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J Clin Oncol 2021 Jun 10:JCO2002730. Epub 2021 Jun 10.

Department of Developmental Neurobiology, St Jude Children's Research Hospital, Memphis, TN.

Purpose: Children with average-risk medulloblastoma (MB) experience survival rates of ≥ 80% at the expense of adverse consequences of treatment. Efforts to mitigate these effects include deintensification of craniospinal irradiation (CSI) dose and volume.

Methods: ACNS0331 (ClinicalTrials. Read More

Radiother Oncol 2021 Jun 5;161:118-125. Epub 2021 Jun 5.

Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Belgium.

Background: Childhood infratentorial tumor patients frequently suffer from long-term cognitive deficits. As each constituent of their treatment can lead to neurotoxicity, cascade effects can lead to profound reorganization of the underlying brain network, the so-called 'connectome'. However, to date, few studies have assessed the relationship between brain network topology, the functional role of network hubs (i. Read More

Cancers (Basel) 2021 May 26;13(11). Epub 2021 May 26.

Laboratory of Laser Molecular Spectroscopy, Institute of Applied Radiation Chemistry, Lodz University of Technology, Wroblewskiego 15, 93-590 Lodz, Poland.

We used Raman imaging to monitor changes in the redox state of the mitochondrial cytochromes in ex vivo human brain and breast tissues, surgically resected specimens of human tissues and in vitro human brain cells of normal astrocytes (NHA), astrocytoma (CRL-1718), glioblastoma (U87-MG) and medulloblastoma (Daoy), and human breast cells of normal cells (MCF 10A), slightly malignant cells (MCF7) and highly aggressive cells (MDA-MB-231) by means of Raman microspectroscopy at 532 nm. We visualized localization of cytochromes by Raman imaging in the major organelles in cancer cells. We demonstrated that the "redox state Raman marker" of the ferric low-spin heme in cytochrome at 1584 cm can serve as a sensitive indicator of cancer aggressiveness. Read More

Int J Mol Sci 2021 May 6;22(9). Epub 2021 May 6.

Intraoperative Imaging Unit, Chair and Clinic of Neurosurgery and Neurotraumatology, Karol Marcikowski University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland.

Medulloblastoma (MB) is one of the most frequent and malignant brain tumors in children. The prognosis depends on the advancement of the disease and the patient's age. Current therapies, which include surgery, chemotherapy, and irradiation, despite being quite effective, cause significant side effects that influence the central nervous system's function and cause neurocognitive deficits. Read More

Case Rep Ophthalmol Med 2021 15;2021:7793382. Epub 2021 May 15.

Department of Neurosurgery, Dr. D.Y. Patil Medical College and Hospital, Pimpri, Pune, Maharashtra, India.

Background: All children between 0 and 16 years presenting with brain tumours confirmed by Magnetic Resonance Imaging (MRI) and treated surgically in our institute were included in this study.

Objective: The aim of this study is to evaluate the neuroophthalmic and clinical characteristics of intracranial space occupying lesions in children.

Methods: Neuroophthalmic manifestations along with location of the tumour by contrast-enhanced MRI, type of surgical intervention, and postoperative histopathological diagnosis were evaluated. Read More

Neuro Oncol 2021 May 28. Epub 2021 May 28.

Group Genome Instability in Tumors, German Cancer Research Center (DKFZ).

Background: Medulloblastomas with chromothripsis developing in children with Li-Fraumeni Syndrome (germline TP53 mutations) are highly aggressive brain tumors with dismal prognosis. Conventional photon radiotherapy and DNA-damaging chemotherapy are not successful for these patients and raise the risk of secondary malignancies. We hypothesized that the pronounced homologous recombination deficiency in these tumors might offer vulnerabilities that can be therapeutically utilized in combination with high linear energy transfer carbon ion radiotherapy. Read More

Int J Radiat Oncol Biol Phys 2021 May 8. Epub 2021 May 8.

Department of Surgery, Duke University Medical Center, Durham, North Carolina. Electronic address:

Purpose: Radiation therapy (RT) modulates immune cells and cytokines, resulting in both clinically beneficial and detrimental effects. The changes in peripheral blood T lymphocyte subsets and cytokines during RT for pediatric brain tumors and the association of these changes with therapeutic outcomes have not been well described.

Methods And Materials: The study population consisted of children (n = 83, aged 3~18) with primary brain tumors (medulloblastoma, glioma, germ cell tumors (GCT), and central nervous system embryonal tumor-not otherwise specified), with or without residual or disseminated (R/D) diseases who were starting standard postoperative focal or craniospinal irradiation (CSI). Read More

Autops Case Rep 2021 Apr 22;11:e2021258. Epub 2021 Apr 22.

Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Departamento de Patología y Citología, Monterrey, México.

Congenital medulloblastoma is a rare brain tumor that appears in less than 1% of pediatric patients. Congenital medulloblastoma has a poor prognosis and should be suspected in patients with clinical manifestations of hyporeactivity, slow suction reflexes, and the presence of hydrocephalus. Herein we present the case of a 12-day-old female newborn who developed non-communicative hydrocephalus, hyporeactivity, and hyporeflexia. Read More

Neurooncol Adv 2021 Jan-Dec;3(1):vdab030. Epub 2021 Apr 28.

Children's Brain Tumour Research Centre, Division of Child Health, Obstetrics and Gynaecology, School of Medicine, University of Nottingham, Nottingham, UK.

Background: Therapeutic intervention in metastatic medulloblastoma is dependent on elucidating the underlying metastatic mechanism. We investigated whether an epithelial-mesenchymal transition (EMT)-like pathway could drive medulloblastoma metastasis.

Methods: A 3D Basement Membrane Extract (3D-BME) model was used to investigate medulloblastoma cell migration. Read More

Diagnostics (Basel) 2021 Apr 2;11(4). Epub 2021 Apr 2.

Department of Onco-Hematology and Cell and Gene Therapy, Bambino Gesù Children's Hospital (IRCCS), 00165 Rome, Italy.

Brain tumors are the most common solid neoplasms of childhood. They are frequently reported in children with Neurofibromatosis type 1 (NF1). The most frequent central nervous system malignancies described in NF1 are optic pathway gliomas and brainstem gliomas. Read More

J Adolesc Young Adult Oncol 2021 Apr 23. Epub 2021 Apr 23.

Department of Radiation Oncology and ACTREC/TMH, Tata Memorial Center, Homi Bhabha National Institute (HBNI), Mumbai, India.

Medulloblastomas, comprising 20%-25% of all primary brain tumors in children are much rarer in adulthood. Disease biology varies substantially across different age groups; however, owing to rarity, adults with medulloblastoma are traditionally treated using pediatric protocols. This is a retrospective audit of adolescent and adult medulloblastoma from a comprehensive cancer center. Read More

World J Surg Oncol 2021 Apr 22;19(1):134. Epub 2021 Apr 22.

Department of Radiology, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Background: Medulloblastoma (MB) is the most common pediatric embryonal tumor. Accurate identification of cerebral spinal fluid (CSF) dissemination is important in prognosis prediction. Both MRI of the central nervous system (CNS) and CSF cytology will appear false positive and negative. Read More

Medicine (Baltimore) 2021 Apr;100(16):e25373

Department of Neurosurgery, West China Hospital, Sichuan University; 37 Guo Xue Xiang Road, Chengdu, Sichuan, P. R. China.

Introduction: Radiation induced gliomas often occurs after radiation therapy for other brain tumors. Medulloblastoma often occurs in children and its associated radiation-induced glioblastoma multiforme's (GBM) after radiotherapy often has a long latency period. Our case is very unique because the medulloblastoma was detected at an advance age and the latency period of radiation-induced GBM was relatively shorter. Read More

Insights Imaging 2021 Apr 6;12(1):43. Epub 2021 Apr 6.

Neurosurgery Department, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, AlKhobar City, Eastern Province, Saudi Arabia.

Manifestations of an atypical variant of medulloblastoma of the posterior fossa in extra-axial locations have been reported, and key questions concerning its interpretation have been raised previously. This review illustrated the clinico-radiological and histopathological features of the posterior fossa extra-axial medulloblastoma and described possible management strategies. We thoroughly reviewed all atypical anatomical locations of medulloblastoma reported within the posterior fossa and extra-axial spaces. Read More

Arch Ital Biol 2020 12;158(3-4):74-81

Department of Neurosurgery, Faculty of Medicine, University of Dicle, 21280, Diyarbakır, Turkey - Email:

Posterior fossa tumors (PFTs) include medulloblastomas, atypical teratoid/rhabdoid tumors, pilocytic astrocytomas, ependymomas, and brainstem gliomas. We evaluated patients with surgery at our clinic, comparing epidemiological, clinical, radiological, and pathological characteristics of medulloblastoma and ependymoma to identify factors that might assist preoperative diagnosis, help to develop treatment algorithms, and have prognostic value after surgery. Pediatric patients from 0 to 16 and young adults from 16 to 29 years of age with surgery for pathologically confirmed ependymomas or medulloblastomas between January 2014 and January 2020 were eligible. Read More

Clin Oncol (R Coll Radiol) 2021 Jul 3;33(7):e295-e304. Epub 2021 Apr 3.

Department of Particle Therapy, University Hospital Essen, West German Proton Therapy Centre Essen, West German Cancer Centre, Essen, Germany; Department of Particle Therapy, University Hospital Essen, West German Proton Therapy Centre Essen (WPE), West German Cancer Center (WTZ), German Cancer Consortium (DKTK), Essen, Germany.

Aims: Proton beam therapy (PBT) has increasingly been applied for the treatment of young children when radiotherapy is needed. The treatment requires intensive multimodality care and is logistically demanding. In this analysis, we evaluated our experiences in treating infants with tumours of the central nervous system with PBT. Read More

Minerva Pediatr (Torino) 2021 Apr 2. Epub 2021 Apr 2.

Doctoral Program, Department of Radiology, Hanoi Medical University, Ha Noi, Vietnam -

Background: To evaluate the performance of diffusion tensor imaging (DTI) parameters for the distinction between pediatric medulloblastomas and pilocytic astrocytomas.

Methods: DTI was performed in 36 patients, who were divided into two groups: group 1 consisted of 26 patients with medulloblastoma, whereas group 2 consisted of 10 patients with pilocytic astrocytoma. The Mann-Whitney U test was utilized to compare the tumoral fractional anisotropy (tFA) and diffusivity (tMD) values and the tumor to parenchyma ratios for these values (rFA and rMD, respectively) between these two groups. Read More

Cancers (Basel) 2021 Mar 11;13(6). Epub 2021 Mar 11.

Department of Dermatology, Emory University School of Medicine, Atlanta, GA, 30322, USA.

Sonic hedgehog subtype of medulloblastoma (SHH MB) with metastasis or specific clinical or molecular alteration shas a poor prognosis and current therapy results in long-term cognitive impairment in the majority of survivors. Thus, a great need exists for new targeted therapeutic approaches to more effectively treat SHH MB in children. Imipramine blue (IB), a novel molecule with anti-tumor properties, inhibits the NADPH oxidase (NOX) family of enzymes, which are critical for SHH MB survival and treatment resistance. Read More

Front Pediatr 2020 2;8:598190. Epub 2021 Mar 2.

Doctoral Program, Department of Radiology, Hanoi Medical University, Ha Noi, Vietnam.

Arterial Spin Labeling (ASL), a perfusion assessment without using gadolinium-based contrast agents, is outstandingly advantageous for pediatric patients. The differentiation of medulloblastomas from pilocytic astrocytomas in children plays a significant role in determining treatment strategies and prognosis. This study aimed to assess the use of ASL parameters during the differentiation between pediatric medulloblastoma and pilocytic astrocytoma. Read More

No Shinkei Geka 2021 Mar;49(2):395-399

Department of Translational Research, Brain Research Institute, Niigata University.

Dysplastic cerebellar gangliocytoma or Lhermitte-Duclos disease(LDD)is a rare benign cerebellar lesion composed of dysplastic ganglion cells that conform to the existing cortical architecture. In this disease, the enlarged ganglion cells are predominantly located within the internal granular layer, and they thicken the cerebellar folia. The architecture of the affected cerebellar hemisphere with the enlarged cerebellar folia and the cystic changes, in some cases, present as "tiger-striped striations," a characteristic imaging finding that is not specific to LDD. Read More

Neuroradiology 2021 Mar 11. Epub 2021 Mar 11.

Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI, 48109, USA.

The authors present an atypical case of presumed stroke-like migraine attacks after radiation therapy (SMART) syndrome in the brainstem. A 29-year-old male, who had been treated with resection and subsequent craniospinal radiation for posterior fossa medulloblastoma 21 years before, presented with subacute progressive left hemiparesis evolving over 4 days. Hematological findings, cerebrospinal fluid (CSF), and electroencephalogram (EEG) were unremarkable. Read More

J Neurooncol 2021 May 10;152(3):567-572. Epub 2021 Mar 10.

The Sidney Kimmel Comprehensive Cancer Center, Bloomberg 11379, 1800 Orleans St., Baltimore, MD, 21231, USA.

Purpose: Therapy for medulloblastoma in patients < 4 years old omits radiotherapy due to anticipated neurocognitive deficits. The German Pediatric Brain Tumor Study Group described a chemotherapy regimen (HIT-SKK' 92 and HIT-SKK 2000) without radiation which yielded a 5-year progression-free survival (PFS) rate of 85% in children with nodular/desmoplastic medulloblastoma (NDMB) and medulloblastoma with extensive nodularity (MBEN). We modified the HIT-SKK regimen to reduce the total number of intrathecal methotrexate (IT MTX) doses from 12 to 2 doses/cycle and obviate Ommaya reservoir implantation through the use of lumbar administration. Read More

Cancers (Basel) 2021 Feb 25;13(5). Epub 2021 Feb 25.

Department of Neurosurgery, Spine and Peripheral Nerve Surgery, University Hospital WAM-CSW, Medical University of Lodz, Zeromskiego 113, 91-647 Lodz, Poland.

To monitor redox state changes and biological mechanisms occurring in mitochondrial cytochromes in cancers improving methods are required. We used Raman spectroscopy and Raman imaging to monitor changes in the redox state of the mitochondrial cytochromes in ex vivo human brain and breast tissues at 532 nm, 633 nm, 785 nm. We identified the oncogenic processes that characterize human infiltrating ductal carcinoma (IDC) and human brain tumors: gliomas; astrocytoma and medulloblastoma based on the quantification of cytochrome redox status by exploiting the resonance-enhancement effect of Raman scattering. Read More

AJNR Am J Neuroradiol 2021 05 4;42(5):961-968. Epub 2021 Mar 4.

Radiology Department (U.L., K.M., F.D.), UCL Great Ormond Street Hospital for Children, London, UK.

Background And Purpose: Primary posterior fossa tumors comprise a large group of neoplasias with variable aggressiveness and short and long-term outcomes. This study aimed to validate the clinical usefulness of a radiologic decision flow chart based on previously published neuroradiologic knowledge for the diagnosis of posterior fossa tumors in children.

Materials And Methods: A retrospective study was conducted (from January 2013 to October 2019) at 2 pediatric referral centers, Children's Hospital of Philadelphia, United States, and Great Ormond Street Hospital, United Kingdom. Read More

Anal Chem 2021 03 2;93(10):4408-4416. Epub 2021 Mar 2.

Techna Institute for the Advancement of Technology for Health, University Health Network, 100 College Street, Toronto, Ontario M5G 1P5, Canada.

Spatially resolved ambient mass spectrometry imaging methods have gained popularity to characterize cancer sites and their borders using molecular changes in the lipidome. This utility, however, is predicated on metabolic homogeneity at the border, which would create a sharp molecular transition at the morphometric borders. We subjected murine models of human medulloblastoma brain cancer to mass spectrometry imaging, a technique that provides a direct readout of tissue molecular content in a spatially resolved manner. Read More

Oncogene 2021 Mar 1;40(12):2258-2272. Epub 2021 Mar 1.

Cancer Biology Program, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA.

The Hedgehog (Hh) pathway plays an indispensable role in bone development and genetic activation of the pathway results in medulloblastoma (MB), the most common malignant brain tumor in children. Inhibitors of Hh pathway (such as vismodegib and sonedigib), which are used to treat MB, cause irreversible defects in bone growth in young children. Cholesterol is required for the activation of the Hh pathway, and statins, inhibitors of cholesterol biosynthesis, suppress MB growth by repressing Hh signaling in tumor cells. Read More

Case Rep Neurol 2021 Jan-Apr;13(1):40-45. Epub 2021 Jan 25.

Neurology Department, Hospital Nossa Senhora da Conceição (HNSC), Porto Alegre, Brazil.

Stroke-like migraine attacks after radiation therapy (SMART) syndrome is a rare late complication of brain irradiation. Patients commonly present recurrent attacks of headaches, seizures, and paroxysmal focal neurological deficits including aphasia, negligence, or hemianopsia. We report a 41-year-old male patient admitted to our emergency room with a reduced level of consciousness and global aphasia. Read More

Int J Part Ther 2021 31;7(3):1-10. Epub 2020 Dec 31.

Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Purpose: Patient travel time can cause treatment delays when providers and families decide to seek proton therapy. We examined whether travel distance or referral pattern (domestic versus international) affects time to radiation therapy and subsequent disease outcomes in patients with medulloblastoma at a large academic proton center.

Patients And Methods: Children with medulloblastoma treated at MD Anderson (MDA) with a protocol of proton beam therapy (PBT) between January 4, 2007, and June 25, 2014, were included in the analysis. Read More

Klin Padiatr 2021 May 17;233(3):127-134. Epub 2021 Feb 17.

Department of Pediatric Oncology and Hematology, Charité Universitätsmedizin Berlin, Berlin, Germany.

Background: MRI has shortcomings in differentiation between tumor tissue and post-therapeutic changes in pretreated brain tumor patients.

Patients: We assessed 22 static FET-PET/CT-scans of 17 pediatric patients (median age 12 years, range 2-16 years, ependymoma n=4, medulloblastoma n=4, low-grade glioma n=6, high-grade glioma n=3, germ cell tumor n=1, choroid plexus tumor n=1, median follow-up: 112 months) with multimodal treatment.

Method: FET-PET/CT-scans were analyzed visually by 3 independent nuclear medicine physicians. Read More

J Biomed Phys Eng 2021 Feb 1;11(1):39-46. Epub 2021 Feb 1.

PhD, Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Some brain tumors such as ependymoma and Medulloblastoma have similar MR images which may result to undifferentiated them from each other.

Objective: This study aimed to compare the apparent diffusion coefficient (ADC) of two different cerebellar pediatric tumors, including ependymoma and medulloblastoma which have shown similar clinical images in conventional magnetic resonance imaging (MRI) methods.

Material And Methods: In this analytical study, thirty six pediatric patients who were suspected to have the mentioned tumors according to their CT image findings were included in this study. Read More