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First Clinical Report of the Intraoperative Macro- and Micro-Photodiagnosis and Photodynamic Therapy Using Talaporfin Sodium for a Patient with Disseminated Lumbar Medulloblastoma. J Clin Med 2023; 12:jcm12020432. [PMID: 36675360 PMCID: PMC9867022 DOI: 10.3390/jcm12020432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/26/2022] [Accepted: 12/30/2022] [Indexed: 01/07/2023] Open
Abstract
Photodiagnosis (PD) and photodynamic therapy (PDT) using the second-generation photosensitizer talaporfin sodium together with an exciting laser for primary intracranial malignant tumors is well recognized in Japan, and many medical institutions are introducing this new therapeutic option. In particular, intraoperative PDT using talaporfin sodium for infiltrating tumor cells in the cavity walls after the resection of malignant glioma is now covered by health insurance after receiving governmental approvement, and this method has been recommended in therapeutic guidelines for primary malignant brain tumors in Japan. On the other hand, experimental and clinical studies on the development of novel therapeutic strategies for malignant spinal cord tumors have not been reported to date, although their histological features are almost identical to those of intracranial malignant tumors. Therefore, the clinical outcomes of malignant spinal cord tumors have been less favorable than those of malignant brain tumors. In this report, we performed the PD and PDT using talaporfin sodium on a patient with a metastatic lumbar lesion that was detected on magnetic resonance image (MRI) 50 months after the resection of cerebellar medulloblastoma who presented with lumbago and sciatica. We were able to detect the target lesion in the conus medullaris using a surgical microscope, and detected the disseminated medulloblastoma cells floating in the cerebrospinal fluid using a compact fluorescence microscope. Furthermore, we performed PDT to the resected lumbar lesion with the adjuvant platinum-based chemotherapy, and the patient survived a meaningful life for more than 2 years after the lumbar surgery. This report describes the first case of a human patient in whom the efficacy of PD and PDT was demonstrated for a malignant spinal cord tumor.
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Animasawun RK, Taresco V, Swainson SME, Suksiriworapong J, Walker DA, Garnett MC. Screening and Matching Polymers with Drugs to Improve Drug Incorporation and Retention in Nanoparticles. Mol Pharm 2020; 17:2083-2098. [PMID: 32348676 DOI: 10.1021/acs.molpharmaceut.0c00236] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Key challenges hindering the clinical translation of the use of nanoparticles (NP) for delivery of drugs to tumors are inadequate drug loading and premature drug release. This study focused on understanding the conditions required to produce nanoparticles that can reach their target site with sufficient drug loading and drug retention for effective pharmacological action. Etoposide, etoposide phosphate, and teniposide were screened against modified poly(glycerol) adipate (PGA) based polymers by monitoring drug release from 40% drug in polymer films and using Fourier transform infrared spectroscopy (FTIR) and contact angle measurements to help understand the release results. Polymers were matched with the specific drugs based on the interactions observed. NP were then prepared by an interfacial deposition method. NPs were characterized and resulted in drug loadings ranging from 3.5% and 5%, respectively, for etoposide phosphate and etoposide with PGA modified with stearate (PGA85%C18) up to 13.4% for teniposide with PGA modified with tryptophan (PGA50%Try) and drug release of just 22-35% over 24 h. Assessment of cytotoxicity showed that etoposide nanoparticles with PGA85%C18 were more potent than an equivalent amount of free drug. This screening method to match polymers to drugs to monitor based drug and polymer interactions thus resulted in the formulation of nanoparticles with higher drug loading and slower release and potential for further development for clinical applications.
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Affiliation(s)
- Rashidat K Animasawun
- Division of Molecular Therapeutics and Formulation, School of Pharmacy, University of Nottingham, University Park, Nottingham, NG7 2RD, United Kingdom
| | - Vincenzo Taresco
- School of Chemistry, University of Nottingham, Nottingham NG7 2RD, United Kingdom
| | - Sadie M E Swainson
- Division of Molecular Therapeutics and Formulation, School of Pharmacy, University of Nottingham, University Park, Nottingham, NG7 2RD, United Kingdom
| | - Jiraphong Suksiriworapong
- Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok 10400, Thailand.,Center of Excellence in Innovative Drug Delivery and Nanomedicine, Faculty of Pharmacy, Mahidol University, 447 Sri-Ayudhaya Road, Ratchathewi, Bangkok 10400, Thailand
| | - David A Walker
- Children's Brain Tumour Research Centre, University of Nottingham, Nottingham, NG7 2RD, United Kingdom
| | - Martin C Garnett
- Division of Molecular Therapeutics and Formulation, School of Pharmacy, University of Nottingham, University Park, Nottingham, NG7 2RD, United Kingdom
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Murase M, Saito K, Abiko T, Yoshida K, Tomita H. Medulloblastoma in Older Adults: A Case Report and Literature Review. World Neurosurg 2018; 117:25-31. [PMID: 29883827 DOI: 10.1016/j.wneu.2018.05.216] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 05/28/2018] [Accepted: 05/29/2018] [Indexed: 10/14/2022]
Abstract
BACKGROUND Medulloblastoma is a malignant tumor of the posterior fossa and is predominantly seen in children younger than 15 years of age. This tumor is uncommon in adults, especially those older than 40 years of age, and reports of cases in patients older than 60 years of age are particularly rare. Although surgery and radiotherapy play important roles in treatment of medulloblastoma in adults, addition of chemotherapy is controversial, especially prior to radiotherapy. CASE DESCRIPTION We present a case of a 63-year-old woman with an atypical medulloblastoma in the cerebellum and a lesion in the suprasellar area that did not appear to be a metastasis of the medulloblastoma. The patient underwent a subtotal resection of the cerebellar medulloblastoma, which was classified histologically as classic subtype and molecularly as non-Wingless/non-Sonic hedgehog subtype in World Health Organization 2016 classification. Then she underwent postoperative chemotherapy followed by radiotherapy. We administered chemotherapy to facilitate therapeutic diagnosis of the suprasellar lesion. The combination treatment resulted in the disappearance of the cerebellar medulloblastoma with treatment toxicity well tolerated. Additionally, the suprasellar lesion remains under control. CONCLUSIONS Even in adults over 60 years of age, medulloblastoma should be included in the differential diagnosis of a cerebellar mass. Chemotherapy for adult medulloblastoma has the potential to be efficacious and tolerable.
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Affiliation(s)
- Makoto Murase
- Department of Neurosurgery, Ashikaga Red Cross Hospital, Ashikaga-shi, Tochigi, Japan.
| | - Katsuya Saito
- Department of Neurosurgery, Ashikaga Red Cross Hospital, Ashikaga-shi, Tochigi, Japan
| | - Tomohiro Abiko
- Department of Neurosurgery, Ashikaga Red Cross Hospital, Ashikaga-shi, Tochigi, Japan
| | - Kazunari Yoshida
- Department of Neurosurgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Hideyuki Tomita
- Department of Neurosurgery, Ashikaga Red Cross Hospital, Ashikaga-shi, Tochigi, Japan
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Yoon JH, Park KD, Kang HJ, Kim H, Lee JW, Kim SK, Wang KC, Park SH, Kim IH, Shin HY. Treatment of pediatric average-risk medulloblastoma using craniospinal irradiation less than 2500 cGy and chemotherapy: single center experience in Korea. World J Pediatr 2017; 13:367-373. [PMID: 28550392 DOI: 10.1007/s12519-017-0044-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 09/30/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND Although craniospinal irradiation (CSI) of 2340 cGy plus tumor booster with chemotherapy have been established as a standard treatment of childhood average-risk (AvR) medulloblastoma (MBL) in Western counties, there are a few recent reports in outcomes of AvR MBL using this strategy in Korean and other Asian children. We investigated the outcome of the Korean children with AvR MBL who were treated with CSI <2500 cGy and chemotherapy. METHODS Between January 2001 and December 2010, clinical characteristics and outcomes of 42 patients who were diagnosed with AvR MBL postoperatively and treated with radiation including CSI <2500 cGy and chemotherapy in Seoul National University Children's Hospital were analyzed. RESULTS Their median age was 9 years (range: 3-18.8), and 29 were male. Histological subtypes were classic type in 28 patients, nodular/desmoplastic in 7, and large cell/anaplastic (LCA) in 7. All the patients received adjuvant radiotherapy (CSI with median 2340 cGy and booster) and multiagent chemotherapy as the first-line treatment. With a median follow-up of 54 months, 12 patients experienced relapse or progression of the tumor. The 3- and 5-year disease-free survival (DFS) rates were 78.0%±6.5% and 75.0%±6.9%, respectively, and overall survival (OS) rates were 85.3%±5.6% and 76.8%±6.9%, respectively. The LCA subtype was associated with poorer DFS (P=0.023) and OS (P=0.008), compared with non-LCA subtypes. CONCLUSIONS The outcomes of children and adolescents with AvR MBL treated with radiation including CSI <2500 cGy and chemotherapy, are compatible to those in Western countries; however, the LCA subtype has a poor outcome with this strategy.
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Affiliation(s)
- Jong Hyung Yoon
- Department of Pediatrics, Cancer Research Institute, New York, USA.,Department of Pediatrics, Hallym University College of medicine, Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Kyung Duk Park
- Department of Pediatrics, Cancer Research Institute, New York, USA
| | - Hyoung Jin Kang
- Department of Pediatrics, Cancer Research Institute, New York, USA
| | - Hyery Kim
- Department of Pediatrics, Cancer Research Institute, New York, USA
| | - Ji Won Lee
- Department of Pediatrics, Cancer Research Institute, New York, USA
| | - Seung-Ki Kim
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kyu-Chang Wang
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea
| | - Sung-Hye Park
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Il Han Kim
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea
| | - Hee Young Shin
- Department of Pediatrics, Cancer Research Institute, New York, USA. .,Division of Hematology/Oncology, Department of Pediatrics, Seoul National University College of Medicine, Seoul National University Children's Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.
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Srinivasan VM, Ghali MGZ, North RY, Boghani Z, Hansen D, Lam S. Modern management of medulloblastoma: Molecular classification, outcomes, and the role of surgery. Surg Neurol Int 2016; 7:S1135-S1141. [PMID: 28194300 PMCID: PMC5299153 DOI: 10.4103/2152-7806.196922] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Accepted: 10/14/2016] [Indexed: 12/20/2022] Open
Affiliation(s)
- Visish M Srinivasan
- Department of Neurosurgery, Baylor College of Medicine, Texas Children's Hospital, Texas, USA
| | - Michael G Z Ghali
- Department of Neurobiology, Drexel University College of Medicine, Philadelphia, USA
| | - Robert Y North
- Department of Neurosurgery, Baylor College of Medicine, Texas Children's Hospital, Texas, USA
| | - Zain Boghani
- Department of Neurosurgery, Baylor College of Medicine, Texas Children's Hospital, Texas, USA
| | - Daniel Hansen
- Department of Neurosurgery, Baylor College of Medicine, Texas Children's Hospital, Texas, USA
| | - Sandi Lam
- Department of Neurosurgery, Baylor College of Medicine, Texas Children's Hospital, Texas, USA
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Wong TT, Liu YL, Ho DMT, Chang KP, Liang ML, Chen HH, Lee YY, Chang FC, Lin SC, Hsu TR, Chen KW, Kwang WK, Hou WY, Wang CY, Yen SH, Guo WY, Chen YW. Factors affecting survival of medulloblastoma in children: the changing concept of management. Childs Nerv Syst 2015; 31:1687-98. [PMID: 26351222 DOI: 10.1007/s00381-015-2884-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 08/10/2015] [Indexed: 01/21/2023]
Abstract
Medulloblastoma (MB) is a type of malignant tumor arising only in the cerebellum that was first defined by Cushing and Bailey in 1920s. In this review paper, we trace the evolution of risk stratification and the correlated changing concept of management in the past years. Outcome analysis of the hospital series of the Taipei Veterans General Hospital, Cheng Hsin General Hospital, and Taipei Medical University Hospital was performed to correlate prognostic indicators with reported studies. The purpose is to provide clues for age-specific and risk-adjusted optimal, effective, but beneficial and protective treatment strategies of these tumors in children.
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Affiliation(s)
- Tai-Tong Wong
- Department of Neurosurgery, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital and National Yang Ming University, School of Medicine, Taipei, Taiwan.
- Pediatric Neurosurgery, Department of Neurosurgery, Taipei Medical University Hospital, 252 Wuxing St, Taipei, 11031, Taiwan.
| | - Yen-Lin Liu
- Department of Pediatrics, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
- National Taiwan University and Academia Sinica, Taipei, Taiwan
| | - Donald Ming-Tak Ho
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital and National Yang Ming University, School of Medicine, Taipei, Taiwan
| | - Kai-Ping Chang
- Department of Pediatrics, Taipei Veterans General Hospital and National Yang Ming University, School of Medicine, Taipei, Taiwan
| | - Muh-Lii Liang
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital and National Yang Ming University, School of Medicine, Taipei, Taiwan
| | - Hsin-Hung Chen
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital and National Yang Ming University, School of Medicine, Taipei, Taiwan
| | - Yi-Yen Lee
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital and National Yang Ming University, School of Medicine, Taipei, Taiwan
| | - Feng-Chi Chang
- Department of Radiology, Taipei Veterans General Hospital and National Yang Ming University, School of Medicine, Taipei, Taiwan
| | - Shih-Chieh Lin
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital and National Yang Ming University, School of Medicine, Taipei, Taiwan
| | - Ting-Rong Hsu
- Department of Pediatrics, Taipei Veterans General Hospital and National Yang Ming University, School of Medicine, Taipei, Taiwan
| | - Kuo-Wei Chen
- Department of Internal Medicine, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Wei-Kang Kwang
- Department of Pathology, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Wu-Yu Hou
- Department of Radiology, Chen Hsin General Hospital, Taipei, Taiwan
| | - Chung-Yih Wang
- Department of Radiation Oncology, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Sang-Hue Yen
- Department of Neurosurgery, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
| | - Wan-You Guo
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital and National Yang Ming University, School of Medicine, Taipei, Taiwan
| | - Yi-Wei Chen
- Department of Oncology, Taipei Veterans General Hospital and National Yang Ming University, School of Medicine, 201 Sec 2 Shi Pai Rd, Taipei, 11217, Taiwan.
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Hirano E, Fuji H, Onoe T, Kumar V, Shirato H, Kawabuchi K. Cost-effectiveness analysis of cochlear dose reduction by proton beam therapy for medulloblastoma in childhood. JOURNAL OF RADIATION RESEARCH 2014; 55:320-7. [PMID: 24187330 PMCID: PMC3951074 DOI: 10.1093/jrr/rrt112] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND The aim of this study is to evaluate the cost-effectiveness of proton beam therapy with cochlear dose reduction compared with conventional X-ray radiotherapy for medulloblastoma in childhood. METHODS We developed a Markov model to describe health states of 6-year-old children with medulloblastoma after treatment with proton or X-ray radiotherapy. The risks of hearing loss were calculated on cochlear dose for each treatment. Three types of health-related quality of life (HRQOL) of EQ-5D, HUI3 and SF-6D were used for estimation of quality-adjusted life years (QALYs). The incremental cost-effectiveness ratio (ICER) for proton beam therapy compared with X-ray radiotherapy was calculated for each HRQOL. Sensitivity analyses were performed to model uncertainty in these parameters. RESULTS The ICER for EQ-5D, HUI3 and SF-6D were $21 716/QALY, $11 773/QALY, and $20 150/QALY, respectively. One-way sensitivity analyses found that the results were sensitive to discount rate, the risk of hearing loss after proton therapy, and costs of proton irradiation. Cost-effectiveness acceptability curve analysis revealed a 99% probability of proton therapy being cost effective at a societal willingness-to-pay value. CONCLUSIONS Proton beam therapy with cochlear dose reduction improves health outcomes at a cost that is within the acceptable cost-effectiveness range from the payer's standpoint.
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Affiliation(s)
- Emi Hirano
- Tokyo Medical and Dental University, Faculty of Dentistry, School of Dentistry, 1-5-45 Yushima, Bunkyou-ku, Tokyo, 113-8510 Japan
| | - Hiroshi Fuji
- Shizuoka Cancer Center, 1007 Shiomonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka-pref. 411-8777, Japan
- Corresponding author. Shizuoka Cancer Center, 1007 Shiomonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka-pref. 411-8777, Japan. Tel: +81-55-989-5222; Fax: +81-55-989-5634;
| | - Tsuyoshi Onoe
- Shizuoka Cancer Center, 1007 Shiomonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka-pref. 411-8777, Japan
| | - Vinay Kumar
- All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Hiroki Shirato
- Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-0808, Japan
| | - Koichi Kawabuchi
- Tokyo Medical and Dental University, Faculty of Dentistry, School of Dentistry, 1-5-45 Yushima, Bunkyou-ku, Tokyo, 113-8510 Japan
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Cooling L, Bombery M, Hoffmann S, Davenport R, Robertson P, Levine JE. The impact of recent vincristine on human hematopoietic progenitor cell collection in pediatric patients with central nervous system tumors. Transfusion 2014; 54:2004-14. [PMID: 24527786 DOI: 10.1111/trf.12574] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 12/12/2013] [Accepted: 12/16/2013] [Indexed: 01/01/2023]
Abstract
BACKGROUND Central nervous system (CNS) malignancies represent 20% of all childhood cancers. To improve outcomes in infants and children with high-risk disease, treatment can include adjuvant chemotherapy and early autologous peripheral blood human progenitor cell collection (AHPCC), followed by high-dose chemotherapy and stem cell rescue. In many protocols, postoperative chemotherapy includes the administration of weekly vincristine (VCR) between induction chemotherapy cycles, regardless of scheduled AHPCC. We observed anecdotal AHPCC failures in children receiving midcycle VCR (MC-VCR). STUDY DESIGN AND METHODS The study was an 8-year retrospective chart review of all children with a CNS malignancy and who underwent AHPCC. Information included patient demographic and clinical data, mobilization regimen, VCR administration, product yields, infusion toxicity, and patient charges. Data were analyzed relative to MC-VCR administration. Graphics and statistical analysis (t-test, chi-square, linear regression) were performed with commercial software. RESULTS Twenty-four patients and 47 AHPCCs were available for analysis. Nine patients (37%) received MC-VCR within 7 days of scheduled AHPCC. MC-VCR was associated with delayed marrow recovery (17.9 days vs. 14.9 days, p=0.0012), decreased median peripheral CD34 counts (75 × 10(6) CD34/L vs. 352 × 10(6) CD34/L, p=0.03), decreased median CD34 yields (2.4 × 10(6) CD34/L vs. 17.8 × 10(6) CD34/kg, p=0.08), more AHPCCs per mobilization (2.9 vs. 1.1, p=0.01), and an increased rate of remobilization (33% vs. 6%). Mean patient charges were 2.5× higher in patients receiving MC-VCR than controls (p=0.01). CONCLUSION MC-VCR should be withheld before scheduled AHPCC to optimize CD34 collection.
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Affiliation(s)
- Laura Cooling
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
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Kawaguchi T, Kumabe T, Saito R, Kanamori M, Yamashita Y, Sonoda Y, Tominaga T. Clinical significance and limitations of repeat resection for pediatric malignant neuroepithelial tumors: clinical article. J Neurosurg Pediatr 2013; 12:309-16. [PMID: 23889352 DOI: 10.3171/2013.6.peds12606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Maximized tumor resection and minimized surgical morbidity are extremely important in the treatment of children with malignant neuroepithelial tumors. However, the indications for repeat surgery for these tumors remain unclear. The present study investigated the clinical significance and limitations of repeat resection for these tumors. METHODS This study included 61 consecutive pediatric patients with malignant neuroepithelial tumor, histologically diagnosed as WHO Grades III and IV. All patients were initially treated between January 1997 and March 2011 and had follow-up of more than 2 years. The number of surgeries, presence of leptomeningeal dissemination, survival, WHO grade, and Eastern Cooperative Oncology Group performance status before and after surgery were retrospectively reviewed. RESULTS Repeat resections were performed for 21 patients (34.4%). Eastern Cooperative Oncology Group performance status was not aggravated by surgery, even after multiple operations. The 5-year survival rates of patients who received single and repeat surgery were 58.6% and 38.7%, respectively (p = 0.12). The mean interval between initial surgery and leptomeningeal dissemination detection was 331 ± 108 days in the single-surgery group and 549 ± 122 days in the repeat-surgery group (p = 0.19). The median survival time after leptomeningeal dissemination was 580 days in the single-surgery group and 890 days in the repeat-surgery group (p = 0.74). CONCLUSIONS Repeat resection with minimized surgical morbidity is an effective method to achieve better local control of pediatric malignant neuroepithelial tumors. Leptomeningeal dissemination was a leading cause of death, but repeat surgery did not increase the frequency of death.
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Affiliation(s)
- Tomohiro Kawaguchi
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
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Clement J, Varlotto J, Rybka W, Frauenhoffer E, Drabick JJ. Unusual case of recurrent extraneural metastatic medulloblastoma in a young adult: durable complete remission with Ewing sarcoma chemotherapy regimen and consolidation with autologous bone marrow transplantation and local radiation. J Clin Oncol 2013; 31:e316-9. [PMID: 23715566 DOI: 10.1200/jco.2012.42.6700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Jincy Clement
- Department of Internal Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA.
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Mahmood M, Xu Y, Dantuluri V, Mustafa T, Zhang Y, Karmakar A, Casciano D, Ali S, Biris A. Carbon nanotubes enhance the internalization of drugs by cancer cells and decrease their chemoresistance to cytostatics. NANOTECHNOLOGY 2013; 24:045102. [PMID: 23291321 DOI: 10.1088/0957-4484/24/4/045102] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Etoposide is a semisynthetic, chemotherapeutic drug widely recommended to treat an extensive range of human cancers. Our studies indicate that, while etoposide is capable of killing human cancer cells, exposure to single-walled carbon nanotubes (SWCNTs) and etoposide results in enhanced cell death that appears to be synergistic and not merely additive. In this study, we used high pressure liquid chromatography and mass spectrometry to quantify the internal effective dose of etoposide when the human pancreatic cancer cell (PANC-1) was exposed to the combination of these agents. Our results unequivocally indicate that SWCNTs improve etoposide uptake and increase its capacity to kill cancer cells. We suggest that a combination of SWCNTs and etoposide may prove to be a more efficient chemotherapeutic protocol, especially because of the potential to lower toxic drug doses to levels that may be useful in decreasing adverse side effects, as well as in lowering the probability of inducing chemoresistance in exposed cancer cells.
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Affiliation(s)
- M Mahmood
- Nanotechnology Center, University of Arkansas at Little Rock, 2801 S. University Ave, Little Rock, AR 72204, USA
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Ito A, Kumabe T, Saito R, Sonoda Y, Watanabe M, Nakazato Y, Tominaga T. Malignant pediatric brain tumor of primitive small round cell proliferation with bland-looking mesenchymal spindle cell elements. Brain Tumor Pathol 2012; 30:109-16. [PMID: 22684841 DOI: 10.1007/s10014-012-0106-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Accepted: 05/22/2012] [Indexed: 11/29/2022]
Abstract
It is often difficult to classify rare malignant pediatric mixed brain tumors composed of mesenchymal elements. A 6-year-old boy presented to our hospital with a left frontal massive tumor manifesting as complaints of rapidly progressive right hemiparesis and motor aphasia over 2 weeks. Computed tomography showed a left frontal mass with thick calcification. Magnetic resonance imaging revealed an enhanced lesion with perifocal edema and mass effect. Total removal of the tumor was performed. Histological examination of the resected tumor revealed an anaplastic malignant small round cell component with a bland-looking mesenchymal spindle cell component. The patient was treated with irradiation to the whole craniospinal axis and a boost to the tumor bed, followed by chemotherapy consisting of ifosfamide, cisplatin, and etoposide, resulting in good control without local recurrence or metastasis at 2 years. A combined malignant tumor composed of ectodermal and mesenchymal components is generally named malignant ectomesenchymoma (MEM). The more malignant part of MEM is the mesenchymal component in most cases. In the present case, the more malignant component was not the mesenchymal component, but the small round cells.
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Affiliation(s)
- Akira Ito
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
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