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02.08.2019 | Original Article

Subgroup-specific outcomes of children with malignant childhood brain tumors treated with an irradiation-sparing protocol

verfasst von: Eveline Teresa Hidalgo, Matija Snuderl, Cordelia Orillac, Svetlana Kvint, Jonathan Serrano, Peter Wu, Matthias A. Karajannis, Sharon L. Gardner

Erschienen in: Child's Nervous System | Ausgabe 1/2020

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Abstract

Purpose

Molecular subgroups of pediatric brain tumors associated with divergent biological, clinical, and prognostic features have been identified. However, data regarding the impact of subgroup affiliation on the outcome of children with malignant brain tumors treated with radiation-sparing protocol is limited. We report long-term clinical outcomes and the molecular subgroups of malignant brain tumors in young children whose first-line treatment was high-dose chemotherapy without irradiation.

Methods

Tumor subclassification was performed using the Illumina HumanMethylation450 BeadChip (450k) genome-wide methylation array profiling platform. Clinical information was obtained from chart review.

Results

Methylation array profiling yielded information on molecular subgroups in 22 children. Median age at surgery was 26 months (range 1–119 months). Among medulloblastomas (MB), all 6 children in the infant sonic hedgehog (SHH) subgroup were long-term survivors, whereas all 4 children in subgroup 3 MB died. There was one long-term survivor in subgroup 4 MB. One out of five children with ependymoma was a long-term survivor (RELPOS). Both children with primitive neuroectodermal tumors died. One child with ATRT TYR and one child with choroid plexus carcinoma were long-term survivors.

Conclusions

The efficacy of high-dose chemotherapy radiation-sparing treatment appears to be confined to favorable molecular subgroups of pediatric brain tumors, such as infant SHH MB. Identification of molecular subgroups that benefit from radiation-sparing therapy will aid in the design of prospective, “precision medicine”–driven clinical trials.

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Titel: Subgroup-specific outcomes of children with malignant childhood brain tumors treated with an irradiation-sparing protocol
verfasst von: Eveline Teresa Hidalgo
Matija Snuderl
Cordelia Orillac
Svetlana Kvint
Jonathan Serrano
Peter Wu
Matthias A. Karajannis
Sharon L. Gardner
Publikationsdatum: 02.08.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Child's Nervous System / Ausgabe 1/2020
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-019-04305-x

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Die Mohs-Chirurgie ist zwar mit mehr Aufwand verbunden als die herkömmliche Exzision; für die Versorgung kutaner Hochrisiko-Plattenepithelkarzinome lohnt sich die zeitintensive Technik aber in jedem Fall. Laut einer aktuellen Studie sinkt im Vergleich das Sterberisiko.

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Springer Medizin

Subgroup-specific outcomes of children with malignant childhood brain tumors treated with an irradiation-sparing protocol