Subscribe to RSS
DOI: 10.1055/a-0889-8256
SIOP-E-BTG and GPOH Guidelines for Diagnosis and Treatment of Children and Adolescents with Low Grade Glioma
SIOP-E BTG und GPOH Empfehlungen für die Diagnose und Behandlung von Kindern und Jugendlichen mit einem niedriggradigen GliomPublication History
Publication Date:
20 May 2019 (online)
![](https://www.thieme-connect.de/media/klinpaed/201903/lookinside/thumbnails/1132_10-1055-a-0889-8256-1.jpg)
Abstract
Low grade gliomas (LGGs) constitute the largest, yet clinically and (molecular-) histologically heterogeneous group of pediatric brain tumors of WHO grades I and II occurring throughout all pediatric age groups and at all central nervous system (CNS) sites. The tumors are characterized by a slow growth rate and may show periods of growth arrest. Around 40% of all LGG patients can be cured by complete neurosurgical resection and are followed by close observation. In case of relapse, second resection often is possible. Following incomplete resection observation is recommended, as long as there is no radiologic tumor growth and the patient does not suffer from significant, tumor-related symptoms. This also applies to patients with a diagnosis of LGG on the basis of radiological criteria. By contrast, clinical worsening and / or radiologic progression are an indication to treatment with either chemo- or radiotherapy. Overall survival is around 90%, and many patients survive with residual tumor, i. e. they suffer from chronic disease. All patients need comprehensive neuro-oncological care, the principles and details of which are summarized in the current guidelines. These represent standard of care for diagnostic work-up (including neuroimaging and neuropathology), and for therapeutic decisions (including the indications to non-surgical treatment) as well as concepts for neurosurgical intervention, chemotherapy and radiotherapy as well as surveillance and rehabilitation. The current treatment algorithm was compiled by members of the LGG working group of the SIOP-E brain tumor group (SIOP-E-BTG) and is based upon the results of previous European LGG studies and international reports.
Zusammenfassung
Niedrigmaligne Gliome (LGG) WHO-Grad I und II stellen die größte, wenn auch klinisch und (molekular-)histologisch heterogene Gruppe pädiatrischer Hirntumore dar. Sie treten in sämtlichen pädiatrischen Altersgruppen und in allen Regionen des zentralen Nervensystems auf. Die Tumoren sind charakterisiert durch ihr langsames Wachstum und können auch Phasen des Wachstumsstillstands zeigen. Rund 40% aller LGG lassen sich komplett resezieren und es genügt, diese Patienten anschließend engmaschig zu beobachten. Im Falle eines Rezidivs ist häufig eine erneute Resektion möglich. Auch nach einer partiellen Resektion sollten Patienten lediglich beobachtet werden, solange der Tumor stabil ist und keine schweren tumorbedingten Symptome auftreten. Dies gilt auch für diejenigen Patienten, deren LGG lediglich auf der Grundlage radiologischer Kriterien diagnostiziert wurde. Eine Indikation für Chemo- oder Radiotherapie besteht hingegen bei klinischer und / oder radiologischer Progression. Das Gesamtüberleben liegt bei ca. 90%, viele Patienten weisen aber einen Resttumor auf. Um dem chronischen Verlauf dieser Tumorerkrankungen Rechnung zu tragen, benötigen die Patienten eine umfassende neuro-onkologische Betreuung, deren Prinzipien und Details in dem vorliegenden Artikel zusammengefasst werden. Dargestellt werden die aktuellen Standards für Diagnose (inklusive Bildgebung und Neuropathologie) und Therapie (inklusive Indikationsstellung für nicht-chirurgische Behandlungen) sowie die Konzepte der neurochirurgischen, chemo- und strahlentherapeutischen Interventionen und der Nachsorge und Rehabilitation. Der aktuelle Behandlungs-Algorithmus wurde von den Mitgliedern der LGG-Arbeitsgruppe der SIOP-E brain tumor group (SIOP-E-BTG) konsentiert und basiert auf den Ergebnissen der europäischen und internationalen LGG-Studien und -Publikationen.
-
References
- 1 Albert FK, Forsting M, Sartor K. et al. Early postoperative magnetic resonance imaging after resection of malignant glioma: Objective evaluation of residual tumor and its influence on regrowth and prognosis. Neurosurgery 1994; 34: 45-60. discussion 60-41
- 2 Armstrong GT, Conklin HM, Huang S. et al. Survival and long-term health and cognitive outcomes after low-grade glioma. Neuro-oncology 2011; 13: 223-234
- 3 Ater JL, Xia C, Mazewski CM. et al. Nonrandomized comparison of neurofibromatosis type 1 and non-neurofibromatosis type 1 children who received carboplatin and vincristine for progressive low-grade glioma: A report from the Children’s Oncology Group. Cancer 2016; 122: 1928-1936
- 4 Ater JL, Zhou T, Holmes E. et al. Randomized study of two chemotherapy regimens for treatment of low-grade glioma in young children: A report from the Children’s Oncology Group. Journal of clinical oncology : Official journal of the American Society of Clinical Oncology 2012; 30: 2641-2647
- 5 Avery RA, Cnaan A, Schuman JS. et al. Intra- and inter-visit reproducibility of ganglion cell-inner plexiform layer measurements using handheld optical coherence tomography in children with optic pathway gliomas. American journal of ophthalmology 2014; 158: 916-923
- 6 Avery RA, Ferner RE, Listernick R. et al. Visual acuity in children with low grade gliomas of the visual pathway: implications for patient care and clinical research. Journal of neuro-oncology 2012; 110: 1-7
- 7 Avery RA, Hwang EI, Ishikawa H. et al. Handheld optical coherence tomography during sedation in young children with optic pathway gliomas. JAMA ophthalmology 2014; 132: 265-271
- 8 Azizi AA, Schouten-van Meeteren AYN. Current and emerging treatment strategies for children with progressive chiasmatic-hypothalamic glioma diagnosed as infants: A web-based survey. Journal of neuro-oncology 2018; 136: 127-134
- 9 Balogun JA, Rutka JT. Surgery of Intracranial Gliomas in Children. Progress in neurological surgery 2018; 30: 204-217
- 10 Bandopadhayay P, Bergthold G, London WB. et al. Long-term outcome of 4,040 children diagnosed with pediatric low-grade gliomas: an analysis of the Surveillance Epidemiology and End Results (SEER) database. Pediatric blood & cancer 2014; 61: 1173-1179
- 11 Banerjee A, Jakacki RI, Onar-Thomas A. et al. A phase I trial of the MEK inhibitor selumetinib (AZD6244) in pediatric patients with recurrent or refractory low-grade glioma: a Pediatric Brain Tumor Consortium (PBTC) study. Neuro-oncology 2017; 19: 1135-1144
- 12 Barkovich A, Raybaud C. Pediatric Neuroimaging. 6th edition Aufl Wolters Kluwer; 2018
- 13 Bian SX, McAleer MF, Vats TS. et al. Pilocytic astrocytoma with leptomeningeal dissemination. Child’s nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery 2013; 29: 441-450
- 14 Boesten T, Gerber NU, Kandels D. et al. Management of primary thalamic low-grade glioma in pediatric patiewnts: Results of the multicenter treatment studies HIT-LGG 1996 and SIOP-LGG 2004. Neuro Oncol Practice 2017; 4: 29-39
- 15 Bouffet E, Jakacki R, Goldman S. et al. Phase II study of weekly vinblastine in recurrent or refractory pediatric low-grade glioma. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 2012; 30: 1358-1363
- 16 Boull C, Hook K, Moertel C. et al. Cutaneous Reactions in Children Treated with the Mitogen-Activated Protein Kinase Extracellular Signal-Regulated Kinase Inhibitor Trametinib for Neural Tumors. Pediatric dermatology 2017; 34: 90-94
- 17 Brock PR, Knight KR, Freyer DR. et al. Platinum-induced ototoxicity in children: a consensus review on mechanisms, predisposition, and protection, including a new International Society of Pediatric Oncology Boston ototoxicity scale. Journal of clinical oncology : Official journal of the American Society of Clinical Oncology 2012; 30: 2408-2417
- 18 Calvert AH, Newell DR, Gumbrell LA. et al. Carboplatin dosage: prospective evaluation of a simple formula based on renal function. Journal of clinical oncology : Official journal of the American Society of Clinical Oncology 1989; 7: 1748-1756
- 19 Capper D, Jones DTW, Sill M. et al. DNA methylation-based classification of central nervous system tumours. Nature 2018; 555: 469-474
- 20 Cavallini A, Fazzi E, Viviani V. et al. Visual acuity in the first two years of life in healthy term newborns: an experience with the teller acuity cards. Functional neurology 2002; 17: 87-92
- 21 Combs SE, Schulz-Ertner D, Thilmann C. et al. Fractionated stereotactic radiation therapy in the management of primary oligodendroglioma and oligoastrocytoma. International journal of radiation oncology, biology, physics 2005; 62: 797-802
- 22 Dalla Via P, Opocher E, Pinello ML. et al. Visual outcome of a cohort of children with neurofibromatosis type 1 and optic pathway glioma followed by a pediatric neuro-oncology program. Neuro-oncology 2007; 9: 430-437
- 23 de Haas V, Grill J, Raquin MA. et al. Relapses of optic pathway tumors after first-line chemotherapy. Pediatric blood & cancer 2009; 52: 575-580
- 24 Dean RL, Emerich DF, Hasler BP. et al. Cereport (RMP-7) increases carboplatin levels in brain tumors after pretreatment with dexamethasone. Neuro-oncology 1999; 1: 268-274
- 25 Dennis ER, Bussiere MR, Niemierko A. et al. A comparison of critical structure dose and toxicity risks in patients with low grade gliomas treated with IMRT versus proton radiation therapy. Technology in cancer research & treatment 2013; 12: 1-9
- 26 Dodgshun AJ, Hansford JR, Cole T. et al. Carboplatin Hypersensitivity Reactions in Pediatric Low Grade Glioma Are Protocol Specific and Desensitization Shows Poor Efficacy. Pediatric blood & cancer 2016; 63: 17-20
- 27 Dombi E, Baldwin A, Marcus LJ. et al. Activity of Selumetinib in Neurofibromatosis Type 1-Related Plexiform Neurofibromas. The New England journal of medicine 2016; 375: 2550-2560
- 28 Duffull SB, Robinson BA. Clinical pharmacokinetics and dose optimisation of carboplatin. Clinical pharmacokinetics 1997; 33: 161-183
- 29 Durnford AJ, Rodgers W, Kirkham FJ. et al. Very good inter-rater reliability of Engel and ILAE epilepsy surgery outcome classifications in a series of 76 patients. Seizure 2011; 20: 809-812
- 30 Fisher MJ, Avery RA, Allen JC. et al. Functional outcome measures for NF1-associated optic pathway glioma clinical trials. Neurology 2013; 81: S15-S24
- 31 Fisher MJ, Loguidice M, Gutmann DH. et al. Visual outcomes in children with neurofibromatosis type 1-associated optic pathway glioma following chemotherapy: A multicenter retrospective analysis. Neuro-oncology 2012; 14: 790-797
- 32 Fisher PG, Tihan T, Goldthwaite PT. et al. Outcome analysis of childhood low-grade astrocytomas. Pediatric blood & cancer 2008; 51: 245-250
- 33 Fogarasi A, De Waele L, Bartalini G. et al. EFFECTS: an expanded access program of everolimus for patients with subependymal giant cell astrocytoma associated with tuberous sclerosis complex. BMC neurology 2016; 16: 126
- 34 Fouladi M, Hunt DL, Pollack IF. et al. Outcome of children with centrally reviewed low-grade gliomas treated with chemotherapy with or without radiotherapy on Children’s Cancer Group high-grade glioma study CCG-945. Cancer 2003; 98: 1243-1252
- 35 Friedman HS, Krischer JP, Burger P. et al. Treatment of children with progressive or recurrent brain tumors with carboplatin or iproplatin: a Pediatric Oncology Group randomized phase II study. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 1992; 10: 249-256
- 36 Garvey M, Packer RJ. An integrated approach to the treatment of chiasmatic-hypothalamic gliomas. Journal of neuro-oncology 1996; 28: 167-183
- 37 Gaudino S, Martucci M, Russo R. et al. MR imaging of brain pilocytic astrocytoma: beyond the stereotype of benign astrocytoma. Child’s nervous system : ChNS : Official journal of the International Society for Pediatric Neurosurgery 2017; 33: 35-54
- 38 Gaudino S, Quaglio F, Schiarelli C. et al. Spontaneous modifications of contrast enhancement in childhood non-cerebellar pilocytic astrocytomas. Neuroradiology 2012; 54: 989-995
- 39 Genc DB, Canpolat C, Berrak SG. Clinical features and management of carboplatin-related hypersensitivity reactions in pediatric low-grade glioma. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 2012; 20: 385-393
- 40 Gnekow AK. Recommendations of the Brain Tumor Subcommittee for the reporting of trials. SIOP Brain Tumor Subcommittee. International Society of Pediatric Oncology. Medical and pediatric oncology 1995; 24: 104-108
- 41 Gnekow AK, Falkenstein F, von Hornstein S. et al. Long-term follow-up of the multicenter, multidisciplinary treatment study HIT-LGG-1996 for low-grade glioma in children and adolescents of the German Speaking Society of Pediatric Oncology and Hematology. Neuro-oncology 2012; 14: 1265-1284
- 42 Gnekow AK, Kaatsch P, Kortmann R. et al. [HIT-LGG: Effectiveness of carboplatin-vincristine in progressive low-grade gliomas of childhood–an interim report]. Klinische Padiatrie 2000; 212: 177-184
- 43 Gnekow AK, Kortmann RD, Pietsch T. et al. Low grade chiasmatic-hypothalamic glioma-carboplatin and vincristin chemotherapy effectively defers radiotherapy within a comprehensive treatment strategy – report from the multicenter treatment study for children and adolescents with a low grade glioma – HIT-LGG 1996 – of the Society of Pediatric Oncology and Hematology (GPOH). Klinische Padiatrie 2004; 216: 331-342
- 44 Gnekow AK, Walker DA, Kandels D. et al. A European randomised controlled trial of the addition of etoposide to standard vincristine and carboplatin induction as part of an 18-month treatment programme for childhood (</=16 years) low grade glioma - A final report. European journal of cancer (Oxford, England : 1990) 2017; 81: 206-225
- 45 Goodden J, Pizer B, Pettorini B. et al. The role of surgery in optic pathway/hypothalamic gliomas in children. Journal of Neurosurgery Pediatrics 2014; 13: 1-12
- 46 Greenberger BA, Pulsifer MB, Ebb DH. et al. Clinical outcomes and late endocrine, neurocognitive, and visual profiles of proton radiation for pediatric low-grade gliomas. International journal of radiation oncology, biology, physics 2014; 89 : . 1060 1068.
- 47 Gropman AL, Packer RJ, Nicholson HS. et al. Treatment of diencephalic syndrome with chemotherapy: growth, tumor response, and long term control. Cancer 1998; 83: 166-172
- 48 Gudrunardottir T, Morgan AT, Lux AL. et al. Consensus paper on post-operative pediatric cerebellar mutism syndrome: the Iceland Delphi results. Child’s nervous system : ChNS : Official Journal of the International Society for Pediatric Neurosurger. 2016; 32: 1195-1203
- 49 Gururangan S, Fangusaro J, Poussaint TY. et al. Efficacy of bevacizumab plus irinotecan in children with recurrent low-grade gliomas–a Pediatric Brain Tumor Consortium study. Neuro-oncology 2014; 16: 310-317
- 50 Hall MD, Bradley JA, Rotondo RL. et al. Risk of Radiation Vasculopathy and Stroke in Pediatric Patients Treated With Proton Therapy for Brain and Skull Base Tumors. International journal of radiation oncology, biology, physics 2018; 101: 854-859
- 51 Harrabi SB, Bougatf N, Mohr A. et al. Dosimetric advantages of proton therapy over conventional radiotherapy with photons in young patients and adults with low-grade glioma. Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft [et al.] 2016; 192: 759-769
- 52 Harreld JH, Mohammed N, Goldsberry G. et al. Postoperative intraspinal subdural collections after pediatric posterior fossa tumor resection: incidence, imaging, and clinical features. AJNR American journal of neuroradiology 2015; 36: 993-999
- 53 Heng MA, Padovani L, Dory-Lautrec P. et al. Can metronomic maintenance with weekly vinblastine prevent early relapse/progression after bevacizumab-irinotecan in children with low-grade glioma?. Cancer medicine 2016; 5: 1542-1545
- 54 Hernaiz Driever P, von Hornstein S, Pietsch T. et al. Natural history and management of low-grade glioma in NF-1 children. Journal of neuro-oncology 2010; 100: 199-207
- 55 Hug EB, Muenter MW, Archambeau JO. et al. Conformal proton radiation therapy for pediatric low-grade astrocytomas. Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft [et al.] 2002; 178: 10-17
- 56 Hukin J, Siffert J, Cohen H. et al. Leptomeningeal dissemination at diagnosis of pediatric low-grade neuroepithelial tumors. Neuro-oncology 2003; 5: 188-196
- 57 Indelicato DJ, Merchant T, Laperriere N. et al. Consensus Report From the Stockholm Pediatric Proton Therapy Conference. International journal of radiation oncology, biology, physics 2016; 96: 387-392
- 58 Jones DT, Gronych J, Lichter P. et al. MAPK pathway activation in pilocytic astrocytoma. Cellular and molecular life sciences : CMLS 2012; 69: 1799-1811
- 59 Jones DT, Hutter B, Jager N. et al. Recurrent somatic alterations of FGFR1 and NTRK2 in pilocytic astrocytoma. Nature genetics 2013; 45: 927-932
- 60 Jones DT, Mulholland SA, Pearson DM. et al. Adult grade II diffuse astrocytomas are genetically distinct from and more aggressive than their paediatric counterparts. Acta neuropathologica 2011; 121: 753-761
- 61 Jones DTW, Kieran MW, Bouffet E. et al. Pediatric low-grade gliomas: next biologically driven steps. Neuro-oncology 2018; 20: 160-173
- 62 Jones DTW, Witt O, Pfister SM. BRAF V600E Status Alone Is Not Sufficient as a Prognostic Biomarker in Pediatric Low-Grade Glioma. Journal of clinical oncology : Official journal of the American Society of Clinical Oncology 2018; 36: 96
- 63 Jozwiak S, Nabbout R, Curatolo P. Management of subependymal giant cell astrocytoma (SEGA) associated with tuberous sclerosis complex (TSC): Clinical recommendations. European journal of paediatric neurology : EJPN : Official journal of the European Paediatric Neurology Society 2013; 17: 348-352
- 64 Kanda T, Nakai Y, Oba H. et al. Gadolinium deposition in the brain. Magnetic resonance imaging 2016; 34: 1346-1350
- 65 Kandels D, Schmidt R, Breitmoser-Greiner S. et al. Second-line treatment for pediatric low grade glioma (LGG) - experiences from the German and Swiss SIOP-LGG 2004 cohort. Neuro Oncology 2016; 18: iii81
- 66 Kandels D, Schmidt R, Warmuth-Metz M. et al. Repeated progressions in pediatric chiasmatic-hypothalamic gliomas (CHG): Can we identify successful treatment strategies?. Neuro Oncology 2018; 20: i109
- 67 Kaufmann A, Gerber NU, Kandels D. et al. Management of Primary Tectal Plate Low-Grade Glioma in Pediatric Patients: Results of the Multicenter Treatment Study SIOP-LGG 2004. Neuropediatrics 2018; 49: 314-323
- 68 Kieran MW, Turner CD, Rubin JB. et al. A feasibility trial of antiangiogenic (metronomic) chemotherapy in pediatric patients with recurrent or progressive cancer. Journal of pediatric hematology/oncology 2005; 27: 573-581
- 69 Kilday JP, Bartels U, Huang A. et al. Favorable survival and metabolic outcome for children with diencephalic syndrome using a radiation-sparing approach. Journal of neuro-oncology 2014; 116: 195-204
- 70 Kilday JP, Laughlin S, Urbach S. et al. Diabetes insipidus in pediatric germinomas of the suprasellar region: characteristic features and significance of the pituitary bright spot. Journal of neuro-oncology 2015; 121: 167-175
- 71 Korinthenberg R, Neuburger D, Trippel M. et al. Long-term results of brachytherapy with temporary iodine-125 seeds in children with low-grade gliomas. International journal of radiation oncology, biology, physics 2011; 79: 1131-1138
- 72 Kornreich L, Blaser S, Schwarz M. et al. Optic pathway glioma: correlation of imaging findings with the presence of neurofibromatosis. AJNR American journal of neuroradiology 2001; 22: 1963-1969
- 73 Kortmann RD, Seidel C, Muller K. et al. Irradiation of Intracranial Gliomas in Children. Progress in neurological surgery 2018; 31: 87-101
- 74 Kortmann RD, Timmermann B, Taylor RE. et al. Current and future strategies in radiotherapy of childhood low-grade glioma of the brain. Part I: Treatment modalities of radiation therapy. Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft [et al.] 2003; 179: 509-520
- 75 Kortmann RD, Timmermann B, Taylor RE. et al. Current and future strategies in radiotherapy of childhood low-grade glioma of the brain. Part II: Treatment-related late toxicity. Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft [et al.] 2003; 179: 585-597
- 76 Krishnatry R, Zhukova N, Guerreiro Stucklin AS. et al. Clinical and treatment factors determining long-term outcomes for adult survivors of childhood low-grade glioma: A population-based study. Cancer 2016; 122: 1261-1269
- 77 Laithier V, Grill J, Le Deley MC. et al. Progression-free survival in children with optic pathway tumors: dependence on age and the quality of the response to chemotherapy–results of the first French prospective study for the French Society of Pediatric Oncology. Journal of clinical oncology : Official journal of the American Society of Clinical Oncology 2003; 21: 4572-4578
- 78 Lambron J, Rakotonjanahary J, Loisel D. et al. Can we improve accuracy and reliability of MRI interpretation in children with optic pathway glioma? Proposal for a reproducible imaging classification. Neuroradiology 2016; 58: 197-208
- 79 Lassaletta A, Scheinemann K, Zelcer SM. et al. Phase II Weekly Vinblastine for Chemotherapy-Naive Children With Progressive Low-Grade Glioma: A Canadian Pediatric Brain Tumor Consortium Study. Journal of clinical oncology : Official journal of the American Society of Clinical Oncology 2016; 34: 3537-3543
- 80 Lassaletta A, Zapotocky M, Mistry M. et al. Therapeutic and Prognostic Implications of BRAF V600E in Pediatric Low-Grade Gliomas. Journal of clinical oncology : Official journal of the American Society of Clinical Oncology 2017; 35: 2934-2941
- 81 Limond JA, Bull KS, Calaminus G. et al. Quality of survival assessment in European childhood brain tumour trials, for children aged 5 years and over. European journal of paediatric neurology : EJPN : Official journal of the European Paediatric Neurology Society 2015; 19: 202-210
- 82 Louis D, Ohgaki H, Wiestler OD. et al. WHO classification of tumours of the central nervous system. Revised. 4th edition Aufl Lyon: IARC Press; 2016
- 83 Marcus KJ, Goumnerova L, Billett AL. et al. Stereotactic radiotherapy for localized low-grade gliomas in children: final results of a prospective trial. International journal of radiation oncology, biology, physics 2005; 61: 374-379
- 84 Massimino M, Spreafico F, Cefalo G. et al. High response rate to cisplatin/etoposide regimen in childhood low-grade glioma. Journal of clinical oncology : Official journal of the American Society of Clinical Oncology 2002; 20: 4209-4216
- 85 Massimino M, Spreafico F, Riva D. et al. A lower-dose, lower-toxicity cisplatin-etoposide regimen for childhood progressive low-grade glioma. Journal of neuro-oncology 2010; 100: 65-71
- 86 Mazloom A, Hodges JC, Teh BS. et al. Outcome of patients with pilocytic astrocytoma and leptomeningeal dissemination. International journal of radiation oncology, biology, physics 2012; 84: 350-354
- 87 McCowage G, Mueller S, Pratilas C. et al. Trametinib in pediatric patients with neurofibromatosis type 1 (NF-1)–associated plexiform neurofibroma: A phase I/IIa study. Journal of clinical oncology: Official journal of the American Society of Clinical Oncology 2018; 36 no. 15_suppl 10504
- 88 Merchant TE, Conklin HM, Wu S. et al. Late effects of conformal radiation therapy for pediatric patients with low-grade glioma: prospective evaluation of cognitive, endocrine, and hearing deficits. Journal of clinical oncology : Official journal of the American Society of Clinical Oncology 2009; 27: 3691-3697
- 89 Merchant TE, Kun LE, Wu S. et al. Phase II trial of conformal radiation therapy for pediatric low-grade glioma. Journal of clinical oncology : Official journal of the American Society of Clinical Oncology 2009; 27: 3598-3604
- 90 Millward CP, Perez Da Rosa S, Avula S. et al. The role of early intra-operative MRI in partial resection of optic pathway/hypothalamic gliomas in children. Child’s nervous system : ChNS : Official journal of the International Society for Pediatric Neurosurgery 2015; 31: 2055-2062
- 91 Mirow C, Pietsch T, Berkefeld S. et al. Children<1 year show an inferior outcome when treated according to the traditional LGG treatment strategy: a report from the German multicenter trial HIT-LGG 1996 for children with low grade glioma (LGG). Pediatric blood & cancer 2014; 61: 457-463
- 92 Mishra KK, Puri DR, Missett BT. et al. The role of up-front radiation therapy for incompletely resected pediatric WHO grade II low-grade gliomas. Neuro-oncology 2006; 8: 166-174
- 93 Moriyama B, Henning SA, Leung J. et al. Adverse interactions between antifungal azoles and vincristine: Review and analysis of cases. Mycoses 2012; 55: 290-297
- 94 Muller K, Gnekow A, Falkenstein F. et al. Radiotherapy in pediatric pilocytic astrocytomas. A subgroup analysis within the prospective multicenter study HIT-LGG 1996 by the German Society of Pediatric Oncology and Hematology (GPOH). Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft [et al.] 2013; 189: 647-655
- 95 Murphy ES, Xie H, Merchant TE. et al. Review of cranial radiotherapy-induced vasculopathy. Journal of neuro-oncology 2015; 122: 421-429
- 96 Opocher E, Kremer LC, Da Dalt L. et al. Prognostic factors for progression of childhood optic pathway glioma: a systematic review. European journal of cancer (Oxford, England : 1990) 2006; 42: 1807-1816
- 97 Ottensmeier H, Zimolong B, Wolff JE. et al. Neuropsychological short assessment of disease- and treatment-related intelligence deficits in children with brain tumours. European journal of paediatric neurology : EJPN : Official journal of the European Paediatric Neurology Society 2015; 19: 298-307
- 98 Packer RJ, Jakacki R, Horn M. et al. Objective response of multiply recurrent low-grade gliomas to bevacizumab and irinotecan. Pediatric blood & cancer 2009; 52: 791-795
- 99 Packer RJ, Pfister S, Bouffet E. et al. Pediatric low-grade gliomas: implications of the biologic era. Neuro-oncology 2017; 19: 750-761
- 100 Parrozzani R, Miglionico G, Leonardi F. et al. Correlation of peripapillary retinal nerve fibre layer thickness with visual acuity in paediatric patients affected by optic pathway glioma. Acta ophthalmologica 2018; DOI: 10.1111/aos.13803.
- 101 Paulino AC, Mazloom A, Terashima K. et al. Intensity-modulated radiotherapy (IMRT) in pediatric low-grade glioma. Cancer 2013; 119: 2654-2659
- 102 Proudfoot R, Phillips B, Wilne S. Guidelines for the Prophylaxis of Pneumocystis jirovecii Pneumonia (PJP) in Children With Solid Tumors. Journal of pediatric hematology/oncology 2017; 39: 194-202
- 103 Qaddoumi I, Sane M, Li S. et al. Diagnostic utility and correlation of tumor markers in the serum and cerebrospinal fluid of children with intracranial germ cell tumors. Child’s nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery 2012; 28: 1017-1024
- 104 Randle SC. Tuberous Sclerosis Complex: A Review. Pediatric annals 2017; 46: e166-e171
- 105 Ris MD, Beebe DW, Armstrong FD. et al. Cognitive and adaptive outcome in extracerebellar low-grade brain tumors in children: a report from the Children’s Oncology Group. Journal of clinical oncology : Official journal of the American Society of Clinical Oncology 2008; 26: 4765-4770
- 106 Robison NJ, Campigotto F, Chi SN. et al. A phase II trial of a multi-agent oral antiangiogenic (metronomic) regimen in children with recurrent or progressive cancer. Pediatric blood & cancer 2014; 61: 636-642
- 107 Ruge MI, Simon T, Suchorska B. et al. Stereotactic brachytherapy with iodine-125 seeds for the treatment of inoperable low-grade gliomas in children: long-term outcome. Journal of clinical oncology : Official journal of the American Society of Clinical Oncology 2011; 29: 4151-4159
- 108 Ryall S, Tabori U, Hawkins C. A comprehensive review of paediatric low-grade diffuse glioma: pathology, molecular genetics and treatment. Brain tumor pathology 2017; 34: 51-61
- 109 Sadighi ZS, Curtis E, Zabrowksi J. et al. Neurologic impairments from pediatric low-grade glioma by tumor location and timing of diagnosis. Pediatric blood & cancer 2018; 65: e27063
- 110 Sala F, Coppola A, Tramontano V. et al. Intraoperative neurophysiological monitoring for the resection of brain tumors in pediatric patients. Journal of neurosurgical sciences 2015; 59: 373-382
- 111 Sardi I, Bresci C, Schiavello E. et al. Successful treatment with a low-dose cisplatin–etoposide regimen for patients with diencephalic syndrome. Journal of neuro-oncology 2012; 109: 375-383
- 112 Sato A, Murnick J, Ladra M. et al. Neurologic compromise and outcome after proton beam therapy (PBT) for posterior fossa tumors (PFTs) of childhood. Neuro-oncology 2018; 20: i175
- 113 Scheinemann K, Bartels U, Tsangaris E. et al. Feasibility and efficacy of repeated chemotherapy for progressive pediatric low-grade gliomas. Pediatric blood & cancer 2011; 57: 84-88
- 114 Singh SK, Leeds NE, Ginsberg LE. MR imaging of leptomeningeal metastases: comparison of three sequences. AJNR American journal of neuroradiology 2002; 23: 817-821
- 115 Stokland T, Liu JF, Ironside JW. et al. A multivariate analysis of factors determining tumor progression in childhood low-grade glioma: A population-based cohort study (CCLG CNS9702). Neuro-oncology 2010; 12: 1257-1268
- 116 Tallen G, Resch A, Calaminus G. et al. Strategies to improve the quality of survival for childhood brain tumour survivors. European journal of paediatric neurology : EJPN : Official journal of the European Paediatric Neurology Society 2015; 19: 619-639
- 117 Taylor T, Jaspan T, Milano G. et al. Radiological classification of optic pathway gliomas: experience of a modified functional classification system. The British journal of radiology 2008; 81: 761-766
- 118 Traunwieser T, Kandels D, Gnekow A. Neurocognitive sequelae in pediatric low grade glioma patients under observation - neuropsychological results from the siop-lgg-2004 study & lgg-register neuro oncology. 2018; 20: i110
- 119 Tsang DS, Murphy ES, Ezell SE. et al. Craniospinal irradiation for treatment of metastatic pediatric low-grade glioma. Journal of neuro-oncology 2017; 134: 317-324
- 120 Tsang DS, Murphy ES, Merchant TE. Radiation Therapy for Optic Pathway and Hypothalamic Low-Grade Gliomas in Children. International journal of radiation oncology, biology, physics 2017; 99: 642-651
- 121 Ullrich NJ, Pomeroy SL, Kapur K. et al. Incidence, risk factors, and longitudinal outcome of seizures in long-term survivors of pediatric brain tumors. Epilepsia 2015; 56: 1599-1604
- 122 van Baarsen K, Roth J, Serova N. et al. Optic pathway-hypothalamic glioma hemorrhage: a series of 9 patients and review of the literature. Journal of neurosurgery 2018; doi:10.3171/2017.8.Jns163085: 1-9
- 123 van de Velde ME, Kaspers GL, Abbink FCH. et al. Vincristine-induced peripheral neuropathy in children with cancer: A systematic review. Critical reviews in oncology/hematology 2017; 114: 114-130
- 124 Verschuur A, Heng-Maillard MA, Dory-Lautrec P. et al. Metronomic Four-Drug Regimen Has Anti-tumor Activity in Pediatric Low-Grade Glioma; The Results of a Phase II Clinical Trial. Frontiers in pharmacology 2018; 9: 00950
- 125 von Hornstein S, Kortmann RD, Pietsch T. et al. Impact of chemotherapy on disseminated low-grade glioma in children and adolescents: report from the HIT-LGG 1996 trial. Pediatric blood & cancer 2011; 56: 1046-1054
- 126 Walker DA, Liu J, Kieran M. et al. A multi-disciplinary consensus statement concerning surgical approaches to low-grade, high-grade astrocytomas and diffuse intrinsic pontine gliomas in childhood (CPN Paris 2011) using the Delphi method. Neuro-oncology 2013; 15: 462-468
- 127 Warmuth-Metz M. Imaging and Diagnosis in Pediatric Brain Tumor Studies. Springer; 2017
- 128 Warmuth-Metz M, Bison B, Leykamm S. Neuroradiologic review in pediatric brain tumor studies. Klinische Neuroradiologie 2009; 19: 263-273
- 129 Warmuth-Metz M, Gnekow AK, Muller H. et al. Differential diagnosis of suprasellar tumors in children. Klinische Padiatrie 2004; 216: 323-330
- 130 Warmuth-Metz M, Kuhl J, Krauss J. et al. Subdural enhancement on postoperative spinal MRI after resection of posterior cranial fossa tumours. Neuroradiology 2004; 46: 219-223
- 131 Warren KE, Poussaint TY, Vezina G. et al. Challenges with defining response to antitumor agents in pediatric neuro-oncology: a report from the response assessment in pediatric neuro-oncology (RAPNO) working group. Pediatric blood & cancer 2013; 60: 1397-1401
- 132 Warren KE, Vezina G, Poussaint TY. et al. Response assessment in medulloblastoma and leptomeningeal seeding tumors: recommendations from the Response Assessment in Pediatric Neuro-Oncology committee. Neuro-oncology 2018; 20: 13-23
- 133 Wilne S, Collier J, Kennedy C. et al. Presentation of childhood CNS tumours: a systematic review and meta-analysis. The Lancet Oncology 2007; 8: 685-695
- 134 Wisoff JH, Sanford RA, Heier LA. et al. Primary neurosurgery for pediatric low-grade gliomas: a prospective multi-institutional study from the Children’s Oncology Group. Neurosurgery 2011; 68: 1548-1554. discussion 1554-1545
- 135 Youland RS, Khwaja SS, Schomas DA. et al. Prognostic factors and survival patterns in pediatric low-grade gliomas over 4 decades. Journal of pediatric hematology/oncology 2013; 35: 197-205
- 136 Zhang G, Li Z, Si D. et al. Diagnostic ability of intraoperative ultrasound for identifying tumor residual in glioma surgery operation. Oncotarget 2017; 8: 73105-73114