Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Post-therapy damage in medulloblastoma patients can be mistaken for new tumors

17.11.2004


St. Jude scientists find that radiation and high-dose chemotherapy damage is usually transient but can mimic cancer and prompt needless additional treatment



Irradiation and high-dose chemotherapy used to treat two types of brain tumors--medulloblastoma and supratentorial PNET--can cause changes in the brain’s white matter that look like tumors when seen on MRI scans. This finding, by a team of investigators led by St. Jude Children’s Research Hospital, is published in the Nov. 15 issue of Journal of Clinical Oncology (JCO). White matter is the part of the brain composed of nerves that are covered in a pearly-white sheath. Much of the cerebral cortex, where high level thinking occurs, is made of white matter.

The study demonstrates that this damage, called white matter lesions (WMLs), can be mistaken for recurrent cancer, prompting physicians to treat the patient aggressively--and needlessly--with more radiation and chemotherapy. "Irradiation and high-dose chemotherapy are treatments we want to use as sparingly as possible," said Amar Gajjar, M.D., member of Hematology-Oncology and director of Neuro-oncology at St. Jude. "This new information represents an important caution sign for physicians who otherwise might assume that WMLs are actually tumors that need further treatment."


Gajjar is senior author of the JCO report, which is the first to describe both the finding and the actual incidence of early-onset WMLs--that is, how frequently these lesions occur in patients with medulloblastoma or PNET who have been treated with radiation and high-dose chemotherapy following surgery. The study is also the first to note the impact of such changes in white matter on intellectual outcome in children with brain tumors. Specifically, the study found that the presence of WMLs is associated with a decline in neurocognitive, or intellectual, function. "In the vast majority of children, the changes seen on MRI scans after treatment are WMLs and not cancer," says Maryam Fouladi, M.D., assistant member of St. Jude Hematology-Oncology and lead author of the report. "Physicians can follow up these initial findings with repeat MRI scans to determine whether the WMLs disappear. If they do disappear, then it wasn’t cancer and didn’t require treatment. But even though these changes tend to be only temporary, some children with these changes tends to develop permanent neurologic problems, such as difficulty swallowing."

The team followed 127 patients for up to 13 months after the start of treatment for brain cancer. During this time 22 of these patients developed WMLs following treatment for brain cancer. The WMLs disappeared in 16 patients (73 percent) within 23.5 months after being detected. In two patients the WMLs remained after 19 and 31 months, respectively. Two other patients developed cancer again while still showing evidence of WMLs. In the remaining patients the WML led to tissue breakdown. Patients with WMLs experienced a significant decline in estimated IQ and math scores.

The researchers concluded that, in patients with medulloblastoma or PNET who had been treated with irradiation and high-dose radiation, WMLs are usually short-lived and do not cause symptoms. However, these WMLs can mimic the early stages of tumor recurrence, and thus make it difficult for physicians to accurately diagnose the return of cancer.

Other authors of this report are Fred Laningham, James W. Langston, Larry E. Kun and Raymond K. Mulhern (St. Jude); Murali Chintagumpala, Charles W. McCluggage, Shaio Woo and Kevin Krull (Texas Children’s Hospital/Baylor College of Medicine, Houston); David Ashley (Royal Children’s Hospital, Melbourne, Australia); and Stewart J. Kellie (Children’s Hospital at Westmead, Sydney, Australia).

Bonnie Cameron | EurekAlert!
Further information:
http://www.stjude.org

More articles from Health and Medicine:

nachricht One gene closer to regenerative therapy for muscular disorders
01.06.2017 | Cincinnati Children's Hospital Medical Center

nachricht The gut microbiota plays a key role in treatment with classic diabetes medication
01.06.2017 | University of Gothenburg

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Can we see monkeys from space? Emerging technologies to map biodiversity

An international team of scientists has proposed a new multi-disciplinary approach in which an array of new technologies will allow us to map biodiversity and the risks that wildlife is facing at the scale of whole landscapes. The findings are published in Nature Ecology and Evolution. This international research is led by the Kunming Institute of Zoology from China, University of East Anglia, University of Leicester and the Leibniz Institute for Zoo and Wildlife Research.

Using a combination of satellite and ground data, the team proposes that it is now possible to map biodiversity with an accuracy that has not been previously...

Im Focus: Climate satellite: Tracking methane with robust laser technology

Heatwaves in the Arctic, longer periods of vegetation in Europe, severe floods in West Africa – starting in 2021, scientists want to explore the emissions of the greenhouse gas methane with the German-French satellite MERLIN. This is made possible by a new robust laser system of the Fraunhofer Institute for Laser Technology ILT in Aachen, which achieves unprecedented measurement accuracy.

Methane is primarily the result of the decomposition of organic matter. The gas has a 25 times greater warming potential than carbon dioxide, but is not as...

Im Focus: How protons move through a fuel cell

Hydrogen is regarded as the energy source of the future: It is produced with solar power and can be used to generate heat and electricity in fuel cells. Empa researchers have now succeeded in decoding the movement of hydrogen ions in crystals – a key step towards more efficient energy conversion in the hydrogen industry of tomorrow.

As charge carriers, electrons and ions play the leading role in electrochemical energy storage devices and converters such as batteries and fuel cells. Proton...

Im Focus: A unique data centre for cosmological simulations

Scientists from the Excellence Cluster Universe at the Ludwig-Maximilians-Universität Munich have establised "Cosmowebportal", a unique data centre for cosmological simulations located at the Leibniz Supercomputing Centre (LRZ) of the Bavarian Academy of Sciences. The complete results of a series of large hydrodynamical cosmological simulations are available, with data volumes typically exceeding several hundred terabytes. Scientists worldwide can interactively explore these complex simulations via a web interface and directly access the results.

With current telescopes, scientists can observe our Universe’s galaxies and galaxy clusters and their distribution along an invisible cosmic web. From the...

Im Focus: Scientists develop molecular thermometer for contactless measurement using infrared light

Temperature measurements possible even on the smallest scale / Molecular ruby for use in material sciences, biology, and medicine

Chemists at Johannes Gutenberg University Mainz (JGU) in cooperation with researchers of the German Federal Institute for Materials Research and Testing (BAM)...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Plants are networkers

19.06.2017 | Event News

Digital Survival Training for Executives

13.06.2017 | Event News

Global Learning Council Summit 2017

13.06.2017 | Event News

 
Latest News

Quantum thermometer or optical refrigerator?

23.06.2017 | Physics and Astronomy

A 100-year-old physics problem has been solved at EPFL

23.06.2017 | Physics and Astronomy

Equipping form with function

23.06.2017 | Information Technology

VideoLinks
B2B-VideoLinks
More VideoLinks >>>