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Kilday JP, Caldarelli M, Massimi L, Chen RHH, Lee YY, Liang ML, Parkes J, Naiker T, van Veelen ML, Michiels E, Mallucci C, Pettorini B, Meijer L, Dorfer C, Czech T, Diezi M, Schouten-van Meeteren AYN, Holm S, Gustavsson B, Benesch M, Müller HL, Hoffmann A, Rutkowski S, Flitsch J, Escherich G, Grotzer M, Spoudeas HA, Azquikina K, Capra M, Jiménez-Guerra R, MacDonald P, Johnston DL, Dvir R, Constantini S, Kuo MF, Yang SH, Bartels U. Intracystic interferon-alpha in pediatric craniopharyngioma patients: an international multicenter assessment on behalf of SIOPE and ISPN. Neuro Oncol 2018; 19:1398-1407. [PMID: 28499018 DOI: 10.1093/neuonc/nox056] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Craniopharyngiomas are frequent hypothalamo-pituitary tumors in children, presenting predominantly as cystic lesions. Morbidity from conventional treatment has focused attention on intracystic drug delivery, hypothesized to cause fewer clinical consequences. However, the efficacy of intracystic therapy remains unclear. We report the retrospective experiences of several global centers using intracystic interferon-alpha. Methods European Société Internationale d'Oncologie Pédiatrique and International Society for Pediatric Neurosurgery centers were contacted to submit a datasheet capturing pediatric patients with cystic craniopharyngiomas who had received intracystic interferon-alpha. Patient demographics, administration schedules, adverse events, and outcomes were obtained. Progression was clinical or radiological (cyst reaccumulation, novel cysts, or solid growth). Results Fifty-six children (median age, 6.3 y) from 21 international centers were identified. Median follow-up from diagnosis was 5.1 years (0.3-17.7 y). Lesions were cystic (n = 22; 39%) or cystic/solid (n = 34; 61%). Previous progression was treated in 43 (77%) patients before interferon use. In such cases, further progression was delayed by intracystic interferon compared with the preceding therapy for cystic lesions (P = 0.0005). Few significant attributable side effects were reported. Progression post interferon occurred in 42 patients (median 14 mo; 0-8 y), while the estimated median time to definitive therapy post interferon was 5.8 (1.8-9.7) years. Conclusions Intracystic interferon-alpha can delay disease progression and potentially offer a protracted time to definitive surgery or radiotherapy in pediatric cystic craniopharyngioma, yet demonstrates a favorable toxicity profile compared with other therapeutic modalities-important factors for this developing age group. A prospective, randomized international clinical trial assessment is warranted.
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Affiliation(s)
- John-Paul Kilday
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Massimo Caldarelli
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Luca Massimi
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Robert Hsin-Hung Chen
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Yi Yen Lee
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Muh-Lii Liang
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Jeanette Parkes
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Thuran Naiker
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Marie-Lise van Veelen
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Erna Michiels
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Conor Mallucci
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Benedetta Pettorini
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Lisethe Meijer
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Christian Dorfer
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Thomas Czech
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Manuel Diezi
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Antoinette Y N Schouten-van Meeteren
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Stefan Holm
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Bengt Gustavsson
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Martin Benesch
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Hermann L Müller
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Anika Hoffmann
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Stefan Rutkowski
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Joerg Flitsch
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Gabriele Escherich
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Michael Grotzer
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Helen A Spoudeas
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Kristian Azquikina
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Michael Capra
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Rolando Jiménez-Guerra
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Patrick MacDonald
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Donna L Johnston
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Rina Dvir
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Shlomi Constantini
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Meng-Fai Kuo
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Shih-Hung Yang
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Ute Bartels
- Children's Brain Tumour Research Network (CBTRN), Royal Manchester Children's Hospital, Oxford Road, Manchester, England, UK; The Centre for Paediatric, Teenage and Young Adult Cancer, Institute of Cancer Sciences, The University of Manchester, England, UK; Department of Pediatric Neurosurgery, A Gemelli Hospital, Rome, Italy; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Groote Schuur Hospital, University of Cape Town, South Africa; Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands; Department of Neurosurgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, England, UK ; Beatrix Childrens' Hospital, University MC, Groningen, Netherlands; Department of Neurosurgery, Medical University of Vienna, Vienna, Austria; Pediatric Haemato-Oncology Unit, University Hospital Lausanne, Switzerland; Pediatric Oncology Department, Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands; Department of Pediatric Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; Department of Pediatrics, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Oldenburg, Germany; Departments of Neurosurgery and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Children's Hospital Zurich, Switzerland; Departments of Paediatric Neuroendocrinology and Neurosurgery, Great Ormond Street Hospital, London, England, UK; Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Ireland; Department of Pediatric Neurosurgery, Hospital Angeles Mexico, Mexico City,Mexico; Department of Neurosurgery, Winnipeg Children's Hospital, Canada; Department of Paediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel; Department of Neurosurgery, National Taiwan University Hospital, Taiwan; Department of Paediatric Oncology, The Hospital for Sick Children, Toronto, Canada
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34
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Varlotto J, DiMaio C, Grassberger C, Tangel M, Mackley H, Pavelic M, Specht C, Sogge S, Nguyen D, Glantz M, Saw C, Upadhyay U, Moser R, Yunus S, Rava P, Fitzgerald T, Glanzman J, Sheehan J. Multi-modality management of craniopharyngioma: a review of various treatments and their outcomes. Neurooncol Pract 2015; 3:173-187. [PMID: 31386091 DOI: 10.1093/nop/npv029] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Indexed: 02/04/2023] Open
Abstract
Craniopharyngioma is a rare tumor that is expected to occur in ∼400 patients/year in the United States. While surgical resection is considered to be the primary treatment when a patient presents with a craniopharyngioma, only 30% of such tumors present in locations that permit complete resection. Radiotherapy has been used as both primary and adjuvant therapy in the treatment of craniopharyngiomas for over 50 years. Modern radiotherapeutic techniques, via the use of CT-based treatment planning and MRI fusion, have permitted tighter treatment volumes that allow for better tumor control while limiting complications. Modern radiotherapeutic series have shown high control rates with lower doses than traditionally used in the two-dimensional treatment era. Intracavitary radiotherapy with radio-isotopes and stereotactic radiosurgery may have a role in the treatment of recurrent cystic and solid recurrences, respectively. Recently, due to the exclusive expression of the Beta-catenin clonal mutations and the exclusive expression of BRAF V600E clonal mutations in the overwhelming majority of adamantinomatous and papillary tumors respectively, it is felt that inhibitors of each pathway may play a role in the future treatment of these rare tumors.
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Affiliation(s)
- John Varlotto
- Department of Radiation Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (J.V., P.R., T.F., J.G.); Penn State Hershey Medical Center, Department of Neurology, Hershey, Pennsylvania (C.D.); Massachusetts General Hospital, Department of Radiation Oncology, Boston, Massachusetts (C.G.); Pennsylvania State University College of Medicine, Hershey, Pennsylvania (M.T., M.P., C.S., D.N., M.G., J.S.); Penn State Hershey Cancer Institute, Hershey, Pennsylvania (H.M.); Penn State Medical Center, Department of Pathology, Hershey, Pennsylvania (C.S., D.N.); Penn State Hershey Medical Center, Department of Radiology, Hershey, Pennsylvania (D.N.); Penn State Neuroscience Institute, Hershey, Pennsylvania (D.N., M.G., J.S.); Northeast Radiation Oncology, Scranton, Pennsylvania (C.S.); University of Massachusetts Medical Center, Division of Neurologic Surgery, Worcester, Massachusetts (U.U., R.M.); Department of Medical Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (S.Y.)
| | - Christopher DiMaio
- Department of Radiation Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (J.V., P.R., T.F., J.G.); Penn State Hershey Medical Center, Department of Neurology, Hershey, Pennsylvania (C.D.); Massachusetts General Hospital, Department of Radiation Oncology, Boston, Massachusetts (C.G.); Pennsylvania State University College of Medicine, Hershey, Pennsylvania (M.T., M.P., C.S., D.N., M.G., J.S.); Penn State Hershey Cancer Institute, Hershey, Pennsylvania (H.M.); Penn State Medical Center, Department of Pathology, Hershey, Pennsylvania (C.S., D.N.); Penn State Hershey Medical Center, Department of Radiology, Hershey, Pennsylvania (D.N.); Penn State Neuroscience Institute, Hershey, Pennsylvania (D.N., M.G., J.S.); Northeast Radiation Oncology, Scranton, Pennsylvania (C.S.); University of Massachusetts Medical Center, Division of Neurologic Surgery, Worcester, Massachusetts (U.U., R.M.); Department of Medical Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (S.Y.)
| | - Clemens Grassberger
- Department of Radiation Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (J.V., P.R., T.F., J.G.); Penn State Hershey Medical Center, Department of Neurology, Hershey, Pennsylvania (C.D.); Massachusetts General Hospital, Department of Radiation Oncology, Boston, Massachusetts (C.G.); Pennsylvania State University College of Medicine, Hershey, Pennsylvania (M.T., M.P., C.S., D.N., M.G., J.S.); Penn State Hershey Cancer Institute, Hershey, Pennsylvania (H.M.); Penn State Medical Center, Department of Pathology, Hershey, Pennsylvania (C.S., D.N.); Penn State Hershey Medical Center, Department of Radiology, Hershey, Pennsylvania (D.N.); Penn State Neuroscience Institute, Hershey, Pennsylvania (D.N., M.G., J.S.); Northeast Radiation Oncology, Scranton, Pennsylvania (C.S.); University of Massachusetts Medical Center, Division of Neurologic Surgery, Worcester, Massachusetts (U.U., R.M.); Department of Medical Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (S.Y.)
| | - Matthew Tangel
- Department of Radiation Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (J.V., P.R., T.F., J.G.); Penn State Hershey Medical Center, Department of Neurology, Hershey, Pennsylvania (C.D.); Massachusetts General Hospital, Department of Radiation Oncology, Boston, Massachusetts (C.G.); Pennsylvania State University College of Medicine, Hershey, Pennsylvania (M.T., M.P., C.S., D.N., M.G., J.S.); Penn State Hershey Cancer Institute, Hershey, Pennsylvania (H.M.); Penn State Medical Center, Department of Pathology, Hershey, Pennsylvania (C.S., D.N.); Penn State Hershey Medical Center, Department of Radiology, Hershey, Pennsylvania (D.N.); Penn State Neuroscience Institute, Hershey, Pennsylvania (D.N., M.G., J.S.); Northeast Radiation Oncology, Scranton, Pennsylvania (C.S.); University of Massachusetts Medical Center, Division of Neurologic Surgery, Worcester, Massachusetts (U.U., R.M.); Department of Medical Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (S.Y.)
| | - Heath Mackley
- Department of Radiation Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (J.V., P.R., T.F., J.G.); Penn State Hershey Medical Center, Department of Neurology, Hershey, Pennsylvania (C.D.); Massachusetts General Hospital, Department of Radiation Oncology, Boston, Massachusetts (C.G.); Pennsylvania State University College of Medicine, Hershey, Pennsylvania (M.T., M.P., C.S., D.N., M.G., J.S.); Penn State Hershey Cancer Institute, Hershey, Pennsylvania (H.M.); Penn State Medical Center, Department of Pathology, Hershey, Pennsylvania (C.S., D.N.); Penn State Hershey Medical Center, Department of Radiology, Hershey, Pennsylvania (D.N.); Penn State Neuroscience Institute, Hershey, Pennsylvania (D.N., M.G., J.S.); Northeast Radiation Oncology, Scranton, Pennsylvania (C.S.); University of Massachusetts Medical Center, Division of Neurologic Surgery, Worcester, Massachusetts (U.U., R.M.); Department of Medical Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (S.Y.)
| | - Matt Pavelic
- Department of Radiation Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (J.V., P.R., T.F., J.G.); Penn State Hershey Medical Center, Department of Neurology, Hershey, Pennsylvania (C.D.); Massachusetts General Hospital, Department of Radiation Oncology, Boston, Massachusetts (C.G.); Pennsylvania State University College of Medicine, Hershey, Pennsylvania (M.T., M.P., C.S., D.N., M.G., J.S.); Penn State Hershey Cancer Institute, Hershey, Pennsylvania (H.M.); Penn State Medical Center, Department of Pathology, Hershey, Pennsylvania (C.S., D.N.); Penn State Hershey Medical Center, Department of Radiology, Hershey, Pennsylvania (D.N.); Penn State Neuroscience Institute, Hershey, Pennsylvania (D.N., M.G., J.S.); Northeast Radiation Oncology, Scranton, Pennsylvania (C.S.); University of Massachusetts Medical Center, Division of Neurologic Surgery, Worcester, Massachusetts (U.U., R.M.); Department of Medical Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (S.Y.)
| | - Charles Specht
- Department of Radiation Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (J.V., P.R., T.F., J.G.); Penn State Hershey Medical Center, Department of Neurology, Hershey, Pennsylvania (C.D.); Massachusetts General Hospital, Department of Radiation Oncology, Boston, Massachusetts (C.G.); Pennsylvania State University College of Medicine, Hershey, Pennsylvania (M.T., M.P., C.S., D.N., M.G., J.S.); Penn State Hershey Cancer Institute, Hershey, Pennsylvania (H.M.); Penn State Medical Center, Department of Pathology, Hershey, Pennsylvania (C.S., D.N.); Penn State Hershey Medical Center, Department of Radiology, Hershey, Pennsylvania (D.N.); Penn State Neuroscience Institute, Hershey, Pennsylvania (D.N., M.G., J.S.); Northeast Radiation Oncology, Scranton, Pennsylvania (C.S.); University of Massachusetts Medical Center, Division of Neurologic Surgery, Worcester, Massachusetts (U.U., R.M.); Department of Medical Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (S.Y.)
| | - Steven Sogge
- Department of Radiation Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (J.V., P.R., T.F., J.G.); Penn State Hershey Medical Center, Department of Neurology, Hershey, Pennsylvania (C.D.); Massachusetts General Hospital, Department of Radiation Oncology, Boston, Massachusetts (C.G.); Pennsylvania State University College of Medicine, Hershey, Pennsylvania (M.T., M.P., C.S., D.N., M.G., J.S.); Penn State Hershey Cancer Institute, Hershey, Pennsylvania (H.M.); Penn State Medical Center, Department of Pathology, Hershey, Pennsylvania (C.S., D.N.); Penn State Hershey Medical Center, Department of Radiology, Hershey, Pennsylvania (D.N.); Penn State Neuroscience Institute, Hershey, Pennsylvania (D.N., M.G., J.S.); Northeast Radiation Oncology, Scranton, Pennsylvania (C.S.); University of Massachusetts Medical Center, Division of Neurologic Surgery, Worcester, Massachusetts (U.U., R.M.); Department of Medical Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (S.Y.)
| | - Dan Nguyen
- Department of Radiation Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (J.V., P.R., T.F., J.G.); Penn State Hershey Medical Center, Department of Neurology, Hershey, Pennsylvania (C.D.); Massachusetts General Hospital, Department of Radiation Oncology, Boston, Massachusetts (C.G.); Pennsylvania State University College of Medicine, Hershey, Pennsylvania (M.T., M.P., C.S., D.N., M.G., J.S.); Penn State Hershey Cancer Institute, Hershey, Pennsylvania (H.M.); Penn State Medical Center, Department of Pathology, Hershey, Pennsylvania (C.S., D.N.); Penn State Hershey Medical Center, Department of Radiology, Hershey, Pennsylvania (D.N.); Penn State Neuroscience Institute, Hershey, Pennsylvania (D.N., M.G., J.S.); Northeast Radiation Oncology, Scranton, Pennsylvania (C.S.); University of Massachusetts Medical Center, Division of Neurologic Surgery, Worcester, Massachusetts (U.U., R.M.); Department of Medical Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (S.Y.)
| | - Michael Glantz
- Department of Radiation Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (J.V., P.R., T.F., J.G.); Penn State Hershey Medical Center, Department of Neurology, Hershey, Pennsylvania (C.D.); Massachusetts General Hospital, Department of Radiation Oncology, Boston, Massachusetts (C.G.); Pennsylvania State University College of Medicine, Hershey, Pennsylvania (M.T., M.P., C.S., D.N., M.G., J.S.); Penn State Hershey Cancer Institute, Hershey, Pennsylvania (H.M.); Penn State Medical Center, Department of Pathology, Hershey, Pennsylvania (C.S., D.N.); Penn State Hershey Medical Center, Department of Radiology, Hershey, Pennsylvania (D.N.); Penn State Neuroscience Institute, Hershey, Pennsylvania (D.N., M.G., J.S.); Northeast Radiation Oncology, Scranton, Pennsylvania (C.S.); University of Massachusetts Medical Center, Division of Neurologic Surgery, Worcester, Massachusetts (U.U., R.M.); Department of Medical Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (S.Y.)
| | - Cheng Saw
- Department of Radiation Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (J.V., P.R., T.F., J.G.); Penn State Hershey Medical Center, Department of Neurology, Hershey, Pennsylvania (C.D.); Massachusetts General Hospital, Department of Radiation Oncology, Boston, Massachusetts (C.G.); Pennsylvania State University College of Medicine, Hershey, Pennsylvania (M.T., M.P., C.S., D.N., M.G., J.S.); Penn State Hershey Cancer Institute, Hershey, Pennsylvania (H.M.); Penn State Medical Center, Department of Pathology, Hershey, Pennsylvania (C.S., D.N.); Penn State Hershey Medical Center, Department of Radiology, Hershey, Pennsylvania (D.N.); Penn State Neuroscience Institute, Hershey, Pennsylvania (D.N., M.G., J.S.); Northeast Radiation Oncology, Scranton, Pennsylvania (C.S.); University of Massachusetts Medical Center, Division of Neurologic Surgery, Worcester, Massachusetts (U.U., R.M.); Department of Medical Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (S.Y.)
| | - Urvashi Upadhyay
- Department of Radiation Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (J.V., P.R., T.F., J.G.); Penn State Hershey Medical Center, Department of Neurology, Hershey, Pennsylvania (C.D.); Massachusetts General Hospital, Department of Radiation Oncology, Boston, Massachusetts (C.G.); Pennsylvania State University College of Medicine, Hershey, Pennsylvania (M.T., M.P., C.S., D.N., M.G., J.S.); Penn State Hershey Cancer Institute, Hershey, Pennsylvania (H.M.); Penn State Medical Center, Department of Pathology, Hershey, Pennsylvania (C.S., D.N.); Penn State Hershey Medical Center, Department of Radiology, Hershey, Pennsylvania (D.N.); Penn State Neuroscience Institute, Hershey, Pennsylvania (D.N., M.G., J.S.); Northeast Radiation Oncology, Scranton, Pennsylvania (C.S.); University of Massachusetts Medical Center, Division of Neurologic Surgery, Worcester, Massachusetts (U.U., R.M.); Department of Medical Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (S.Y.)
| | - Richard Moser
- Department of Radiation Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (J.V., P.R., T.F., J.G.); Penn State Hershey Medical Center, Department of Neurology, Hershey, Pennsylvania (C.D.); Massachusetts General Hospital, Department of Radiation Oncology, Boston, Massachusetts (C.G.); Pennsylvania State University College of Medicine, Hershey, Pennsylvania (M.T., M.P., C.S., D.N., M.G., J.S.); Penn State Hershey Cancer Institute, Hershey, Pennsylvania (H.M.); Penn State Medical Center, Department of Pathology, Hershey, Pennsylvania (C.S., D.N.); Penn State Hershey Medical Center, Department of Radiology, Hershey, Pennsylvania (D.N.); Penn State Neuroscience Institute, Hershey, Pennsylvania (D.N., M.G., J.S.); Northeast Radiation Oncology, Scranton, Pennsylvania (C.S.); University of Massachusetts Medical Center, Division of Neurologic Surgery, Worcester, Massachusetts (U.U., R.M.); Department of Medical Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (S.Y.)
| | - Shakeeb Yunus
- Department of Radiation Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (J.V., P.R., T.F., J.G.); Penn State Hershey Medical Center, Department of Neurology, Hershey, Pennsylvania (C.D.); Massachusetts General Hospital, Department of Radiation Oncology, Boston, Massachusetts (C.G.); Pennsylvania State University College of Medicine, Hershey, Pennsylvania (M.T., M.P., C.S., D.N., M.G., J.S.); Penn State Hershey Cancer Institute, Hershey, Pennsylvania (H.M.); Penn State Medical Center, Department of Pathology, Hershey, Pennsylvania (C.S., D.N.); Penn State Hershey Medical Center, Department of Radiology, Hershey, Pennsylvania (D.N.); Penn State Neuroscience Institute, Hershey, Pennsylvania (D.N., M.G., J.S.); Northeast Radiation Oncology, Scranton, Pennsylvania (C.S.); University of Massachusetts Medical Center, Division of Neurologic Surgery, Worcester, Massachusetts (U.U., R.M.); Department of Medical Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (S.Y.)
| | - Paul Rava
- Department of Radiation Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (J.V., P.R., T.F., J.G.); Penn State Hershey Medical Center, Department of Neurology, Hershey, Pennsylvania (C.D.); Massachusetts General Hospital, Department of Radiation Oncology, Boston, Massachusetts (C.G.); Pennsylvania State University College of Medicine, Hershey, Pennsylvania (M.T., M.P., C.S., D.N., M.G., J.S.); Penn State Hershey Cancer Institute, Hershey, Pennsylvania (H.M.); Penn State Medical Center, Department of Pathology, Hershey, Pennsylvania (C.S., D.N.); Penn State Hershey Medical Center, Department of Radiology, Hershey, Pennsylvania (D.N.); Penn State Neuroscience Institute, Hershey, Pennsylvania (D.N., M.G., J.S.); Northeast Radiation Oncology, Scranton, Pennsylvania (C.S.); University of Massachusetts Medical Center, Division of Neurologic Surgery, Worcester, Massachusetts (U.U., R.M.); Department of Medical Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (S.Y.)
| | - Thomas Fitzgerald
- Department of Radiation Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (J.V., P.R., T.F., J.G.); Penn State Hershey Medical Center, Department of Neurology, Hershey, Pennsylvania (C.D.); Massachusetts General Hospital, Department of Radiation Oncology, Boston, Massachusetts (C.G.); Pennsylvania State University College of Medicine, Hershey, Pennsylvania (M.T., M.P., C.S., D.N., M.G., J.S.); Penn State Hershey Cancer Institute, Hershey, Pennsylvania (H.M.); Penn State Medical Center, Department of Pathology, Hershey, Pennsylvania (C.S., D.N.); Penn State Hershey Medical Center, Department of Radiology, Hershey, Pennsylvania (D.N.); Penn State Neuroscience Institute, Hershey, Pennsylvania (D.N., M.G., J.S.); Northeast Radiation Oncology, Scranton, Pennsylvania (C.S.); University of Massachusetts Medical Center, Division of Neurologic Surgery, Worcester, Massachusetts (U.U., R.M.); Department of Medical Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (S.Y.)
| | - Jonathan Glanzman
- Department of Radiation Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (J.V., P.R., T.F., J.G.); Penn State Hershey Medical Center, Department of Neurology, Hershey, Pennsylvania (C.D.); Massachusetts General Hospital, Department of Radiation Oncology, Boston, Massachusetts (C.G.); Pennsylvania State University College of Medicine, Hershey, Pennsylvania (M.T., M.P., C.S., D.N., M.G., J.S.); Penn State Hershey Cancer Institute, Hershey, Pennsylvania (H.M.); Penn State Medical Center, Department of Pathology, Hershey, Pennsylvania (C.S., D.N.); Penn State Hershey Medical Center, Department of Radiology, Hershey, Pennsylvania (D.N.); Penn State Neuroscience Institute, Hershey, Pennsylvania (D.N., M.G., J.S.); Northeast Radiation Oncology, Scranton, Pennsylvania (C.S.); University of Massachusetts Medical Center, Division of Neurologic Surgery, Worcester, Massachusetts (U.U., R.M.); Department of Medical Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (S.Y.)
| | - Jonas Sheehan
- Department of Radiation Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (J.V., P.R., T.F., J.G.); Penn State Hershey Medical Center, Department of Neurology, Hershey, Pennsylvania (C.D.); Massachusetts General Hospital, Department of Radiation Oncology, Boston, Massachusetts (C.G.); Pennsylvania State University College of Medicine, Hershey, Pennsylvania (M.T., M.P., C.S., D.N., M.G., J.S.); Penn State Hershey Cancer Institute, Hershey, Pennsylvania (H.M.); Penn State Medical Center, Department of Pathology, Hershey, Pennsylvania (C.S., D.N.); Penn State Hershey Medical Center, Department of Radiology, Hershey, Pennsylvania (D.N.); Penn State Neuroscience Institute, Hershey, Pennsylvania (D.N., M.G., J.S.); Northeast Radiation Oncology, Scranton, Pennsylvania (C.S.); University of Massachusetts Medical Center, Division of Neurologic Surgery, Worcester, Massachusetts (U.U., R.M.); Department of Medical Oncology, University of Massachusetts Medical Center, Worcester, Massachusetts (S.Y.)
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