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Shofty B, Bokstein F, Ram Z, Ben-Sira L, Freedman S, Kesler A, Constantini S, Shofty B, Mauda-Havakuk M, Ben-Bashat D, Dvir R, Pratt LT, Weizman L, Joskowicz L, Tal M, Ravid L, Ben-Sira L, Constantini S, Dodgshun A, Maixner W, Sullivan M, Hansford J, Ma J, Wang B, Toledano H, Muhsinoglu O, Luckman J, Michowiz S, Goldenberg-Cohen N, Schroeder K, Rosenfeld A, Grant G, McLendon R, Cummings T, Becher O, Gururangan S, Aguilera D, Mazewski C, Janss A, Castellino RC, Schniederjan M, Hayes L, Brahma B, MacDonald T, Osugi Y, Kiyotani C, Sakamoto H, Yanagisawa T, Kanno M, Kamimura S, Kosaka Y, Hirado J, Takimoto T, Nakazawa A, Hara J, Hwang E, Mun A, Kilburn L, Chi S, Knipstein J, Oren M, Dvir R, Hardy K, Rood B, Packer R, Kandels D, Schmidt R, Geh M, Breitmoser-Greiner S, Gnekow AK, Bergthold G, Bandopadhayay P, Rich B, Chan J, Santagata S, Hoshida Y, Ramkissoon S, Ramkissoon L, Golub T, Tabak B, Ferrer-Luna R, Weng PY, Stiles C, Grill J, Kieran MW, Ligon KL, Beroukhim R, Fisher MJ, Levin MH, Armstrong GT, Broad JH, Zimmerman R, Bilaniuk LT, Feygin T, Liu GT, Gan HW, Phipps K, Spoudeas HA, Kohorst M, Warad D, Keating G, Childs S, Giannini C, Wetjen N, Rao; AN, Nakamura H, Makino K, Hide T, Kuroda JI, Shinojima N, Yano S, Kuratsu JI, Rush S, Madden J, Hemenway M, Foreman N, Sie M, den Dunnen WFA, Lourens HJ, Meeuwsen-de Boer TGJ, Scherpen FJG, Kampen KR, Hoving EW, de Bont ESJM, Gnekow AK, Kandels D, Walker DA, Perilongo G, Grill J, Stokland T, Sehested AM, van Schouten AYN, de Paoli A, de Salvo GL, Pache-Leschhorn S, Geh M, Schmidt R, Gnekow AK, Gass D, Rupani K, Tsankova N, Stark E, Anderson R, Feldstein N, Garvin J, Deel M, McLendon R, Becher O, Karajannis M, Wisoff J, Muh C, Schroeder K, Gururangan S, del Bufalo F, Carai A, Macchiaiolo M, Messina R, Cacchione A, Palmiero M, Cambiaso P, Mastronuzzi A, Anderson M, Leary S, Sun Y, Buhrlage S, Pilarz C, Alberta J, Stiles C, Gray N, Mason G, Packer R, Hwang E, Biassoni V, Schiavello E, Bergamaschi L, Chiaravalli S, Spreafico F, Massimino M, Krishnatry R, Kroupnik T, Zhukova N, Mistry M, Zhang C, Bartels U, Huang A, Adamski J, Dirks P, Laperriere N, Silber J, Hawkins C, Bouffet E, Tabori U, Riccardi R, Rizzo D, Chiaretti A, Piccardi M, Dickmann A, Lazzareschi I, Ruggiero A, Guglielmi G, Salerni A, Manni L, Colosimo C, Falsini B, Rosenfeld A, Etzl M, Miller J, Carpenteri D, Kaplan A, Sieow N, Hoe R, Tan AM, Chan MY, Soh SY, Orphanidou-Vlachou E, MacPherson L, English M, Auer D, Jaspan T, Arvanitis T, Grundy R, Peet A, Bandopadhayay P, Bergthold G, Sauer N, Green A, Malkin H, Dabscheck G, Marcus K, Ullrich N, Goumnerova L, Chi S, Beroukhim R, Kieran M, Manley P, Donson A, Kleinschmidt-DeMasters B, Aisner D, Bemis L, Birks D, Mulcahy-Levy J, Smith A, Handler M, Rush S, Foreman N, Davidson A, Figaji A, Pillay K, Kilborn T, Padayachy L, Hendricks M, van Eyssen A, Parkes J, Gass D, Dewire M, Chow L, Rose SR, Lawson S, Stevenson C, Jones B, Pai A, Sutton M, Pruitt D, Fouladi M, Hummel T, Cruz O, de Torres C, Sunol M, Morales A, Santiago C, Alamar M, Rebollo M, Mora J, Sauer N, Dodgshun A, Malkin H, Bergthold G, Manley P, Chi S, Ramkissoon S, MacGregor D, Beroukhim R, Kieran M, Sullivan M, Ligon K, Bandopadhayay P, Hansford J, Messina R, De Benedictis A, Carai A, Mastronuzzi A, Rebessi E, Palma P, Procaccini E, Marras CE, Aguilera D, Castellino RC, Janss A, Schniederjan M, McNall R, Kim S, MacDOnald T, Mazewski C, Zhukova N, Pole J, Mistry M, Fried I, Krishnatry R, Stucklin AG, Bartels U, Huang A, Laperriere N, Dirks P, Zelcer S, Sylva M, Johnston D, Scheinemann K, An J, Hawkins C, Nathan P, Greenberg M, Bouffet E, Malkin D, Tabori U, Kiehna E, Da Silva S, Margol A, Robison N, Finlay J, McComb JG, Krieger M, Wong K, Bluml S, Dhall G, Ayyanar K, Moriarty T, Moeller K, Farber D. LOW GRADE GLIOMAS. Neuro Oncol 2014; 16:i60-i70. [PMCID: PMC4046289 DOI: 10.1093/neuonc/nou073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2023] Open
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Shih CS, Ekoma S, Ho C, Pradhan K, Hwang E, Jakacki R, Fisher M, Kilburn L, Horn M, Vezina G, Rood B, Packer R, Mittal R, Omar S, Khalifa N, Bedir R, Avery R, Hwang E, Acosta M, Hutcheson K, Santos D, Zand D, Kilburn L, Rosenbaum K, Rood B, Packer R, Kalin-Hajdu E, Ospina L, Carret AS, Marzouki M, Decarie JC, Freeman E, Hershon L, Warmuth-Metz M, Zurakowski D, Bison B, Falkenstein F, Gnekow A, Ehrstedt C, Laurencikas E, Bjorklund AC, Stromberg B, Hedborg F, Pfeifer S, Bertin D, Packer RJ, Vallero S, Basso ME, Romano E, Peretta P, Morra I, D'Alonzo G, Fagioli F, Toledano H, Laviv Y, Dratviman-Storobinsky O, Michowiz S, Yaniv I, Cohen IJ, Goldenberg-Cohen N, Muller K, Gnekow A, Warmuth-Metz M, Pietsch T, Zwiener I, Falkenstein F, Meyer FM, Micke O, Hoffmann W, Kortmann RD, Shofty B, Ben-Sira L, Roth J, Constantini S, Shofty B, Weizmann L, Joskowicz L, Kesler A, Ben-Bashat D, Yalon M, Dvir R, Freedman S, Roth J, Ben-Sira L, Constantini S, Bandopadhayay P, Dagi L, Robison N, Goumnerova L, Ullrich N, Opocher E, De Salvo GL, De Paoli A, Simmons I, Sehested A, Walker DA, Picton SV, Gnekow A, Grill J, Driever PH, Azizi AA, Viscardi E, Perilongo G, Cappellano AM, Bouffet E, Silva F, Paiva P, Cavalheiro S, Seixas MT, Silva NS, Antony R, Fraser K, Lin J, Falkenstein F, Kwiecien R, Mirow C, Thieme B, von Hornstein S, Pietsch T, Faldum A, Warmuth-Metz M, Kortmann RD, Gnekow AK, Shofty B, Bokshtein F, Kesler A, Ben-Sira L, Freedman S, Constantini S, Panandiker AP, Klimo P, Thompson C, Armstrong G, Kun L, Boop F, Sanford A, Orge F, Laschinger K, Gold D, Bangert B, Stearns D, Cappellano AM, Senerchia A, Paiva P, Cavalheiro S, Silva F, Silva NS, Gnekow AK, Falkenstein F, Walker D, Perilongo G, Picton S, Grill J, Kortmann RD, Stokland T, van Meeteren AS, Slavc I, Faldum A, de Salvo GL, Fernandez KS, Antony R, Lulla RR, Flores M, Benavides VC, Mitchell C, AlKofide A, Hassonah M, Khafagh Y, Ayas MA, AlFawaz I, Anas M, Barria M, Siddiqui K, Al-Shail E, Fisher MJ, Ullrich NJ, Ferner RE, Gutmann DH, Listernick R, Packer RJ, Tabori U, Hoffman RO, Ardern-Holmes SL, Hummel TR, Hargrave DR, Charrow J, Loguidice M, Balcer LJ, Liu GT, Fisher MJ, Listernick R, Gutmann DH, Ferner RE, Packer RJ, Ullrich NJ, Tabori U, Hoffman RO, Ardern-Holmes SL, Hummel TR, Hargrave DR, Loguidice M, Balcer LJ, Liu GT, Jeeva I, Nelson O, Guy D, Damani A, Gogi D, Picton S, Simmons I, Jeeva I, Picton S, Guy D, Nelson O, Dewsbery S, Gogi D, Simmons I, Sievert AJ, Lang SS, Boucher K, Slaunwhite E, Brewington D, Madsen P, Storm PB, Resnick AC, Hemenway M, Madden J, Macy M, Foreman N, Rush S, Mascelli S, Raso A, Barla A, Nozza P, Biassoni R, Pignatelli S, Cama A, Verri A, Capra V, Garre M, Bergthold G, Piette C, Raquin MA, Dufour C, Varlet P, Dhermain F, Puget S, Sainte-Rose C, Abely M, Canale S, Grill J, Terashima K, Chow K, Jones J, Ahern C, Jo E, Ellezam B, Paulino A, Okcu MF, Su J, Adesina A, Mahajan A, Dauser R, Whitehead W, Lau C, Chintagumpala M, Kebudi R, Tuncer S, Cakir FB, Gorgun O, Agaoglu FY, Ayan I, Darendeliler E, Wolf D, Cohen K, Jeyapalan JN, Morley ICF, Hill AA, Tatevossian RG, Qaddoumi I, Ellison DW, Sheer D, Donson A, Barton V, Birks D, Kleinschmidt-DeMasters BK, Hemenway M, Handler M, Foreman N, Rush S, Tatevossian R, Qaddoumi I, Tang B, Dalton J, Shurtleff S, Punchihewa C, Orisme W, Neale G, Gajjar A, Baker S, Sheer D, Ellison D, Gilheeney S, Jamzadeh A, Winchester M, Yataghene K, De Braganca K, Khakoo Y, Lyden D, Dunkel I, Terasaki M, Eto T, Morioka M, Ho CY, Bar E, Giannini C, Karajannis MA, Zagzag D, Eberhart CG, Rodriguez FJ, Lee Y, Bartels U, Tabori U, Huang A, Bouffet E, Zaky W, Bluml S, Grimm J, Wong K, McComb G, Gilles F, Finlay J, Dhall G, Chen HH, Chen YW, Chang FC, Lin SC, Chang KP, Ho DM, Wong TT, Lee CC, Azizi AA, Fox R, Grill J, Mirow C, Gnekow A, Walker D, Perilongo G, Opocher E, Wheatley K, van Meeteren AYS, Phuakpet K, Tabori U, Bartels U, Huang A, Kulkarni A, Laperriere N, Bouffet E, Epari S, Nair V, Gupta T, Patil P, Moiyadi A, Shetty P, Kane S, Jalali R, Dorris K, Nadi M, Sutton M, Wang L, Stogner K, Li D, Hurwitz B, Stevenson C, Miles L, Kim MO, Fuller C, Hawkins C, Bouffet E, Jones B, Drake J, Fouladi M, Fontebasso AM, Shirinian M, Jones DTW, Quang DAK, Jacob K, Cin H, Witt H, Gerges N, Montpetit A, Brunet S, Lepage P, Klekner A, Lambert S, Kwan T, Hawkins C, Tabori U, Collins VP, Albrecht S, Pfister SM, Jabado N, Arrington D, Manley P, Kieran M, Chi S, Robison N, Chordas C, Ullrich N. LOW GRADE GLIOMAS. Neuro Oncol 2012; 14:i69-i81. [PMCID: PMC3483338 DOI: 10.1093/neuonc/nos092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
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Khatua S, Brown R, Pearlman M, Vats T, Satge D, Stiller C, Rutkowski S, von Bueren AO, Lacour B, Sommelet D, Nishi M, Massimino M, Garre ML, Moreno F, Hasle H, Jakab Z, Greenberg M, von der Weid N, Kuehni C, Zurriaga O, Vicente ML, Peris-Bonet R, Benesch M, Vekemans M, Sullivan S, Rickert C, Fisher PG, Von Behren J, Nelson DO, Reynolds P, Fukuoka K, Yanagisawa T, Suzuki T, Koga T, Wakiya K, Adachi JI, Mishima K, Fujimaki T, Matsutani M, Nishikawa R, Gidding C, Schieving J, Wesseling P, Ligtenberg M, Hoogerbrugge N, Jongmans M, Crosier S, Nicholson SL, Robson K, Jacques T, Wharton S, Bown N, Michalski A, Pizer B, Clifford S, Sanden E, Visse E, Siesjo P, Darabi A, Nousome D, Lupo PJ, Scheurer ME, Nulman I, Barrera M, Maxwell C, Koren G, Gorelyshev S, Matuev K, Lubnin A, Laskov M, Lemeneva N, Mazerkina N, Khuhlaeva E, Muller K, Bruns F, Pietsch T, Rutkowski S, Kortmann RD, Krishnatry R, Shirsat N, Kunder R, Epari S, Gupta T, Kurkure P, Vora T, Arora B, Moiyadi A, Jalali R, Swieszkowska E, Dembowska-Baginska B, Drogosiewicz M, Filipek I, Perek-Polnik M, Grajkowska W, Perek D, Johnston D, Cyr J, Strother D, Lafay-Cousin L, Fryer C, Scheinemann K, Carret AS, Fleming A, Larouche V, Bouffet E, Friedrich C, Gnekow AK, Fleischhack G, Kramm CM, Fruehwald MC, Muller HL, Calaminus G, Kordes U, Faldum A, Pietsch T, Warmuth-Metz M, Kortmann RD, Jung I, Kaatsch P, Rutkowski S, Caretti V, Bugiani M, Boor I, Schellen P, Vandertop WP, Noske DP, Kaspers G, Wurdinger T, Wesseling P, Robinson G, Chingtagumpala M, Adesina A, Dalton J, Santi M, Sievert A, Wright K, Armstrong G, Boue D, Olshefski R, Scott S, Huang A, Cohn R, Gururangan S, Bowers D, Gilbertson R, Gajjar A, Ellison D, Chick E, Donson A, Owens E, Smith AA, Madden JR, Foreman NK, Bakry D, Aronson M, Durno C, Hala R, Farah R, Amayiri N, Alharbi Q, Shamvil A, Ben-Shachar S, Constantini S, Rina D, Ellise J, Keiles S, Pollet A, Qaddoumi I, Gallinger S, Malkin D, Bouffet E, Hawkins C, Tabori U, Trivedi M, Goodden J, Chumas P, Tyagi A, O'kane R, Trivedi M, Goodden J, Chumas P, Tyagi A, O'Kane R, Crimmins D, Picton S, Elliott M. EPIDEMIOLOGY. Neuro Oncol 2012. [DOI: 10.1093/neuonc/nos100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Wagner S, Benesch M, Berthold F, Gnekow AK, Rutkowski S, Sträter R, Warmuth-Metz M, Kortmann RD, Pietsch T, Wolff JEA. Secondary dissemination in children with high-grade malignant gliomas and diffuse intrinsic pontine gliomas. Br J Cancer 2006; 95:991-7. [PMID: 17047647 PMCID: PMC2360717 DOI: 10.1038/sj.bjc.6603402] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
In children, treatment regimen for high-grade gliomas (HGG) and diffuse intrinsic pontine gliomas (DIPG) are generally not stratified according to disease stage. The hypothesis was that secondary disseminating disease (SDD) in children with HGG is related to an even worse outcome. Description of SDD pattern was performed. In total, 270 children with newly diagnosed HGG or DIPG were eligible for retrospective analysis of SDD. Medical and computer records of these patients were reviewed for demographic characteristics, sites of dissemination, prognostic variables. Forty-six (17%) of the 270 patients had developed SDD. The median time to SDD was 8.2 months. The median overall survival (OS) after dissemination was 3.2 months. The SDD was located parenchymal in the supratentorial (34.8%), infratentorial (6.5%), supratentorial and infratentorial (19.6%), spinal (10.9%), spinal and cerebral (6.5%) regions of the CNS, or leptomeningeal (21.7%). For HGG patients, the median OS was shorter among patients with SDD than among patients without SDD (1.02 vs 1.41 years, P=0.0495). In the group of patients with SDD, patients with cerebrospinal fluid dissemination had a worse outcome compared with patients with parenchymal metastases. Summarising, SDD is a negative prognostic factor for patients with HGG outside the pons. Treatment stratification should be considered.
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Affiliation(s)
- S Wagner
- Department of Pediatric Hematology and Oncology, Klinik St Hedwig, University of Regensburg, Regensburg, Germany.
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Abstract
In contrary to the adult age the most common suprasellar tumors in children are with decreasing frequency craniopharyngiomas, chiasmatic/hypothalamic low-grade gliomas, germinomas and lesions attributable to a Langerhans cell histiocytosis. For differential diagnostic purposes also the rare hypothalamic hamartoma and meningeal metastases in the infundibular recess of the third ventricle are included. The typical aspects of the various tumors on computed tomography (CT) and magnetic resonance imaging (MRI) together with important clinical differences are illustrated. On the basis of imaging results and clinical symptoms differential diagnosis between the various tumor entities should be feasible in many cases. Of course, only in strictly defined cases like typical chiasmatic/hypothalamic and optic pathway gliomas or bilocular germ cell tumors a histological confirmation is dispensable.
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Gnekow AK, Kortmann RD, Pietsch T, Emser A. Low Grade Chiasmatic-Hypothalamic Glioma - Carboplatin and Vincristin Chemotherapy Effectively Defers Radiotherapy within a Comprehensive Treatment Strategy. Klin Padiatr 2004; 216:331-42. [PMID: 15565548 DOI: 10.1055/s-2004-832355] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Low grade gliomas arise in all CNS-locations and age groups, chiasmatic-hypothalamic tumors occur especially in young children. Early radiotherapy (RT) shall be deferred by chemotherapy (CT) within the concept of the HIT-LGG 1996 study, offering a comprehensive treatment strategy for all age groups. PATIENTS 198 of 905 protocol patients (21.9 %) had a chiasmatic (34), chiasmatic-hypothalamic (144) or hypothalamic (20) primary tumor, median age at diagnosis 3.6 years (0.2-16.3 y.), 54 had neurofibromatosis (27.3 %), 108 female (54.5 %). 98 children had severe visual impairment as their first symptom. The initial neurosurgical intervention resulted in 5 complete, 26 subtotal, 45 partial resections, 67 biopsies; 55 children had a diagnosis on the basis of neuroradiologic findings. Histology showed 132 pilocytic astrocytoma I degrees , 6 astrocytoma II degrees /nos and 2 DIGG/DIA I degrees (3 not known). RESULTS 82 children were treated at diagnosis, 68 upon clinical or radiological progression following observation times of 3.0 to 115.0 months. RT: 27 children received conventional (18) or interstitial (8) RT (1 not documented) at a median age of 7.3 years; 7 tumors went into further progression. At a median observation time of 50.1 months 21 tumors are stable, 3 regressive (2 not evaluable, 1 death). CT: 123 children received vincristin/carboplatin at a median age of 3.7 years. 105/123 achieved CR/PR/SD. 44/123 tumors were progressive after median 22.5 months, 37 with a chiasmatic-hypothalamic primary, 16/44 were irradiated. At a median observation time of 44.7 months 2 children are in complete remission, 92 tumors are stable, 8 regressive, 9 progressive. 4 children died, 8 are not evaluable. At 60 months overall survival of the cohort is 0.93; PFS of the CT-group is 0.61, the RT-free survival 0.83. Within the CT-group children with an age at diagnosis < 1 year and non-pilocytic histology are at increased risk for early progression. Causative factors cannot be defined, yet. CONCLUSION Within the comprehensive treatment strategy for low grade glioma HIT-LGG 1996 chemotherapy is effective to delay the need for early radiotherapy in chiasmatic-hypothalamic glioma. More effective reduction of the risk for progression has to be sought for young children < 1 year.
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Affiliation(s)
- A K Gnekow
- I. Hospital for Children and Adolescents, Augsburg.
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Abstract
BACKGROUND Childhood low-grade oligodendroglioma (WHO grade II) are rare. No controlled pediatric study has been published, to generate high level evidence for the best treatment. Therefore, we retrospectively analyzed data available from pediatric patients. PROCEDURE We pooled data from two prospective German multicentre studies (HIT-DOK and HIT-LGG). Eligibility criteria were: (1) primary neoplasm, (2) histology of pure oligodendroglioma WHO grade II, (3) intracranial location, (4) age <18 years, (5) date of diagnosis: 1990-2002, (6) observation time >6 months. The outcome was analyzed by using the SPSS-software. RESULTS Nineteen boys and 13 girls were eligible (median age 10.3 years). The tumor locations included: 26 peripheral tumors (23 cerebral hemisphere, 3 cerebellum), and 6 central tumors (4 thalamus, 1 frontal mesencephalon, 1 basal ganglia). Resections were classified as complete in 18 (14 cerebral hemispheres, 3 cerebellum, 1 thalamus) and less than complete in 14 patients (3 subtotal resections, 8 partial resections, 3 biopsy). The 5-year event-free survival (EFS) and overall survival (OS) rates of all patients were 81.3 and 84.4%, respectively (median observation time 3.8 years). All of the 26 children with peripheral tumors were alive with no tumor progression, but five of six patients with central tumors died of disease (median time to death 1.6 years). This survival difference was statistically significant for EFS (P < 0.0001) and OS (P < 0.0001). The difference between completely resected versus incompletely resected tumors was far less striking (P > 0.06). CONCLUSIONS The outcome of children with centrally located low-grade oligodendroglioma is particularly poor, while tumors of the cerebral hemispheres and cerebellum carry an excellent prognosis, even with minor tumor resection.
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Affiliation(s)
- Ove Peters
- Department of Pediatric Oncology and Hematology, St. Hedwig Children's Hospital Regensburg, Germany.
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Blohm ME, Calaminus G, Gnekow AK, Heidemann PH, Bolkenius M, Weinel P, von Schweinitz D, Ambros PF, Schneider DT, Harms D, Göbel U. Disseminated choriocarcinoma in infancy is curable by chemotherapy and delayed tumour resection. Eur J Cancer 2001; 37:72-8. [PMID: 11165132 DOI: 10.1016/s0959-8049(00)00365-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Infantile choriocarcinoma has a poor prognosis with only 2 surviving children reported in the literature. 2 additional successfully treated children are presented. 2 infants (age 3 and 4 months at diagnosis) suffering from rapidly progressive choriocarcinoma with widespread haematogenous metastases involving the liver were treated according to the cooperative germ cell tumour treatment protocol (MAKEI 96) of the German Society of Pediatric Oncology and Hematology (GPOH). PEI-chemotherapy (cisplatin, etoposide, ifosfamide; no ifosfamide before the age of 4 months) was combined with delayed tumour resection. Treatment resulted in sustained remission in both children (event-free survival 42 and 40 months). Interphase fluorescent in situ hybridisation (FISH) analysis of the paraffin-embedded tumour sample from case one revealed four to eight copies of chromosomes X, 1 and 17 and two Y chromosomes. Hybridisation with sub-telomere and centromere specific probes for chromosome 1 displayed an imbalance between the short and long arms of chromosome 1. In the tumour cells from case 2, only a polysomy of chromosome X could be proven, other aberrations were not analysed in this case for technical reasons.
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Affiliation(s)
- M E Blohm
- Heinrich Heine University Medical Center, Children's Hospital, Department of Pediatric Hematology and Oncology, Moorenstr. 5, 40225, Düsseldorf, Germany
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Gnekow AK, Kaatsch P, Kortmann R, Wiestler OD. [HIT-LGG: effectiveness of carboplatin-vincristine in progressive low-grade gliomas of childhood--an interim report]. Klin Padiatr 2000; 212:177-84. [PMID: 10994547 DOI: 10.1055/s-2000-9674] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND The rationale of the HIT-LGG protocol is to delay standard radiotherapy through administration of chemotherapy for children with progressive low grade glioma at an age under 5 years and in older children upon individual decision. PATIENTS AND METHOD Until October 10th., 1999, 402 patients from 69 hospitals were registered. 130 children with progressive tumors were treated after a median observation time of 5 months: 46 patients received primary radiotherapy and 84 primary chemotherapy. A ten week induction period with weekly Vincristine and pulses of Carboplatin at weeks 1, 4, 7 and 10 is followed by consolidation with simultaneous application of both drugs every 4 weeks until week 53. RESULTS Of 84 patients in the chemotherapy arm of the study (49 male, 35 female, 23 NF I, median age 2.99 years) 36 received treatment at diagnosis and 43 after a median observation time of 19.7 months. 94.3% achieved a clinical and neuroradiological response according to protocol criteria (5 CR, 30 PR/OR, 31 SD) after a median of 5.1 months. 4 tumors showed primary progression (9 too early, 5 not known). Only 6 of 84 children received radiation therapy for progressive disease during (2) or after termination (4) of chemotherapy, after a median delay of 25.6 months at a median age of 6.0 years. At a median observation time of 21.0 months, 6 children are in CR, 11 in PR, 48 have SD, 4 tumors are progressive and 3 children died of their tumor. (9 too early, 3 not known). PFS is at 72% after 36 months. 24 of 27 children experiencing allergic reactions to Carboplatin had to interrupt chemotherapy prematurely. CONCLUSIONS Combination therapy with Carboplatin and Vincristine can effectively delay the start of radiotherapy in children with progressive low-grade glioma. The high rate of hypersensitivity reactions has to prompt future modifications of treatment.
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Affiliation(s)
- A K Gnekow
- Klinik für Kinder und Jugendliche, KZV Augsburg.
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Seyger MM, Ritterbach J, Creutzig U, Gnekow AK, Göbel U, Graf N, Reiter A, Lampert F, Harbott J. 12q13, a new recurrent breakpoint in acute non-lymphoblastic leukemia. Cancer Genet Cytogenet 1995; 80:23-8. [PMID: 7697629 DOI: 10.1016/0165-4608(94)00157-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The karyotypes of 312 successfully analyzed samples of children with acute non-lymphoblastic leukemia (ANLL), which were sent to us by 72 German hospitals, were examined in order to find new recurrent chromosome abnormalities of possible clinical relevance. Whereas most of the patients had one of the specific aberrations of ANLL or a normal karyotype, random numerical or structural changes were found in 61 children (20%). Four of them showed an abnormality involving band 12q13: t(12;17)(q13;q21), t(12;21)(q13;q21), t(2;12)(p13;q13), and t(5;12)(p11;q13). Despite the fact that FAB subtypes were different (M0, M1 M6, AHL), the blasts of all patients were characterized by immaturity and were difficult to classify. The breakpoint 12q13 might be of clinical importance in ANLL, because the four patients in our study, as well as the 21 patients with this aberration found in the literature, had a very poor prognosis.
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Affiliation(s)
- M M Seyger
- Oncocytogenetic Laboratory, Children's Hospital, University of Giessen, Germany
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11
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Gnekow AK. Recommendations of the Brain Tumor Subcommittee for the reporting of trials. SIOP Brain Tumor Subcommittee. International Society of Pediatric Oncology. Med Pediatr Oncol 1995; 24:104-108. [PMID: 7990757 DOI: 10.1002/mpo.2950240209] [Citation(s) in RCA: 77] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Since its constitution during the 22nd annual meeting of the International Society of Pediatric Oncology in Rome in 1990, the Brain Tumor Subcommittee has worked to arrive at a consensus for reporting criteria that should be adopted when brain tumor trials are presented. This consensus is presented here concerning minimum requirements for diagnostic procedures and a systematic approach to define the extent of surgically achieved resection by a radiodiagnostic classification aided by the surgical report as well as response and remission criteria.
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Affiliation(s)
- A K Gnekow
- 1. Kinderklinik, KZVA, Augsburg, Germany
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12
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Göbel U, Bamberg M, Calaminus G, Gnekow AK, Herrmann HD, Lenard HG, Spaar HJ, Niethammer D, Kühl J, Harms D. [Improved prognosis of intracranial germ cell tumors by intensified therapy: results of the MAKEI 89 therapy protocol]. Klin Padiatr 1993; 205:217-24. [PMID: 7690863 DOI: 10.1055/s-2007-1025230] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Germ cell tumors of the central nervous system are histological identical to the extracranial tumor sites. According to the localisation germ cell tumors of the CNS are different in symptoms, diagnostic approaches, kind and location of metastases and stratification of therapy. Since 1986 patients with intracranial germ cell tumors are registered in the ongoing study for non-testicular germ cell tumors (MAKEI) of the German Society of Pediatric Oncology and Hematology, and are treated in accordance to therapy guidelines for extracranial sites. In MAKEI 89 therapy strategy was revised with a reduction of radiotherapy and an increased cumulative cisplatinum dose from 200 mg/m2 to 400 mg/m2. Patients with germinoma receive after histologic diagnosis radiotherapy consisting of 30 Gy craniospinal irradiation and 15 Gy tumorboost. Malignant non-germinoma receive after diagnosis by tumor marker in CSF and/or serum 2 courses bleomycin 15 mg/m2 day 1-3, Etoposide 150 mg/m2 day 1 + 2 and cisplatinum 20 mg/m2 days 4-8 (BEP), continued by 2 courses Vinblastine 3 mg/m2 day 1 + 2, Ifosfamide 1500 mg/m2 days 1-5 and cisplatinum 20 mg/m2 days 1-5 (VIP), followed by 30 Gy craniospinal irradiation and 20 Gy tumor boost. In teratoma first line therapy is complete resection. In incomplete resected cases adjuvant chemotherapy according to histological grading is administered. Until 31st January, 1993 101 patients (pts) were registered, containing 69 protocol pts. Diagnosis in protocol pts was teratoma in 8 cases, 2 pts died postnatal because of extended disease, 2/8 pts relapsed, but were salvaged by chemotherapy. 40 pts offered germinomas.(ABSTRACT TRUNCATED AT 250 WORDS)
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MESH Headings
- Adolescent
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/cerebrospinal fluid
- Brain Neoplasms/drug therapy
- Brain Neoplasms/mortality
- Brain Neoplasms/radiotherapy
- Brain Neoplasms/surgery
- Chemotherapy, Adjuvant
- Child
- Child, Preschool
- Chorionic Gonadotropin/cerebrospinal fluid
- Chorionic Gonadotropin, beta Subunit, Human
- Combined Modality Therapy
- Cranial Irradiation
- Dysgerminoma/drug therapy
- Dysgerminoma/mortality
- Dysgerminoma/radiotherapy
- Dysgerminoma/surgery
- Female
- Follow-Up Studies
- Humans
- Infant
- Infant, Newborn
- Male
- Neoplasms, Germ Cell and Embryonal/drug therapy
- Neoplasms, Germ Cell and Embryonal/mortality
- Neoplasms, Germ Cell and Embryonal/radiotherapy
- Neoplasms, Germ Cell and Embryonal/surgery
- Peptide Fragments/cerebrospinal fluid
- Prognosis
- Radiotherapy Dosage
- Survival Rate
- Teratoma/drug therapy
- Teratoma/mortality
- Teratoma/radiotherapy
- Teratoma/surgery
- alpha-Fetoproteins/cerebrospinal fluid
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Affiliation(s)
- U Göbel
- Universitäts-Kinderklinik Düsseldorf
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13
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Göbel U, Bamberg M, Engert J, Gnekow AK, Haas HJ, Jürgens H, Kühl J, Lenard HG, Lumenta C, Niethammer D. [Treatment of non-testicular germ cell tumors in children and adolescents with BEP and VIP: initial results of the MAKEI 89 therapy study]. Klin Padiatr 1991; 203:236-45. [PMID: 1719267 DOI: 10.1055/s-2007-1025435] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The pilot protocol of the German Society of Pediatric Oncology for treatment of non testicular germ cell tumors was initiated in November 1987. The final protocol was started at 1. 1. 89. Different therapy was administered depending on histology, primary localisation or stage of tumors. Patients with malignant germ cell tumors such as dysgerminomas, embryonal carcinomas, yolk sac tumors or chorio carcinomas received BEP (Bleomycin 15 mg/m2/days 1-3, Etoposide 100 mg/m2/days 4-8, Cisplatinum 20 mg/m2/days 4-8), followed by VIP (Vinblastine 3 mg/m2/days 1 + 2, Ifosfamide 1500 mg/m2/days 1-5 including Mesna uroprotection and Cisplatinum 20 mg/m2/days 1-5). Patients with ovary tumors of stage 1 were treated with 3 courses of BEP, patients with ovary tumors stage II and extragonadal localisation received 3 courses of VIP in addition to 3 courses of BEP. In cases of extended tumors 4 courses of BEP were followed by delayed resection of tumors and 4 courses of VIP. Patients with intracranial germinomas were treated with 30 Gy of craniospinal radiation therapy and additional 15 Gy as a tumor boost. Since some cases of spinal extension were reported a spinal radiation therapy seems to be indispensable. Patients with intracranial embryonal carcinomas, yolk sac tumors or chorio carcinomas tumors were given 2 courses of BEP and VIP followed by 30 Gy of craniospinal radiation therapy and additional 20 Gy as a tumor boost. Patients with immature teratomas of the ovary grade 1-3 and grade 3 of tumors with extragonadal localisation were treated with 3 courses of BEP after resection of tumors. Until 1. 1. 1991 92 patients were reported to the study--27 with intracranial and 65 with extracranial primary localisation of tumors. 43 patients suffered from teratomas (including 20 immature teratomas grade 1-3), 18 from germinomas (seminomas/dysgerminomas) and 31 from malignant non-seminomatous germ cell tumors. After an observation period of 29 months disease-free survival rate was 80% (79/92 patients, Kaplan-Meier Statistics). Outcome of intracranial tumors was death or relapse in 2/9 patients with malignant non-seminomatous germ cell tumors, in 2/14 patients with intracranial germinomas, in 2/4 patients with teratomas. Patients with extracranial localisation of tumors suffered from death or relapse in 1/21 cases with non-seminomatous tumors, in 0/4 cases with dysgerminomas and 5/39 cases with teratomas. During pilot study one infant with a malignant non-seminomatous germ cell tumor died of a pneumopathia. Therefore infants treated according to the final protocol did not receive Bleomycin.(ABSTRACT TRUNCATED AT 400 WORDS)
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Affiliation(s)
- U Göbel
- Universitäts-Kinderkliniken Düsseldorf
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