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dc.date.accessioned2018-07-05T11:41:12Z
dc.date.issued2017
dc.identifierhttp://publications.icr.ac.uk/16316/
dc.identifier.citationPEDIATRIC BLOOD & CANCER, 2017, 64 (11)
dc.identifier.issn1545-5009
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/2000
dc.description.abstractBackground: The introduction of aggressive chemo-radiotherapy regimens has improved overall survival in children with primitive neuroectodermal tumours (PNET). However, these combinations may result in neurotoxicity. Previously reported magnetic resonance imaging abnormalities in children receiving intensive sequential chemotherapy, hyperfractionated accelerated radiotherapy (HART) and high-dose thiotepa prompted us to investigate the degree of brain volume loss and patients' functional status after therapy. Methods: We retrospectively reviewed clinico-radiological data of children with PNET treated in this way at our centre. Results: We studied 14 children treated between December 2009 and April 2013. Data were not complete for one child. Performance status was severely restricted in four children, and mildly to moderately impaired in 7 of the 13 children. Eleven of 13 children showed mild-to-severe generalised neuroparenchymal atrophy, in 7 of whom neuroparenchymal volume loss was moderate to severe. Of these seven, six had received high-dose thiotepa. There was no correlation between brain volume loss and Lansky performance status. However, unexpected neurotoxicities, such as symptoms of transverse myelitis, were observed. Conclusion: Measurement of brain volume loss in patients treated with HART and high-dose thiotepa may not be sufficient to predict function. However, correlation of brain volume loss due to late neurotoxicity with performance decline may be more obvious over longer period of follow-up. The combination of HART and myeloablative courses of thiotepa is associated with severe neurotoxicity and subsequent decline in performance status in a significant proportion of patients.
dc.languageeng
dc.language.isoeng
dc.subjectbrain volume chemotherapy Lansky medulloblastoma radiotherapy central-nervous-system corpus-callosum white-matter magnetic-resonance craniospinal radiotherapy maintenance chemotherapy risk medulloblastoma radiation-therapy classification irradiation Oncology Hematology Pediatrics
dc.titleImpact of induction chemotherapy, hyperfractionated accelerated radiotherapy and high-dose thiotepa on brain volume loss and functional status of children with primitive neuroectodermal tumour
dc.typeJournal Article
rioxxterms.licenseref.startdate2017
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfPEDIATRIC BLOOD & CANCER
pubs.issue11
pubs.notesISI Document Delivery No.: FH3OO Times Cited: 0 Cited Reference Count: 32 Szychot, Elwira Seunarine, Kiran Mankad, Kshitij Thust, Steffi Clark, Chris Gaze, Mark N. Michalski, Antony NIHR University College London Hospitals Biomedical Research Centre NIHR University College London Hospitals Biomedical Research Centre. 0 Wiley Hoboken 1545-5017 none Background: The introduction of aggressive chemo-radiotherapy regimens has improved overall survival in children with primitive neuroectodermal tumours (PNET). However, these combinations may result in neurotoxicity. Previously reported magnetic resonance imaging abnormalities in children receiving intensive sequential chemotherapy, hyperfractionated accelerated radiotherapy (HART) and high-dose thiotepa prompted us to investigate the degree of brain volume loss and patients' functional status after therapy. Methods: We retrospectively reviewed clinico-radiological data of children with PNET treated in this way at our centre. Results: We studied 14 children treated between December 2009 and April 2013. Data were not complete for one child. Performance status was severely restricted in four children, and mildly to moderately impaired in 7 of the 13 children. Eleven of 13 children showed mild-to-severe generalised neuroparenchymal atrophy, in 7 of whom neuroparenchymal volume loss was moderate to severe. Of these seven, six had received high-dose thiotepa. There was no correlation between brain volume loss and Lansky performance status. However, unexpected neurotoxicities, such as symptoms of transverse myelitis, were observed. Conclusion: Measurement of brain volume loss in patients treated with HART and high-dose thiotepa may not be sufficient to predict function. However, correlation of brain volume loss due to late neurotoxicity with performance decline may be more obvious over longer period of follow-up. The combination of HART and myeloablative courses of thiotepa is associated with severe neurotoxicity and subsequent decline in performance status in a significant proportion of patients.
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Magnetic Resonance
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Magnetic Resonance
pubs.volume64
pubs.embargo.termsNot known
icr.researchteamMagnetic Resonanceen_US
dc.contributor.icrauthorSzychot, Elwiraen


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