Cognitive outcomes among survivors of focal low-grade brainstem tumors diagnosed in childhood.

Pediatric focal low-grade brainstem tumors are associated with excellent prognosis. Surgical resection and conformal radiation therapy are front-line treatment options; radiation therapy (RT) serves as an excellent treatment for disease progression. Given high survival rates and limited research regarding functional outcomes, the current study examined neurocognitive outcomes in a group of low-grade brainstem glioma survivors.

Whole-Body Pediatric Neuroblastoma Imaging: 123I-mIBG and Beyond.

Pediatric cancer imaging stands to benefit from higher tumor detection sensitivity without ionizing radiation exposure. A prospective protocol compared diagnostic I-metaiodobenzylguanidine (I-mIBG) with whole-body diffusion-weighted MRI (DWI) to validate adjunctive methods of identifying small-volume oligometastatic neuroblastoma tumor deposits. Dual-modality imaging (I-mIBG and DWI) was obtained within a 3- and 25-day window at baseline and again at one year in the first enrolled patient.

Phase II Trial of Erlotinib during and after Radiotherapy in Children with Newly Diagnosed High-Grade Gliomas.

Background: Epidermal growth factor receptor is overexpressed in most pediatric high-grade gliomas (HGG). Since erlotinib had shown activity in adults with HGG, we conducted a phase II trial of erlotinib and local radiotherapy (RT) in children with newly diagnosed HGG.

Methods: Following maximum surgical resection, patients between 3 and 21 years with non-metastatic HGG received local RT at 59.

Methods for image guided and intensity modulated radiation therapy in high-risk abdominal neuroblastoma.

Purpose: Our purpose was to determine methods for image guided intensity modulated radiation therapy (IMRT) in pediatric abdominal high-risk neuroblastoma and to quantify the degree of normal tissue dose reduction by using volumes compliant with International Commission on Radiation Units and Measurements (ICRU) Report 62.

Methods And Materials: Eight consecutive children with high-risk abdominal neuroblastoma (median age, 2.5 years; range, 20 months-5 years) were treated with IMRT using volumes accounting for physiologic motion (IMRT_phys) and daily pretreatment cone beam computed tomographic localization.

Effect of time from diagnosis to start of radiotherapy on children with diffuse intrinsic pontine glioma.

Background: Children with diffuse intrinsic pontine glioma (DIPG) continue to have poor outcomes, and radiotherapy (RT) is the only temporarily effective treatment. In this retrospective analysis, we studied the effect of time from diagnosis to start of RT on event-free survival (EFS) and overall survival (OS) in children with DIPG.

Methods: Records of children (n = 95) with DIPG treated with RT at a single institution between April 1999 and September 2009 were analyzed.

Clinico-radiologic characteristics of long-term survivors of diffuse intrinsic pontine glioma.

Diffuse intrinsic pontine glioma (DIPG) is the deadliest central nervous system tumor in children. The survival of affected children has remained poor despite treatment with radiation therapy (RT) with or without chemotherapy. We reviewed the medical records of all surviving patients with DIPG treated at our institution between October 1, 1992 and May 31, 2011.

Phase I trial, pharmacokinetics, and pharmacodynamics of vandetanib and dasatinib in children with newly diagnosed diffuse intrinsic pontine glioma.

Purpose: Testing of promising drug combinations is crucial in the treatment of diffuse intrinsic pontine glioma (DIPG). As the VEGF and platelet-derived growth factor (PDGF) pathways are critical in gliomas, we evaluated the safety, maximum tolerated dose (MTD), pharmacokinetics, and pharmacodynamics of vandetanib, a VEGFR-2 inhibitor, combined with dasatinib, a potent PDGFR inhibitor, during and after radiotherapy in children with newly diagnosed DIPG.

Experimental Design: Dasatinib was started concurrently with radiotherapy.

Management and outcome of focal low-grade brainstem tumors in pediatric patients: the St. Jude experience.

Object: Whereas diffuse intrinsic pontine gliomas generally have a short symptom duration and more cranial nerve involvement, focal brainstem gliomas are commonly low grade, with fewer cranial neuropathies. Although these phenotypic distinctions are not absolute predictors of outcome, they do demonstrate correlation in most cases. Because there is a limited literature on focal brainstem gliomas in pediatric patients, the objective of this paper was to report the management and outcome of these tumors.

Intensity modulated radiation therapy provides excellent local control in high-risk abdominal neuroblastoma.

Background: Locoregional failure is a significant concern in patients with high-risk abdominal neuroblastoma (NB) receiving radiotherapy. Locoregional control outcomes were studied in children with NB receiving intensity modulated radiotherapy (IMRT).

Procedure: Twenty children (11 females, 9 males) with NB (median age at diagnosis 3.

Novel assessment of renal motion in children as measured via four-dimensional computed tomography.

Objectives: Abdominal intensity-modulated radiation therapy and proton therapy require quantification of target and organ motion to optimize localization and treatment. Although addressed in adults, there is no available literature on this issue in pediatric patients. We assessed physiologic renal motion in pediatric patients.

Sequencing of local therapy affects the pattern of treatment failure and survival in children with atypical teratoid rhabdoid tumors of the central nervous system.

Purpose: To assess the pattern of treatment failure associated with current therapeutic paradigms for childhood atypical teratoid rhabdoid tumors (AT/RT).

Methods And Materials: Pediatric patients with AT/RT of the central nervous system treated at our institution between 1987 and 2007 were retrospectively evaluated. Overall survival (OS), progression-free survival, and cumulative incidence of local failure were correlated with age, sex, tumor location, extent of disease, and extent of surgical resection.

Enhancement of cell recognition in vitro by dual-ligand cancer targeting gold nanoparticles.

A dual-ligand gold nanoparticle (DLGNP) was designed and synthesized to explore the therapeutic benefits of multivalent interactions between gold nanoparticles (GNPs) and cancer cells. DLGNP was tested on human epidermal cancer cells (KB), which had high expression of folate receptor. The cellular uptake of DLGNP was increased by 3.

Daily image-guided localization for neuroblastoma.

The purpose was to quantify the setup margin for pediatric patients with neuro-blastoma using cone beam CT imaging (CBCT) and ultrasound localization. Ten patients, with a median age of 4.3 years (1.

Phase I study of vandetanib during and after radiotherapy in children with diffuse intrinsic pontine glioma.

Purpose: To evaluate the safety, maximum-tolerated dose, pharmacokinetics, and pharmacodynamics of vandetanib, an oral vascular endothelial growth factor receptor 2 (VEGFR2) and epidermal growth factor receptor inhibitor, administered once daily during and after radiotherapy in children with newly diagnosed diffuse intrinsic pontine glioma.

Patients And Methods: Radiotherapy was administered as 1.8-Gy fractions (total cumulative dose of 54 Gy).

Radiation therapy as part of local control of metastatic neuroblastoma: the St Jude Children's Research Hospital experience.

Purpose: The purpose of the study was to compare outcomes of pediatric patients with high-risk metastatic neuroblastoma who received radiotherapy (RT) with those of patients who did not.

Patients And Methods: We reviewed the records of 63 patients with newly diagnosed metastatic neuroblastoma treated at our institution (1989-2001) to investigate their characteristics at presentation, dose and field of RT, treatment response, and failure patterns.

Results: Seventeen patients received RT, and 46 did not.

Irradiation of pediatric high-grade spinal cord tumors.

Purpose: To report the outcome using radiation therapy (RT) for pediatric patients with high-grade spinal cord tumors.

Methods And Materials: A retrospective chart review was conducted that included 17 children with high-grade spinal cord tumors treated with RT at St. Jude Children's Research Hospital between 1981 and 2007.

Locoregional tumor progression after radiation therapy influences overall survival in pediatric patients with neuroblastoma.

Purpose: There is renewed attention to primary site irradiation and local control for patients with high-risk neuroblastoma (NB). We conducted a retrospective review to identify factors that might predict for locoregional tumor control and its impact on overall survival.

Methods And Materials: Between July 2000 through August 2006, a total of 44 pediatric patients with NB received radiation therapy (RT) with curative intent using computed tomography (CT)-based treatment planning.