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01-04-2009 | Clinical study - patient study

A multimodal strategy based on surgery, radiotherapy, ICE regimen and high dose chemotherapy in atypical teratoid/rhabdoid tumours: a single institution experience

Authors: Paola Fidani, Maria Antonietta De Ioris, Annalisa Serra, Luigi De Sio, Ilaria Ilari, Raffaele Cozza, Renata Boldrini, Giuseppe Maria Milano, Maria Luisa Garrè, Alberto Donfrancesco

Published in: Journal of Neuro-Oncology | Issue 2/2009

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Abstract

Purpose Atypical Teratoid/Rhabdoid Tumour is a rare and aggressive childhood tumour. The outcome of a series treated with the same multimodal strategy was reported. Patients The patients were treated with surgery, 2 courses of ifosfamide/carboplatin/etoposide(ICE), 2 courses of cyclophosphamide/etoposide/carboplatino/thiotepa (CECAT) or 2 other ICE courses, high dose chemotherapy (HDC) and radiotherapy. Results Eight patients underwent primary surgery achieving a complete removal in 3. Progressive disease (PD) occurred in 2/8 patients during ICE courses and in 3/4 during CECAT courses. After 4 courses 5 patients presented a PD. HDC was performed in 3 patients followed by local radiotherapy. The Kaplan Meier OS and EFS probability at 5 years are, respectively, 50% (CI 11–80%) and 33% (CI 6–66%). Conclusion A strategy based on surgery, including a second surgical look, and on radiotherapy appears the best option. ICE regimen and HDC correlate with good prognosis in some patients but this approach needs further evaluation.
Literature
2.
go back to reference Lefkowity IB, Rorke LB, Packer RJ et al (1987) Atypical teratoid tumor of infancy: definition of an entity. Ann Neurol 22:448–449 Lefkowity IB, Rorke LB, Packer RJ et al (1987) Atypical teratoid tumor of infancy: definition of an entity. Ann Neurol 22:448–449
4.
go back to reference Kleihues P, Louis DN, Scheithauer BW et al (2002) The WHO classification of tumours of the nervous system. J Neuropathol Exp Neurol 61:215–225PubMed Kleihues P, Louis DN, Scheithauer BW et al (2002) The WHO classification of tumours of the nervous system. J Neuropathol Exp Neurol 61:215–225PubMed
5.
go back to reference Parwani AV, Stelow EB, Pambuccian SE et al (2005) Atypical teratoid/rhabdoid tumor of the brain: cytopathologic characteristics and differential diagnosis. Cancer 25(105):65–70. doi:10.1002/cncr.20872 CrossRef Parwani AV, Stelow EB, Pambuccian SE et al (2005) Atypical teratoid/rhabdoid tumor of the brain: cytopathologic characteristics and differential diagnosis. Cancer 25(105):65–70. doi:10.​1002/​cncr.​20872 CrossRef
6.
go back to reference Biegel JA, Fogelgren B, Zhou JY et al (2000) Mutations of the INI1 rhabdoid tumor suppressor gene in medulloblastomas and primitive neuroectodermal tumours of the central nervous system. Clin Cancer Res 6:2759–2763PubMed Biegel JA, Fogelgren B, Zhou JY et al (2000) Mutations of the INI1 rhabdoid tumor suppressor gene in medulloblastomas and primitive neuroectodermal tumours of the central nervous system. Clin Cancer Res 6:2759–2763PubMed
7.
go back to reference Biegel JA, Tan L, Zhang F et al (2002) Alterations of the hSNF5/INI1 gene in central nervous system atypical teratoid/rhabdoid tumours and renal and extrarenal rhabdoid tumours. Clin Cancer Res 8:3461–3467PubMed Biegel JA, Tan L, Zhang F et al (2002) Alterations of the hSNF5/INI1 gene in central nervous system atypical teratoid/rhabdoid tumours and renal and extrarenal rhabdoid tumours. Clin Cancer Res 8:3461–3467PubMed
8.
go back to reference Haberler C, Laggner U, Slavc I, Czech T, Ambros I, Ambros P, Budka H, Hainfellner JA (2006) Immunohistochemical analysis of INI1 protein in malignant pediatric CNS tumours and in a fraction of primitive neuroectodermal tumours without rhabdoid phenotype. Am J Surg Pathol 30:1462–1468. doi:10.1097/01.pas.0000213329.71745.ef PubMedCrossRef Haberler C, Laggner U, Slavc I, Czech T, Ambros I, Ambros P, Budka H, Hainfellner JA (2006) Immunohistochemical analysis of INI1 protein in malignant pediatric CNS tumours and in a fraction of primitive neuroectodermal tumours without rhabdoid phenotype. Am J Surg Pathol 30:1462–1468. doi:10.​1097/​01.​pas.​0000213329.​71745.​ef PubMedCrossRef
9.
go back to reference Burger PC, Yu IT, Tihan T et al (1998) Atypical teratoid/rhabdoid tumor of the central nervous system: a highly malignant tumor of infancy and childhood frequently mistaken for medulloblastoma: a pediatric oncology group study. Am J Surg Pathol 22:1083–1092. doi:10.1097/00000478-199809000-00007 PubMedCrossRef Burger PC, Yu IT, Tihan T et al (1998) Atypical teratoid/rhabdoid tumor of the central nervous system: a highly malignant tumor of infancy and childhood frequently mistaken for medulloblastoma: a pediatric oncology group study. Am J Surg Pathol 22:1083–1092. doi:10.​1097/​00000478-199809000-00007 PubMedCrossRef
10.
go back to reference Rorke LB, Packer RJ, Biegel JA (1996) Central nervous system atypical teratoid/rhabdoid tumours of infancy and childhood: definition of an entity. J Neurosurg 85:56–65PubMedCrossRef Rorke LB, Packer RJ, Biegel JA (1996) Central nervous system atypical teratoid/rhabdoid tumours of infancy and childhood: definition of an entity. J Neurosurg 85:56–65PubMedCrossRef
11.
go back to reference Zimmerman MA, Goumnerova LC, Proctor M, Scott RM, Marcus K, Pomeroy SL, Turner CD, Chi SN, Chordas C, Kieran MW (2005) Continuous remission of newly diagnosed and relapsed central nervous system atypical teratoid/rhabdoid tumor. J Neurooncol Mar 72:77–84CrossRef Zimmerman MA, Goumnerova LC, Proctor M, Scott RM, Marcus K, Pomeroy SL, Turner CD, Chi SN, Chordas C, Kieran MW (2005) Continuous remission of newly diagnosed and relapsed central nervous system atypical teratoid/rhabdoid tumor. J Neurooncol Mar 72:77–84CrossRef
12.
go back to reference Tekautz TM, Fuller CE, Blaney S et al (2005) Atypical teratoid/rhabdoid tumours (ATRT): improved survival in children 3 years of age and older with radiation therapy and high-dose alkylator-based chemotherapy. J Clin Oncol 23:1491–1499. doi:10.1200/JCO.2005.05.187 PubMedCrossRef Tekautz TM, Fuller CE, Blaney S et al (2005) Atypical teratoid/rhabdoid tumours (ATRT): improved survival in children 3 years of age and older with radiation therapy and high-dose alkylator-based chemotherapy. J Clin Oncol 23:1491–1499. doi:10.​1200/​JCO.​2005.​05.​187 PubMedCrossRef
Metadata
Title
A multimodal strategy based on surgery, radiotherapy, ICE regimen and high dose chemotherapy in atypical teratoid/rhabdoid tumours: a single institution experience
Authors
Paola Fidani
Maria Antonietta De Ioris
Annalisa Serra
Luigi De Sio
Ilaria Ilari
Raffaele Cozza
Renata Boldrini
Giuseppe Maria Milano
Maria Luisa Garrè
Alberto Donfrancesco
Publication date
01-04-2009
Publisher
Springer US
Published in
Journal of Neuro-Oncology / Issue 2/2009
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI
https://doi.org/10.1007/s11060-008-9750-y