4.3 Medulloblastoma- Group 3/Treatment
Group 3 accounts for 28% of all patients diagnosed with medulloblastoma. Unfortunately, these patients face the worst outlook in comparison to their SHH, WNT, and Group 4 counterparts, which are in part due to the high rate of metastasis in this subtype [41]. Group 3 tumors are most frequently found in infants and children with very few adults and older individuals. Molecular characterization of these tumors demonstrates many of these patients display MYC amplification with an associated poor overall prognosis. Furthermore, many of these patients have an overexpression of OTX2. There has been a correlation found between MYC over-expression and OTX2. More precisely, OTX2 overexpression has been thought to contribute to the over-expression of MYC [41, 44] This known interaction serves as a potential therapeutic target in these patients, but at present, very few treatment specific
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The overall prognosis of this tumor is not optimistic with mean survival sitting between 6 and 11 months [52]. This diagnosis is most often associated with infants and young children. Given the significant neurologic complications of radiation to the developing brain, physicians are often hesitant to radiate. Furthermore, the efficacy of chemotherapy has been historically difficult to quantify given a wide variety of regimens used with few patients enrolled in each study [53].
Historically, rhabdoid tumors have been difficult to diagnose given their heterogeneous nature. When using histological features alone, these tumors would often times be diagnosed as medulloblastoma or PNET [54]. Now, these tumors must be positive for mutations in INI1 or BRG1 in order to be diagnosed as an AT/RT [8]. This creates a much more objective standard for diagnosing these tumors, which in turn will lead to more homogenous groups of patients to better inform treatment and
Wolchok does not name specific instruments used for measurements, discuss reliability in terms of type and size of reliability coefficients, or name specific control procedures. The success rates of the different types of treatments are determined by visible tumor growth difference after treatment is administered as well as overall survival. Wolchok also notes that measuring success among immunotherapy treatments can be difficult and take nearly double the time to see results than other treatment methods. Even in patients whose brain scans show tumor growth 12 weeks after the treatment has begun, the growth may be indicative of T cells and other immune cells flooding the tumor. Henceforth, the difficulty of determining success among patients being treated with immunotherapies is far more perplexing than patients who have undergone chemotherapy or
The limitation listed caused for those children to be excluded from the study. Some children had verbal disabilities as well. The strengths were that the researchers had an audit trial and had independent auditing of the qualitative analysis. Credibility of the article was confirmed through, the design and research questions being consistent with the interpretive descriptive methodology. “The other nurse researcher conducted member checking with three participants by presenting and reviewing a summary of the findings to verify the accuracy of interpretation. Quantitative and qualitative findings were triangulated in this inquiry, optimizing representative credibility and enhancing substantive completeness” (Macartney & et al., 2014, P.392). The conclusions drawn by the researcher are the survivors experience multiple symptoms and have many way of coping with the symptoms. Their symptoms has a negative impact on their daily lives. This research contributes to nursing because through understanding the children symptoms and ways that brain tumors affect their lives we can provide additional support to the patient and families. This article gives us as nursing additional information to turn to when providing care for patients with brain tumors. Yes. There are grounds for further research on brain tumors.
DIPG (Diffuse Intrinsic Pontine Glioma) is a disease which strikes at the heart of childhood. At the base of the brain, just above the spinal cord is the brainstem. The tumor affects the pons area of the brainstem, supplying the nervous system function unattainable. ‘“There’s not a single drug approved”’ (Mukhopadhyay). Due to the location of the tumor, it cannot be surgically removed. Unfortunately, the only option available is Radiation that is considered temporary, with no benefits. “Chemotherapy is frequently ineffective, since anti-cancer drugs cannot cross the blood-brain barrier and reach the tumor” (Zhiping 2). In the end, leaves the patient and parents hopeless for fighting this
Gliomas are the most common type of primary brain tumor, accounting for 10-20% of its total. (5,19–21). Histopathology pattern is the most important feature in glioma classification. (22) The 2007 WHO classification of tumors of the central nervous system divides gliomas into four main types, with increasing degree of malignancy (from I-IV). Low-grade gliomas are defined a grade I and grade II, in opposition to the “high-grade gliomas”, WHO grade III and IV. The so-called “diffuse low-grade gliomas” integrate 2007 WHO II class, and include diffuse astrocytomas, oligodendroglioma and oligoastrocytoma (mixed glioma) (19). There are some pertinent critics to this grading system, such as the great inter-variability among neuropathologist experts. More importantly, 2007 WHO grading doesn’t contemplate the continuum between grade II and III. In fact, many DLGG has an “intermediate” behavior, with some more aggressive microfoci lodged in the core of the neoplasm (19,23,24). Hence, the term diffuse low-grade glioma is preferred in this article.
Also in the current study there were three cases of each of the following: undifferentiated round cell sarcoma and synovial sarcoma with mean ADC values: 0.52 + 0.20 and 1.02 + 0.30 x 10-3 mm2/sec (mean + SD) respectively; thus our results are consistent with those of Oka K, et al (24). In this study we encountered a case of malignant myxoid tumor (high-grade myxofibrosarcoma), its ADC
Dysregulation of the phosphoinositide 3-kinase (PI3K) pathway is one of the common factors observed in approximately 30% of human cancers [10]. In human cancer, PTEN loss or PIK3CA mutation occurs frequently which results in deregulation of the PI3K signaling pathway leading to resistance to antitumor therapies [11]. These pathways are also found to be involved in maintaining the transformed tumor state and metastasized mesothelioma [12-14]. In a recent study, the MET inhibitor PHA-665752 was shown to exert anti-proliferative effects in mesothelioma cell lines by inhibiting MET-dependent PI3K/AKT and RAF/MAPK [15, 16]. Several PI3K/AKT dual inhibitors have been currently studied in clinical trials which have been effective in mutant cancers. One such recently introduced dual PI3K/mTOR inhibitor, PF-04691502 (PF0) has shown potent anti-tumor activity against U87, SKOV3 (PIK3CA mutation), as well as gefitinib- and erlotinib-resistant non–small cell lung carcinoma xenografts indicating it has a broad anti-tumor activity [11]. In this study, we aim to develop and evaluate the potential of this dual inhibitor PF0 encapsulated targeted hybrid nanocarriers for the treatment of MM. In our understanding this is the first study to evaluate the
These CNS tumors have complex morphological features with many sources citing that the histiogenesis is uncertain about their cells of origin. The 2006 text Tumors of the Eye and Ocular Adenexa states that these tumors are capillary hemangiomas and are “endothelium-lined capillaries interspersed with pale, vacuolated stromal cells” and that these stromal cells are “believed to be astrocytes that have imbibed plasma lipids.”2 In 2008, the Intraocular Tumors: An Atlas Textbook 2nd Edition reports that “[t]here is little information available about the pathology of this rare neoplasm. It is a diffuse vascular mass composed mostly of small-caliber vessels believed to be derived from endothelial cells of uveal blood vessels.”3 The 2011 Eye Pathology: An Atlas and Text 2nd Edition, states that these retinal hemangioblastomas are “composed of capillaries
Common malignant brain cancers increase significantly according to statistical data collected by the National Cancer Institute. In 1984, the annual incidence rates of primary brain tumor and primary brain lymphoma also increased notably, the rate of lymphoma almost tripling,
A tumor in the brain is dangerous if it starts to compress parts of the brain causing neurological symptoms. This action can destroy the brain tissue it surrounds or it can block fluid in the brain from flowing. Although it is not cancerous it can also compress parts of the spinal cord depending where it is in the brain and can also stop the flow of blood in veins surrounding it.
24 patients developed new lesions in other regions of the brain and repeated GKS was performed. No local recurrence was observed in any patient with a mean of 17.8 months after GKS. Tentative any side effects or symptomatic radiation injuries in our patients was detected. Of the 24 patients who developed new lesions, 17 had a single lesion in the first recurrence and 24 in the total group had multiple injuries in a time after the first radiosurgery. All patients had previously been treated with chemotherapy (methotrexate). There seems to be a trend towards the development of new tumors in patients who had received no prior drug treatment for human immunodeficiency virus with retroviral therapy. No evidence of a relationship between recurrence and the original presentation of multiple or solitary lesions. The median survival time was 46.3 months for patients treated with prior antiretroviral
Rhabdomyosarcoma is an awfully common childhood and adolescent sarcoma characterized by skeletal muscle differentiation (Carroll & Nodit, 2013). According to the American Cancer Society (2014), rhabdomyosarcoma is a lot more prevalent in children due to the fact that rhabdomyblasts start to form approximately seven weeks into the development of an embryo and these are the cells that
Retinoblastoma is a form of cancer found in young children, which develops from cells of the retina, the tissue of the eye that detects light. It arises from a mutation, either a point mutation or complete deletion of both of the Rb tumour suppressor genes within a cell, and can be a result of inherited or sporadic genetic default. Loss or defect of this region on chromosome 13 means cells can proliferate uncontrollably, leading to tumour formation that not only affects the eye but can spread to the brain or cause metastases in bone, soft tissue and the central nervous system via haematogenous spread. The invasive treatment of large tumours can cause major consequences for sufferers; for example enucleation leads to loss of vision and radiotherapy can increase a child’s chances of developing second metastases.
Cancer, one of the most feared words in our vocabulary of this time, especially in childhood (Druker 1). Most people when thinking of “childhood cancer” envision very young children, although a “Nation Institute of Health Policy concerning inclusion of children in clinical research defines children as being younger than twenty-one years of age while the Food and Drug Administration considers children to be fifteen years and younger” (Ries 158). That being said, most cancers incidence peak among children occurs during the first year of life (Gurney 149). Some of the most well-known nationwide childhood cancers are leukemia, brain cancer, and other central nervous system cancers (oeconline 1). In conjunction, “the side effects of treatment,
Childhood cancer is something that can bring tears to your eyes when someone you know has been diagnosed. Good news is that approximately 80% of children are now surviving the specific cancers they have been diagnosed with. We know that children that receive chemotherapy and radiation have much greater side effects than ones that only have to deal with chemotherapy. Chemotherapy is a type of cancer treatment that uses a specific chemical makeup including anti-cancer drugs and are given to a patient to help get rid of their cancer cells. Radiation, on the other hand, is an emission of energy that can be used to destroy or shrink the cancer cells that are being produced. This type of treatment has much harder consequences and side effects compared to chemotherapy. Some of the side effects of chemotherapy and radiation are some learning and memory issues when the radiation involves the brain. Chest radiations also can cause cancers to come back or new cancers to evolve. These are
The human body is a complex system that is composed of billions of cells, undergoing growth, division and death in an orderly fashion on a daily basis. When this process occurs in an abnormal manner, the outcome is typically referred to as a tumor. In today’s world, tumor is a term that is commonly heard throughout the world. Also referred to as neoplasm, a tumor is an abnormal growth of tissue resulting from the rapid cell division due to some form of mutation (Cooper). They are classified into four main groups: benign, in situ, malignant and those with uncertain or unknown behaviour. Of the four classes of tumor, malignant neoplasms are those tumors that are typically referred to as cancers (Cooper). These tumors involve abnormal cell growth that has the potential to invade and destroy the surrounding tissue, possibly forming metastases and becoming fatal. Eye tumors are secondary tumors that results from a primary tumor that has spread from other parts of the body and have invaded the eye. There are two primary types that occur within the eye: retinoblastoma in children, and melanoma in adults.