Original Article
Treatment of Early Childhood Medulloblastoma by Postoperative Chemotherapy Alone
N Engl J Med 2005; 352:978-986March 10, 2005
- Abstract
Background
The prognosis for young children with medulloblastoma is poor, and survivors are at high risk for cognitive deficits. We conducted a trial of the treatment of this brain tumor by intensive postoperative chemotherapy alone.
Methods
After surgery, children received three cycles of intravenous chemotherapy (cyclophosphamide, vincristine, methotrexate, carboplatin, and etoposide) and intraventricular methotrexate. Treatment was terminated if a complete remission was achieved. Leukoencephalopathy and cognitive deficits were evaluated.
Results
Forty-three children were treated according to protocol. In children who had complete resection (17 patients), residual tumor (14), and macroscopic metastases (12), the five-year progression-free and overall survival rates (±SE) were 82±9 percent and 93±6 percent, 50±13 percent and 56±14 percent, and 33±14 percent and 38±15 percent, respectively. The rates in 31 patients without macroscopic metastases were 68±8 percent and 77±8 percent. Desmoplastic histology, metastatic disease, and an age younger than two years were independent prognostic factors for tumor relapse and survival. Treatment strategies at relapse were successful in 8 of 16 patients. There were no major instances of unexpected toxicity. In 19 of 23 children, asymptomatic leukoencephalopathy was detected by magnetic resonance imaging. After treatment, the mean IQ was significantly lower than that of healthy controls within the same age group but higher than that of patients in a previous trial who had received radiotherapy.
Conclusions
Postoperative chemotherapy alone is a promising treatment for medulloblastoma in young children without metastases.
Media in This Article
Figure 1
Survival According to Subgroups of Children without Macroscopic Metastases (with or without Postoperative Residual Tumors) and Those with Macroscopic Metastases.Figure 2
Progression-free Survival among 23 Children with Classic and 20 Children with Desmoplastic Medulloblastoma.Article Activity
- Article
Twenty-five to 35 percent of cases of medulloblastoma, the most common malignant brain tumor of childhood, occur in children younger than three years of age.1 In contrast to the prognosis for older children, the prognosis for infants and young children treated with surgery, radiotherapy, and chemotherapy remains poor: survival rates have been static for two decades.2 The lack of progress relates not only to the frequent occurrence of metastases at diagnosis but also to the biology of medulloblastoma in young children.3-5 In addition, the susceptibility of the immature brain to radiotherapy-induced cognitive deficits,6-8 which increase for years after radiotherapy,9,10 has set age limitations on the use of radiotherapy in children. Some patients have been cured by postoperative chemotherapy alone,11-14 but survival rates after chemotherapy, with or without radiotherapy, remain unsatisfactory at 25 to 45 percent.
A pilot trial showed that postoperative chemotherapy can delay the start of radiotherapy.15 In the present trial we investigated whether intensive postoperative chemotherapy alone improves survival and cognitive function in young children. Instead of radiotherapy, we administered intraventricular methotrexate through an implanted subcutaneous reservoir, with the aim of prolonging cytotoxic methotrexate levels in the cerebrospinal fluid by giving repeated small single doses.16 Patients underwent detailed neuropsychological testing and were monitored for leukoencephalopathy, which can be a toxic effect of methotrexate.17
Methods
Patients
From April 1992 through December 1997, we registered 62 children with medulloblastoma who were under three years of age. We excluded eight patients because they had a different histopathological diagnosis in central review, eight because they had different chemotherapy or primary radiotherapy or both, and three because they had no therapy or were lost to follow-up. The remaining 43 patients (28 boys and 15 girls) were treated in 31 pediatric oncology centers. Informed consent was obtained from legal representatives of all patients.
Surgery
The maximum possible surgical removal of the primary tumor, depending on the anatomical location of the tumor and the condition of the child, was recommended. The extent of resection was assessed by magnetic resonance imaging (MRI) or computed tomography (CT) performed within 72 hours after surgery. After histologic confirmation of the diagnosis, an intraventricular subcutaneous reservoir (an Ommaya or a Rickham reservoir) was implanted in the anterior horn of a lateral ventricle.
Pathological Analysis
The diagnosis of medulloblastoma was histologically confirmed in all 43 patients by a central pathology laboratory. Tumors were classified according to the World Health Organization classification of brain tumors as classic medulloblastoma (23 patients) or desmoplastic medulloblastoma (20 patients). Other histologies (six atypical teratoid rhabdoid tumors, one ependymoblastoma, and one choroid-plexus carcinoma) were excluded. Cytospin preparations of lumbar cerebrospinal fluid were available from 29 patients for the analysis of tumor cells.
Treatment
Chemotherapy was started two to four weeks after surgery. Children received three two-month cycles of chemotherapy, each consisting of cyclophosphamide, methotrexate (followed by leucovorin rescue after 42 hours), vincristine, carboplatin, and etoposide (Table 1Table 1
Chemotherapy Regimen.). Doses of cyclophosphamide, vincristine, and carboplatin were adjusted for age (6 months of age or less, 66 percent of the full dose; 7 to 12 months of age, 80 percent). The patients also received 36 intraventricular doses of methotrexate. Treatment was stopped if patients had complete continuous remission after three cycles of chemotherapy. Otherwise, children received second surgery, radiotherapy, or experimental chemotherapy as deemed appropriate.Evaluation and Follow-up
The presence of macroscopic solid or laminar metastases was evaluated by initial cranial and spinal MRI (with or without gadolinium) according to the tumor staging system of Chang and colleagues.18 In this system, stage M1 denotes disseminated tumor cells in the cerebrospinal fluid, stage M2 intracranial macroscopic solid or laminar metastases, and stage M3 spinal macroscopic solid or laminar metastases. Residual postoperative tumors were evaluated with MRI within 72 hours after surgery. Neurologic status was assessed before each cycle of chemotherapy. After each cycle, cranial MRI scans and audiograms were obtained, and children underwent spinal MRI and cytologic analysis of lumbar cerebrospinal fluid if initial staging revealed metastatic disease.
Complete response was defined as the total disappearance of residual tumors or macroscopic metastasis during chemotherapy or at the end of treatment. Partial response was defined as a decrease of at least 25 percent of the tumor size, stable disease as a decrease or increase of less than 25 percent, and progressive disease as an increase of at least 25 percent.
Before each treatment, the complete blood count, electrolyte levels, and creatinine concentration were determined, and liver-function tests were performed. Serum concentrations of methotrexate were measured at standard intervals until levels were below 0.25 μmol per liter.
Intraventricular administration of methotrexate was omitted in patients with suspected infection of the central nervous system, thrombocytopenia (a platelet count of less than 30,000 per cubic millimeter), or evidence of disturbed circulation of cerebrospinal fluid. In patients with a ventriculoperitoneal or ventriculoatrial shunt, intraventricular administration was permitted only in cases of metastatic disease. To determine the extent and course of leukoencephalopathy, cranial MRI findings obtained during and after treatment were classified independently by two reviewers according to the classification methods of Fazekas.19
After treatment, legal representatives of all surviving children were informed, and we requested permission to perform a neuropsychological examination. All children for whom consent was obtained underwent detailed age-adapted neuropsychological examination, performed by the same psychologist. The intelligence levels of patients were determined by the Colored Progressive Matrices test and the Kaufmann-Assessment Battery for Children. Sensorimotor abilities were measured by the Developmental Test of Visual-Motor Integration.
Statistical Analysis
Survival was estimated by the Kaplan–Meier method, and the log-rank test was used for comparisons. For the univariate analysis, a local significance level of 5 percent was used (i.e., this significance level was assessed for each test separately). Plus–minus values are standard errors. A stepwise multivariate Cox regression analysis was used to analyze possible prognostic factors for the risk of recurrence or death (score test, P≤0.05 for inclusion criteria; likelihood-ratio test, P≥ 0.10 for exclusion criteria). The grade of leukoencephalopathy, the cumulative doses of intraventricular and intravenous methotrexate, and the doses of craniospinal irradiation were correlated with the use of the Spearman rank-correlation method. Results of intelligence tests are expressed as T scores (mean [±SD], 50±10) and were compared with the use of the Mann–Whitney U test.
Results
Staging
In 31 children (72 percent), no cranial (Chang stage M2+) or spinal (stage M3+) metastases were detectable at diagnosis. The remaining 12 children (28 percent) had macroscopic metastases (Table 2Table 2
Initial Stage, Extent of Resection of the Primary Tumor, and Response to Chemotherapy.).Progression-free and Overall Survival
The estimated five-year progression-free and overall survival rates among the 43 children were 58±9 percent and 66±7 percent, respectively. In children who had complete resection, those who had residual tumor, and those who had stage M2 or M3 metastatic disease, the five-year progression-free and overall survival rates were 82±9 percent and 93±6 percent, 50±13 percent and 56±14 percent, and 33±14 percent and 38±15 percent, respectively (Figure 1Figure 1
Survival According to Subgroups of Children without Macroscopic Metastases (with or without Postoperative Residual Tumors) and Those with Macroscopic Metastases.). The median follow-up times of surviving patients in these three groups were 7.1 years (range, 3.6 to 9.2), 6.1 years (2.7 to 10.2), and 5.5 years (4.2 to 7.3), respectively. In 31 patients without macroscopic metastases, differences between groups with complete and incomplete surgical resection were significant for overall survival (P=0.009) and for progression-free survival (P=0.04). Of 17 children without residual postoperative tumor, 14 remained in complete continuous remission without radiotherapy. The five-year progression-free and overall survival rates among 31 patients without macroscopic metastases were 68±8 percent and 77±8 percent, and 21 of these 31 patients remain in continuous remission without radiotherapy. Differences between nonmetastatic and metastatic (stage M2 or M3) disease were significant (P<0.002). Of 12 patients with initial macroscopic metastases, 3 achieved a continuous remission without radiotherapy.Twenty patients with desmoplastic medulloblastoma had significantly better five-year progression-free and overall survival rates (85±8 percent and 95±5 percent) than did 23 patients with classic medulloblastoma (34±10 percent and 41±11 percent, P<0.001 for both progression-free survival and overall survival) (Figure 2Figure 2
Progression-free Survival among 23 Children with Classic and 20 Children with Desmoplastic Medulloblastoma.).Response to Chemotherapy
The overall response rate was 62 percent in 26 patients with measurable disease after initial surgery (residual tumor or metastasis) (Table 2). In three of nine patients, cerebrospinal fluid was cleared of tumor cells (stage M1) during chemotherapy. No tumor relapse occurred during chemotherapy in patients without measurable disease after surgery. The five-year progression-free survival rate among 29 patients without evidence of disease at the end of chemotherapy was higher than the rate in 14 patients with less than complete remission after chemotherapy (68±9 percent vs. 36±13 percent, P<0.002). The overall survival rate was also higher among the patients without evidence of disease than among the patients with less than complete remission (77±8 percent vs. 34±13 percent, P<0.001).
Resistant Disease and Relapses
At the end of the designated chemotherapy, 14 patients had residual disease and received further chemotherapy, radiotherapy, or both. Of these patients, 10 died of progressive disease. Of the remaining four patients, three reached complete remission and one has had stable disease for seven years after further chemotherapy; two patients received additional radiotherapy.
Tumor relapses occurred in 9 of 29 patients without residual disease after chemotherapy. In three patients the tumor relapsed locally, whereas three patients had combined local and stage M2 or M3 relapses and three patients had distant relapses only. After 15.4 months, 75 percent of all patients had no progression or relapse. The relapses that did occur were observed within 2 to 75 months; only two patients had a relapse more than 2 years after initial diagnosis. In total, 16 patients received further treatment at progression or relapse, and 3 patients received no further treatment. Eight of these 16 patients were successfully treated by chemotherapy (2 patients), radiotherapy (2), or both (4, including high-dose chemotherapy in 2 patients). Six of the 16 children (38 percent) are alive after the inclusion of radiotherapy in the salvage therapy.
Prognostic Factors
Multivariate analysis identified histology, stage of metastases, and age as prognostic factors. The risk of an event (relapse or death) was 93 percent lower for children with desmoplastic medulloblastoma than for children with classic medulloblastoma (hazard ratio, 0.07; 95 percent confidence interval, 0.02 to 0.29; P<0.001). Patients with macroscopic metastasis (stage M2 or M3) had a 742 percent higher risk of relapse or death (hazard ratio, 8.42; 95 percent confidence interval, 2.36 to 30.03), and children with microscopic dissemination of tumor cells into the cerebrospinal fluid (stage M1) had a 98 percent higher risk of relapse or death (hazard ratio, 1.98; 95 percent confidence interval, 0.47 to 8.36; P=0.007 for all metastases) than patients with stage M0 tumors. Children less than two years of age at diagnosis had a risk of relapse or death that was 302 percent higher than that of children between two and three years of age (hazard ratio, 4.02; 95 percent confidence interval, 1.28 to 12.65; P=0.012). Postoperative residual tumors, response to chemotherapy, sex, and the use of intraventricular methotrexate (31 patients received cumulative doses of ≥48 mg) were not identified as independent prognostic factors.
Toxicity
There was no major unexpected toxicity from systemic chemotherapy. Myelotoxicity was the most frequently reported side effect; patients required a median of 2 erythrocyte transfusions (range, 0 to 5) during chemotherapy. Admission for neutropenia and fever was common (median, 3 episodes; range, 0 to 6). No treatment-related deaths or lethal infections occurred.
Toxicity data for intraventricular chemotherapy were available from 38 patients. No toxicity was reported for 33 patients, whereas 2 patients had cerebral seizures that were temporally unrelated to the administration of methotrexate. One patient had a cerebrospinal fluid infection with Staphylococcus epidermidis. In two of six patients with a ventriculoperitoneal shunt, abdominal ascites developed (no infectious agent was identified); in one child, episodes of ascites did not recur after discontinuation of intraventricular methotrexate, whereas in the other child ascites ceased after removal of the shunt. Methotrexate in the ventricular cerebrospinal fluid was measured in 38 patients 24 hours after each application, and no toxic levels (>5 μmol per liter) were found. In two patients, lumbar cerebrospinal fluid levels of methotrexate were analyzed routinely 24 hours after administration, and levels between 0.21 and 2.2 μmol per liter were documented.
T2-weighted cranial MRIs of 23 children were available for the evaluation of leukoencephalopathy during and after treatment. Leukoencephalopathy was not detected in four patients. In 19 patients, all without related symptoms, leukoencephalopathy was classified as mild (spotted, circumscribed lesions in 4 children), moderate (patchy lesions in 9 children), or severe (confluent lesions in 6 children). The maximal grade of leukoencephalopathy was observed one year after treatment. At further follow-up, the severity of leukoencephalopathy decreased to a lower grade in 10 patients and remained stable in 8 patients. One patient was not available for follow-up. A significant correlation between the grade of leukoencephalopathy and the cumulative dose of intraventricular methotrexate was found (correlation coefficient, 0.53; P<0.01), but there was no correlation between the leukoencephalopathy grade and doses of intravenous methotrexate. In six assessable children who had received craniospinal radiotherapy after the application of methotrexate, grade 2 or 3 leukoencephalopathy developed.
Neuropsychological Evaluation
Detailed neuropsychological follow-up was performed in 14 patients at a median of 4.8 years (range, 3.9 to 8.1) after diagnosis. The mean IQ was significantly lower than in healthy controls within the same age group (T scores, 45±9 vs. 53±8 for the Colored Progressive Matrices test; 38±10 vs. 50±7 for the Kaufmann-Assessment Battery for Children; and 39±8 vs. 52±13 for the Visual-Motor Integration test; P<0.001) (Figure 3Figure 3
Effect of Treatment on Neurocognitive Functions.). The general intelligence of the children who did not receive radiotherapy was significantly higher than the general intelligence of children in a former trial who had received radiotherapy but had not been treated with intraventricular methotrexate15 (Colored Progressive Matrices test, 45±9 vs. 36±5; P<0.005). In addition, there was a trend toward different scores on the Kaufmann-Assessment Battery for Children and the Visual-Motor Integration test between these two groups and a trend toward higher T scores for all applied tests in children receiving systemic chemotherapy only, as compared with children treated with systemic and intraventricular chemotherapy (Figure 3). Patients treated with radiotherapy after chemotherapy had the lowest IQs (Colored Progressive Matrices test, 32±7; Kaufmann-Assessment Battery for Children, 28±11; and Visual-Motor Integration test, 33±11).Discussion
Our study shows that young children with medulloblastoma can enjoy a lengthy remission after treatment with postoperative chemotherapy alone. The estimated survival rates among the 43 patients (five-year progression-free survival, 58±9 percent; overall survival, 66±7 percent) compare favorably with the results of other studies in which combined radiotherapy and chemotherapy or chemotherapy alone was used. The results of our study are especially promising for young children without metastases or postoperative residual tumors (progression-free survival, 82±9 percent; overall survival, 93±6 percent). Likewise, the outcome of children without macroscopic metastases, regardless of the presence or absence of postoperative residual tumors, is encouraging, reaching five-year progression-free and overall survival rates of 68±8 percent and 77±8 percent, respectively.
Radiotherapy was successfully averted in 20 of 31 patients who had no macroscopic metastases. Survival was significantly lower among patients with a stage M2 or M3 tumor (progression-free survival, 33±14 percent; overall survival, 38±15 percent). The identification of stage M1 and macroscopic metastases as strong adverse prognostic factors supports the stratification criteria currently applied in older children.5 Other treatments are required for children with macroscopic metastases at diagnosis, but it is noteworthy that three children in this subgroup have remained in remission for more than five years without requiring radiotherapy. Although the presence of a postoperative residual tumor was not shown statistically to be an independent adverse prognostic factor, we believe that this presentation justifies maximal surgery at diagnosis. Given the small size of this study, we regard multivariate analysis as explorative, and P values as descriptive.
Overall response rates in our study (62 percent) compare favorably with rates reported previously.12,20 Notably, no tumor progression was observed during chemotherapy in the 31 children without initial macroscopic metastases. In contrast to other studies in which the risk of progression along the neuroaxis increased with the duration of chemotherapy,21,22 our study involved chemotherapy that had a favorable safety profile.
Survival among patients in our pilot trial with delayed radiotherapy was poorer than among patients in the present trial, and no patient in the pilot trial received successful salvage therapy after relapse (overall survival rate, 71 percent and 45 percent for nonmetastatic disease without and with postoperative residual tumor, respectively, and 0 percent for patients with initial metastases). The psychological outcome and the school performance were worse in the survivors who received radiotherapy than in the children in the present trial. However, the two regimens differed not only in the use of radiotherapy and intraventricular methotrexate but also in the systemic chemotherapy (procarbazine, ifosfamide, and cytarabine were used in the pilot trial but not in the present study).
Desmoplastic medulloblastoma in older children is associated with a better survival,23 but the relevance of desmoplasia in young children is unclear. In our study, the 20 children with desmoplastic histology had a better outcome than the 23 with classical medulloblastoma (progression-free survival, 85±8 percent vs. 34±10 percent; overall survival, 95±5 percent vs. 41±11 percent; P<0.001), and desmoplastic histology was identified as an independent favorable prognostic factor. These data suggest that the stratification of risk groups may be improved by consideration of desmoplasia in young children with medulloblastoma. In our study, an age of two years or less at diagnosis was a statistically significant adverse risk factor as compared with an age between two and three years.
Neurotoxicity after the administration of intrathecal methotrexate has been related to direct toxic effects and interference with metabolic pathways in the brain,24 and cases of inadvertent intraparenchymal instillation of methotrexate have been described.25 Therefore, toxicity and the neuropsychological outcome were of special interest in our study. No child had symptoms of methotrexate-induced neurotoxicity. Toxic methotrexate levels in cerebrospinal fluid were not reported. Chemical peritonitis developed during chemotherapy in two of six children with a ventriculoperitoneal shunt. Thus, intraventricular methotrexate cannot be recommended for children with a ventriculoperitoneal shunt lacking a device for transient shunt occlusion.
Not unexpectedly, moderate to severe leukoencephalopathy was found in 15 of 23 patients. A significant correlation was found between the grade of leukoencephalopathy and the cumulative dose of intraventricular methotrexate, suggesting a dose-dependent effect of methotrexate on leukoencephalopathy. Leukoencephalopathy did not cause symptoms and was a transient phenomenon in 10 children.
After treatment, the results of all IQ tests (the Colored Progressive Matrices test, the Kaufmann-Assessment Battery for Children, and the Developmental Test of Visual-Motor Integration) were significantly lower than the results of the tests in healthy controls of the same age group, indicating that the disease itself, surgery, and chemotherapy have a negative effect on neurocognitive functions. However, the results of the Colored Progressive Matrices test in children treated with chemotherapy alone was significantly higher than the results of the test in patients in our previous trial who received radiotherapy but did not receive intraventricular methotrexate (45±9 vs. 36±5, P<0.005).
In conclusion, this study shows that lengthy remissions can be obtained in young children with medulloblastoma by intensive postoperative chemotherapy. Results are especially promising for patients without initial metastases, in whom radiotherapy should be reserved for salvage strategies at relapse.
Supported by grants from the German Cancer Aid (Deutsche Krebshilfe 70-1667), the German Children's Cancer Foundation (Deutsche Kinderkrebsstiftung DKS 2001.03 and DKS 2004.03), and the Association of Parents for Children with Cancer, Würzburg, Germany. Miss Emser is supported by the German Children's Cancer Foundation, and Dr. Pietsch is supported by the German Cancer Foundation, by the German Ministry of Education and Research, and by a Bonfor Grant of the University of Bonn.
Dr. Kuehl is deceased.
This article is dedicated to the memory of Joachim Kuehl, who died in 2003. The pediatric neuro-oncology community will preserve his memory.
We are indebted to the following participating pediatric centers, in the name of the German Pediatric Brain Tumor Study Group of the German Society of Pediatric Oncology and Hematology: University of Aachen, Aachen (R. Mertens); University of Berlin/Charité, Berlin (G. Henze); University of Bonn, Bonn (U. Bode); Prof.-Hess-Kinderklinik, Bremen (J. Spaar); University of Düsseldorf, Düsseldorf (U. Goebel); University of Erlangen, Erlangen (J. Beck); University of Essen, Essen (W. Havers); University of Freiburg, Freiburg (C. Niemeyer); Klinikum Fulda, Fulda (H. Töllner); University of Giessen, Giessen (A. Reiter); University of Göttingen, Göttingen (M. Lakomek); University of Hamburg, Hamburg (G. Janka-Schaup); University of Heidelberg, Heidelberg (B. Selle); University of Homburg/Saar, Homburg/Saar (N. Graf); Klinikum Karlsruhe, Karlsruhe (W. Dupuis); University of Kiel, Kiel (M. Suttorp); Klinikum Koblenz, Koblenz (M. Rister); University of Köln, Köln (F. Berthold); University of Lübeck, Lübeck (P. Bucsky); Klinikum Mannheim, Mannheim (O. Sauer); University of Marburg, Marburg (C. Eschenbach); Kinderklinik München-Schwabing, Munich (S. Mueller-Weihrich); University of Munich, Munich (J. Haas); University of Münster, Münster (H. Juergens); Klinik St. Hedwig Regensburg, Regensburg (M. Helmig); DRK-Kinderklinik Siegen, Siegen (F.-J. Göbel); Olga-Hospital, Stuttgart (J. Treuner); Krankenanstalt Trier, Trier (W. Rauh); University of Tübingen, Tübingen (D. Niethammer); University of Würzburg, Würzburg (J. Kuehl); and Klinikum Wuppertal, Wuppertal (B. Dohrn) — all in Germany. We are also indebted to W. Roggendorf (Institute of Neuropathology, University of Würzburg, Würzburg, Germany) and the pathologists of all the participating centers for their cooperation; to Julia Becker (HIT data center, Würzburg) for excellent data management; and to K. Kerksiek and P.-G. Schlegel for assistance with preparation of the manuscript.
Source Information
From the Department of Pediatric Oncology, Children's Hospital (S.R., F.D., H.O., J.K.), and the Departments of Neuroradiology (M.W.-M.) and Pediatric Neurosurgery (N.S.), University of Würzburg, Würzburg; the Department of Pediatric Oncology, Children's Hospital (U.B.) and National Reference Center for Brain Tumors, Department of Neuropathology (T.P.), University of Bonn, Bonn; the Department of Pediatric Oncology, Children's Hospital, University of Homburg/Saar, Homburg/Saar (N.G.); Institute for Medical Statistics, Epidemiology, and Informatics, University of Mainz, Mainz (A.E.); the Department of Pediatric Oncology, Children's Hospital, University of Regensburg, Regensburg (J.E.A.W.); and the Department of Radiotherapy, University of Leipzig, Leipzig (R.D.K.) — all in Germany.
Address reprint requests to Dr. Rutkowski at the Department of Pediatric Oncology, Children's Hospital, University of Würzburg, Josef-Schneider-Str. 2, D-97080 Würzburg, Germany, or at rutkowski@mail.uni-wuerzburg.de.
A complete list of investigators is provided in the Appendix.
Appendix
In addition to the authors, the following investigators participated in the German Pediatric Brain Tumor Study Group Trial (HIT-SKK'92) as members of the study committee: Germany — J. Beck, University of Erlangen, Erlangen; F. Berthold, University of Koeln, Koeln; A. Gnekow, Klinikum Krankenhauszweckverbandes Augsburg, Augsburg; U. Goebel, University of Düsseldorf, Düsseldorf; P. Gutjahr and P. Kaatsch, University of Mainz, Mainz; W. Havers, University of Essen, Essen; G. Henze, University of Berlin, Berlin; M. Lakomek, University of Goettingen, Goettingen; E. Maas, Olga-Hospital, Stuttgart; U. Mittler, University of Magdeburg, Magdeburg; S. Mueller-Weihrich, Kinderklinik Muenchen-Schwabing, Munich; D. Niethammer, University of Tübingen, Tübingen; D. Rating, University of Heidelberg, Heidelberg; H.-J. Riehm and P. Weinel, University of Hannover, Hannover; J. Spaar, Prof.-Hess-Kinderklinik, Bremen; O. Wiestler, University of Bonn, Bonn; K. Winkler, University of Hamburg, Hamburg; Austria — I. Slavc, University of Vienna, Vienna; C. Urban, University of Graz, Graz.
- References
References
1
Kaatsch P ,Rickert CH ,Kuehl J ,Schuez J ,Michaelis J . Population-based epidemiologic data on brain tumors in German children. Cancer 2001;92:3155-3164
CrossRef | Web of Science | Medline2
Kellie SJ . Chemotherapy of central nervous system tumours in infants. Childs Nerv Syst 1999;15:592-612
CrossRef | Web of Science | Medline3
Evans AE ,Jenkin RD ,Sposto R , et al. The treatment of medulloblastoma: results of a prospective randomized trial of radiation therapy with and without CCNU, vincristine, and prednisone. J Neurosurg 1990;72:572-582
CrossRef | Web of Science | Medline4
Zeltzer PM ,Boyett JM ,Finlay JL , et al. Metastasis stage, adjuvant treatment, and residual tumor are prognostic factors for medulloblastoma in children: conclusions from the Children's Cancer Group 921 randomized phase III study. J Clin Oncol 1999;17:832-845
Web of Science | Medline5
Packer RJ ,Rood BR ,MacDonald TJ . Medulloblastoma: present concepts of stratification into risk groups. Pediatr Neurosurg 2003;39:60-67
CrossRef | Web of Science | Medline6
Mulhern RK ,Horowitz ME ,Kovnar EH ,Langston J ,Sanford RA ,Kun LE . Neurodevelopmental status of infants and young children treated for brain tumors with preirradiation chemotherapy. J Clin Oncol 1989;7:1660-1666
Web of Science | Medline7
Jenkin D ,Danjoux C ,Greenberg M . Subsequent quality of life for children irradiated for a brain tumor before age four years. Med Pediatr Oncol 1998;31:506-511
CrossRef | Medline8
Kiltie AE ,Lashford LS ,Gattamaneni HR . Survival and late effects in medulloblastoma patients treated with craniospinal irradiation under three years old. Med Pediatr Oncol 1997;28:348-354
CrossRef | Medline9
Hoppe-Hirsch E ,Brunet L ,Laroussinie F , et al. Intellectual outcome in children with malignant tumors of the posterior fossa: influence of the field of irradiation and quality of surgery. Childs Nerv Syst 1995;11:340-346
CrossRef | Web of Science | Medline10
Palmer SL ,Goloubeva O ,Reddick WE , et al. Patterns of intellectual development among survivors of pediatric medulloblastoma: a longitudinal analysis. J Clin Oncol 2001;19:2302-2308
Web of Science | Medline11
White L ,Kellie S ,Gray E , et al. Postoperative chemotherapy in children less than 4 years of age with malignant brain tumors: promising initial response to a VETOPEC-based regimen. J Pediatr Hematol Oncol 1998;20:125-130
CrossRef | Web of Science | Medline12
Ater JL ,van Eys J ,Woo SY ,Moore B III ,Copeland DR ,Bruner J . MOPP chemotherapy without irradiation as primary postsurgical therapy for brain tumors in infants and young children. J Neurooncol 1997;32:243-252
CrossRef | Web of Science | Medline13
Baram TZ ,van Eys J ,Dowell RE ,Cangir A ,Pack B ,Bruner JM . Survival and neurologic outcome of infants with medulloblastoma treated with surgery and MOPP chemotherapy: a preliminary report. Cancer 1987;60:173-177
CrossRef | Web of Science | Medline14
White L ,Johnston H ,Jones R , et al. Postoperative chemotherapy without radiation in young children with malignant non-astrocytic brain tumours. Cancer Chemother Pharmacol 1993;32:403-406
CrossRef | Web of Science | Medline15
Kuehl J ,Beck J ,Bode U , et al. Delayed radiation therapy after postoperative chemotherapy in children less than 3 years of age with medulloblastoma: results of the trial HIT-SKK'87 and preliminary results of the pilot trial HIT-SKK'92. Med Pediatr Oncol 1995;25:Suppl:250-250 abstract.16
Ruggiero A ,Conter V ,Milani M , et al. Intrathecal chemotherapy with antineoplastic agents in children. Paediatr Drugs 2001;3:237-246
CrossRef | Medline17
Riva D ,Giorgi C ,Nichelli F , et al. Intrathecal methotrexate affects cognitive function in children with medulloblastoma. Neurology 2002;59:48-53
CrossRef | Web of Science | Medline18
Chang CH ,Housepian EM ,Herbert C Jr . An operative staging system and a megavoltage radiotherapeutic technic for cerebellar medulloblastomas. Radiology 1969;93:1351-1359
Web of Science | Medline19
Fazekas F . Magnetic resonance signal abnormalities in asymptomatic individuals: their incidence and functional correlates. Eur Neurol 1989;29:164-168
CrossRef | Web of Science | Medline20
Duffner PK ,Horowitz ME ,Krischer JP , et al. Postoperative chemotherapy and delayed radiation in children less than three years of age with malignant brain tumors. N Engl J Med 1993;328:1725-1731
Full Text | Web of Science | Medline21
Attard-Montalto S ,Plowman N ,Breatnach F ,Saha V ,Eden OB . Is there a danger in delaying radiotherapy in childhood medulloblastoma? Br J Radiol 1993;66:807-813
CrossRef | Web of Science | Medline22
Hartsell WF ,Gajjar A ,Heideman R , et al. Patterns of failure in children with medulloblastoma: effects of preirradiation chemotherapy. Int J Radiat Oncol Biol Phys 1997;39:15-24
CrossRef | Web of Science | Medline23
Eberhart CG ,Kepner JL ,Goldthwaite PT , et al. Histopathologic grading of medulloblastomas: a Pediatric Oncology Group study. Cancer 2002;94:552-560
CrossRef | Web of Science | Medline24
Vezmar S ,Becker A ,Bode U ,Jaehde U . Biochemical and clinical aspects of methotrexate neurotoxicity. Chemotherapy 2003;49:92-104
CrossRef | Web of Science | Medline25
Gottschling S ,Reinhard H ,Meyer S ,Krenn T ,Graf N ,Strowitzki M . Severe encephalopathy caused by intraparenchymal methotrexate instillation due to the design of the catheter. Med Pediatr Oncol 2003;41:491-492
CrossRef | Medline
- Citing Articles (172)
Citing Articles
1
Ian F. Pollack. 2012. Ataxia resulting from posterior fossa tumors of childhood and other mass lesions. , 161-173.
CrossRef2
Ryan DeMarchi, Michael Ellis, Cynthia Hawkins, James T. Rutka. 2012. Medulloblastoma and primitive neuroectodermal tumors. , 503-517.
CrossRef3
Roger J. Packer, Tobey Macdonald, Gilbert Vezina, Robert Keating, Mariarita Santi. 2012. Medulloblastoma and primitive neuroectodermal tumors. , 529-548.
CrossRef4
Fausto J. Rodriguez, Caterina Giannini. 2012. Diagnostic neuropathology of tumors of the central nervous system. , 77-107.
CrossRef5
Jaishri Blakeley, Stuart A. Grossman. 2012. Chemotherapy with cytotoxic and cytostatic agents in brain cancer. , 229-254.
CrossRef6
Eun Sil Park, Ki Woong Sung, Hee Jo Baek, Kyung Duk Park, Hyeon Jin Park, Sung Chul Won, Do Hoon Lim, Heung Sik Kim. (2012) Tandem High-Dose Chemotherapy and Autologous Stem Cell Transplantation in Young Children with Atypical Teratoid/Rhabdoid Tumor of the Central Nervous System. Journal of Korean Medical Science 27:2, 135
CrossRef7
Anita Villani, David Malkin, Uri Tabori. (2011) Syndromes Predisposing to Pediatric Central Nervous System Tumors: Lessons Learned and New Promises. Current Neurology and Neuroscience Reports
CrossRef8
Katja von Hoff, Bernward Hinkes, Elke Dannenmann-Stern, André O. von Bueren, Monika Warmuth-Metz, Niels Soerensen, Angela Emser, Isabella Zwiener, Paul G. Schlegel, Joachim Kuehl, Michael C. Frühwald, Rolf D. Kortmann, Torsten Pietsch, Stefan Rutkowski. (2011) Frequency, Risk-Factors and Survival of Children With Atypical Teratoid Rhabdoid Tumors (AT/RT) of the CNS Diagnosed between 1988 and 2004, and Registered to the German HIT Database. Pediatric Blood & Cancer 57:6, 978-985
CrossRef9
Cristina Nay Fellay, Didier Frappaz, Marie P. Sunyach, Enrico Franceschi, Alba A. Brandes, Roger Stupp. (2011) Medulloblastomas in adults. Current Opinion in Neurology 24:6, 626-632
CrossRef10
Nicolas U. Gerber, Katja von Hoff, André O. von Bueren, Wiebke Treulieb, Frank Deinlein, Martin Benesch, Isabella Zwiener, Niels Soerensen, Monika Warmuth-Metz, Torsten Pietsch, Uwe Mittler, Joachim Kuehl, Rolf-Dieter Kortmann, Michael A. Grotzer, Stefan Rutkowski. (2011) A long duration of the prediagnostic symptomatic interval is not associated with an unfavourable prognosis in childhood medulloblastoma. European Journal of Cancer
CrossRef11
M. Benesch. (2011) Therapy optimisation studies in pediatric neurooncology – historical perspectives and future directions. memo - Magazine of European Medical Oncology 4:S3, 19-20
CrossRef12
Jingying Xu, Anat Erdreich-Epstein, Ignacio Gonzalez-Gomez, Elizabeth Y. Melendez, Goar Smbatyan, Rex A. Moats, Michael Rosol, Jaclyn A. Biegel, C. Patrick Reynolds. (2011) Novel cell lines established from pediatric brain tumors. Journal of Neuro-Oncology
CrossRef13
Adelheid Woehrer, Irene Slavc, Andreas Peyrl, Thomas Czech, Christian Dorfer, Daniela Prayer, Susanne Stary, Berthold Streubel, Marina Ryzhova, Andrey Korshunov, Stefan M. Pfister, Christine Haberler. (2011) Embryonal tumor with abundant neuropil and true rosettes (ETANTR) with loss of morphological but retained genetic key features during progression. Acta Neuropathologica
CrossRef14
Franck Bourdeaut, Catherine Miquel, Claire Alapetite, Thomas Roujeau, Francois Doz. (2011) Medulloblastomas. Current Opinion in Oncology 23:6, 630-637
CrossRef15
Olaf Ansorge. (2011) The neuropathological approach to the diagnosis of brain tumours. Diagnostic Histopathology 17:11, 465-475
CrossRef16
Stefan Rieken, Angela Mohr, Daniel Habermehl, Thomas Welzel, Katja Lindel, Olaf Witt, Andreas E. Kulozik, Wolfgang Wick, Jürgen Debus, Stephanie E. Combs. (2011) Outcome and Prognostic Factors of Radiation Therapy for Medulloblastoma. International Journal of Radiation Oncology*Biology*Physics 81:3, e7-e13
CrossRef17
Vijay Ramaswamy, Paul A. Northcott, Michael D. Taylor. (2011) FISH and chips: the recipe for improved prognostication and outcomes for children with medulloblastoma. Cancer Genetics 204:11, 577-588
CrossRef18
Cynthia Hawkins, Sidney Croul. (2011) Viruses and human brain tumors: cytomegalovirus enters the fray. Journal of Clinical Investigation 121:10, 3831-3833
CrossRef19
Shizuka Watanabe, Yuriko Azami, Miwa Ozawa, Takahiro Kamiya, Daisuke Hasegawa, Chitose Ogawa, Yasushi Ishida, Ryota Hosoya, Junko Kizu, Atsushi Manabe. (2011) Intellectual development after treatment in children with acute leukemia and brain tumor. Pediatrics International 53:5, 694-700
CrossRef20
Izabel Hazin, Georges Dellatolas, Danielle Garcia, Francisco Pedrosa, Arli Pedrosa. (2011) Intellectual Impairment After Treatment for Medulloblastoma and Astrocytoma in Childhood. Journal of Pediatric Hematology/Oncology 33:7, 506-515
CrossRef21
S. Asuthkar, A. K. Nalla, C. S. Gondi, D. H. Dinh, M. Gujrati, S. Mohanam, J. S. Rao. (2011) Gadd45a sensitizes medulloblastoma cells to irradiation and suppresses MMP-9-mediated EMT. Neuro-Oncology 13:10, 1059-1073
CrossRef22
F. El Majdoub, T. Simon, M. Hoevels, F. Berthold, V. Sturm, M. Maarouf. (2011) Interstitial Brachytherapy using Stereotactic Implanted 125Iodine Seeds for Recurrent Medulloblastoma. Clinical Oncology 23:8, 532-537
CrossRef23
Birte Wolff, Ann Ng, Daniela Roth, Kathleen Parthey, Monika Warmuth-Metz, Matthias Eyrich, Uwe Kordes, Rolf Kortmann, Torsten Pietsch, Christof Kramm, Johannes EA Wolff. (2011) Pediatric high grade glioma of the spinal cord: results of the HIT-GBM database. Journal of Neuro-Oncology
CrossRef24
Mark Van Poppel, Paul Klimo, Mariko Dewire, Robert A. Sanford, Frederick Boop, Alberto Broniscer, Karen Wright, Amar J. Gajjar. (2011) Resection of infantile brain tumors after neoadjuvant chemotherapy: the St. Jude experience. Journal of Neurosurgery: Pediatrics 8:3, 251-256
CrossRef25
Dimitris Kombogiorgas, Stephanie Puget, Nathalie Boddaert, Andrew Peet, Martin English, Kal Natarajan, Jacques Grill, Dominique Couanet, Christian Sainte-Rose, Spyros Sgouros. (2011) Appraisal of the current staging system for residual medulloblastoma by volumetric analysis. Child's Nervous System
CrossRef26
Tomoru Miwa, Shizuo Oi, Yuichiro Nonaka, Ryo Tamogami, Hikaru Sasaki, Satoshi Yoshinari, Hiroyuki Ida. (2011) Aggressive large cell medulloblastoma extending to the extracranial region in brain-dead state. Child's Nervous System 27:8, 1341-1346
CrossRef27
Martin Benesch, Daniela Sperl, André O. Bueren, Irene Schmid, Katja Hoff, Monika Warmuth-Metz, Rudolf Ferrari, Lisa Lassay, Rolf-Dieter Kortmann, Torsten Pietsch, Stefan Rutkowski. (2011) Primary central nervous system primitive neuroectodermal tumors (CNS-PNETs) of the spinal cord in children: four cases from the German HIT database with a critical review of the literature. Journal of Neuro-Oncology 104:1, 279-286
CrossRef28
Roger E McLendon, Adesina Adekunle, Veena Rajaram, Mehmet Koçak, Susan M Blaney. (2011) Embryonal Central Nervous System Neoplasms Arising in Infants and Young Children: A Pediatric Brain Tumor Consortium Study. Archives of Pathology & Laboratory Medicine 135:8, 984-993
CrossRef29
Ian F. Pollack. (2011) Multidisciplinary management of childhood brain tumors: a review of outcomes, recent advances, and challenges. Journal of Neurosurgery: Pediatrics 8:2, 135-148
CrossRef30
Marco Gessi, André O. Bueren, Stefan Rutkowski, Torsten Pietsch. (2011) p53 expression predicts dismal outcome for medulloblastoma patients with metastatic disease. Journal of Neuro-Oncology
CrossRef31
Ian F. Pollack, Regina I. Jakacki. (2011) Childhood brain tumors: epidemiology, current management and future directions. Nature Reviews Neurology 7:9, 495-506
CrossRef32
Sarah E.S. Leary, Tianni Zhou, Emiko Holmes, J. Russel Geyer, Douglas C. Miller. (2011) Histology predicts a favorable outcome in young children with desmoplastic medulloblastoma. Cancer 117:14, 3262-3267
CrossRef33
Michael D. Chan, Albert Attia, Stephen B. Tatter, Glenn Lesser, Michael E. Zapadka, Ryan T. Mott, Annette Carter, Kevin P. McMullen, Edward G. Shaw, Thomas E. Ellis. (2011) Radiation-induced adult medulloblastoma: a two-case report and review of the literature. Journal of Neuro-Oncology 103:3, 745-749
CrossRef34
Maura Massimino, Felice Giangaspero, Maria Luisa Garrè, Lorenza Gandola, Geraldina Poggi, Veronica Biassoni, Gemma Gatta, Stefan Rutkowski. (2011) Childhood medulloblastoma. Critical Reviews in Oncology/Hematology 79:1, 65-83
CrossRef35
Monika Warmuth-Metz, Sophia Blashofer, André O. Bueren, Katja Hoff, Brigitte Bison, Fabian Pohl, Rolf-Dieter Kortmann, Torsten Pietsch, Stefan Rutkowski. (2011) Recurrence in childhood medulloblastoma. Journal of Neuro-Oncology 103:3, 705-711
CrossRef36
Pratiti Bandopadhayay, Timothy E. Hassall, Jeffrey V. Rosenfeld, Greg C. Wheeler, Peter A. Downie, Maria L. Kirby, Richard J. Cohn, Michael J. Sullivan, David M. Ashley. (2011) ANZCCSG BabyBrain99; intensified systemic chemotherapy, second look surgery and involved field radiation in young children with central nervous system malignancy. Pediatric Blood & Cancer 56:7, 1055-1061
CrossRef37
Cristina Zanini, Giorgia Mandili, Daniele Bertin, Francesco Cerutti, Denisa Baci, Marco Leone, Isabella Morra, Luca Cordero, Marco Forni. (2011) Analysis of different medulloblastoma histotypes by two-dimensional gel and MALDI-TOF. Child's Nervous System
CrossRef38
Ching-Hon Pui, Amar J. Gajjar, Javier R. Kane, Ibrahim A. Qaddoumi, Alberto S. Pappo. (2011) Challenging issues in pediatric oncology. Nature Reviews Clinical Oncology 8:9, 540-549
CrossRef39
Leigh Marcus, Robert Murphy, Elizabeth Fox, Cynthia McCully, Raphael Cruz, Katherine E. Warren, Thorsten Meyer, Edward McNiff, Frank M. Balis, Brigitte C. Widemann. (2011) The plasma and cerebrospinal fluid pharmacokinetics of the platinum analog satraplatin after intravenous administration in non-human primates. Cancer Chemotherapy and Pharmacology
CrossRef40
Sunil Bhat, Satya Prakash Yadav, Vaishali Suri, Rana Patir, Purna Kurkure, Stewart Kellie, Anupam Sachdeva. (2011) Management of Childhood Brain Tumors: Consensus Report by the Pediatric Hematology Oncology (PHO) Chapter of Indian Academy of Pediatrics (IAP). The Indian Journal of Pediatrics
CrossRef41
A. O. von Bueren, K. von Hoff, T. Pietsch, N. U. Gerber, M. Warmuth-Metz, F. Deinlein, I. Zwiener, A. Faldum, G. Fleischhack, M. Benesch, J. Krauss, J. Kuehl, R. D. Kortmann, S. Rutkowski. (2011) Treatment of young children with localized medulloblastoma by chemotherapy alone: Results of the prospective, multicenter trial HIT 2000 confirming the prognostic impact of histology. Neuro-Oncology 13:6, 669-679
CrossRef42
C. M. Kramm, S. Butenhoff, U. Rausche, M. Warmuth-Metz, R.-D. Kortmann, T. Pietsch, A. Gnekow, N. Jorch, G. Janssen, F. Berthold, J. E. Wolff. (2011) Thalamic high-grade gliomas in children: a distinct clinical subset?. Neuro-Oncology 13:6, 680-689
CrossRef43
Johannes E. Wolff, Rolf-Dieter Kortmann, Birte Wolff, Torsten Pietsch, Ove Peters, Hans-Joerg Schmid, Stefan Rutkowski, Monika Warmuth-Metz, Christoph Kramm. (2011) High dose methotrexate for pediatric high grade glioma: results of the HIT-GBM-D Pilot study. Journal of Neuro-Oncology 102:3, 433-442
CrossRef44
Ali Varan. (2011) Risk-adapted chemotherapy in childhood medulloblastoma. Expert Review of Anticancer Therapy 11:5, 771-780
CrossRef45
Nicolas U. Gerber, Katja Hoff, André O. Bueren, Wiebke Treulieb, Monika Warmuth-Metz, Torsten Pietsch, Niels Soerensen, Andreas Faldum, Angela Emser, Paul G. Schlegel, Frank Deinlein, Rolf-Dieter Kortmann, Stefan Rutkowski. (2011) Outcome of 11 children with ependymoblastoma treated within the prospective HIT-trials between 1991 and 2006. Journal of Neuro-Oncology 102:3, 459-469
CrossRef46
Verena Wiegering, Matthias Eyrich, Stefan Rutkowski, Matthias Wölfl, Paul G. Schlegel, Beate Winkler. (2011) TH1 predominance is associated with improved survival in pediatric medulloblastoma patients. Cancer Immunology, Immunotherapy 60:5, 693-703
CrossRef47
L. Taillandier, M. Blonski, C. Carrie, V. Bernier, F. Bonnetain, F. Bourdeaut, I.-C. Thomas, P. Chastagner, F. Dhermain, F. Doz, D. Frappaz, J. Grill, R. Guillevin, A. Idbaih, A. Jouvet, C. Kerr, F.-L. Donadey, L. Padovani, J. Pallud, M.-P. Sunyach. (2011) Les médulloblastomes : revue générale. Revue Neurologique 167:5, 431-448
CrossRef48
Jan Küchler, Wolfgang Hartmann, Anke Waha, Arend Koch, Elmar Endl, Peter Wurst, Dagmar Kindler, Thomas Mikeska, Andreas Waha, Cynthia G. Goodyer, Reinhard Büttner, Karl Schilling, Torsten Pietsch. (2011) p75NTR induces apoptosis in medulloblastoma cells. International Journal of Cancer 128:8, 1804-1812
CrossRef49
Roger J. Packer. (2011) Risk Stratification of Medulloblastoma: A Paradigm for Future Childhood Brain Tumor Management Strategies. Current Neurology and Neuroscience Reports 11:2, 124-126
CrossRef50
Wen-yan Li, Lu Ma, Jian Liu, Hua Yang, Qing Mao. (2011) Melanotic medulloblastoma in children. Child's Nervous System 27:4, 517-521
CrossRef51
Karel Zitterbart, Hana Filkova, Lenka Tomasikova, Eva Necesalova, Iva Zambo, Dagmar Kantorova, Iva Slamova, Vladimira Vranova, Dita Zezulkova, Martina Pesakova, Zdenek Pavelka, Renata Veselska, Petr Kuglik, Jaroslav Sterba. (2011) Low-level copy number changes of MYC genes have a prognostic impact in medulloblastoma. Journal of Neuro-Oncology 102:1, 25-33
CrossRef52
David W. Ellison, James Dalton, Mehmet Kocak, Sarah Leigh Nicholson, Charles Fraga, Geoff Neale, Anna M. Kenney, Dan J. Brat, Arie Perry, William H. Yong, Roger E. Taylor, Simon Bailey, Steven C. Clifford, Richard J. Gilbertson. (2011) Medulloblastoma: clinicopathological correlates of SHH, WNT, and non-SHH/WNT molecular subgroups. Acta Neuropathologica 121:3, 381-396
CrossRef53
J. H. Phi, J. Lee, K.-C. Wang, B.-K. Cho, I.-O. Kim, C.-K. Park, C.-Y. Kim, H. S. Ahn, I. H. Kim, S.-K. Kim. (2011) Cerebrospinal fluid M staging for medulloblastoma: Reappraisal of Chang's M staging based on the CSF flow. Neuro-Oncology 13:3, 334-344
CrossRef54
André O von Bueren, Christoph Oehler, Tarek Shalaby, Katja von Hoff, Martin Pruschy, Burkhardt Seifert, Nicolas U Gerber, Monika Warmuth-Metz, Duncan Stearns, Charles G Eberhart, Rolf D Kortmann, Stefan Rutkowski, Michael A Grotzer. (2011) c-MYC expression sensitizes medulloblastoma cells to radio- and chemotherapy and has no impact on response in medulloblastoma patients. BMC Cancer 11:1, 74
CrossRef55
Adelheid Woehrer, Irene Slavc, Thomas Waldhoer, Harald Heinzl, Nadine Zielonke, Thomas Czech, Martin Benesch, Johannes A. Hainfellner, Christine Haberler. (2010) Incidence of atypical teratoid/rhabdoid tumors in children. Cancer 116:24, 5725-5732
CrossRef56
David I. Sandberg, Juan Solano, Carol K. Petito, Abdul Mian, Caihong Mou, Tulay Koru-Sengul, Manuel Gonzalez-Brito, Kyle R. Padgett, Ali Luqman, Juan Carlos Buitrago, Farid Alam, Jerome R. Wilkerson, Kenneth M. Crandall, John W. Kuluz. (2010) Safety and pharmacokinetic analysis of methotrexate administered directly into the fourth ventricle in a piglet model. Journal of Neuro-Oncology 100:3, 397-406
CrossRef57
Antonio Ruggiero, Daniela Rizzo, Giorgio Attinà, Ilaria Lazzareschi, Stefano Mastrangelo, Palma Maurizi, Roberta Migliorati, Patrizia Bertolini, Maria Pastore, Cesare Colosimo, Riccardo Riccardi. (2010) Phase I study of temozolomide combined with oral etoposide in children with recurrent or progressive medulloblastoma. European Journal of Cancer 46:16, 2943-2949
CrossRef58
Amar Gajjar, Steven C. Clifford. 2010. Embryonal Tumors. , 34-51.
CrossRef59
David J Sher. (2010) Cost–effectiveness studies in radiation therapy. Expert Review of Pharmacoeconomics & Outcomes Research 10:5, 567-582
CrossRef60
David W. Ellison. (2010) Childhood medulloblastoma: novel approaches to the classification of a heterogeneous disease. Acta Neuropathologica 120:3, 305-316
CrossRef61
Michael E. Msall. (2010) Developing preschool surveillance tools for adaptive functioning: Lessons for neuro-oncology. European Journal of Paediatric Neurology 14:5, 368-379
CrossRef62
Kristen E. Robinson, John F. Kuttesch, Jennifer E. Champion, Charissa F. Andreotti, Dana W. Hipp, Alexandra Bettis, Anna Barnwell, Bruce E. Compas. (2010) A quantitative meta-analysis of neurocognitive sequelae in survivors of pediatric brain tumors. Pediatric Blood & Cancer 55:3, 525-531
CrossRef63
Belén Ferri Ñiguez, Juan F. Martínez-Lage, María-José Almagro, José-Luis Fuster, Cristina Serrano, María Amparo Torroba, Joaquín Sola. (2010) Embryonal tumor with abundant neuropil and true rosettes (ETANTR): a new distinctive variety of pediatric PNET: a case-based update. Child's Nervous System 26:8, 1003-1008
CrossRef64
Martin Benesch, Daniela Weber-Mzell, Nicolas U. Gerber, Katja von Hoff, Frank Deinlein, Jürgen Krauss, Monika Warmuth-Metz, Rolf-Dieter Kortmann, Torsten Pietsch, Pablo Hernáiz Driever, Franz Quehenberger, Christian Urban, Stefan Rutkowski. (2010) Ependymoma of the spinal cord in children and adolescents: a retrospective series from the HIT database. Journal of Neurosurgery: Pediatrics 6:2, 137-144
CrossRef65
Eric Bouffet, Uri Tabori, Annie Huang, Ute Bartels. (2010) Possibilities of new therapeutic strategies in brain tumors. Cancer Treatment Reviews 36:4, 335-341
CrossRef66
Dezső Schuler. (2010) A kemoterápia szerepe a gyermekkori medulloblastoma kezelésében. Magyar Onkológia 54:2, 145-152
CrossRef67
Theodore Nicolaides, Tarik Tihan, Biljana Horn, Jaclyn Biegel, Michael Prados, Anuradha Banerjee. (2010) High-dose chemotherapy and autologous stem cell rescue for atypical teratoid/rhabdoid tumor of the central nervous system. Journal of Neuro-Oncology 98:1, 117-123
CrossRef68
Sharon Conroy, Martin Garnett, Michael Vloeberghs, Richard Grundy, Ian Craven, David Walker. (2010) Medulloblastoma in childhood: revisiting intrathecal therapy in infants and children. Cancer Chemotherapy and Pharmacology 65:6, 1173-1189
CrossRef69
Jason T. Huse, Eric C. Holland. (2010) Targeting brain cancer: advances in the molecular pathology of malignant glioma and medulloblastoma. Nature Reviews Cancer 10:5, 319-331
CrossRef70
Laura J. Klesse, Daniel C. Bowers. (2010) Childhood Medulloblastoma. CNS Drugs 24:4, 285-301
CrossRef71
Dattatraya Muzumdar, Enrique CG Ventureyra. (2010) Treatment of posterior fossa tumors in children. Expert Review of Neurotherapeutics 10:4, 525-546
CrossRef72
Aurora Navajas, Jordi Giralt. (2010) Evidence in medulloblastomas. Clinical and Translational Oncology 12:4, 271-277
CrossRef73
Stefan Rutkowski, Bruce Cohen, Jonathan Finlay, Roberto Luksch, Vita Ridola, Dominique Valteau-Couanet, Junichi Hara, Maria-Luisa Garre, Jacques Grill. (2010) Medulloblastoma in young children. Pediatric Blood & Cancer 54:4, 635-637
CrossRef74
Amar Gajjar, Barry Pizer. (2010) Role of high-dose chemotherapy for recurrent medulloblastoma and other CNS primitive neuroectodermal tumors. Pediatric Blood & Cancer 54:4, 649-651
CrossRef75
Michael Karremann, Ulrike Rausche, Gudrun Fleischhack, Michaela Nathrath, Torsten Pietsch, Christof M. Kramm, Johannes E. A. Wolff. (2010) Clinical and epidemiological characteristics of pediatric gliosarcomas. Journal of Neuro-Oncology 97:2, 257-265
CrossRef76
Stephen A. Sands, Jennifer A. Oberg, Sharon L. Gardner, Jennifer A. Whiteley, Julia L. Glade-Bender, Jonathan L. Finlay. (2010) Neuropsychological functioning of children treated with intensive chemotherapy followed by myeloablative consolidation chemotherapy and autologous hematopoietic cell rescue for newly diagnosed CNS tumors: An analysis of the Head Start II survivors. Pediatric Blood & Cancer 54:3, 429-436
CrossRef77
Katja von Hoff, Wolfgang Hartmann, André Oscar von Bueren, Nicolas Ulrich Gerber, Michael Andreas Grotzer, Torsten Pietsch, Stefan Rutkowski. (2010) Large cell/anaplastic medulloblastoma: Outcome according to myc status, histopathological, and clinical risk factors. Pediatric Blood & Cancer 54:3, 369-376
CrossRef78
Patricia K. Duffner. (2010) Risk factors for cognitive decline in children treated for brain tumors. European Journal of Paediatric Neurology 14:2, 106-115
CrossRef79
David I. Sandberg, Kenneth M. Crandall, Tulay Koru-Sengul, Kyle R. Padgett, John Landrum, Darwin Babino, Carol K. Petito, Juan Solano, Manuel Gonzalez-Brito, John W. Kuluz. (2010) Pharmacokinetic analysis of etoposide distribution after administration directly into the fourth ventricle in a piglet model. Journal of Neuro-Oncology 97:1, 25-32
CrossRef80
H. Kimura, L. Zhang, M. Zhao, K. Hayashi, H. Tsuchiya, K. Tomita, M. Bouvet, J. Wessels, R. M. Hoffman. (2010) Targeted therapy of spinal cord glioma with a genetically modified Salmonella typhimurium. Cell Proliferation 43:1, 41-48
CrossRef81
Roger J. Packer, Tobey MacDonald, Gilbert Vezina. (2010) Central Nervous System Tumors. Hematology/Oncology Clinics of North America 24:1, 87-108
CrossRef82
R.G. Grundy, S.H. Wilne, K.J. Robinson, J.W. Ironside, T. Cox, W.K. Chong, A. Michalski, R.H.A. Campbell, C.C. Bailey, N. Thorp, B. Pizer, J. Punt, D.A. Walker, D.W. Ellison, D. Machin. (2010) Primary postoperative chemotherapy without radiotherapy for treatment of brain tumours other than ependymoma in children under 3 years: Results of the first UKCCSG/SIOP CNS 9204 trial. European Journal of Cancer 46:1, 120-133
CrossRef83
James C. Marsh, Benjamin T. Gielda, Arnold M. Herskovic, Ross A. Abrams. (2010) Cognitive Sparing during the Administration of Whole Brain Radiotherapy and Prophylactic Cranial Irradiation: Current Concepts and Approaches. Journal of Oncology 2010, 1-16
CrossRef84
Yue-Jun Fu, Jun Du, Ren-Jia Yang, Li-Tian Yin, Ai-Hua Liang. (2010) Potential adenovirus-mediated gene therapy of glioma cancer. Biotechnology Letters 32:1, 11-18
CrossRef85
Arie Perry. 2010. Therapy-Associated Neuropathology. , 417-425.
CrossRef86
Thomas E. Merchant, Ian F. Pollack, Jay S. Loeffler. (2010) Brain Tumors Across the Age Spectrum: Biology, Therapy, and Late Effects. Seminars in Radiation Oncology 20:1, 58-66
CrossRef87
Ozlem Demir, Sheila Singh, Lars Klimaschewski, Isil Aksan Kurnaz. (2009) From Birth Till Death: Neurogenesis, Cell Cycle, and Neurodegeneration. The Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology 292:12, 1953-1961
CrossRef88
Martin Benesch, Andrea Moser, Petra Sovinz, Herwig Lackner, Wolfgang Schwinger, Hans Eder, Christian Urban. (2009) Medulloblastoma in a child with down syndrome: Long-term remission with multimodality treatment. Pediatric Blood & Cancer 53:6, 1150-1151
CrossRef89
Martin Benesch, Nele Siegler, Katja von Hoff, Lisa Lassay, Gabriele Kropshofer, Hermann Müller, Constanze Sommer, Stefan Rutkowski, Gudrun Fleischhack, Christian Urban. (2009) Safety and toxicity of intrathecal liposomal cytarabine (Depocyte) in children and adolescents with recurrent or refractory brain tumors: a multi-institutional retrospective study. Anti-Cancer Drugs 20:9, 794-799
CrossRef90
Michael Glantz, Santosh Kesari, Lawrence Recht, Gudrun Fleischhack, Alexis Van Horn. (2009) Understanding the Origins of Gliomas and Developing Novel Therapies: Cerebrospinal Fluid and Subventricular Zone Interplay. Seminars in Oncology 36, S17-S24
CrossRef91
Donna L. Johnston, Daniel Keene, Ute Bartels, Anne-Sophie Carret, Bruce Crooks, David D. Eisenstat, Chris Fryer, Lucie Lafay-Cousin, Valerie Larouche, Albert Moghrabi, Beverly Wilson, Shayna Zelcer, Mariana Silva, Josee Brossard, Eric Bouffet. (2009) Medulloblastoma in children under the age of three years: a retrospective Canadian review. Journal of Neuro-Oncology 94:1, 51-56
CrossRef92
Maryam Fouladi, Sri Gururangan, Albert Moghrabi, Peter Phillips, Lindsey Gronewold, Dana Wallace, Robert A. Sanford, Amar Gajjar, Larry E. Kun, Richard Heideman. (2009) Carboplatin-based primary chemotherapy for infants and young children with CNS tumors. Cancer 115:14, 3243-3253
CrossRef93
Anna M. Butturini, Mary Jacob, Jennifer Aguajo, Noam A. Vander-Walde, Judy Villablanca, Rima Jubran, Anat Erdreich-Epstein, Araz Marachelian, Girish Dhall, Jonathan L. Finlay. (2009) High-dose chemotherapy and autologous hematopoietic progenitor cell rescue in children with recurrent medulloblastoma and supratentorial primitive neuroectodermal tumors. Cancer 115:13, 2956-2963
CrossRef94
Sabine Mueller, Susan Chang. (2009) Pediatric brain tumors: Current treatment strategies and future therapeutic approaches. Neurotherapeutics 6:3, 570-586
CrossRef95
Shawna L. Palmer, Laurie Leigh. (2009) Survivors of pediatric posterior fossa tumors: Cognitive outcome, intervention, and risk-based care. European Journal of Oncology Nursing 13:3, 171-178
CrossRef96
Erica L. Woodahl, Matthew H. Crouthamel, Tot Bui, Danny D. Shen, Rodney J. Y. Ho. (2009) MDR1 (ABCB1) G1199A (Ser400Asn) polymorphism alters transepithelial permeability and sensitivity to anticancer agents. Cancer Chemotherapy and Pharmacology 64:1, 183-188
CrossRef97
Sarah Fattet, Christine Haberler, Patricia Legoix, Pascale Varlet, Arielle Lellouch-Tubiana, Severine Lair, Elodie Manie, Marie-Anne Raquin, Danielle Bours, Sabrina Carpentier, Emmanuel Barillot, Jacques Grill, Francois Doz, Stephanie Puget, Isabelle Janoueix-Lerosey, Olivier Delattre. (2009) Beta-catenin status in paediatric medulloblastomas: correlation of immunohistochemical expression with mutational status, genetic profiles, and clinical characteristics. The Journal of Pathology 218:1, 86-94
CrossRef98
Michael Karremann, Torsten Pietsch, Gisela Janssen, Christof M. Kramm, Johannes E. A. Wolff. (2009) Anaplastic ganglioglioma in children. Journal of Neuro-Oncology 92:2, 157-163
CrossRef99
Duo Chen, Xiangtai Wei, Qiang Yin, Junhong Guan, Weiran Pan, Chenglin Wang, Yunhui Liu. (2009) The microscopic surgical treatment for tumor of posterior cranial fossa in children. Clinical Oncology and Cancer Research 6:2, 95-99
CrossRef100
Jun Matsubayashi, Kuniaki Tsuchiya, Takashi Matsunaga, Kiyoshi Mukai. (2009) Methotrexate-related leukoencephalopathy without radiation therapy: Distribution of brain lesions and pathological heterogeneity on two autopsy cases. Neuropathology 29:2, 105-115
CrossRef101
Roger J. Packer. (2009) Primary postoperative chemotherapy without radiotherapy for intracranial ependymoma in children. Current Neurology and Neuroscience Reports 9:2, 94-96
CrossRef102
Preethi Prasad, Hernan Vasquez, Chandra M. Das, Vidya Gopalakrishnan, Johannes E. A. Wolff. (2009) Histone acetylation resulting in resistance to methotrexate in choroid plexus cells. Journal of Neuro-Oncology 91:3, 279-286
CrossRef103
P FOSSATI, U RICARDI, R ORECCHIA. (2009) Pediatric medulloblastoma: Toxicity of current treatment and potential role of protontherapy. Cancer Treatment Reviews 35:1, 79-96
CrossRef104
Joon Won Yoon, Richard Gilbertson, Stephen Iannaccone, Philip Iannaccone, David Walterhouse. (2009) Defining a role for Sonic hedgehog pathway activation in desmoplastic medulloblastoma by identifying GLI1 target genes. International Journal of Cancer 124:1, 109-119
CrossRef105
Robert P. Sanders, Arzu Onar, James M. Boyett, Alberto Broniscer, E. Brannon Morris, Ibrahim Qaddoumi, Gregory T. Armstrong, Frederick A. Boop, Robert A. Sanford, Larry E. Kun, Thomas E. Merchant, Amar Gajjar. (2008) M1 Medulloblastoma: high risk at any age. Journal of Neuro-Oncology 90:3, 351-355
CrossRef106
S. Rutkowski, G. Fleischhack. (2008) Medulloblastome, primitiv neuroektodermale Tumoren und Ependymome. Monatsschrift Kinderheilkunde 156:12, 1187-1193
CrossRef107
Richard P. Kadota, Donald H. Mahoney, John Doyle, Reggie Duerst, Henry Friedman, Emi Holmes, Larry Kun, Tianni Zhou, Ian F. Pollack. (2008) Dose intensive melphalan and cyclophosphamide with autologous hematopoietic stem cells for recurrent medulloblastoma or germinoma. Pediatric Blood & Cancer 51:5, 675-678
CrossRef108
Alberto Gulino, Antonietta Arcella, Felice Giangaspero. (2008) Pathological and molecular heterogeneity of medulloblastoma. Current Opinion in Oncology 20:6, 668-675
CrossRef109
Shaker Abdullah, Ibrahim Qaddoumi, Eric Bouffet. (2008) Advances in the Management of Pediatric Central Nervous System Tumors. Annals of the New York Academy of Sciences 1138:1, 22-31
CrossRef110
Takaaki Yanagisawa, Ute Bartels, Eric Bouffet. (2008) Role of Prognostic Factors in the Management of Pediatric Solid Tumors. Annals of the New York Academy of Sciences 1138:1, 32-42
CrossRef111
Jason Fangusaro, Jonathan L. Finlay. (2008) Radiation therapy approaches do not currently improve overall survival in young children with sPNET as compared to the Head Start I and II experience. Pediatric Blood & Cancer 51:1, 149-150
CrossRef112
J. Clayton, M. Vloeberghs, T. Jaspan, D. Walker, D. MacArthur, R. Grundy. (2008) Intrathecal chemotherapy delivered by a lumbar-thecal catheter in metastatic medulloblastoma: a case illustration. Acta Neurochirurgica 150:7, 709-712
CrossRef113
Aaron C. Spalding, Daniel A. Hamstra. (2008) Radiation therapy reduces local failure and improves overall survival in sPNET. Pediatric Blood & Cancer 51:1, 148-148
CrossRef114
Natacha Entz-Werle, Emilie De Carli, Stéphane Ducassou, Michèle Legrain, Jacques Grill, Christelle Dufour. (2008) Medulloblastoma: what is the role of molecular genetics?. Expert Review of Anticancer Therapy 8:7, 1169-1181
CrossRef115
Girish Dhall, Howard Grodman, Lingyun Ji, Stephen Sands, Sharon Gardner, Ira J. Dunkel, Geoffrey B. McCowage, Blanca Diez, Jeffrey C. Allen, Anjali Gopalan, Albert S. Cornelius, Amanda Termuhlen, Minnie Abromowitch, Richard Sposto, Jonathan L. Finlay. (2008) Outcome of children less than three years old at diagnosis with non-metastatic medulloblastoma treated with chemotherapy on the “Head Start” I and II protocols. Pediatric Blood & Cancer 50:6, 1169-1175
CrossRef116
Junichi Yoshimura, Kenichi Nishiyama, Hiroshi Mori, Hideaki Takahashi, Yukihiko Fujii. (2008) Intrathecal chemotherapy for refractory disseminated medulloblastoma. Child's Nervous System 24:5, 581-585
CrossRef117
David I. Sandberg, Kenneth M. Crandall, Carol K. Petito, Kyle R. Padgett, John Landrum, Darwin Babino, Danshe He, Juan Solano, Manuel Gonzalez-Brito, John W. Kuluz. (2008) Chemotherapy administration directly into the fourth ventricle in a new piglet model. Journal of Neurosurgery: Pediatrics 1:5, 373-380
CrossRef118
Pawel K Wlodarski, Jaroslaw Jozwiak. (2008) Therapeutic targets for medulloblastoma. Expert Opinion on Therapeutic Targets 12:4, 449-461
CrossRef119
Zakia Shinwari, Pulicat S. Manogaran, Salman A. Alrokayan, Khaled A. Al-Hussein, Abdelilah Aboussekhra. (2008) Vincristine and lomustine induce apoptosis and p21WAF1 up-regulation in medulloblastoma and normal human epithelial and fibroblast cells. Journal of Neuro-Oncology 87:2, 123-132
CrossRef120
Joseph L. Lasky, Eun Jun Choi, Samantha Johnston, William H. Yong, Jorge Lazareff, Theodore Moore. (2008) Congenital Brain Tumors. Journal of Pediatric Hematology/Oncology 30:4, 326-331
CrossRef121
Kevin C. Braganca, Roger J. Packer. (2008) Neurotoxicity of chemotherapeutic and biologic agents in children with cancer. Current Neurology and Neuroscience Reports 8:2, 114-122
CrossRef122
Roger J. Packer, Tobey MacDonald, Gilbert Vezina. (2008) Central Nervous System Tumors. Pediatric Clinics of North America 55:1, 121-145
CrossRef123
Eli E Bar, Duncan Stearns. (2008) New developments in medulloblastoma treatment: the potential of a cyclopamine–lovastatin combination. Expert Opinion on Investigational Drugs 17:2, 185-195
CrossRef124
M. Douglas Ris, Dean W. Beebe. (2008) Neurodevelopmental outcomes of children with low-grade gliomas. Developmental Disabilities Research Reviews 14:3, 196-202
CrossRef125
Valerie Larouche, Annie Huang, Ute Bartels, Eric Bouffet. (2007) Tumors of the central nervous system in the first year of life. Pediatric Blood & Cancer 49:S7, 1074-1082
CrossRef126
Yasushi Nishihira, Chun-Feng Tan, Junko Hirato, Junichi Yoshimura, Kenichi Nishiyama, Hideaki Takahashi, Yukihiko Fujii, Hitoshi Takahashi. (2007) A case of congenital supratentorial tumor: Atypical teratoid/rhabdoid tumor or primitive neuroectodermal tumor?. Neuropathology 27:6, 551-555
CrossRef127
John R Crawford, Tobey J MacDonald, Roger J Packer. (2007) Medulloblastoma in childhood: new biological advances. The Lancet Neurology 6:12, 1073-1085
CrossRef128
Jaroslaw Jozwiak, Wieslawa Grajkowska, Pawel Wlodarski. (2007) Pathogenesis of medulloblastoma and current treatment outlook. Medicinal Research Reviews 27:6, 869-890
CrossRef129
Jacques Grill, Ranjeev Bhangoo. (2007) Recent development in chemotherapy of paediatric brain tumours. Current Opinion in Oncology 19:6, 612-615
CrossRef130
Li-Tian Yin, Yue-Jun Fu, Qiao-Ling Xu, Jun Yang, Zeng-Li Liu, Ai-Hua Liang, Xiao-Jun Fan, Cheng-Gang Xu. (2007) Potential biochemical therapy of glioma cancer. Biochemical and Biophysical Research Communications 362:2, 225-229
CrossRef131
Maria Moschovi, Theodora Stavrou, Nick Dessypris, Ilias Skalkidis, Dimitris Karalis, Gregory H. Reaman, Alisa M. Goldstein, Neophytos Prodromou, Fotini Tzortzatou-Stathopoulou, Eleni Th. Petridou. (2007) Survival among children with medulloblastoma in Greece: gains from transition to chemotherapy and socio-economic differentials. European Journal of Cancer Prevention 16:5, 460-465
CrossRef132
Stefan Pfister, Marc Remke, Grischa Toedt, Wiebke Werft, Axel Benner, Frank Mendrzyk, Andrea Wittmann, Frauke Devens, Katja von Hoff, Stefan Rutkowski, Andreas Kulozik, Bernhard Radlwimmer, Wolfram Scheurlen, Peter Lichter, Andrey Korshunov. (2007) Supratentorial primitive neuroectodermal tumors of the central nervous system frequently harbor deletions of theCDKN2A locus and other genomic aberrations distinct from medulloblastomas. Genes, Chromosomes and Cancer 46:9, 839-851
CrossRef133
Richard G Grundy, Sophie A Wilne, Claire L Weston, Kath Robinson, Linda S Lashford, James Ironside, Tim Cox, W Kling Chong, Richard HA Campbell, Cliff C Bailey, Rao Gattamaneni, Sue Picton, Nicky Thorpe, Conor Mallucci, Martin W English, Jonathan AG Punt, David A Walker, David W Ellison, David Machin. (2007) Primary postoperative chemotherapy without radiotherapy for intracranial ependymoma in children: the UKCCSG/SIOP prospective study. The Lancet Oncology 8:8, 696-705
CrossRef134
JA Laissue, H Blattmann, H P Wagner, M A Grotzer, D N Slatkin. (2007) Prospects for microbeam radiation therapy of brain tumours in children to reduce neurological sequelae. Developmental Medicine & Child Neurology 49:8, 577-581
CrossRef135
Toshio Uesaka, Tadahisa Shono, Daisuke Kuga, Satoshi O. Suzuki, Hiroaki Niiro, Kyoko Miyamoto, Kenichi Matsumoto, Masahiro Mizoguchi, Masaru Ohta, Toru Iwaki, Tomio Sasaki. (2007) Enhanced expression of DNA topoisomerase II genes in human medulloblastoma and its possible association with etoposide sensitivity. Journal of Neuro-Oncology 84:2, 119-129
CrossRef136
Erna MC Michiels, Antoinette YN Schouten-Van Meeteren, François Doz, Elvira C van Dalen, Erna MC Michiels. 2007. Chemotherapy for children with medulloblastoma. .
CrossRef137
A. M. Stark, S. Modlich, A. Claviez, A. Baalen, H.-H. Hugo, H. M. Mehdorn. (2007) Congenital diffuse anaplastic astrocytoma with ependymal and leptomeningeal spread: case report. Journal of Neuro-Oncology 84:3, 325-328
CrossRef138
Anna Skowrońska-Gardas, Marzanna Chojnacka, Marzena Morawska-Kaczyńska, Danuta Perek, Marta Perek-Polnik. (2007) Patterns of failure in children with medulloblastoma treated with 3D conformal radiotherapy. Radiotherapy and Oncology 84:1, 26-33
CrossRef139
Daniel C. Bowers, Lynn Gargan, Bradley E. Weprin, Arlynn F. Mulne, Roy D. Elterman, Louis Munoz, Cole A. Giller, Naomi J. Winick. (2007) Impact of site of tumor recurrence upon survival for children with recurrent or progressive medulloblastoma. Journal of Neurosurgery: Pediatrics 107:1, 5-10
CrossRef140
Ki Woong Sung, Keon Hee Yoo, Eun Joo Cho, Hong Hoe Koo, Do Hoon Lim, Hyung Jin Shin, Seung Do Ahn, Young Shin Ra, Eun Seok Choi, Thad T. Ghim. (2007) High-dose chemotherapy and autologous stem cell rescue in children with newly diagnosed high-risk or relapsed medulloblastoma or supratentorial primitive neuroectodermal tumor. Pediatric Blood & Cancer 48:4, 408-415
CrossRef141
Marcos A. Santos, Célia M.P. Viégas, Renata A. Servidoni, Mario H.M. Barros, Maria Isabel Pinel, Carlos M.M. Araújo. (2007) Timing of radiation in children with medulloblastoma/PNET. Pediatric Blood & Cancer 48:4, 416-422
CrossRef142
Martin Benesch, Petra Sovinz, Barbara Krammer, Herwig Lackner, Georg Mann, Wolfgang Schwinger, Helmut Gadner, Christian Urban. (2007) Feasibility and Toxicity of Intrathecal Liposomal Cytarabine in 5 Children and Young Adults With Refractory Neoplastic Meningitis. Journal of Pediatric Hematology/Oncology 29:4, 222-226
CrossRef143
James W Clarke, Mersiha Hadziahmetovic, Katherine Tzou, Ching C Lau, Arnold C Paulino, John C Grecula, Joseph F Montebello, Nina A Mayr, Simon S Lo. (2007) What is the best adjuvant treatment for very young patients with medulloblastoma?. Expert Review of Neurotherapeutics 7:4, 373-381
CrossRef144
Charles S. McManamy, Jane Pears, Claire L. Weston, Zoltan Hanzely, James W. Ironside, Roger E. Taylor, Richard G. Grundy, Steven C. Clifford, David W. Ellison, . (2007) Nodule Formation and Desmoplasia in Medulloblastomas—Defining the Nodular/Desmoplastic Variant and Its Biological Behavior. Brain Pathology 17:2, 151-164
CrossRef145
D. Kombogiorgas, S. Sgouros, A. R. Walsh, A. D. Hockley, M. Stevens, R. Grundy, A. Peet, M. English, D. Spooner. (2007) Outcome of children with posterior fossa medulloblastoma: a single institution experience over the decade 1994–2003. Child's Nervous System 23:4, 399-405
CrossRef146
Iacopo Sardi, Duccio Cavalieri, Maura Massimino. (2007) Emerging Treatments and Gene Expression Profiling in High-Risk Medulloblastoma. Pediatric Drugs 9:2, 81-96
CrossRef147
Todd J. Janus, W. K. Alfred Yung. 2007. Primary Neurological Tumors. , 1053-1080.
CrossRef148
Frank Berthold, Uta Dirksen, Ulrich Gö Bel, Norbert Graf, Barbara Hero, Heribert Jü Rgens, Thomas Klingebiel, Ewa Koscielniak, Dietrich Von Schweinitz, Thorsten Simon, Regina Wieland, Johannes Wolff. 2007. Solide Tumoren. , 805-870.
CrossRef149
Bernward G. Hinkes, Katja Hoff, Frank Deinlein, Monika Warmuth-Metz, Niels Soerensen, Beate Timmermann, Uwe Mittler, Christian Urban, Udo Bode, Torsten Pietsch, Paul G. Schlegel, Rolf D. Kortmann, Joachim Kuehl, Stefan Rutkowski. (2006) Childhood pineoblastoma: experiences from the prospective multicenter trials HIT-SKK87, HIT-SKK92 and HIT91. Journal of Neuro-Oncology 81:2, 217-223
CrossRef150
Robyn Stargatt, Jeffrey V. Rosenfeld, Vicki Anderson, Timothy Hassall, Wirginia Maixner, David Ashley. (2006) Intelligence and adaptive function in children diagnosed with brain tumour during infancy. Journal of Neuro-Oncology 80:3, 295-303
CrossRef151
Peter C. Warnke, Klaus Kopitzki, Jens Timmer, Christoph B. Ostertag. (2006) Capillary physiology of human medulloblastoma. Cancer 107:9, 2223-2227
CrossRef152
Stefan Rutkowski. (2006) Current treatment approaches to early childhood medulloblastoma. Expert Review of Neurotherapeutics 6:8, 1211-1221
CrossRef153
Nicholas G. Gottardo, Amar Gajjar. (2006) Current therapy for medulloblastoma. Current Treatment Options in Neurology 8:4, 319-334
CrossRef154
Amit Jain, Rakesh Jalali, Trimurti D. Nadkarni, Suash Sharma. (2006) Primary intramedullary primitive neuroectodermal tumor of the cervical spinal cord. Journal of Neurosurgery: Spine 4:6, 497-502
CrossRef155
S. Rutkowski, A. Gnekow, G. Fleischhack, S. Wagner, G. Calaminus, J. Wolff, H. Müller, N. Sörensen, A. Faldum, M. Tatagiba, T. Pietsch, M. Warmuth-Metz, R. Kortmann. (2006) Hirntumoren bei Kindern und Jugendlichen. Der Onkologe 12:6, 533-545
CrossRef156
Timothy R. Gershon, Orren J. Becher. (2006) Medulloblastoma: Therapy and biologic considerations. Current Neurology and Neuroscience Reports 6:3, 200-206
CrossRef157
Melissa J Siegel, Jonathan L Finlay, Stergios Zacharoulis. (2006) State of the art chemotherapeutic management of pediatric brain tumors. Expert Review of Neurotherapeutics 6:5, 765-779
CrossRef158
Shih-Hwa Chiou, Chung-Lan Kao, Han-Tso Lin, Wen-Ser Tseng, Ren-Shyan Liu, Chen-Fun Chung, Hung-Hai Ku, Ching-Po Lin, Tai-Tong Wong. (2006) Monitoring the growth effect of xenotransplanted human medulloblastoma in an immunocompromised mouse model using in vitro and ex vivo green fluorescent protein imaging. Child's Nervous System 22:5, 475-480
CrossRef159
Maria Luisa Garre’, Armando Cama, Claudia Milanaccio, Lorenza Gandola, Maura Massimino, Sandro Dallorso. (2006) New concepts in the treatment of brain tumors in very young children. Expert Review of Neurotherapeutics 6:4, 489-500
CrossRef160
Arie Perry, Robert E. Schmidt. (2006) Cancer therapy-associated CNS neuropathology: an update and review of the literature. Acta Neuropathologica 111:3, 197-212
CrossRef161
A Ehrbrecht, U Müller, M Wolter, A Hoischen, A Koch, B Radlwimmer, B Actor, A Mincheva, T Pietsch, P Lichter, G Reifenberger, RG Weber. (2006) Comprehensive genomic analysis of desmoplastic medulloblastomas: identification of novel amplified genes and separate evaluation of the different histological components. The Journal of Pathology 208:4, 554-563
CrossRef162
M V Blagosklonny. (2006) Target for cancer therapy: proliferating cells or stem cells. Leukemia 20:3, 385-391
CrossRef163
Susannah Motl, Yanli Zhuang, Christopher M Waters, Clinton F Stewart. (2006) Pharmacokinetic Considerations in the Treatment of CNS Tumours. Clinical Pharmacokinetics 45:9, 871-903
CrossRef164
M.J. Ruiz-Gómez, M. Martínez-Morillo. (2006) Iron(III) Chloride Hexahydrate Does Not Enhance Methotrexate Cytotoxicity on <i>Saccharomyces cerevisiae</i>. Chemotherapy 52:5, 226-230
CrossRef165
Jen-Ho Tseng, Ming-Yuan Tseng. (2006) Survival Analysis of Children with Primary Malignant Brain Tumors in England and Wales: A Population-Based Study. Pediatric Neurosurgery 42:2, 67-73
CrossRef166
S. Rutkowski, M. Warmuth-Metz, N. Sörensen, A. Faldum, T. Pietsch, H. Müller, A. Gnekow, U. Göbel, J. Wolff, G. Fleischhack, R. Kortmann. (2005) Hirntumoren im Kindesalter. Der Onkologe 11:10, 1090-1100
CrossRef167
Roger J Packer. (2005) Is postoperative chemotherapy alone sufficient to treat young children with medulloblastoma?. Nature Clinical Practice Oncology 2:8, 386-387
CrossRef168
Laura Newman. (2005) POSTOPERATIVE CHEMOTHERAPY BOLSTERS FIVE-YEAR OUTCOMES IN EARLY CHILDHOOD MEDULLOBLASTOMAS. Neurology Today 5:7, 67
CrossRef169
(2005) Treatment of Brain Tumors. New England Journal of Medicine 352:22, 2350-2353
Full Text170
Aurora Navajas Gutiérrez, Ana Fernández-Teijeiro Álvarez, . (2005) Embryonic tumours of the central nervous system. Clinical and Translational Oncology 7:5, 219-227
CrossRef171
DeAngelis, Lisa M., . (2005) Chemotherapy for Brain Tumors — A New Beginning. New England Journal of Medicine 352:10, 1036-1038
Full Text172
Michael B. Ranke, David A. Price, Anders Lindberg, Patrick Wilton, Feyza Darendeliler, Edward O. Reiter. (2005) Final Height in Children with Medulloblastoma Treated with Growth Hormone. Hormone Research 64:1, 28-34
CrossRef
- Letters
