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Outcome of pediatric pineoblastoma after surgery, radiation and chemotherapy

  • Clinical-patient studies
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Abstract

Introduction Pineoblastomas are a category of supratentorial primitive neuroectodermal tumors (sPNETs) occurring in the pineal gland; some studies support the impression that patients with pineoblastomas have a worse prognosis than those with other sPNETs. Methods We reviewed the medical records and tissue sections of all patients with the diagnosis of pineoblastoma that were treated at the Dana-Farber Cancer Institute/Children’s Hospital Boston Pediatric Brain Tumor Program between 1986 and 2005. Results Thirteen patients with the pathologic diagnosis of pineoblastoma were treated at our Hospital; 11 of these cases had complete records suitable for study. The median age was 8 years 8 months (5 F, 6 M). Surgical, radiation and chemotherapeutic regimens varied from case to case. Three patients had gross total resection and are alive and free of disease, versus four of eight with subtotal resection or biopsy only. Patients who received CSI and multi-agent chemotherapy had improved overall survival. Conclusions Seven of eleven patients with pineoblastoma are currently alive and free of disease, reflecting an improved outcome and longer survival than previously appreciated. Gross total surgical resection appeared to correlate with improved survival, as did treatment with craniospinal irradiation and multi-agent chemotherapy. Further study of this group of patients as a distinct diagnostic entity will be necessary to determine optimal therapy.

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References

  1. Ullrich N, Pomeroy S (2003) Pediatric brain tumors. Neurol Clin 21:897–913

    Article  PubMed  Google Scholar 

  2. Reddy A et al (2000) Outcome for children with supratentorial primitive neuroectodermal tumors treated with surgery, radiation, and chemotherapy. Cancer 88(9):2189–2193

    Article  PubMed  CAS  Google Scholar 

  3. Gururangan S et al (2003) High-dose chemotherapy with autologous stem-cell rescue in children and adults with newly diagnosed pineoblastomas. J Clin Oncol 21(11):2187–2191

    Article  PubMed  CAS  Google Scholar 

  4. Jakacki R (1999) Pineal and nonpineal supratentorial primitive neuroectodermal tumors. Childs Nerv Syst 15:586–591

    Article  PubMed  CAS  Google Scholar 

  5. Li M et al (2005) Molecular genetics of supratentorial primitive neuroectodermal tumors and pineoblastoma. Neurosurg Focus 19(5):1–17

    Article  Google Scholar 

  6. Jakacki R et al (1995) Survival and prognostic factors following radiation and/or chemotherapy for primitive neuroectodermal tumors of the pineal region in infants and children: a report of the childrens cancer group. J Clin Oncol 13(6):1377–1383

    PubMed  CAS  Google Scholar 

  7. Cohen B et al (1995) Prognostic factors and treatment results for supratentorial primitive neuroectodermal tumors in children using radiation and chemotherapy: a children’s cancer group randomized trial. J Clin Oncol 13(7):1687–1696

    PubMed  CAS  Google Scholar 

  8. Louis D et al (2007) WHO classification of tumors of the central nervous system. International Agency for Research on Cancer, Lyon

    Google Scholar 

  9. Judkins A et al (2004) Immunohistochemical analysis of hSNF5/INI1 in pediatric CNS neoplasms. Am J Surg Pathol 28(5):644–650

    PubMed  Google Scholar 

  10. Judkins A et al (2005) INI protein expression ditinguishes atypical teratoid/rhabdoid tumor from chorioid plexus carcinoma. J Neuropathol Exp Neurol 64(5):391–397

    PubMed  CAS  Google Scholar 

  11. Cuccia V et al (2006) Pineoblastomas in children. Childs Nerv Syst 22:577–585

    Article  PubMed  Google Scholar 

  12. Hinkes B et al (2006) Childhood pineoblastoma: experiences from the prospective multicenter trials HIT-SKK87, HIT-SKK92 and HIT91. J Neurooncol 81(2):217–223

    Article  PubMed  Google Scholar 

  13. Gururangan S et al (2003) High-dose chemotherapy with autologous stem-cell rescue in children and adults with newly diagnosed pineoblastomas. J Clin Oncol 21(11):2187–2191

    Article  PubMed  CAS  Google Scholar 

  14. Lamont J et al (2004) Combined histopathological and molecular cytogenetic stratification of medulloblastoma patients. Clin Cancer Res 10:5482–5493

    Article  PubMed  CAS  Google Scholar 

  15. Fernandez-Teijeiro A et al (2004) Combining gene expression profiles and clinical parameters for risk stratification in medulloblastomas. J Clin Oncol 22(6):994–998

    Article  PubMed  CAS  Google Scholar 

  16. Gajjar A et al (2004) Clinical, histopathologic, and molecular markers of prognosis: toward a new disease risk stratification system for medulloblastoma. J Clin Oncol 22(6):984–993

    Article  PubMed  CAS  Google Scholar 

  17. Eberhart C et al (2002) Histopathologic grading of medulloblastomas—a pediatric oncology group study. Cancer 94(2):552–560

    Article  PubMed  Google Scholar 

  18. Giangaspero F et al (2006) Stratification of medulloblastoma on the basis of histopathological grading. Acta Neuropathol 112:5–12

    Article  PubMed  Google Scholar 

  19. Brown A et al (2006) Cytogenetics of pineoblastoma: four new cases and a literature review. Cancer Genet Cytogenet 170:175–179

    Article  PubMed  CAS  Google Scholar 

  20. Saran F et al (1998) Survival of very young children with medulloblastoma (primitive neuroectodermal tumor of the posterior fossa) treated with craniospinal irradiation. Int J Radiat Oncol Biol Phys 42(5):959–967

    PubMed  CAS  Google Scholar 

  21. Geyer J et al (2005) Multiagent chemotherapy and deferred radiotherapy in infants with malignant brain tumors: a report from the children’s cancer group. J Clin Oncol 23(30):7621–7631

    Article  PubMed  Google Scholar 

  22. Duffner P et al (1995) Lack of efficacy of postoperative chemotherapy and delayed radiation in very young children with pineoblastoma. Pediatric oncology group. Med Pediatr Oncol 25(1):38–44

    Article  PubMed  CAS  Google Scholar 

  23. Duffner P et al (1999) The treatment of malignant brain tumors in infants and very young children: an update of the pediatric oncology group experience. Neuro-oncology 4:152–161

    Google Scholar 

  24. Kellie S et al (2002) Activity of postoperative carboplatin, etoposide, and high-dose methotrexate in pediatric CNS embryonal tumors: results of a phase II study in newly diagnosed children. Med Pediatr Oncol 93:168–174

    Article  Google Scholar 

  25. Bronsicer A et al (2004) High-dose chemotherapy with autologous stem-cell rescue in the treatment of patients with recurrent non-cerebellar primitive neuroectodermal tumors. Pediatr Blood Cancer 42:261–267

    Article  Google Scholar 

  26. Graham M et al (1997) High-dose chemotherapy with autologous stem-cell rescue in patients with recurrent and high-risk pediatric brain tumors. J Clin Oncol 15(5):1814–1823

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA

    Stephen W. Gilheeney, Susan Chi, Christopher Turner, Leslie Lehman & Mark W. Kieran

  2. Memorial Sloan Kettering Cancer Center, Howard 1104, 1275 York Avenue, New York, NY, 10021, USA

    Stephen W. Gilheeney

  3. Department of Pathology (Neuropathology), Children’s Hospital Boston, Boston, MA, USA

    Ali Saad & Umberto De Girolami

  4. Department of Oncology, Children’s Hospital Boston, Boston, MA, USA

    Susan Chi, Christopher Turner, Leslie Lehman & Mark W. Kieran

  5. Department of Neurology, Children’s Hospital Boston, Boston, MA, USA

    Nicole J. Ullrich

  6. Department of Neurosurgery, Children’s Hospital Boston, Boston, MA, USA

    Liliana Goumnerova & R. Michael Scott

  7. Department of Radiation Oncology, Children’s Hospital Boston, Boston, MA, USA

    Karen Marcus

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  1. Stephen W. Gilheeney
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  2. Ali Saad
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  3. Susan Chi
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  4. Christopher Turner
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  8. Karen Marcus
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  9. Leslie Lehman
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  10. Umberto De Girolami
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Correspondence to Stephen W. Gilheeney.

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Gilheeney, S.W., Saad, A., Chi, S. et al. Outcome of pediatric pineoblastoma after surgery, radiation and chemotherapy. J Neurooncol 89, 89–95 (2008). https://doi.org/10.1007/s11060-008-9589-2

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  • DOI: https://doi.org/10.1007/s11060-008-9589-2

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