Abstract:
BACKGROUND:Previous pilot studies have shown the feasibility of preoperative chemotherapy in patients with medulloblastoma, but benefits and risks compared with initial surgery have not been assessed. METHODS:Two therapeutic strategies were retrospectively compared in 92 patients with metastatic medulloblastoma treated at Gustave Roussy between 2002 and 2015: surgery at diagnosis (n = 54, group A) and surgery delayed after carboplatin and etoposide-based neoadjuvant therapy (n = 38, group B). Treatment strategies were similar in both groups. RESULTS:The rate of complete tumor excision was significantly higher in group B than in group A (93.3% vs 57.4%, P = 0.0013). Postoperative complications, chemotherapy-associated side effects, and local progressions were not increased in group B. Neoadjuvant chemotherapy led to a decrease in the primary tumor size in all patients; meanwhile 4/38 patients experienced a distant progression. The histological review of 19 matched tumor pairs (before and after chemotherapy) showed that proliferation was reduced and histological diagnosis feasible and accurate even after neoadjuvant chemotherapy. The 5-year progression-free and overall survival rates were comparable between groups. Comparison of the longitudinal neuropsychological data showed that intellectual outcome tended to be better in group B (the mean predicted intellectual quotient value was 6 points higher throughout the follow-up). CONCLUSION:Preoperative chemotherapy is a safe and efficient strategy for metastatic medulloblastoma. It increases the rate of complete tumor excision and may improve the neuropsychological outcome without jeopardizing survival. KEY POINTS:1. Preoperative chemotherapy increases the rate of complete tumor removal.2. No additional risk (toxic or disease progression) is linked to the delayed surgery.3. Preoperative chemotherapy could have a positive impact on the neuropsychological outcome of patients.
journal_name
Neuro Oncoljournal_title
Neuro-oncologyauthors
Guerrini-Rousseau L,Abbas R,Huybrechts S,Kieffer-Renaux V,Puget S,Andreiuolo F,Beccaria K,Blauwblomme T,Bolle S,Dhermain F,Longaud Valès A,Roujeau T,Sainte-Rose C,Tauziede-Espariat A,Varlet P,Zerah M,Valteau-Couanet D,Ddoi
10.1093/neuonc/noaa083subject
Has Abstractpub_date
2020-11-26 00:00:00pages
1686-1695issue
11eissn
1522-8517issn
1523-5866pii
5817932journal_volume
22pub_type
杂志文章相关文献
NEURO-ONCOLOGY文献大全abstract::For gamma knife planning, 2.4-mm-slice MRIs are taken under rigid frame fixation, so tiny tumors become visible. This study evaluated differences in the numbers of brain metastases between conventional contrast-enhanced MRI (6 ± 1 mm slice thickness) taken before patient referral and contrast-enhanced MRI for gamma kn...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/noq084
更新日期:2010-11-01 00:00:00
abstract::The homeobox transcription factor OTX2 plays an essential role during embryonic brain development. It is normally silenced in the adult brain, but is overexpressed by genomic amplification or other mechanisms in the majority of medulloblastomas (MBs). Retinoic acids (RAs) can suppress OTX2 expression and inhibit MB gr...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/nop062
更新日期:2010-07-01 00:00:00
abstract::Background Nuclear factor IA (NFIA), a transcription factor and essential regulator in embryonic glial development, is highly expressed in human glioblastoma (GBM) compared with normal brain, but its contribution to GBM and cancer pathogenesis is unknown. Here we demonstrate a novel role for NFIA in promoting growth a...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/not167
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Outcomes for patients with recurrent glioblastoma multiforme (GBM) are poor and may be improved by immunotherapy. We investigated the safety and efficacy of an autologous heat-shock protein peptide complex-96 (HSPPC-96) vaccine for patients with recurrent GBM. METHODS:In this open-label, single-arm, phase I...
journal_title:Neuro-oncology
pub_type: 杂志文章,多中心研究
doi:10.1093/neuonc/not203
更新日期:2014-01-01 00:00:00
abstract::We examined DNA damage responses and repair in four human glioma cell lines (A7, U87, T98G, and U373) and normal human astrocytes (NHAs) after clinically relevant radiation doses to establish whether we could identify differences among them that might suggest new approaches to selective radiosensitization. We used pho...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1215/15228517-2007-030
更新日期:2007-10-01 00:00:00
abstract:Background:Children with brain tumors treated with cranial radiation therapy (RT) often exhibit cognitive late effects, commonly associated with reduced white matter (WM) volume and decreased neurogenesis. The impact of radiation damage in particular regions or tissues on brain development as a whole has not been eluci...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/nox211
更新日期:2018-05-18 00:00:00
abstract:BACKGROUND:Several lines of evidence suggest a T cell-mediated immune response in paraneoplastic neurological syndromes with anti-Hu antibodies (Hu-PNS). In order to investigate whether suppression of T cell-mediated immune responses in Hu-PNS patients improved their neurological outcome, we performed a prospective ope...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/nou126
更新日期:2015-01-01 00:00:00
abstract::Tobacco products are major contributors of exogenous N-nitroso compounds, a group of potent neurocarcinogens. Overall results from studies of smoking and brain tumors have been null, but have provided little information on duration, age at smoking initiation, and latency. We prospectively examined the relation between...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1215/15228517-2007-005
更新日期:2007-07-01 00:00:00
abstract:Background:Glioblastoma cell-initiated vascularization is an alternative angiogenesis called vasculogenic mimicry. However, current knowledge on the mechanism of de novo vessel formation from glioblastoma stem cells (GSCs) is limited. Methods:Sixty-four glioblastoma samples from patients and 10 fluorescent glioma xeno...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/nox016
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Glioblastomas with a specific mutation in the isocitrate dehydrogenase 1 (IDH1) gene have a better prognosis than gliomas with wild-type IDH1. METHODS:Here we compare the IDH1 mutational status in 172 contrast-enhancing glioma patients with the invasion profile generated by a patient-specific mathematical m...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/nou027
更新日期:2014-06-01 00:00:00
abstract:Background:Glioblastoma (GBM) is one of the most common, aggressive, and invasive human brain tumors. There are few reliable mechanism-based therapeutic approaches for GBM patients. The transcriptional repressor RE1 silencing transcriptional factor (REST) regulates the oncogenic properties of a class of GBM stem-like c...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/now232
更新日期:2017-04-01 00:00:00
abstract::An increase in the incidence of CNS tumors has been observed in many countries in the last decades. The reality of this trend has been much debated, as it has happened during a period when computer-assisted tomography and MRI have dramatically improved the detection of these tumors. The Gironde CNS Tumor Registry prov...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/nor120
更新日期:2011-12-01 00:00:00
abstract::Peripheral neuropathies induced by chemotherapy (CIPN) are an increasingly frequent problem. Contrary to hematologic adverse effects, which can be treated with hematopoetic growth factors, neither prophylaxis nor specific treatment is available, and only symptomatic treatment can be offered. Neurotoxic drugs are becom...
journal_title:Neuro-oncology
pub_type: 杂志文章,评审
doi:10.1093/neuonc/nos203
更新日期:2012-09-01 00:00:00
abstract::Tumor treating fields (TTFields) are low-intensity electric fields alternating at an intermediate frequency (200kHz), which have been demonstrated to block cell division and interfere with organelle assembly. This novel treatment modality has shown promise in a variety of tumor types. It has been evaluated in randomiz...
journal_title:Neuro-oncology
pub_type: 杂志文章,评审
doi:10.1093/neuonc/now182
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Cisplatin-Induced Peripheral Neuropathy (CIPN) is a frequent serious dose-dependent adverse event that can determine dosage limitations for cancer treatment. CIPN severity correlates with the amount of platinum detected in sensory neurons of the dorsal root ganglia (DRG). However, the exact pathophysiology o...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/noaa151
更新日期:2020-06-29 00:00:00
abstract:Background:Platelet-derived growth factor (PDGF) signaling is important in gliomagenesis and PDGF receptor-β is expressed on most endothelial cells in glioblastoma specimens. Methods:We report the results of feasibility, phase I, and phase II studies of tandutinib (MLN518), an orally bioavailable inhibitor of type III...
journal_title:Neuro-oncology
pub_type: 杂志文章,多中心研究
doi:10.1093/neuonc/now185
更新日期:2017-04-01 00:00:00
abstract::The Atlas of Cancer Mortality in the United States, 1950-94 (Devesa et al.) published in 1999 by the National Institutes of Health suggests that there are elevated rates of brain and other nervous system cancer in the northwestern, north central, and southeastern parts of the country. Being descriptive in nature, the ...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1215/S1152851703000450
更新日期:2004-07-01 00:00:00
abstract:Background:Molecular profile of glioblastoma multiforme (GBM) revealed 4 subtypes, 2 of which, proneural and mesenchymal, have been predominantly observed, with the latter displaying a more aggressive phenotype and increased therapeutic resistance. Single-cell RNA sequencing revealed that multiple subtypes actually res...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/now253
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:The germline genetic events underpinning medulloblastoma (MB) initiation, and therefore the ability to determine who is at risk, are still unknown for the majority of cases. Microsatellites are short repeated sequences that make up ~3% of the genome. Repeat lengths vary among individuals and are often nonran...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/noz179
更新日期:2020-01-11 00:00:00
abstract::Glial tumors with oligodendroglial components are considered chemo-responsive. Forty newly diagnosed patients (11 anaplastic oligodendrogliomas [OD] and 29 anaplastic oligoastrocytomas [OA]) were enrolled into this multicenter, open-label, single-arm Phase II trial of first-line temozolomide (200 mg/m(2) on days 1-5 e...
journal_title:Neuro-oncology
pub_type: 杂志文章,多中心研究
doi:10.1093/neuonc/nop065
更新日期:2010-05-01 00:00:00
abstract::In photodynamic diagnosis, 5-aminolevulinic acid (5-ALA) is widely used for the fluorescence-guided resection of malignant brain tumors, where 5-ALA is converted to protoporphyrin IX, which exhibits strong fluorescence. Little is known, however, about the detailed molecular mechanisms underlying 5-ALA-induced fluoresc...
journal_title:Neuro-oncology
pub_type: 杂志文章,收录出版
doi:10.1093/neuonc/nor116
更新日期:2011-11-01 00:00:00
abstract::Functional diffusion mapping (fDM) has shown promise as a sensitive imaging biomarker for predicting survival in initial studies consisting of a small number of patients, mixed tumor grades, and before routine use of anti-angiogenic therapy. The current study tested whether fDM performed before and after radiochemothe...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/nor220
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:High-grade gliomas likely remodel the metabolic machinery to meet the increased demands for amino acids and nucleotides during rapid cell proliferation. Glycine, a non-essential amino acid and intermediate of nucleotide biosynthesis, may increase with proliferation. Non-invasive measurement of glycine by mag...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/noaa034
更新日期:2020-07-07 00:00:00
abstract::Glioblastoma multiforme, a highly aggressive tumor of the central nervous system, has a dismal prognosis that is due in part to its resistance to radio- and chemotherapy. The protein kinase C (PKC) family of serine threonine kinases has been implicated in the formation and proliferation of glioblastoma multiforme. Mem...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/nor084
更新日期:2011-07-01 00:00:00
abstract:INTRODUCTION:Surgery is first-line therapy for glioblastoma, and there is evidence that gross total resection is associated with improved survival. Gross total resection, however, is not always possible, and relationships among extent (percent) of resection (EOR), residual volume (RV), and survival are unknown. The goa...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/not137
更新日期:2014-01-01 00:00:00
abstract::Treatment for newly diagnosed anaplastic oligodendroglial tumors is controversial. Radiotherapy (RT) alone and in combination with chemotherapy (CT) are the most well studied strategies. However, CT alone is often advocated, especially in cases with 1p19q codeletion. We retrospectively identified 1013 adults diagnosed...
journal_title:Neuro-oncology
pub_type: 杂志文章,多中心研究
doi:10.1093/neuonc/nor040
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:We report a phase I study to examine the pharmacokinetics, safety, and recommended dosage of weekly intravenous bolus 5-fluorouracil (5-FU) in children and young adults with recurrent ependymoma. METHODS:Patients 22 years of age or less with recurrent ependymoma were treated with bolus dosage 5-FU weekly fo...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/nov181
更新日期:2015-12-01 00:00:00
abstract::Antiangiogenic therapy is associated with increased radiographic responses in glioblastomas, but tumors invariably recur. Because tumor-associated macrophages have been shown to mediate escape from antiangiogenic therapy in preclinical models, we examined the role of macrophages in patients with recurrent glioblastoma...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/not082
更新日期:2013-08-01 00:00:00
abstract::People with neurofibromatosis 1 (NF1) have multiple benign neurofibromas and a 10% lifetime risk of developing malignant peripheral nerve sheath tumors (MPNSTs). Most MPNSTs develop from benign plexiform neurofibromas, so the burden of benign tumors may be a risk factor for developing MPNST. We studied 13 NF1 patients...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1215/15228517-2008-011
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND:EORTC study 22033-26033 showed no difference in progression-free survival between high-risk low-grade glioma receiving either radiotherapy (RT) or Temozolomide (TMZ) chemotherapy alone as primary treatment. Considering the potential long-term deleterious impact of radiotherapy on memory functioning, this stu...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/noaa252
更新日期:2020-11-01 00:00:00