Diffuse brainstem gliomas in children. A nightmare for a paediatric oncologist.

Česká verzia

Authors: Z. Pavelka ¹; K. Zitterbart ¹; T. Pavlík ²; L. Křen ³; M. Votava ⁴; J. Ventruba ⁵; E. Brichtová ⁵; J. Skotáková ⁶; P. Šlampa ⁷; H. Ošlejšková ⁸
Authors place of work: Klinika dětské onkologie LF MU a FN Brno-PDM ¹; Institut biostatistiky a analýz PřF MU a LF MU Brno ²; Ústav patologie LF MU a FN Brno-PMDV ³; Ústav soudního lékařství LF MU a FN U sv. Anny v Brně ⁴; Neurochirurgické oddělení, KDCHOaT LF MU a FN Brno-PDM ⁵; Klinika dětské radiologie LF MU a FN Brno-PDM ⁶; Klinika radiační onkologie, Masarykův onkologický ústav, Brno ⁷; Klinika dětské neurologie, LF MU a FN Brno-PDM ⁸
Published in the journal: Cesk Slov Neurol N 2008; 71/104(1): 41-46
Category: Přehledný referát

Summary

Children with diffuse brainstem gliomas represent the cathegory of patients with extremly poor prognosis. Their diagnosis is based upon typical magnetic resonance imaging, histological confirmation is usually not required. Radiotherapy has been essential and the only accepted treatment modality, but it only extends progression free survival. The role for chemotherapy is unclear an it has been a part of investigational studies. Less then 10% of children with diffuse brainstem gliomas survive 2 years. These children are the ideal cancidates for new therapeutic strategies.

Key words:
difusse brainstem glioma, chemotherapy, radiotherapy, prognosis

Zdroje

1) Gupta N, Banerjee A, Hass-Kogan D. Pediatric CNS tumors. Berlin (Germany): Springer 2004.

2) Walker DA, Perilongo G, Punt Jonathan AG, Taylor RE. Brain and spinal tumors of childhood. London: Arnold 2004.

3) Kleihues P, Cavanee WK. Pathology and genetics of tumors of the nervous system. Lyon: International Agency for Research on Cancer (IARC) Press 2000.

4) Rickert CH, Paulus W. Epidemiology of central nervous system tumors in childhood and adolescence based on the new WHO classification. Childs Nerv Syst 2001; 17(9): 503–511.

5) Sure U, Ruedi D, Tachibana O, Yonekawa Y, Ohgaki H, Kleihues P et al. Determination of p53 mutations, EGFR overexpression, and loss of p16 expression in pediatric glioblastomas. J Neuropathol Exp Neurol 1997; 56(7): 782-789.

6) Pollack IF, Finkelstein SD, Woods J, Burnham J, Holme EJ, Hamilton RL et al. Expression of p53 and prognosis in children with malignant gliomas. N Engl J Med 2002; 346(6): 420-427.

7) Gilbertson RJ, Hill DA, Hernan R, Kocak M, Geyer R, Olson J, et al. ERBB1 is amplified and overexpressed in high-grade diffusely infiltrative pediatric brain stem glioma. Clin Cancer Res 2003; 9: 3620-3624.

8) Finlay JL, Zacharoulis S. The treatment of high grade gliomas and diffuse intrinsic pontine tumors of childhood and adolescence: a historical – and futuristic – prespective. J Neurooncol 2005; 75(3): 253-266.

9) Lesniak MS, Klem JM, Weingart J, Carson BS Sr. Surgical outcome following resection of contrast-enhanced pediatric brainstem gliomas. Pediatr Neurosurg 2003; 39(6): 314-322.

10) Albright AL, Packer RJ, Zimmerman R, Rorke LB, Boyett J, Hammond GD. Magnetic resonance scans should replace biopsies for the diagnosis of diffuse brain stem gliomas: a report from the Children’s Cancer Group. Neurosurgery 1993; 33(6): 1026-1029.

11) Pincus DW, Richter EO, Yachnis AT, Bennet J, Bhatti MT, Smith A. Brainstem stereotactic biopsy sampling in children. J Neurosurg 2006; 104(2 Suppl): 108-114.

12) Molloy PT, Bilaniuk LT, Vaughan SN, Needle MN, Liu GT, Zackai EH et al. Brainstem tumors in patients with neurofibromatosis type 1: a distinct clinical entity. Neurology 1995; 45(10): 1897-1902.

13) Pollack IF, Hamilton RL, Burnham J, Holmes EJ, Finkelstein SD, Sposto R et al. Impact of proliferation index on outcome in childhood malignant gliomas: results in a multi-institutional cohort. Neurosurgery 2002; 50(6): 1238-1244.

14) Freeman CR, Farmer JP. Pediatric brainstem gliomas: a review. Int J Radiat Oncol Biol Phys 1998, 40(2): 265–271.

15) Freeman CR. Hyperfractionated radiotherapy for diffuse intrinsic brain stem tumors in children. Pediatr Neurosurg 1996; 24: 103-10.

16) Mandell LR, Kadota R, Freeman C, Douglass EC, Fontanesi J, Cohen ME et al. There is no role for hyperfractionated radiotherapy in the management of children with newly diagnosed diffuse intrinsic brainstem tumors: results of a Pediatric Oncology Group phase III trial comparing conevtional vs. hyperfractionated radiotherapy. Int J Radiat Biol Phys 1999; 43: 959-964.

17) Freeman CR, Perilongo G. Chemotherapy for brainstem gliomas. Childs Nerv Syst 1999; 15: 545–553.

18) Childrensoncologygroup.org [homepage on the Internet]. Available from: http://members.childrensoncologygroup.org/protocols/.

19) Broniscer A, Leite CC, Lanchote VL, Machado TM, Cristofani LM. Radiation therapy nad high-dose tamoxifen in the treatment of patients with diffuse brainstem gliomas: results of a Brazilian cooperative study. Brainstem Glioma Cooperative Group. J Clin Oncol 2000; 18: 1246–1253.

20) Walter AW, Gajjar A, Ochs JS, Langston JW, Sanford RA, Kun LE et al. Carboplatin and etoposide with hyperfractionated radiotherapy in children with newly diagnosed diffuse pontine gliomas: a phase I/II study. Med Pediatr Oncol 1998; 30: 28–33.

21) Bouffet E, Raquin M, Doz F, Gentet JC, Radary C, Demeocq F et al. Radiotherapy followed by high dose busulfan and thiotepa: a prospective assessment of high dose chemotherapy in children with diffuse pontine gliomas. Cancer 2000; 88: 685–692.

22) Sposto R, Ertel IJ, Jenkin RD, Boesel CP, Venes JL, Ortega JA et al. The effectiveness of chemotherapy for treatment of high grade astrocytoma in children: results of a randomized trial. A report from the Children’s Cancer Study Group. J Neurooncol 1989; 7: 165-177.

23) Freeman CR, Kepner J, Kun LE, Sanford RA, Kadota R, Mandell L et al. A detrimental effect of a combined chemotherapy-radiotherapy approach in children with diffuse intrinsic brainstem gliomas? Int J Radiat Oncol Biol Phys 2000; 47: 561–564.

24) Sterba J, Pavelka Z, Slampa P. Concomitant radiotherapy and metronomic temozolomide in pediatric high-risk brain tumors. Neoplasma 2002; 49(2): 117-120.

25) Packer RJ, Prados M, Phillips P, Nicholson HS, Boyett JM, Goldwein J et al. Treatment of children with newly diagnosed brainstem gliomas with intravenous recombinant beta-interferon and hyperfractionated radiation therapy: a Children´s Cancer Group phase I/II study. Cancer 1996; 77: 2150–2156.

26) Bello L, Carrabba G, Giussani C, Lucini V, Cerutti F, Scaglione F et al. Low-dose chemotherapy combined with an antiangiogenic drug reduces human glioma growth in vivo. Cancer Res 2001; 61(20): 7501-7506.

27) Fine HA, Figg WD, Jaeckle K, Wen PY, Kyritsis AP, Loeffler JS et al. Phase II trial of the angiogenic agent thalidomide in patients with recurrent high-grade gliomas. J Clin Oncol 2000; 18 (4): 708-715.

28) Joki T, Heese O, Nikas DC, Bello L, Zhang J, Kraeft SK et al. Expression of cyclooxygenase 2 (COX-2) in human glioma and in vitro inhibition by a specific COX-2 inhibitor, NS-398. Cancer Res 2000; 60 (17): 4926-4931.

29) Heimberger AB, Learn CA, Archer GE, McLendon RE, Chewning TA, Tuck FL et al. Brain tumors in mice are susceptible to blockade of Epidermal Growth Factor Receptor (EGFR) with the oral, specific, EGFR-Tyrosine Kinase Inhibitor ZD1839 (Iressa). Clin Cancer Res 2002; 8 (11): 3496-3435.

30) Fisher MJ, Adamson PC. Anti-angiogenic agents for the treatment of brain tumors. Neuroimaging Clin N Am 2002; 12 (4): 477-499.

31) Rutkowski S, De Vleeschouwer S, Kaempgen E, Wolff JE, Kuhl J, Demaerel P et al. Surgery and adjuvant dendritic cell/based tumour vaccination for patiens with relapsed malignant glioma, a feasibility study. Br J Cancer 2004; 91(9): 1656-1662.

32) Sterba J, Valik D, Mudry P, Kepak T, Pavelka Z, Bajciova V et al. Combined oral metronomic biodifferentiating and antiangiogenic therapy is feasible and clinically effective in relapsed solid tumors: Single institution pilot study of oral salvage/maintenance therapy for relapsed, primary refractory or very high-risk solid tumors in children. Karger Onkologie 2006; 29(7): 308-313.