Abstract
Metastatic disease is a major problem in the management of the most frequent childhood brain tumors, in ependymoma and primitive neuroectodermal tumors (PNET). Today, contrast enhanced craniospinal MRI and careful analysis of craniospinal fluid are a prerequisite for correct staging of both tumors and imply therapeutic consequences. So far metastatic spread of medulloblastoma and some ependymomas is prevented by conventional chemotherapy and radiotherapy. However, some forms of diffuse metastatic dissemination in medulloblastoma are resistant to conventional therapeutic regimens and require new experimental strategies.
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Kühl J, Berthold F, Bode U, Bucsky P, Graf N, Gnekow A, Maass E, Bamberg M, Kaatsch P, Kleihues P, Rating D, Riehm H, Sörensen N, for the German Pediatric Brain Tumor Study Group: Preradiation chemotherapy of children with poor-prognosis medulloblastoma: response rate and toxicity of the ifosfamide-containing multidrug regimen HIT’ 88/’89. Am J Pediatr Hematol Oncol 15 (Suppl A): 567–571, 1993
M. Cohen, P. Duffner (eds): Ependymomas. In: Brain Tumors in Children. Principles of Diagnosis and Treatment. 2nd ed. 1994. Raven Press, New York
Kovnar E, Kun L, Krischer J: Patterns of dissemination and recurrence in childhood ependymoma: preliminary results of Pediatric Oncology Group protocol A 8532. Ann Neurol 30: 457, 1991
Goldwein J, Leahy J, Packer R et al.: Intracranial ependy momas in children. Int J Radiat Oncol Biol Phys 19: 1497–1502, 1990
Shaw E, Evans R, Scheithauer B, Ilstrup D et al.: Postoperative radiotherapy of intracranial ependymoma in pediatric and adult patients. Int J Radiat Oncol Biol Phys 13: 1457–1462, 1987
Salazar O, Castro-Vita H, vanHoutte P, Rubin P, Aygun C: Improved survival in cases of intracranial ependymoma after radiation therapy. J Neurosurg 59: 652–659, 1983
Evans A, Anderson J, Lefkowitz-Bourdreaux I, Finlay J: Adjuvant chemotherapy of childhood posterior fossa ependymoma: cranio-spinal irradiation with or without adjuvant CCNU, vincristine, and prednisone: a Childrens Cancer Group study. Med Pediatr Oncol 27: 8–14, 1996
Harisiadis L, Chang C: Medulloblastoma in children. Int J Radiat Oncol Biol Phys 9: 833–842, 1977
Zeltzer P, Boyette J, Finlay J, Albright L, Wisoff J, Geyer R, McGuire P, Allen J, Rorke L, Stanley P, Stehbens J, Stevens K, Shurin S, Milstein J, Packer R, Bleyer R: Prognostic factors for survival differ in high risk infra-and supratentorial primitive neuroectodermal tumors (PNETs) (abstract). Pediatr Neurosurg 19: 333, 1993
Landberg T, Lindgren M, Cavallin-Stahl E, Svahn-Tapper G, Sundbaärg G, Garwicz S, Lagergren J, Gunnesson V, Brun A, Cronqist S: Improvements in the radiotherapy of medulloblastoma. Cancer 45: 670–678, 1980
Kaufman B, Moran C, Park T: Spinal magnetic resonance imaging immediately after craniotomy for detection of metastatic disease. Pediatr Neurosurg 23: 171–181, 1995
Goldwein J, Radcliffe J, Johnson J, Moshang T, Packer R et al.: Updated results of a pilot study of low dose craniospinal irradiation plus chemotherapy for children under five with cerebellar primitive neuroectodermal tumors (medulloblastoma). Int J Radiat Oncol Biol Phys 34: 899–904, 1996
Kühl J, Mittler U, Urban C, Bamberg M, Berthold F, Bode U, Deinlein F, Graf N, Müller H, Kaatsch P, Ledihues P, Kormann R, Rating D, Riehm HJ, Scheurlen W, Schulte F, Slavc I, Sörensen N, Wiestler O, Wolff J (abstract): Neoadjuvant chemotherapy of medulloblastoma – Recent results of the HIT-trials. J Neuro-Oncol 30: 128, 1996
Tait D, Thornton-Jones H, Bloom H, Lemerle J, Morris-Jones P: Adjuvant chemotherapy for medulloblastoma: the first multi-centre control trial of the International Society of Paediatric Oncology (SIOP I). Eur J Cancer 26: 464–469, 1990
Evans A, Jenkin D, Sposto R, Ortega J, Wilson C, Wara W, Ertel I, Kramer S, Chang C, Leikin S, Hammond D: The treatment of medulloblastoma. J Neurosurg 72: 572–582, 1990
Bailey C, Gnekow A, Wellek S, Jones M, Round C, Brown J, Phillips A, Neidhardt M: Prospective randomised trial of chemotherapy given before radiotherapy in childhood medulloblastoma. International Society of Paediatric Oncology (SIOP) and the (German) Society of Paediatric Oncology (GPO): SIOP II. Med Pediatr Oncol 25: 166–178, 1995
Mahoney D, Strother D, Camitta B, Bowen T, Ghim T, Pick T, Wall D, Yu L, Shuster J, Friedman H: High-dose melphalan and cyclophosphamide with autologous bone marrow rescue for recurrent/progressive malignant brain tumors in children: a pilot pediatric oncology group study. J Clin Oncol 14: 382–388, 1996
Slavc I, Schuller E, Seidl R, Czech T, Dieckmann K: Intraventricular mafosfamide in pediatric brain tumor patients with meningeal dissemination (abstract). J Neuro-Oncol 30: 137, 1996
Deutsch M, Reigel D: The value of myelography in the management of childhood medulloblastoma. Cancer 45: 2194–2197, 1980
Dorwart R, Wara W, Norman D, Levin V: Complete myelographic evaluation of spinal metastases from medulloblastoma. Radiology 139: 403–408, 1981
Packer R, Sutton L, Goldwein J, Perilongo G, Bunin G, Ryan J, Cohen B, D'Angio G, Kramer E, Zimmerman R, Rorke L, Evans A, Schut L: Improved survival with the use of adjuvant chemotherapy in the treatment of medulloblastoma. J Neurosurg 74: 433–440, 1991
Kleinman G, Hochberg F, Rihardson E:: Systemic metastases from medulloblastoma: report of two cases and review of the literature. Cancer 48: 2296–2309, 1981
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Scheurlen, W., Kühl, J. Current diagnostic and therapeutic management of CNS metastasis in childhood primitive neuroectodermal tumors and ependymomas. J Neurooncol 38, 181–185 (1998). https://doi.org/10.1023/A:1005919900622
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DOI: https://doi.org/10.1023/A:1005919900622