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Brain tumours under the age of three. The price of survival

A retrospective study of 20 long-term survivors

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Summary

Between 1975 and 1989, 98 children with brain tumours under the age of three at time of diagnosis were entered into a retrospective study. Twenty of them are alive and free of tumour more than five years after treatment and were evaluated in this study. Thirteen tumour localizations were infratentorial and 7 were supratentorial. A histological examination was performed in 15 patients: 5 ependymomas, 6 medulloblastomas and 4 astrocytomas were identified. Fifteen patients underwent surgical removal of tumour, all but one received radiotherapy and 8 were given chemotherapy.

Only two children have not late effects. Analysis of long-term sequelae in survivors showed central endocrinopathies in 14 (70%), a neurological handicap in 13 (65%) and impaired cognitive functions in 17 (85%). Irradiation was clearly responsible for mental sequelae in 7 patients and endocrinopathies in 6 patients. The other possible causes are tumour injury, hydrocephalus or surgery. The risks incurred with radiotherapy and advances in infant brain tumour therapy are discussed.

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References

  1. Baram TZ, van EysJ, Dowel RE, Cangir A, Pack B, Bruner J (1987) Survival and neurologic outcome of infants with medulloblastoma treated with surgery and MOPP regimen. Cancer 60: 173–177

    PubMed  Google Scholar 

  2. Bloom HJG (1978) SIOP brain tumor trial. Abstracts of the 10th meeting of the International society of pediatric oncology. Medical Education Service: 25–39

  3. Brauner R, Czernichow P, Rappaport R (1984) Precocious puberty after hypothalamic and pituitary irradiation in young children. N Engl J Med 311: 920

    Google Scholar 

  4. Brauner R, Rappaport R, Prevot C, Czernichow R, Zucker JM, Bataini P, Lemerle J, Sarrazin D, Guyda HJ (1989) A prospective study of the development of growth hormone deficiency in children given cranial irradiation and its relation to statural growth. J Clin Endocrinol Metabl 68: 346–351

    Google Scholar 

  5. Brenot JC (1989) Repères et références statistiques sur les enseignements et la formation. Ministère de l'éducation nationale de la jeunesse et des sports, p 120

  6. Brouwers P, Riccardi R, Fedio P, Poplack DJ (1985) Long-term neuropsychologic sequelae of childhood leukemia: Correlation with CT brain scan abnormalities. J Pediatr 106: 723–728

    PubMed  Google Scholar 

  7. Calvo FA, Hornedo J, de la Torre A, Sachetti A, Arellano A, Aramburo P, Aragon G, Otero J (1983) Intracranial tumors with risk of dissemination in Neuroaxis. Int J Rad Oncol Biol Phys 9: 1297–1301

    Google Scholar 

  8. Chin HW, Maruyama Y (1984) Age at treatment and long-term performance results in medulloblastoma. Cancer 53: 1952–1958

    PubMed  Google Scholar 

  9. Danoff BF, Cowchock FS, Marquette C, Mulgrew L, Kramer S (1982) Assessment of the long-term effects of primary radiation therapy for brain tumors in children. Cancer 49: 1580–1586

    PubMed  Google Scholar 

  10. Davis PC, Hoffman JC, Pearl GS, Brain I (1986) CT evaluation of effects of cranial radiation therapy in children. AJR 147: 587–593

    PubMed  Google Scholar 

  11. Deutsch M (1982) Radiotherapy for brain tumors in very young children. Cancer 50: 2785–2789

    PubMed  Google Scholar 

  12. Duffner PK, Cohen ME, Voorhess ML, MacGillivray MH, Brecher ML, Panahon A, Gilani BB (1985) Long-term effects of cranial irradiation on endocrine function in children with brain tumors. Cancer 56: 2189–2193

    PubMed  Google Scholar 

  13. Fossati-Bellani F, Bellegotti L, Tesaro-Tess JD, Ballerini E, Savoiardo M, Lombardi F, Morandi F, Mossimino M, Gasparini M (1988) Preradiation chemotherapy for childhood and poor prognosis medulloblastoma. Pediatr Neurosci 14: 151

    Google Scholar 

  14. Geyer JR, Taylor E, Balsom W, Milstein J, Bleyer WA (1989) Radiation induced white matter necrosis in the immature CNS is correlated with migration of cells from the subependymal zone. Proc ASCO 30: 101

    Google Scholar 

  15. Haymaker W, Adams RD (1982) Sources in microglial cells during CNS development. In: Histology and histopathology of the nervous system. Ch C Thomas, Springfield, Ill, pp 495–511

    Google Scholar 

  16. Hirsch JF, Renier D, Czernichow, Benveniste L, Pierre-Kahn (1979) Medulloblastoma in childhood: Survival and functional results. Acta Neurochir (Wien) 48: 1–15

    Google Scholar 

  17. Horowitz ME, Mulhern RK, Kun LE, Kovnar E, Sanford RA, Simmons J, Hayes A, Jenkins JJ (1988) Brain tumors in the very young child: Postoperative chemotherapy in combined-modality treatment. Cancer 61: 428–434

    PubMed  Google Scholar 

  18. Jacobi G, Kornhuber B (1987) Malignant brain tumours in children. In: Jellinger K (ed) Therapy of malignant brain tumours. Springer, Wien New York

    Google Scholar 

  19. Jooma R, Kendall BE, Hayward RD (1984) Intracranial tumors in neonates: A report of seventeen cases. Surg Neurol 21: 165–170

    PubMed  Google Scholar 

  20. Kalifa D, Flamant F, Hartmann O, Vassel G, Lemerle J (1988) Post surgical chemotherapy without radiation in patients less than three years with malignant brain tumors. Pediatr Neurosci 14: 163

    Google Scholar 

  21. Kovnar E, Kun L, Douglass E, Kellie S, Sanford R, Langston J, Jenkins J, Fairclough D (1988) Preirradiation cisplatin and VP 16 for high risk medulloblastoma and other primitive neuroectodermal tumors of the central nervous system. Pediatr Neurosci 14: 151

    Google Scholar 

  22. Kun LE, Mulhern RK, Crisco JJ (1983) Quality of life in children treated for brain tumors. J Neurosurg 58: 1–6

    PubMed  Google Scholar 

  23. Li FP, Winston KR, Gimbrere K (1984) Follow-up of children with brain tumors. Cancer 54: 135–138

    PubMed  Google Scholar 

  24. Loeffler JS, Kretschmar CS, Sallan SE, la Vally BL, Winston KR, Fischer EG, Tarbell NJ (1988) Pre-radiation chemotherapy for infants and poor prognosis children with medulloblastoma. Int J Rad Oncol Biol Phys 15: 177–181

    Google Scholar 

  25. Meadows AT, Gordon J, Massari DJ, Littman P, Fergusson J, Moss K (1981) Declines in IQ scores and cognitive dysfunction in children with acute lymphoblastic leukaemia treated with cranial radiation. Lancet ii: 1015–1018

    Google Scholar 

  26. Mulhern RK, Kun LE (1985) Neuropsychologic function in children with brain tumors: Interval changes in the six months following treatment. Med Pediatr Oncol 13: 318–324

    PubMed  Google Scholar 

  27. Packer RJ, Meadows AT, Rorke LB, Goldwein JL, d'Angio G (1987) Long-term sequelae of cancer treatment on the central nervous system. Med Pediatr Oncol 15: 241–253

    PubMed  Google Scholar 

  28. Packer RJ, Sutton LN, Atkins TE, Radcliffe J, Bunin GR, d'Angio G, Siegel KR, Schut L (1989) A prospective study of cognitive function in children receiving whole-brain radiotherapy and chemotherapy: 2 years results. J Neurosurg 70: 707–713

    PubMed  Google Scholar 

  29. Rappaport R, Brauner R (1989) Growth and endocrine disorders secondary to cranial irradiation. Pediatr Res 25: 561–567

    PubMed  Google Scholar 

  30. Saaman NA, Vieto R, Schultz PN, Maor M, Meoz RT, Sampiere VA, Cangir A, Ried HL, Jesse RH (1982) Hypothalamic, pituitary and thyroid dysfunction after radiotherapy to the head and neck. Int J Rad Oncol Biol Phys 8: 1857–1867

    Google Scholar 

  31. Schlieper AE, Esseltine DW, Tarshis E (1989) Cognitive function in long survivors of childhood acute lymphoblastic leukemia. pediatr. Hematol Oncol 6: 1–9

    Google Scholar 

  32. Sheline GE, Wara WM, Smith V (1980) Therapeutic irradiation and brain injury. Int J Rad Oncol Biol Phys 6: 1215–1228

    Google Scholar 

  33. Silverman GL, Palkes H, Talent B, Kovnar E, Clouse JW, Thomas PRM (1984) Late effects of radiotherapy on patients with cerebellar medulloblastoma. Cancer 54: 825–829

    PubMed  Google Scholar 

  34. Soni SS, Marten GW, Pitner Se, Cuenas DA, Powazek M (1975) Effects of central-nervous-system irradiation on neuropsychologic functioning of children with acute lymphoblastic leukemia. The N Engl J Med: 113–118

  35. Spunberg JJ, Chang CH, Goldman M, Auricchio E, Bell JJ (1981) Quality of long-term survival follwing irradiation for intracranial tumors in children under the age of two. Int J Oncol Biol Phys 7: 727–736

    Google Scholar 

  36. Tomita T, McLone DG (1985) Brain tumors during the first twenty-four months of life. Neurosurgery 17: 913–919

    PubMed  Google Scholar 

  37. Tomita T, McLone DG (1986) Medulloblastoma in childhood: results of radical resection and low-dose neuraxis radiation therapy. J Neurosurg 64: 238–242

    PubMed  Google Scholar 

  38. Van Eys J, Cangir A, Coody D, Smith B (1985) MOPP regimen as primary chemotherapy for brain tumors in infants. J Neuro-Oncol 3: 237–243

    Google Scholar 

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Authors and Affiliations

  1. Service de Pediatrie, Institut Gustave Roussy, Villejuif

    E. Suc, C. Kalifa, G. Vassal & J. Lemerle

  2. Service d'Endocrinologie Pediatrique, Hopital Necker Enfants Malades, Paris

    R. Brauner

  3. Service de Radiotherapie, Institut Gustave Roussy, France

    J. L. Habrand

  4. Service d'Anatomopathologie, Institut Gustave Roussy, Villejuif, France

    M. J. Terrier-Lacombe

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  1. E. Suc
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  2. C. Kalifa
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  3. R. Brauner
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  4. J. L. Habrand
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  5. M. J. Terrier-Lacombe
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  6. G. Vassal
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  7. J. Lemerle
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Suc, E., Kalifa, C., Brauner, R. et al. Brain tumours under the age of three. The price of survival. Acta neurochir 106, 93–98 (1990). https://doi.org/10.1007/BF01809448

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