Special Kids - Celebrating The Uniqueness of ALL Children

Aggressive Treatment Effective in Kids' Brain Cancer

Newer radiotherapy delivery systems cut dose, side effects after rare disease surgery

SATURDAY, Jan. 31 (HealthDay News) -- The best way to treat a rare form of childhood brain cancer called ependymoma is aggressive surgery followed by targeted radiotherapy, U.S. researchers say.

Ependymoma affects the central nervous system. Aggressive surgery has proven effective, but concerns about side effects have limited the use of radiation therapy.

In this study, Dr. Thomas Merchant, of St. Jude Children's Research Hospital in Memphis, Tenn., and colleagues used surgery and computer-guided radiotherapy to treat 153 patients, including some under the age of 3. During a median of 5.3 years of follow-up, tumor progression occurred in 36 patients, and 23 patients died.

The researchers calculated the overall rate of event-free survival after seven years to be 69.1 percent and overall survival to be 81 percent. Patients who had radiotherapy immediately after surgery had higher event-free survival and overall survival rates -- 76.9 percent and 85 percent, respectively.

The estimated overall rate of local tumor control after seven years was 87.3 percent. Treatment was generally well-tolerated by the patients, said the study, which was published online and in the March print issue of The Lancet Oncology.

"This study highlights the long-term benefits ... of gross total resection and high-dose postoperative radiotherapy for the treatment of children with localized ependymoma, even for those who are younger than 3 years," Merchant said.

The study also "provides unique insight into the role of radiation therapy in the initial management of young children" and indicates "that future efforts to combat ependymoma should also prioritize increasing the rate of gross total resection."

Merchant noted that "newer methods of radiotherapy delivery promise further reductions in the dose [delivered] to healthy tissue" to further reduce radiation therapy-related side effects.

More information

The U.S. National Cancer Institute has more about ependymoma.

-- Robert Preidt

SOURCE: The Lancet Oncology, news release, Jan. 31, 2009

Last Updated: Jan. 31, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

Gene Governs Response to Leukemia Chemotherapy

Acute lymphoblastic leukemia is most common pediatric cancer By Amanda Gardner HealthDay Reporter WEDNESDAY, Jan. 7 (HealthDay News) -- A mutation in leukemia cells predicts which children with acute lymphoblastic leukemia are more likely to relapse. The discovery, reported online Jan. 7 in the New England Journal of Medicine, might lead to tests to help physicians fine-tune treatment for different subsets of patients. "The treatment of acute lymphoblastic leukemia (ALL) is really one of the success stories in American and international medicine in that close to 80 percent of patients can be cured with an intensive and prolonged chemotherapy regimen," said Dr. Arthur Frankel, a professor of medicine at the Texas A&M Health Science Center College of Medicine, who was not involved with the study. "Having said that," Frankel added, "there are two changes that would improve the quality of care and maybe improve quality of life and the cure rate. One is that you'd like to identify patients that don't need this two years of aggressive chemotherapy. At the same time, there is a need for identifying early those children and adults that would do very poorly and trying to come up with new treatments." ALL, or cancer of white blood cells called leukocytes, is the most common pediatric cancer. Although current therapies are effective in a majority of pediatric patients, they can be hard to endure. And still, about 20 percent of patients will relapse, and only about a third of those who relapse will survive beyond five years. Scientists have already identified a number of genetic mutations and deletions in genes (including the one that's the subject of the new report, IKAROS) that regulate the normal development of leukocytes, said study senior author Dr. James R. Downing, scientific director of St. Jude Children's Research Hospital, in Memphis, Tenn. "But in prior studies, we never really saw any association with outcome," Downing said. Downing and his colleagues conducted gene analyses of 221 children with high-risk ALL who were being treated for the disease as part of another study. Deletions or changes in the IKAROS gene (of which there were several) that were found in slightly more than one-quarter of the patients were associated with a worse outcome. The findings were validated in a second group of 258 children. IKAROS produces the IKAROS protein, which is involved in regulating other genes. "The mutations of IKAROS were shown to be independent prognostic indicators, they had high value to identify patients at high risk of relapse over and above known risk factors," Downing said. "Identification of these lesions at the time of diagnosis would provide new information to better identify those patients." It's unknown how the gene works at this point, but Downing speculated that it has to do with the gene's role in regulating the formation of lymphocyte cells. Diagnostic tests need to be developed before the study results -- which also need to be replicated -- can be of benefit to patients, the researchers said. There's another potential benefit down the road: new information to help find new targets for drugs. More information Visit the U.S. National Cancer Institute for more on ALL in children. SOURCES: James R. Downing, M.D., scientific director, St. Jude Children's Research Hospital, Memphis, Tenn.; Arthur Frankel, M.D., professor, medicine, Texas A&M Health Science Center College of Medicine, and director, Cancer Center, Cancer Research Institute and Division of Hematology/Oncology, Scott & White Hospital, Jan. 7, 2009, New England Journal of Medicine, online Last Updated: Jan. 07, 2009 Copyright © 2009 ScoutNews, LLC. All rights reserved.

The Today Show Report on Autism and Vaccines

I applaud Matt Lauer for his slightly off-handed remark at the end of this video featuring Dr. Nancy Snyderman's report on the "controversy" over Autism and vaccines. I am glad that NBC also chose to not edit the end of this video. 

Learn About Clinical Trials

A clinical trial (also clinical research) is a research study in human volunteers to answer specific health questions. Interventional trials determine whether experimental treatments or new ways of using known therapies are safe and effective under controlled environments. Observational trials address health issues in large groups of people or populations in natural settings.

ClinicalTrials.gov offers up-to-date information for locating federally and privately supported clinical trials for a wide range of diseases and conditions.

ClinicalTrials.gov currently contains 63,580 trials sponsored by the National Institutes of Health, other federal agencies, and private industry. Studies listed in the database are conducted in all 50 States and in 158 countries ClinicalTrials.gov receives over 40 million page views per month 50,000 visitors daily.

The U.S. National Institutes of Health (NIH), through its National Library of Medicine (NLM), has developed this site in collaboration with the Food and Drug Administration (FDA), as a result of the FDA Modernization Act, which was passed into law in November 1997. See the FDA document - Guidance for Industry: Information Program on Clinical Trials for Serious or Life-Threatening Diseases and Conditions (March 2002).

You can learn more about this site from its Frequently Asked Questions and Factsheet.