Childhood Astrocytomas Treatment (PDQ®): Treatment - Health Professional Information [NCI] - General Information
This PDQ summary contains content that is also included in the PDQ Childhood Cerebellar Astrocytoma,PDQ Childhood Cerebral Astrocytoma,and PDQ Childhood Visual Pathway/ Hypothalamic Glioma summaries. In the future,the PDQ Childhood Cerebellar Astrocytoma,PDQ Childhood Cerebral Astrocytoma,and PDQ Childhood Visual Pathway/Hypothalamic Glioma summaries.will be removed from the National Cancer ...
Childhood Brain and Spinal Cord Tumors Treatment Overview (PDQ®): Treatment - Patient Information [NCI] - nci_ncicdr0000257997-nci-header
This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.Childhood Brain and Spinal Cord Tumors Treatment Overview
Neuroblastoma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Treatment of Stage 4S Neuroblastoma
Most cases of stage 4S neuroblastoma do not require therapy. However, if bulk disease is causing organ compromise and risk of death, low-dose to moderate-dose chemotherapy and/or radiation therapy is used. Eight percent to 10% of these patients will have MYCN amplification and are treated with high-risk protocols. (Refer to the Treatment of High-Risk Neuroblastoma section of this summary for more information about the treatment of stage 4S high-risk neuroblastoma.)Table 9. Children's Oncology Group (COG) Neuroblastoma Stage 4S Group Assignment Schema Used for COG-P9641 and COG-A3961 StudiesaINSS StageAgeMYCNStatusINPC ClassificationDNA PloidybRisk GroupINPC = International Neuroblastoma Pathologic Classification; INSS = International Neuroblastoma Staging System.a The COG-P9641 and COG-A3961 trials established the current standard of care for neuroblastoma patients in terms of risk group assignment and treatment strategies.b DNA Ploidy: DNA Index (DI) > 1 is favorable, = 1 is
Pituitary Tumors Treatment (PDQ®): Treatment - Health Professional Information [NCI] - General Information About Pituitary Tumors
Pituitary tumors represent from 10% to 25% of all intracranial neoplasms. Depending on the study cited, pituitary tumors can be classified into three groups according to their biological behavior:[1,2]Benign adenoma.Invasive adenoma.Carcinoma. Adenomas comprise the largest portion of pituitary neoplasms with an overall estimated prevalence of approximately 17%. Only a minority of adenomas are symptomatic. In addition, pituitary adenomas may be distinguished anatomically as intrapituitary, intrasellar, diffuse, and invasive. Invasive adenomas, which account for approximately 35% of all pituitary neoplasms, may invade the dura mater, cranial bone, or sphenoid sinus. Carcinomas account for 0.1% to 0.2% of all pituitary tumors.[6,7]Clinical PresentationThe most characteristic-presenting features of pituitary adenomas include inappropriate pituitary hormone secretion and visual field deficits.Rare signs and symptoms of pituitary disease include:Cranial nerve palsies.Temporal
Childhood Ependymoma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Treatment of Newly Diagnosed Childhood Ependymoma
In the newly diagnosed patient, careful evaluation to fully determine the extent of disease must precede the treatment of ependymoma. Surgery should be performed in an attempt at maximal tumor reduction; children have improved progression-free survival (PFS) if there is minimal residual disease present after surgery.[1,2] Postoperatively, magnetic resonance imaging (MRI) should be performed to determine the extent of resection, although the rate of dissemination is low. If not performed preoperatively, MRI of the entire neuraxis should be obtained to evaluate for disease dissemination. Myxopapillary ependymomas, considered to be a benign histologic subtype of ependymoma, have a relatively high incidence of central nervous system (CNS) tumor dissemination at diagnosis and at follow-up, and require imaging of the complete cranial spinal axis at the time of diagnosis and during follow-up.[3,4] Patients with residual tumor or disseminated disease should be considered at high risk for
Pituitary Tumors Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Changes to This Summary (07 / 27 / 2012)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above. Stage Information for Pituitary TumorsUpdated staging information for 2010 (cited Edge et al. as reference 1).This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ NCI's Comprehensive Cancer Database pages.
Childhood Ependymoma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Histopathologic Classification of Childhood Ependymal Tumors
In the most recent World Health Organization (WHO) classification of brain tumors, ependymal tumors are classified into four main subtypes:Subependymoma (WHO Grade I).Myxopapillary ependymoma (WHO Grade I).Ependymoma (WHO Grade II). Variants include cellular, papillary, tanycytic, clear cell, and mixed.Anaplastic (also known as malignant) ependymoma (WHO Grade III).The subependymoma is a slow-growing benign neoplasm, typically attached to the ventricle wall, and is composed of glial tumor cell clusters embedded in a fibrillary matrix. The myxopapillary ependymoma arises almost exclusively in the location of the conus medullaris, cauda equina, and filum terminale of the spinal cord, and is characterized histologically by tumor cells arranged in a papillary manner around vascularized myxoid stromal cores.The ependymoma, which is considered a Grade II neoplasm originating from the walls of the ventricles or from the spinal canal, is composed of neoplastic ependymal cells.
Pituitary Tumors Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Thyrotropin-Producing Tumors Treatment
Standard Treatment Options for Thyrotropin-Producing TumorsStandard treatment options for thyrotropin-producing tumors include the following:Surgery (usually a transsphenoidal approach), with or without adjuvant radiation therapy.[1,2] Somatostatin analogues, such as octreotide.[3,4]Transsphenoidal surgery is the treatment of choice for patients with thyrotropic adenomas. Adjuvant radiation therapy may be employed when surgery is known to be noncurative even if the patient is still euthyroid because relapse is inevitable, and the full effect of radiation therapy requires months or years. Medical therapy may be required for patients who still have hyperthyroid symptoms despite surgery and external radiation. Somatostatin analogues are the drugs of choice for treatment; however, the efficacy of treatment may wane with time.[1,2,3,4]Current Clinical TrialsCheck for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with pituitary tumor. The
Childhood Brain Stem Glioma Treatment (PDQ®): Treatment - Patient Information [NCI] - About This PDQ Summary
About PDQPhysician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government's center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.Purpose of This SummaryThis PDQ cancer information summary has current
Neuroblastoma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage Information for Neuroblastoma
Staging EvaluationA thorough evaluation for metastatic disease is performed before therapy initiation. The following studies are typically performed:Metaiodobenzylguanidine (mIBG) scanBefore resection of the primary tumor, bone involvement is assessed by mIBG scan, which is applicable to all sites of disease, and by technetium-99 scan if the results of the mIBG scan are negative or unavailable.[2,3] Approximately 90% of neuroblastomas will be mIBG avid. It has a sensitivity and specificity of 90% to 99% and is equally distributed between primary and metastatic sites. Although iodine 128 (123 I) has a shorter half-life, it is preferred over131 I because of its lower radiation dose, better quality images, less thyroid toxicity, and lower cost. Imaging with 123 I-mIBG is optimal for identifying soft tissue and bony metastases and is superior to 18F-fluorodeoxyglucose positron emission tomography–computerized tomography (PET-CT) in a prospective comparison. Baseline mIBG