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 Millions through license revenues
27.04.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn

nachricht New High-Performance Center Translational Medical Engineering
26.04.2017 | Fraunhofer ITEM

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: Making lightweight construction suitable for series production

More and more automobile companies are focusing on body parts made of carbon fiber reinforced plastics (CFRP). However, manufacturing and repair costs must be further reduced in order to make CFRP more economical in use. Together with the Volkswagen AG and five other partners in the project HolQueSt 3D, the Laser Zentrum Hannover e.V. (LZH) has developed laser processes for the automatic trimming, drilling and repair of three-dimensional components.

Automated manufacturing processes are the basis for ultimately establishing the series production of CFRP components. In the project HolQueSt 3D, the LZH has...

Im Focus: Wonder material? Novel nanotube structure strengthens thin films for flexible electronics

Reflecting the structure of composites found in nature and the ancient world, researchers at the University of Illinois at Urbana-Champaign have synthesized thin carbon nanotube (CNT) textiles that exhibit both high electrical conductivity and a level of toughness that is about fifty times higher than copper films, currently used in electronics.

"The structural robustness of thin metal films has significant importance for the reliable operation of smart skin and flexible electronics including...

Im Focus: Deep inside Galaxy M87

The nearby, giant radio galaxy M87 hosts a supermassive black hole (BH) and is well-known for its bright jet dominating the spectrum over ten orders of magnitude in frequency. Due to its proximity, jet prominence, and the large black hole mass, M87 is the best laboratory for investigating the formation, acceleration, and collimation of relativistic jets. A research team led by Silke Britzen from the Max Planck Institute for Radio Astronomy in Bonn, Germany, has found strong indication for turbulent processes connecting the accretion disk and the jet of that galaxy providing insights into the longstanding problem of the origin of astrophysical jets.

Supermassive black holes form some of the most enigmatic phenomena in astrophysics. Their enormous energy output is supposed to be generated by the...

Im Focus: A Quantum Low Pass for Photons

Physicists in Garching observe novel quantum effect that limits the number of emitted photons.

The probability to find a certain number of photons inside a laser pulse usually corresponds to a classical distribution of independent events, the so-called...

Im Focus: Microprocessors based on a layer of just three atoms

Microprocessors based on atomically thin materials hold the promise of the evolution of traditional processors as well as new applications in the field of flexible electronics. Now, a TU Wien research team led by Thomas Müller has made a breakthrough in this field as part of an ongoing research project.

Two-dimensional materials, or 2D materials for short, are extremely versatile, although – or often more precisely because – they are made up of just one or a...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Expert meeting “Health Business Connect” will connect international medical technology companies

20.04.2017 | Event News

Wenn der Computer das Gehirn austrickst

18.04.2017 | Event News

7th International Conference on Crystalline Silicon Photovoltaics in Freiburg on April 3-5, 2017

03.04.2017 | Event News

 
Latest News

Bare bones: Making bones transparent

27.04.2017 | Life Sciences

Study offers new theoretical approach to describing non-equilibrium phase transitions

27.04.2017 | Physics and Astronomy

From volcano's slope, NASA instrument looks sky high and to the future

27.04.2017 | Earth Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>