ABSTRACT
Children with diffuse intrinsic pontine glioma (DIPG) need new and more efficient treatments. They can be developed at relapse or at diagnosis, but therefore they must be combined with radiotherapy. Survival of children after recurrence and its predictors were studied to inform the possibility to design early phase clinical trials for DIPG at this stage. Among 142 DIPG patients treated between 1998 and 2014, 114 had biopsy-proven DIPG with histone H3 status available for 83. We defined as long survivors' patients who survived more than 3 months after relapse which corresponds to the minimal life expectancy requested for phase I/II trials. Factors influencing post-relapse survival were accordingly compared between short and long-term survivors after relapse. Fifty-seven percent of patients were considered long survivors and 70% of them had a Lansky Play Scale (LPS) above 50% at relapse. Patients who became steroids-independent after initial treatment for at least 2 months had better survival after relapse (3.7 versus 2.6 months, p = 0.001). LPS above 50% at relapse was correlated with better survival after relapse (3.8 versus 1.8 months, p < 0.001). Patients with H3.1 mutation survived longer after relapse (4.9 versus 2.7 months, p = 0.007). Patients who received a second radiotherapy at the time of relapse had an improved survival (7.5 versus 4 months, p = 0.001). In the two-way ANOVA analysis, steroid-independence and LPS predicted survival best and the type of histone H3 (H3.1 or H3.3) mutated did not improve prediction. Survival of many DIPG patients after relapse over 3 months would make possible to propose specific trials for this condition. Steroid-independence, H3 mutation status and LPS should be considered to predict eligibility.
Subject(s)
Brain Stem Neoplasms/diagnosis , Brain Stem Neoplasms/therapy , Glioma/diagnosis , Glioma/therapy , Neoplasm Recurrence, Local/diagnosis , Neoplasm Recurrence, Local/therapy , Adolescent , Adult , Brain Stem Neoplasms/mortality , Child , Child, Preschool , Female , Glioma/mortality , Humans , Infant , Kaplan-Meier Estimate , Male , Neoplasm Recurrence, Local/mortality , Treatment Outcome , Young AdultABSTRACT
This chapter presents guidelines for the follow-up of children with brain tumors, whether benign or malignant, in their transition to adulthood. The consequences of their disease and its treatment overlap greatly. The complications and long-term follow-up are detailed based on the specialists involved.
Subject(s)
Brain Neoplasms/pathology , Brain Neoplasms/surgery , Neurosurgical Procedures , Adolescent , Adult , Brain Neoplasms/psychology , Cardiovascular System/growth & development , Cardiovascular System/physiopathology , Child , Endocrine Glands/pathology , Endocrine Glands/physiopathology , Follow-Up Studies , Humans , Magnetic Resonance Imaging , Maxillofacial Development/physiology , Neoplasms, Radiation-Induced/pathology , Neoplasms, Radiation-Induced/surgery , Nervous System Diseases/pathology , Nervous System Diseases/physiopathology , Quality of Life , Radiosurgery/adverse effects , Respiratory System/growth & development , Respiratory System/physiopathology , Young AdultSubject(s)
Dapsone/urine , Leprosy/drug therapy , Dapsone/therapeutic use , Humans , Patient ComplianceABSTRACT
En el presente trabajo se estudiaron 132 pacientes de ambos sexos, portadores de psoriasis, a los que se realizo tratamiento con antralina unguento al 0,03% en las lesiones del cuerpo y antralina aerosol a la misma concentracion en cuero cabelludo.Se busco establecer la eficacia de la droga en ambas formas farmaceuticas mediante la medicion del tiempo requerido para obtener la mejoria clinica. Los pacientes fueron controlados periodicamente durante cinco meses, observandose al termino de ese tiempo la desaparicion de las lesiones en la mayoria de ellos.Se destaca el hecho de que para su aplicacion no fue necesario el uso de metodos y aparatos especiales,ni de personal idoneo. En base a estos resultados, hemos considerado a la antralina como droga de eleccion para el tratamiento local de la psoriasis, como terapeutica unica o asociada al tratamiento sistemico en aquellos casos que, por su gravedad o extension, asi lo requirieron
Subject(s)
Child , Adolescent , Adult , Middle Aged , Humans , Male , Female , Anthralin , Psoriasis , AerosolsABSTRACT
En el presente trabajo se estudiaron 132 pacientes de ambos sexos, portadores de psoriasis, a los que se realizo tratamiento con antralina unguento al 0,03% en las lesiones del cuerpo y antralina aerosol a la misma concentracion en cuero cabelludo.Se busco establecer la eficacia de la droga en ambas formas farmaceuticas mediante la medicion del tiempo requerido para obtener la mejoria clinica. Los pacientes fueron controlados periodicamente durante cinco meses, observandose al termino de ese tiempo la desaparicion de las lesiones en la mayoria de ellos.Se destaca el hecho de que para su aplicacion no fue necesario el uso de metodos y aparatos especiales,ni de personal idoneo. En base a estos resultados, hemos considerado a la antralina como droga de eleccion para el tratamiento local de la psoriasis, como terapeutica unica o asociada al tratamiento sistemico en aquellos casos que, por su gravedad o extension, asi lo requirieron
