_0008922 in glioma and explored its biological functions. Methods The expression of hsa_circ_0008922 in forty glioma tissues and four glioma cell lines (A172, U251, SF763 and U87) was detected by quantitative real-time polymerase chain reaction (qRT-PCR). The correlation between hsa_circ_0008922 expression and clinicopathological features of glioma patients was evaluated by Fisher's exact test. To understand the potential function of hsa_circ_0008922 in glioma, we constructed small interfering RNA (siRNA) to hsa_circ_0008922 to downregulate its expression in glioma cell lines A172 and U251. With these hsa_circ_0008922 downregulated cells, a series of assays were carried out as follows. Cell proliferation was detected by CCK8 assay, migration and invasion were determined by wound healing assay and transwell assay, respectively. Colony formation ability was evaluated by plate clonogenic assay. Moreover, flow cytometry combined with Western blot was performed to analyze apoptosis status and the expression of apoptotic related proteins (caspase 3 and caspase 9). Finally, the possible biological pathways and potential miRNA targets of hsa_circ_0008922 were predicted by bioinformatics. Results We found that the expression of hsa_circ_0008922 in glioma tissues was 3.4 times higher than that in normal tissues. The expression of has_circ_0008922 was correlated with WHO tumor grade. After down-regulating the expression of hsa_circ_0008922, malignant biological behavior of glioma cells was inhibited, such as cell proliferation, colony formation, migration, and invasion. At the same time, it also induced apoptosis of glioma cells. Predicted analysis by bioinformatics demonstrated that hsa_circ_0008922 may be involved in tumor-related pathways by acting as a molecular sponge for multiple miRNAs (hsa-let-7e-5p, hsa-miR-506-5p, hsa-let-7b-5p, hsa-let-7c-5p and hsa-let-7a-5p). Finally, we integrated our observation to build a circRNA-miRNA-mRNA predictive network.
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Affiliation(s)
- Chunhong Xue
- Department of Histology and Embryology, School of Basic Medicine Science, Guangxi Medical University, Nanning, China
| | - Chang Liu
- Department of Neurosurgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China,Postdoctoral Research Station, School of Basic Medicine Science, Guangxi Medical University, Nanning, China
| | - Xiang Yun
- Department of International Cooperation and External Exchange, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiaoqiong Zou
- Department of Histology and Embryology, School of Basic Medicine Science, Guangxi Medical University, Nanning, China
| | - Xin Li
- Department of Histology and Embryology, School of Basic Medicine Science, Guangxi Medical University, Nanning, China
| | - Ping Wang
- Department of Histology and Embryology, School of Basic Medicine Science, Guangxi Medical University, Nanning, China
| | - Feng Li
- Department of Histology and Embryology, School of Basic Medicine Science, Guangxi Medical University, Nanning, China
| | - Yingying Ge
- Department of Histology and Embryology, School of Basic Medicine Science, Guangxi Medical University, Nanning, China,Key Laboratory of Preclinical Medicine (Guangxi Medical University), Education Department of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Qingmei Zhang
- Department of Histology and Embryology, School of Basic Medicine Science, Guangxi Medical University, Nanning, China,Key Laboratory of Preclinical Medicine (Guangxi Medical University), Education Department of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Xiaoxun Xie
- Department of Histology and Embryology, School of Basic Medicine Science, Guangxi Medical University, Nanning, China,Key Laboratory of Preclinical Medicine (Guangxi Medical University), Education Department of Guangxi Zhuang Autonomous Region, Nanning, China,Key Laboratory of Early Prevention and Treatment of Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, China
| | - Xisheng Li
- Department of Neurosurgery, The People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, China
| | - Bin Luo
- Department of Histology and Embryology, School of Basic Medicine Science, Guangxi Medical University, Nanning, China,Key Laboratory of Preclinical Medicine (Guangxi Medical University), Education Department of Guangxi Zhuang Autonomous Region, Nanning, China
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Balogun JA, Bankole OB, Okere O, Uche EO, Balogun FM, Shilong DJ, Jimoh AO, Adeolu AA. Epidemiology of brain tumors among adolescents and young adults in Nigeria. J Clin Neurosci 2021; 96:50-55. [PMID: 34974248 DOI: 10.1016/j.jocn.2021.12.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 12/16/2021] [Indexed: 12/25/2022]
Abstract
Adolescents and Young Adults (AYA), have distinct endocrine and psychosocial peculiarities. Brain tumors occur less among AYAs, compared to other age groups and with better prognosis. There is however a paucity of literature about brain tumors in AYA in sub-Saharan Africa. We aim to describe the clinical characteristics of brain tumors in AYA across five neurosurgical centers in Nigeria and the associated factors. We report results for older children (10-14 years), adolescents (15-19 years) and young adults (20-24 years). This was a retrospective review of AYA with brain tumors over a 10-year period (2010-2019). Data analysis was by descriptive statistics, Chi square test and multinomial regression at α0.05. There were 104 AYAand the male to female ratio was 1.2:1. Headache (79.8%) and visual symptoms (65.4%) were the most common presenting symptoms. Focal limb weakness (44.1%) occurred less frequently. Median duration of symptoms prior to presentation was 9 months. Glioma was the most common tumor (31, 29.8%) while pituitary adenoma and craniopharyngioma constituted 30.8% of the tumors. Patients with symptom duration of ≤one year were more likely to have infratentorial tumors. There was no significant association between the KPS following intervention and the AYA characteristics. Age group was not significantly associated with any of the presenting symptoms except ataxia, which was significantly higher among the 10 to 14 years group.We have described the epidemiology of brain tumors within AYA in Nigeria and highlighted a need to maximize their care and meet their special needs.
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Affiliation(s)
- James A Balogun
- Division of Neurosurgery, Department of Surgery, College of Medicine, University of Ibadan, Nigeria; Department of Neurosurgery, University College Hospital, Ibadan, Nigeria.
| | - Olufemi B Bankole
- Neurosurgery Unit, Department of Surgery, College of Medicine University of Lagos, Nigeria; Neurosurgery Unit, Department of Surgery, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Oghenekevwe Okere
- Department of Neurosurgery, University College Hospital, Ibadan, Nigeria
| | - Enoch O Uche
- Neurosurgery Unit, Department of Surgery, University of Nigeria Ituku/Ozalla Campus, Enugu, Nigeria
| | - Folusho M Balogun
- Adolescent Health Unit, Institute of Child Health, College of Medicine University of Ibadan, Nigeria
| | - Danaan J Shilong
- Neurosurgery Division, Department of Surgery, College of Health Sciences University of Jos, Jos, Nigeria
| | - Abdullahi O Jimoh
- Neurosurgery Unit, Department of Surgery Ahmadu Bello University, Zaria, Nigeria
| | - Augustine A Adeolu
- Division of Neurosurgery, Department of Surgery, College of Medicine, University of Ibadan, Nigeria; Department of Neurosurgery, University College Hospital, Ibadan, Nigeria
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Roux A, Beccaria K, Blauwblomme T, Mahlaoui N, Chretien F, Varlet P, Puget S, Pallud J. Toward a transitional care from childhood and adolescence to adulthood in surgical neurooncology? A lesson from the Necker-Enfants Malades and the Sainte-Anne Hospitals collaboration. J Neurosurg Pediatr 2021; 28:380-386. [PMID: 34330092 DOI: 10.3171/2021.3.peds2141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 03/23/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Transitional care in surgical neurooncology is poorly studied. However, this period is pivotal, since it allows the patient to be empowered in his or her disease management. Here, the authors describe the experience of the Necker-Enfants Malades and the Sainte-Anne Hospital collaboration. METHODS The mixed transitional consultations started in September 2019 in a dedicated space for transitional care, named the "La Suite" department, located in the Necker-Enfants Malades Hospital, Paris, France. The authors organized planned consultations to schedule the clinical and radiological follow-up in the adult neurosurgical department but also emergency consultations to manage tumor recurrence in young adult patients. Transitional care was performed jointly by pediatric and adult neurosurgeons who have developed clinical and research skills in the field of surgical neurooncology. Neuropathological analysis was performed by a neuropathologist who is specialized in pediatric and adult neurooncology. RESULTS Fourteen patients benefited from a mixed transitional consultation. All of them accepted to start their management in an adult neurosurgical environment. Eleven patients (78.6%) for whom the disease was controlled benefited from a planned consultation. Three patients (21.4%) required rapid neurosurgical management for a tumor recurrence (n = 2) or for a new primary CNS tumor (n = 1) and benefited from an emergency consultation. CONCLUSIONS For adult patients harboring a brain tumor during childhood or adolescence, the authors suggest that neurosurgeons specialized in adult surgical neurooncology with a full knowledge in pediatric neurooncology will combine the required skills to optimize care management for these patients within a dedicated multidisciplinary organization framework.
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Affiliation(s)
- Alexandre Roux
- 1Service de Neurochirurgie, GHU Paris-Hôpital Sainte-Anne, Paris
- 2Université de Paris, Sorbonne Paris Cité, Paris
- 3INSERM UMR 1266, IMA-Brain, Institut de Psychiatrie et Neurosciences de Paris
| | - Kévin Beccaria
- 2Université de Paris, Sorbonne Paris Cité, Paris
- 4Service de Neurochirurgie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris
| | - Thomas Blauwblomme
- 2Université de Paris, Sorbonne Paris Cité, Paris
- 4Service de Neurochirurgie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris
| | - Nizar Mahlaoui
- 5Centre de référence déficits immunitaires héréditaires (Ceredih), Hôpital universitaire Necker-Enfants malades, AP-HP, Paris; Unité d'immuno-hématologie et rhumatologie pédiatrique, Hôpital universitaire Necker-Enfants malades, AP-HP, Paris
- 6La Suite, Hôpital universitaire Necker-Enfants malades, AP-HP, Paris; and
| | - Fabrice Chretien
- 2Université de Paris, Sorbonne Paris Cité, Paris
- 7Service de Neuropathologie, GHU Paris-Hôpital Sainte-Anne, Paris, France
| | - Pascale Varlet
- 2Université de Paris, Sorbonne Paris Cité, Paris
- 3INSERM UMR 1266, IMA-Brain, Institut de Psychiatrie et Neurosciences de Paris
- 7Service de Neuropathologie, GHU Paris-Hôpital Sainte-Anne, Paris, France
| | - Stéphanie Puget
- 2Université de Paris, Sorbonne Paris Cité, Paris
- 4Service de Neurochirurgie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris
| | - Johan Pallud
- 1Service de Neurochirurgie, GHU Paris-Hôpital Sainte-Anne, Paris
- 2Université de Paris, Sorbonne Paris Cité, Paris
- 3INSERM UMR 1266, IMA-Brain, Institut de Psychiatrie et Neurosciences de Paris
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Characteristics and management of hydrocephalus in adult patients with cerebellar glioblastoma: lessons from a French nationwide series of 118 cases. Neurosurg Rev 2021; 45:683-699. [PMID: 34195892 DOI: 10.1007/s10143-021-01578-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/19/2021] [Accepted: 06/02/2021] [Indexed: 10/21/2022]
Abstract
The characteristics of hydrocephalus associated with cerebellar glioblastoma (cGB) remain poorly known. The objectives were to describe the occurence of hydrocephalus in a French nationwide series of adult patients with cGB, to identify the characteristics associated with hydrocephalus and to analyze the outcomes associated with the different surgical strategies, in order to propose practical guidelines. Consecutive cases of adult cGB patients prospectively recorded into the French Brain Tumor Database between 2003 and 2017 were screened. Diagnosis was confirmed by a centralized neuropathological review. Among 118 patients with cGB (mean age 55.9 years), 49 patients (41.5%) presented with pre-operative hydrocephalus. Thirteen patients (11.0%) developed acute (n=7) or delayed (n=6) hydrocephalus postoperatively. Compared to patients without hydrocephalus at admission, patients with hydrocephalus were younger (52.0 years vs 58.6 years, p=0.03) and underwent more frequently tumor resection (93.9% vs 73.9%, p=0.006). A total of 40 cerebrospinal-fluid diversion procedures were performed, including 18 endoscopic third ventriculostomies, 12 ventriculoperitoneal shunts and 10 external ventricular drains. The different cerebrospinal-fluid diversion options had comparable functional results and complication rates. Among the 89 patients surgically managed for cGB without prior cerebrospinal-fluid diversion, 7 (7.9%) were long-term shunt-dependant. Hydrocephalus is frequent in patients with cGB and has to be carefully managed in order not to interfere with adjuvant oncological treatments. In case of symptomatic hydrocephalus, a cerebrospinal-fluid diversion is mandatory, especially if surgical resection is not feasible. In case of asymptomatic hydrocephalus, a cerebrospinal-fluid diversion has to be discussed only if surgical resection is not feasible.
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Sun W, Zhou H, Han X, Hou L, Xue X. Circular RNA: A novel type of biomarker for glioma (Review). Mol Med Rep 2021; 24:602. [PMID: 34165178 PMCID: PMC8240176 DOI: 10.3892/mmr.2021.12240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 05/12/2021] [Indexed: 12/18/2022] Open
Abstract
With the rapid development of sequencing technologies, the characteristics and functions of circular RNAs (circRNAs) in different tissues, and their underlying pathophysiological mechanisms, have been identified. circRNAs are significantly enriched in the brain and are continually expressed from the embryonic stage to the adult stage in rats. Previous studies have reported that certain circRNAs are differentially expressed in glioma and regulate a number of biological processes, such as cell proliferation, metastasis and oncogenesis of glioma. Furthermore, certain circRNAs have been associated with tumor size, World Health Organization tumor grade and poor prognosis in patients with glioma. It has been hypothesized that circRNAs may be involved in the onset and progression of glioma through transcriptional regulation, protein translation and binding to microRNAs. These properties and functions suggest the potential of circRNAs as prognostic biomarkers and therapeutic targets for glioma. For the present review, published studies were examined from PubMed, Embase, Cochrane Central and the reference lists of the retrieved articles. The aim of the present review was to summarize the progress of circRNA research in glioma, discuss the potential diagnostic and prognostic values, and the roles of circRNAs in glioma, and provide a novel theoretical basis and research concepts for the prediction, diagnosis and treatment of glioma.
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Affiliation(s)
- Wei Sun
- Department of Radiotherapy, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, P.R. China
| | - Huandi Zhou
- Department of Radiotherapy, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, P.R. China
| | - Xuetao Han
- Department of Radiotherapy, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, P.R. China
| | - Liubing Hou
- Department of Radiotherapy, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, P.R. China
| | - Xiaoying Xue
- Department of Radiotherapy, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, P.R. China
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11
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Yeo KK, Burgers DE, Brodigan K, Fasciano K, Frazier AL, Warren KE, Reardon DA. Adolescent and young adult neuro-oncology: a comprehensive review. Neurooncol Pract 2021; 8:236-246. [PMID: 34055371 PMCID: PMC8153805 DOI: 10.1093/nop/npab001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Adolescent and young adult (AYA; ages 15-39) patients represent a population that experiences significant challenges in cancer care and research, exemplified by poorer clinical outcomes as well as unmet psychosocial and reproductive health needs. Despite central nervous system (CNS) tumors being one of the most common malignancies diagnosed in the age group, there is a clear paucity of AYA CNS tumor-specific publications, especially those related to the unique psychosocial and reproductive health needs of this population of patients. In this review, we examine various aspects of AYA oncological care including tumor biology, clinical outcome, clinical trials enrollment rate, site of care, unique psychosocial needs, and oncofertility. We assess the current state of these issues, highlight areas of deficiencies, and outline the steps needed to address these concerns. We emphasize the importance of comprehensive molecular testing as part of the diagnostic work-up, expansion of clinical trial availability, access to psychosocial care and oncofertility expertise, and the development of AYA-specific clinical research to define best practices and advancing care for this population.
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Affiliation(s)
- Kee Kiat Yeo
- Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Darcy E Burgers
- Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, Massachusetts
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Katelynn Brodigan
- Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, Massachusetts
| | - Karen Fasciano
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, Massachusetts
| | - A Lindsay Frazier
- Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Katherine E Warren
- Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - David A Reardon
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
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12
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Picart T, Meyronet D, Pallud J, Dumot C, Metellus P, Zouaoui S, Berhouma M, Ducray F, Bauchet L, Guyotat J. Management, functional outcomes and survival in a French multicentric series of 118 adult patients with cerebellar glioblastoma. J Cancer Res Clin Oncol 2021; 147:1843-1856. [PMID: 33399987 DOI: 10.1007/s00432-020-03474-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/18/2020] [Indexed: 12/25/2022]
Abstract
PURPOSE To analyze the outcomes and predictors in a large series of cerebellar glioblastomas in order to guide patient management. METHODS The French brain tumor database and the Club de Neuro-Oncologie of the Société Française de Neurochirurgie retrospectively identified adult patients with cerebellar glioblastoma diagnosed between 2003 and 2017. Diagnosis was confirmed by a centralized neuropathological review. RESULTS Data from 118 cerebellar glioblastoma patients were analyzed (mean age 55.9 years, 55.1% males). The clinical presentation associated raised intracranial pressure (50.8%), static cerebellar syndrome (68.6%), kinetic cerebellar syndrome (49.2%) and/or cranial nerve disorders (17.8%). Glioblastomas were hemispheric (55.9%), vermian (14.4%) or both (29.7%). Hydrocephalus was present in 49 patients (41.5%). Histologically, tumors corresponded either to IDH-wild-type or to K27-mutant glioblastomas. Surgery consisted of total (12.7%), subtotal (35.6%), partial resection (33.9%) or biopsy (17.8%). The postoperative Karnofsky performance status was improved, stable and worsened in 22.4%, 43.9% and 33.7% of patients, respectively. Progression-free and overall survivals reached 5.1 months and 9.1 months, respectively. Compared to other surgical strategies, total or subtotal resection improved the Karnofsky performance status (33.3% vs 12.5%, p < 0.001), prolonged progression-free and overall survivals (6.5 vs 4.3 months, p = 0.015 and 16.7 vs 6.2 months, p < 0.001, respectively) and had a comparable complication rate (40.4% vs 31.1%, p = 0.29). After total or subtotal resection, the functional outcomes were correlated with age (p = 0.004) and cerebellar hemispheric tumor location (p < 0.001) but not brainstem infiltration (p = 0.16). CONCLUSION In selected patients, maximal resection of cerebellar glioblastoma is associated with improved onco-functional outcomes, compared with less invasive procedures.
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Affiliation(s)
- Thiébaud Picart
- Department of Neurosurgery, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, 59 Boulevard Pinel, 69667, Bron, France.
- Claude Bernard University Lyon 1, Lyon, France.
- Department of Cancer Cell Plasticity, INSERM U1052, Cancer Research Center of Lyon, Lyon, France.
| | - David Meyronet
- Claude Bernard University Lyon 1, Lyon, France
- Department of Cancer Cell Plasticity, INSERM U1052, Cancer Research Center of Lyon, Lyon, France
- Groupe Hospitalier Est, Department of Neuropathology, Hospices Civils de Lyon, Bron, France
| | - Johan Pallud
- Department of Neurosurgery, Hôpital Sainte-Anne, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- IMA-Brain, INSERM U894, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
| | - Chloé Dumot
- Department of Neurosurgery, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, 59 Boulevard Pinel, 69667, Bron, France
- Claude Bernard University Lyon 1, Lyon, France
- CarMeN Laboratory, Inserm U1060, INRA U1397, INSA Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Philippe Metellus
- Hôpital Privé Clairval, Ramsay Général de Santé, Marseille, France
- Institut de Neurophysiopathologie, UMR 7051, Université D'Aix-Marseille, Marseille, France
| | - Sonia Zouaoui
- Department of Neurosurgery, Montpellier University Hospital, Montpellier, France
- FBTDB (French Brain Tumor DataBase), Montpellier University Hospital, Montpellier, France
| | - Moncef Berhouma
- Department of Neurosurgery, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, 59 Boulevard Pinel, 69667, Bron, France
- Claude Bernard University Lyon 1, Lyon, France
- CREATIS Laboratory, Inserm U1206, UMR 5220, Université de Lyon, Villeurbanne, France
| | - François Ducray
- Claude Bernard University Lyon 1, Lyon, France
- Department of Cancer Cell Plasticity, INSERM U1052, Cancer Research Center of Lyon, Lyon, France
- Department of Neurooncology, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Bron, France
| | - Luc Bauchet
- Department of Neurosurgery, Montpellier University Hospital, Montpellier, France
- FBTDB (French Brain Tumor DataBase), Montpellier University Hospital, Montpellier, France
- Institut Des Neurosciences de Montpellier, INSERM U1051, Hôpital Saint Eloi, Montpellier, France
| | - Jacques Guyotat
- Department of Neurosurgery, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, 59 Boulevard Pinel, 69667, Bron, France
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13
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Lim PS, Tran S, Kroeze SGC, Pica A, Hrbacek J, Bachtiary B, Walser M, Leiser D, Lomax AJ, Weber DC. Outcomes of adolescents and young adults treated for brain and skull base tumors with pencil beam scanning proton therapy. Pediatr Blood Cancer 2020; 67:e28664. [PMID: 32881313 DOI: 10.1002/pbc.28664] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/24/2020] [Accepted: 08/06/2020] [Indexed: 11/11/2022]
Abstract
BACKGROUND The use of proton therapy (PT) in adolescents and young adults (AYAs) is becoming increasingly popular. This study aims to assess the outcomes and late toxicity consequences in AYAs (15-39 years) with brain/skull base tumors treated with pencil beam scanning proton therapy. METHODS One hundred seventy six AYAs treated curatively at the Paul Scherrer Institute (PSI) were identified. Median age was 30 years (range 15-39) and median prescribed dose was 70.0 Gy (relative biological effectiveness [RBE]) (range 50.4-76.0). The most common tumors treated were chordomas/chondrosarcomas (61.4%), followed by gliomas (15.3%), and meningiomas (14.2%). RESULTS After a median follow up of 66 months (range 12-236), 24 (13.6%) local only failures and one (0.6%) central nervous system (CNS) distant only failure were observed. The 6-year local control, distant progression-free survival, and overall survival were 83.2%, 97.4%, and 90.2%, respectively. The 6-year high-grade (≥grade [G] 3) PT-related late toxicity-free survival was 88.5%. Crude late toxicity rates were 26.2% G1, 37.8% G2, 12.2% G3, 0.6% G4, and 0.6% G5. The one G4 toxicity was a retinopathy and one G5 toxicity was a brainstem hemorrhage. The 6-year cumulative incidences for any late PT-related pituitary, ototoxicity, and neurotoxicity were 36.3%, 18.3%, and 25.6%; whilst high-grade (≥G3) ototoxicity and neurotoxicity were 3.4% and 2.9%, respectively. No secondary malignancies were observed. The rate of unemployment was 9.5% pre-PT, increasing to 23.8% post-PT. Sixty-two percent of survivors were working whilst 12.7% were in education post-PT. CONCLUSIONS PT is an effective treatment for brain/skull base tumors in the AYA population with a reasonable late toxicity profile. Despite good clinical outcomes, around one in four AYA survivors are unemployed after treatment.
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Affiliation(s)
- Pei S Lim
- Department of Radiation Oncology, University College London Hospitals, London, United Kingdom
| | - Sébastien Tran
- Department of Radiation Oncology, Geneva University Hospital, Geneva, Switzerland
| | - Stephanie G C Kroeze
- Department of Radiation Oncology, University Hospital Zürich, Zürich, Switzerland
| | - Alessia Pica
- Center for Proton Therapy, Paul Scherrer Institute, Villigen, Switzerland
| | - Jan Hrbacek
- Center for Proton Therapy, Paul Scherrer Institute, Villigen, Switzerland
| | - Barbara Bachtiary
- Center for Proton Therapy, Paul Scherrer Institute, Villigen, Switzerland
| | - Marc Walser
- Center for Proton Therapy, Paul Scherrer Institute, Villigen, Switzerland
| | - Dominic Leiser
- Center for Proton Therapy, Paul Scherrer Institute, Villigen, Switzerland
| | - Antony J Lomax
- Center for Proton Therapy, Paul Scherrer Institute, Villigen, Switzerland.,Department of Physics, ETH Zürich, Zürich, Switzerland
| | - Damien C Weber
- Center for Proton Therapy, Paul Scherrer Institute, Villigen, Switzerland.,University of Zürich, Zürich, Switzerland.,University of Bern, Bern, Switzerland
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14
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Affiliation(s)
- Julie Bennett
- Division of Neuro-Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Eric Bouffet
- Division of Neuro-Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
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