Hóa trị liệu điều trị u thần kinh đệm bậc thấp tủy sống tiến triển ở trẻ em: 3 trường hợp và xem lại y văn về u thần kinh đệm bậc thấp

Trần Thu Hà, Bùi Ngọc Lan, Nguyễn Thị Nga, Hoàng Ngọc Thạch

Main Article Content

Tóm tắt

U thần kinh đệm bậc thấp (u TKĐBT) là u não thường gặp nhất ở trẻ em, chiếm khoảng 30 – 50% các khối u não mới chẩn đoán và chiếm khoảng 80 % u thần kinh đệm. U có thể gặp ở bất kỳ vị trí nào của hệ thần kinh trung ương (TKTƯ), hay gặp nhất ở hố sau chiếm 20 - 25%; những vị trí hay gặp khác như thân não hoặc đường giữa (đường thị giác, trên yên, thể mái, đồi thị); u nguyên phát ở tủy sống hiếm gặp, chỉ chiếm khoảng 5%. Các khối u TKĐBT trong tủy sống và nội sọ có chung đặc điểm mô bệnh học và có đặc điểm sinh học tương tự nhau. Trẻ em với u TKĐBT có tỷ lệ sống lâu dài cao, vì vậy chiến lược điều trị hướng tới kiểm soát bệnh trong thời kỳ niên thiếu và vị thành niên, đồng thời tập trung giảm thiểu tình trạng bệnh lâu dài gây ra bởi khối u và các liệu pháp điều trị.
Nhân báo cáo ba trường hợp u TKĐBT tủy sống tiến triển và đáp ứng của các bệnh nhân này với hóa trị liệu, bài viết này tổng quan lại vấn đề chẩn đoán, điều trị u TKĐBT hệ thần kinh trung ương nói chung và u thần kinh đệm bậc thấp tủy sống nói riêng.
 

Article Details

Từ khóa

hóa trị liệu, u thần kinh đệm bậc thấp, tủy sống, hệ thần kinh trung ương.

Các tài liệu tham khảo

1. Cooperative multicenter study for Children and adolescent with Low grade glioma. SIOP- LGG 2004. Version I, April 2004.
2. Scheinemann K, Hukin J. Low-grade glioma. Pediatric Neuro - oncology. Springer, Third edition; 2015, 90-99.
3. Banerjee A, Nicolaides T. Low-grade glioma. Pediatric CNS tumors. Springer, Third edition 2017:1-36.
4. Cosnarovici MM, Cosnarovici RV, Piciu D. Updates on the 2016 Word Health Organization Classification of Pediatric Tumors of the Central Nervous System- a systematic review. Med Pham Rep 2021;94(3):282-288.
5. Peter C, David T, Caterina G et al. Pilocytic astrocytoma: pathology, molecular mechanisms and markers. Acta Neuropathol 2015;129(6):775-88. https://doi.org/10.1007/s00401-015-1410-7
6. Wisoff JH, Sanford RA, Heier LA et al. Primary neurosurgery for Pediatric low-grade glioma: a prospective multi-institutional study from the Children’s Oncology Group. Neurosurgery 2011;68(6):1548-1554. https://doi.org/10.1227/NEU.0b013e318214a66e
7. Hessissen L, Parkes J, Amayiri N et al. SIOP PODC Adapted treatment guidelines for low grade gliomas in low and middle income settings. Practice guideline 2017;64 Suppl 5. https://doi.org/10.1002/pbc.26737.
8. Gnekow AK , Kandels D, Tilburg C et al. SIOP-E-BTG and GPOH Guidelines for Diagnosis and Treatment of Children and Adolescents with Low Grade Glioma. Klin Padiatr 2019;231(3):107-135. https://doi.org/10.1055/a-0889-8256
9. Packer RJ, Ater J, Allen J et al. Carboplatin and vincristine chemotherapy for children with newly diagnosed progressive low-grade glioma. J Neurosurg 1997;86(5):747-754. https://doi.org/10.3171/jns.1997.86.5.0747
10. Kim AH, Thompson EA, Governale LS et al. Recurrence after gross-total resection of low-grade pediatric brain tumors: the frequency and timing of postoperative imaging. J Neurosurg Pediatr 2014;14(4):356-364. https://doi.org/10.3171/2014.6.PEDS1321
11. Joel M , Dennis W, Linda R et al. Conformal Radiation Therapy for Pediatric Patients with Low-Grade Glioma: Results from the Children's Oncology Group Phase 2 Study ACNS0221. Int J Radiat Oncol Biol Phys 2019;103(4):861-868. https://doi.org/10.1016/j.ijrobp.2018.11.004
12. 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, endocrime and hearing deficits. J Clin Oncol 2009;27(22):3691-3697. https://doi.org/10.1200/JCO.2008.21.2738
13. 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(7):1173-1179. https://doi.org/10.1002/pbc.24958
14. Alter 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. J Clin Oncol 2012;30(21):2641-2647. https://doi.org/10.1200/JCO.2011.36.6054
15. Gnekov AK, Walker DA, Kandels D et al. Corrigendum to “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” [Eur J of Canc (2017) 206–225]. Eur J Cancer 2018;90:156-157. https://doi.org/10.1016/j.ejca.2017.11.017
16. Lafay-Cousin L, Holm S, Qaddoumi I et al. Weekly Vinblastine in Pediatric low-grade glioma patient with Carboplatin allergic reaction. Cancer 2005;103(12):2636-2642. https://doi.org/10.1002/cncr.21091
17. Lassaletta A, Scheinemann K, Zelcer SM et al. Phase II weekly vinblastine for chemotherapy-naïve children with progressive low grade glioma: A Canadian Pediatric Brain Tumor Consortium study. J Clin Oncol 2016;34(29):3537-3543. https://doi.org/10.1200/JCO.2016.68.1585
18. Gorsi HS, Khanna PC, Tumblin M et al. Single agent bevacizumab in the treatment of recurrent or refractory pediatric low grade glioma : A single institutional experience. Pediatr Blood Cancer 2018;65(9):e27264. https://doi.org/10.1002/pbc.27234
19. 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 Oncol 2014;16:310-317. https://doi.org/10.1093/neuonc/not154
20. Ouyang T, Zhang N, Benjamin T et al. Subependymal giant cell astrocytoma: current concepts, management, and future directions. Childs Nerv Syst 2014;30:561-570. https://doi.org/10.1007/s00381-014-2383-x
21. Ullrich NJ, Prabhu SP, Reddy AT et al. A phase II study of continuous oral mTOR inhibitor everolimus for recurrent, radiographic-progressive neurofibromatosis type 1-associated pediatric low-grade glioma: a Neurofibromatosis Clinical Trials Consortium study. Neuro Oncol 2020;22(10):1527-1535. https://doi.org/10.1093/neuonc/noaa071.
22. Yalon M, Rood B, MacDonald TJ et al. A feasibility and efficacy study of rapamycin and erlotinib for recurrent pediatric low-grade glioma (LGG). Pediatric Blood and Cancer 2013;60:71-76. https://doi.org/10.1002/pbc.24142
23. Karajannis MA, Legault G, Fisher MJ et al. Phase II study of sorafenib in children with recurrent or progressive low-grade astrocytomas. Neuro Oncol 2014;16(10):1408-1416. https://doi.org/10.1093/neuonc/nou059
24. Theodore N, Kellie J, John C et al. Phase I study of vemurafenib in children with recurrent or progressive BRAF V600E mutant brain tumors: Pacific Pediatric Neuro-Oncology Consortium study (PNOC-002). Oncotarget 2020;11(21):1942-1952. https://doi.org/10.18632/oncotarget.27600.
25. Hargrave DR, Bouffet E, Tabori U et al. Efficacy and safety of Dabrafenib in Pediatric patients with BRAF V600 mutation positive relapsed or refractory low-grade gliomas: Result from a Phase I/II Study. Clinical cancer research: an official journal of the Americal Association for cancer reseach 2019;25(24):7303-7311. https://doi.org/10.1158/1078-0432.CCR-19-2177
26. Nobre L, Zapotocky M, Ramaswamy V et al. Outcomes of BRAF V600 Pediatric glioma treated with target BRAF inhibition. JCO precision oncology 2020;4:561-571.
27. Fangusaro J, Thomas AO, Poussaint TY et al. Selumetinib in paediatric patients with BRAF-aberrant or neurofibromatosis type 1-associated recurrent, refractory, or progressive low-grade glioma: a multicentre, phase 2 trial. Lancet 2019;20(7):1011-1022. https://doi.org/10.1016/S1470-2045(19)30277-3
28. Carey SS, Sadighi Z, Wu S et al. Evaluating pediatric spinal low grade glioma: a 30 year retrospective analysis. J Neurooncol 2019;145(3):519-529. https://doi.org/10.1007/s11060-019-03319-4.
29. Scheinemann K, Bartels U, Huang A et al. Survival and functional outcome of childhood spinal cord low-grade gliomas. J Neurosurg Pediatrics 2009;4:254-261.
30. Hassall TEG, Mitchell AE, Ashley DM. Carboplatin chemotherapy for progressive intramedullary spinal cord low-grade gliomas in children: three case studies and a review of the literature. Neuro Oncol 2001: 251-257.
31. Epstein F, Epstein N. Surgical treatment of spinal cord astrocytomas of childhood: A series of 19 patients. J Neurosurg 1982;57(5):685-689. https://doi.org/10.3171/jns.1982.57.5.0685
32. Nishio S, Morioka T, Fujii K et al. Spinal cord glioma: Management and outcome with reference to adjuvant therapy. J Clin. Neurosci 2000;7(1):20-23. https://doi.org/10.1054/jocn.1999.0128
33. Houten JK, Cooper PR. Spinal cord astrocytoma: presentation, management and outcome. J Neurooncol 2000;47(3):219-224. https://doi.org/10.1023/a:1006466422143
34. Bouffet E, Amat D, Devaux Y et al. Chemotherapy for spinal cord astrocytoma. Med Pediatr Oncol 1997;29:560-562.
35. Lowis SP, Pizer BL, Coakham H et al. Chemotherapy for spinal cord astrocytoma: Can natural histoty be modifed?. Childs Nerv Syst 1998;14:317-321.
36. Doireau V, Grill J, Zerah M et al. Chemotherapy for unresectable and recurrent intramedullary glial tumours in children. British J Cancer 1999;81(5):835-840.
37. Valera E, Serafini L, Machado H et al. Complete surgical resection in children with low grade astrocytomas after neoadjuvant chemotherapy. Childs Nerv syst 2003;19(2):86-90. https://doi.org/10.1007/s00381-002-0704-y
38. Merchant TE, Kiehna EN, Thompson SJ et al. Pediatric low-grade and ependymal spinal cord tumors. Pediatr. Neurosurg 2000;32:30-36. https://doi.org/10.1159/000028894
39. Fakhreddine M, Mahajan, Penas-Prado M. Treatment, prognostic factors, and outcomes in spinal cord astrocytomas. Neuro Oncol 2013;15(4):406-412. https://doi.org/10.1093/neuonc/nos309
40. Perwein T, Benesch M, Kandels D et al. High frequency of disease progression in pediatric spinal cord low-grade glioma (LGG): management strategies and results from the German LGG study group. Neuro-Oncology 2021;23(7):1148-1162. https://doi.org/10.1093/neuonc/noaa296