Skip to main content

Central Nervous System

  • Chapter
  • First Online:
  • 2852 Accesses

Abstract

This chapter will discuss malignant gliomas, low-grade gliomas, CNS lymphomas, ependymomas, choroid plexus tumors, pediatric gliomas, craniopharyngiomas, pineal tumors, medulloblastomas, meningiomas, acoustic neuromas, pituitary tumors, primary spinal cord tumors, arteriovenous malformations, and trigeminal neuralgia. Brain metastases will be discussed in the palliative care chapter.

This is a preview of subscription content, log in via an institution.

References

  • Abdel-Wahab M, Etuk B, Palermo J, et al. Spinal cord gliomas: a multi-institutional retrospective analysis. Int J Radiat Oncol Biol Phys. 2006;64:1060–71.

    Article  PubMed  Google Scholar 

  • Abedalthagafi M, Phillips JJ, Kim GE, et al. The alternative lengthening of telomere phenotype is significantly associated with loss of ATRX expression in high-grade pediatric and adult astrocytomas: a multi-institutional study of 214 astrocytomas. Mod Pathol. 2013;26:1425–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Abrey LE, Ben-Porat L, Panageas KS, et al. Primary central nervous system lymphoma: the Memorial Sloan-Kettering Cancer Center prognostic model. J Clin Oncol. 2006;24:5711–5.

    Article  PubMed  Google Scholar 

  • Aghi MK, Carter BS, Cosgrove GR, et al. Long-term recurrence rates of atypical meningiomas after gross total resection with or without post-operative adjuvant radiation. Neurosurgery. 2009;64:56–60.

    Article  PubMed  Google Scholar 

  • Ashley DM, Merchant TE, Strother D, et al. Induction chemotherapy and conformal radiation therapy for very young children with nonmetastatic medulloblastoma: Children's Oncology Group study P9934. J Clin Oncol. 2012;30:3181–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Ater 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;30:2641–7.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bailey CC, Gnekow A, Wellek S, et al. Prospective randomised trial of chemotherapy given before radiotherapy in childhood medulloblastoma. International Society of Paediatric Oncology (SIOP) and the (German) Society of Paediatric Oncology (GPO): SIOP II. Med Pediatr Oncol. 1995;25:166–78.

    Article  CAS  PubMed  Google Scholar 

  • Bakkouri WE, Kania RE, Guichard J-P, et al. Conservative management of 386 cases of unilateral vestibular schwannoma: tumor growth and consequences for treatment. J Neurosurg. 2009;110:662–9.

    Article  PubMed  Google Scholar 

  • Bamberg M, Kortmann RD, Calaminus G, et al. Radiation therapy for intracranial germinoma: results of the German cooperative prospective trials MAKEI 83/86/89. J Clin Oncol. 1999;17:2585–92.

    Article  CAS  PubMed  Google Scholar 

  • Bataini JP, Delanian S, Ponvert D. Chiasmal gliomas: results of irradiation management in 57 patients and review of literature. Int J Radiat Oncol Biol Phys. 1991;21:615–23.

    Article  CAS  PubMed  Google Scholar 

  • Bauman GS, Gaspar LE, Fisher BJ, et al. A prospective study of short-course radiotherapy in poor prognosis glioblastoma multiforme. Int J Radiat Oncol Biol Phys. 1994;29:835–9.

    Article  CAS  PubMed  Google Scholar 

  • Baumert BG, Hegi ME, van den Bent MJ, et al. Temozolomide chemotherapy versus radiotherapy in high-risk low-grade glioma (EORTC 22033-26033): a randomised, open-label, phase 3 intergroup study. Lancet Oncol. 2016.; epub ahead of print

    Google Scholar 

  • Bell EH, McElroy JP, Fleming J, et al. Comprehensive mutation analysis in NRG Oncology/RTOG 9813: a phase III trial of RT + TMZ + RT + nu for anaplastic astrocytoma and mixed anaplastic oligoastrocytoma (Astrocytoma Dominant). J Clin Oncol.2016; 34(suppl; abstr 2016).

    Google Scholar 

  • Bleehen NM, Girling DJ, Gregor A, et al. A Medical Research Council phase II trial of alternating chemotherapy and radiotherapy in small-cell lung cancer. The Medical Research Council Lung Cancer Working Party. Br J Cancer. 1991;64:775–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Brastianos PK, Horowitz PM, Santagata S, et al. Genomic sequencing of meningiomas identifies oncogenic SMO and AKT1 mutations. Nat Genet. 2013;45:285–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Brastianos PK, Shankar GM, Gill CM, et al. Dramatic Response of BRAF V600E Mutant Papillary Craniopharyngioma to Targeted Therapy. J Natl Cancer Inst. 2016;108

    Google Scholar 

  • Brastianos PK, Taylor-Weiner A, Manley PE, et al. Exome sequencing identifies BRAF mutations in papillary craniopharyngiomas. Nat Genet. 2014;46:161–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Brown PD, Buckner JC, O'Fallon JR, et al. Adult patients with supratentorial pilocytic astrocytomas: a prospective multicenter clinical trial. Int J Radiat Oncol Biol Phys. 2004;58:1153–60.

    Article  PubMed  Google Scholar 

  • Buckner JC, Shaw EG, Pugh SL, et al. Radiation plus procarbazine, CCNU, and vincristine in low-grade glioma. N Engl J Med. 2016;374:1344–55.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Bull KS, Spoudeas HA, Yadegarfar G, et al. Reduction of health status 7 years after addition of chemotherapy to craniospinal irradiation for medulloblastoma: a follow-up study in PNET 3 trial survivors on behalf of the CCLG (formerly UKCCSG). J Clin Oncol. 2007;25:4239–45.

    Article  PubMed  Google Scholar 

  • Burkhard C, Di Patre P-L, Schüler D, et al. A population-based study of the incidence and survival rates in patients with pilocytic astrocytoma. J Neurosurg. 2003;98:1170–4.

    Article  PubMed  Google Scholar 

  • Cairncross G, Wang M, Shaw E, et al. Phase III trial of chemoradiotherapy for anaplastic oligodendroglioma: long-term results of RTOG 9402. J Clin Oncol. 2013;31:337–43.

    Article  CAS  PubMed  Google Scholar 

  • Calaminus G, Kortmann R, Worch J, et al. SIOP CNS GCT 96: final report of outcome of a prospective, multinational nonrandomized trial for children and adults with intracranial germinoma, comparing craniospinal irradiation alone with chemotherapy followed by focal primary site irradiation for patients with localized disease. Neuro-Oncology. 2013;15:788–96.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Cancer Genome Atlas Research Network, Brat DJ, Verhaak RGW, et al. Comprehensive, integrative genomic analysis of diffuse lower-grade gliomas. N Engl J Med. 2015;372:2481–98.

    Article  CAS  Google Scholar 

  • Chan JL, Lee SW, Fraass BA, et al. Survival and failure patterns of high-grade gliomas after three-dimensional conformal radiotherapy. J Clin Oncol. 2002;20:1635–42.

    Article  PubMed  Google Scholar 

  • Chang CH, Housepian EM, Herbert C. An operative staging system and a megavoltage radiotherapeutic technic for cerebellar medulloblastomas. Radiology. 1969;93:1351–9.

    Article  CAS  PubMed  Google Scholar 

  • Chang S, Zhang P, Cairncross G et al. ATCT-12, Results of NRG oncology/RTOG 9813: a phase III randomized study of radiation therapy (RT) and temozolomide (TMZ) versus RT and nitrosourea (NU) therapy for anaplastic astrocytoma (AA). J Clin Oncol. 201533(suppl; abstr 2002).

    Google Scholar 

  • Chinot OL, Wick W, Mason W, et al. Bevacizumab plus radiotherapy–temozolomide for newly diagnosed glioblastoma. N Engl J Med. 2014;370:709–22.

    Article  CAS  PubMed  Google Scholar 

  • Clark VE, Erson-Omay EZ, Serin A, et al. Genomic analysis of non-NF2 meningiomas reveals mutations in TRAF7, KLF4, AKT1, and SMO. Science. 2013;339:1077–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Cohen KJ, Pollack IF, Zhou T, et al. Temozolomide in the treatment of high-grade gliomas in children: a report from the Children's Oncology Group. Neuro-Oncology. 2011;13:317–23.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Combs SE, Thilmann C, Edler L, et al. Efficacy of fractionated stereotactic reirradiation in recurrent gliomas: long-term results in 172 patients treated in a single institution. J Clin Oncol. 2005;23:8863–9.

    Article  PubMed  Google Scholar 

  • DeAngelis LM, Seiferheld W, Schold SC, et al. Combination chemotherapy and radiotherapy for primary central nervous system lymphoma: Radiation Therapy Oncology Group Study 93-10. J Clin Oncol. 2002;20:4643–8.

    Article  PubMed  Google Scholar 

  • Dhall G, Grodman H, Ji L, et al. Outcome of children less than three years old at diagnosis with non-metastatic medulloblastoma treated with chemotherapy on the “Head Start” I and II protocols. Pediatr Blood Cancer. 2008;50:1169–75.

    Article  PubMed  Google Scholar 

  • Duffner PK, Horowitz ME, Krischer JP, et al. Postoperative chemotherapy and delayed radiation in children less than three years of age with malignant brain tumors. N Engl J Med. 1993;328:1725–31.

    Article  CAS  PubMed  Google Scholar 

  • Dziuk TW, Woo S, Butler EB, et al. Malignant meningioma: an indication for initial aggressive surgery and adjuvant radiotherapy. J Neuro-Oncol. 1998;37:177–88.

    Article  CAS  Google Scholar 

  • Eckel-Passow JE, Lachance DH, Molinaro AM, et al. Glioma ’groups based on 1p/19q, IDH, and TERT promoter mutations in tumors. N Engl J Med. 2015;372:2499–508.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Espinoza JC, Haley K, Patel N, et al. Outcome of young children with high-grade glioma treated with irradiation-avoiding intensive chemotherapy regimens: Final report of the Head Start II and III trials. Pediatr Blood Cancer. 2016;63:1806–13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Evans AE, Jenkin RD, Sposto R, et al. The treatment of medulloblastoma. Results of a prospective randomized trial of radiation therapy with and without CCNU, vincristine, and prednisone. J Neurosurg. 1990;72:572–82.

    Article  CAS  PubMed  Google Scholar 

  • Evans DGR, Birch JM, Ramsden RT, et al. Malignant transformation and new primary tumours after therapeutic radiation for benign disease: substantial risks in certain tumour prone syndromes. J Med Genet. 2006;43:289–94.

    Article  CAS  PubMed  Google Scholar 

  • Finlay JL, Boyett JM, Yates AJ, et al. Randomized phase III trial in childhood high-grade astrocytoma comparing vincristine, lomustine, and prednisone with the eight-drugs-in-1-day regimen. Childrens Cancer Group. J Clin Oncol. 1995;13:112–23.

    Article  CAS  PubMed  Google Scholar 

  • Fisher BJ, Hu C, Macdonald DR, et al. Phase 2 study of temozolomide-based chemoradiation therapy for high-risk low-grade gliomas: preliminary results of Radiation Therapy Oncology Group 0424. Int J Radiat Oncol Biol Phys. 2015;91:497–504.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Flickinger JC, Kano H, Niranjan A, et al. Dose selection in stereotactic radiosurgery. Prog Neurol Surg. 2013;27:49–57.

    Article  PubMed  Google Scholar 

  • Flickinger JC, Pollock BE, Kondziolka D, et al. A dose-response analysis of arteriovenous malformation obliteration after radiosurgery. Int J Radiat Oncol Biol Phys. 1996;36:873–9.

    Article  CAS  PubMed  Google Scholar 

  • Flickinger JC, Torres C, Deutsch M. Management of low-grade gliomas of the optic nerve and chiasm. Cancer. 1988;61:635–42.

    Article  CAS  PubMed  Google Scholar 

  • Fogh SE, Andrews DW, Glass J, et al. Hypofractionated stereotactic radiation therapy: An effective therapy for recurrent high-grade gliomas. J Clin Oncol. 2010;28:3048–53.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gajjar A, Bowers DC, Karajannis MA, et al. Pediatric brain tumors: innovative genomic information is transforming the diagnostic and clinical landscape. J Clin Oncol. 2015;33:2986–98.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Gajjar A, Chintagumpala M, Ashley D, et al. Risk-adapted craniospinal radiotherapy followed by high-dose chemotherapy and stem-cell rescue in children with newly diagnosed medulloblastoma (St Jude Medulloblastoma-96): long-term results from a prospective, multicentre trial. Lancet Oncol. 2006;7:813–20.

    Article  PubMed  Google Scholar 

  • Gavrilovic IT. Long-term follow-up of high-dose methotrexate-based therapy with and without whole brain irradiation for newly diagnosed primary CNS lymphoma. J Clin Oncol. 2006;24:4570–4.

    Article  CAS  PubMed  Google Scholar 

  • Geyer JR, Sposto R, Jennings M, et al. Multiagent chemotherapy and deferred radiotherapy in infants with malignant brain tumors: a report from the Children's Cancer Group. J Clin Oncol. 2005;23:7621–31.

    Article  PubMed  Google Scholar 

  • Gilbert MR, Dignam JJ, Armstrong TS, et al. A randomized trial of bevacizumab for newly diagnosed glioblastoma. N Engl J Med. 2014;370:699–708.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Goldman S, Bouffet E, Fisher PG, et al. Phase II trial assessing the ability of neoadjuvant chemotherapy with or without second-look surgery to eliminate measurable disease for nongerminomatous germ cell tumors: a Children's Oncology Group Study. J Clin Oncol. 2015;33:2464–71.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Goldsmith BJ, Wara WM, Wilson CB, et al. Postoperative irradiation for subtotally resected meningiomas. J Neurosurg. 1994;80:195–201.

    Article  CAS  PubMed  Google Scholar 

  • Goodwin JW, Crowley J, Eyre HJ, et al. A phase II evaluation of tamoxifen in unresectable or refractory meningiomas: a Southwest Oncology Group study. J Neuro-Oncol. 1993;15:75–7.

    Article  CAS  Google Scholar 

  • Gorlia T, van den Bent MJ, Hegi ME, et al. Nomograms for predicting survival of patients with newly diagnosed glioblastoma: prognostic factor analysis of EORTC and NCIC trial 26981-22981/CE.3. Lancet Oncol. 2008;9:29–38.

    Article  PubMed  Google Scholar 

  • Goyal LK, Suh JH, Mohan DS, et al. Local control and overall survival in atypical meningioma: a retrospective study. Int J Radiat Oncol Biol Phys. 2000;46:57–61.

    Article  CAS  PubMed  Google Scholar 

  • Gripp S, Kambergs J, Wittkamp M, et al. Coverage of anterior fossa in whole-brain irradiation. Int J Radiat Oncol Biol Phys. 2004;59:515–20.

    Article  PubMed  Google Scholar 

  • Gronseth G, Cruccu G, Alksne J, et al. Practice parameter: the diagnostic evaluation and treatment of trigeminal neuralgia (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the European Federation of Neurological Societies. Neurology. 2008;71:1183–90.

    Article  CAS  PubMed  Google Scholar 

  • Grundy RG, Wilne SA, Weston CL, et al. Primary postoperative chemotherapy without radiotherapy for intracranial ependymoma in children: the UKCCSG/SIOP prospective study. Lancet Oncol. 2007;8:696–705.

    Article  PubMed  Google Scholar 

  • Haas-Kogan DA, Missett BT, Wara WM, et al. Radiation therapy for intracranial germ cell tumors. Int J Radiat Oncol Biol Phys. 2003;56:511–8.

    Article  PubMed  Google Scholar 

  • Hargrave D, Bartels U, Bouffet E. Diffuse brainstem glioma in children: critical review of clinical trials. Lancet Oncol. 2006;7:241–8.

    Article  PubMed  Google Scholar 

  • Hegi ME, Diserens A-C, Gorlia T, et al. MGMT gene silencing and benefit from temozolomide in glioblastoma. N Engl J Med. 2005;352:997–1003.

    Article  CAS  PubMed  Google Scholar 

  • Jadid KD, Feychting M, Höijer J, et al. Long-term follow-up of incidentally discovered meningiomas. Acta Neurochir. 2015;157:225–30.

    Article  PubMed  Google Scholar 

  • Jaeckle K, Vogelbaum M, Ballman K, et al. CODEL (Alliance-N0577; EORTC-26081/22086; NRG-1071; NCIC-CEC-2): Phase III Randomized Study of RT vs. RT+TMZ vs. TMZ for Newly Diagnosed 1p/19q-Codeleted Anaplastic Oligodendroglial Tumors. Analysis of Patients Treated on the Original Protocol Design (PL02.005). Neurology 2016.

    Google Scholar 

  • Jakacki RI, Burger PC, Zhou T, et al. Outcome of children with metastatic medulloblastoma treated with carboplatin during craniospinal radiotherapy: a Children's Oncology Group Phase I/II study. J Clin Oncol. 2012;30:2648–53.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Jansen MHA, van Vuurden DG, Vandertop WP, et al. Diffuse intrinsic pontine gliomas: a systematic update on clinical trials and biology. Cancer Treat Rev. 2012;38:27–35.

    Article  CAS  PubMed  Google Scholar 

  • Janssens GO, Jansen MH, Lauwers SJ, et al. Hypofractionation vs conventional radiation therapy for newly diagnosed diffuse intrinsic pontine glioma: a matched-cohort analysis. Int J Radiat Oncol Biol Phys. 2013;85:315–20.

    Article  PubMed  Google Scholar 

  • Ji Y, Rankin C, Grunberg S, et al. Double-blind phase III randomized trial of the antiprogestin agent mifepristone in the treatment of unresectable meningioma: SWOG S9005. J Clin Oncol. 2015;33:4093–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Kapoor S, Batra S, Carson K, et al. Long-term outcomes of vestibular schwannomas treated with fractionated stereotactic radiotherapy: an institutional experience. Int J Radiat Oncol Biol Phys. 2011;81:647–53.

    Article  PubMed  Google Scholar 

  • Kaprealian T, Raleigh DR, Sneed PK, et al. Parameters influencing local control of meningiomas treated with radiosurgery. J Neuro-Oncol. 2016;128:357–64.

    Article  CAS  Google Scholar 

  • Karim AB, Maat B, Hatlevoll R, et al. A randomized trial on dose-response in radiation therapy of low-grade cerebral glioma: European Organization for Research and Treatment of Cancer (EORTC) Study 22844. Int J Radiat Oncol Biol Phys. 1996;36:549–56.

    Article  CAS  PubMed  Google Scholar 

  • Karim AB, Afra D, Cornu P, et al. Randomized trial on the efficacy of radiotherapy for cerebral low-grade glioma in the adult: European Organization for Research and Treatment of Cancer Study 22845 with the Medical Research Council study BRO4: an interim analysis. Int J Radiat Oncol Biol Phys. 2002;52:316–24.

    Article  PubMed  Google Scholar 

  • Keime-Guibert F, Chinot O, Taillandier L, et al. Radiotherapy for glioblastoma in the elderly. N Engl J Med. 2007;356:1527–35.

    Article  CAS  PubMed  Google Scholar 

  • Kondziolka D, Lunsford LD, McLaughlin MR, et al. Long-term outcomes after radiosurgery for acoustic neuromas. N Engl J Med. 1998;339:1426–33.

    Article  CAS  PubMed  Google Scholar 

  • Kondziolka D, Mathieu D, Lunsford LD, et al. Radiosurgery as definitive management of intracranial meningiomas. Neurosurgery. 2008;62:53–8.

    Article  PubMed  Google Scholar 

  • Korfel A, Thiel E, Martus P, et al. Randomized phase III study of whole-brain radiotherapy for primary CNS lymphoma. Neurology. 2015;84:1242–8.

    Article  CAS  PubMed  Google Scholar 

  • Kretschmar C, Kleinberg L, Greenberg M, et al. Pre-radiation chemotherapy with response-based radiation therapy in children with central nervous system germ cell tumors: a report from the Children's Oncology Group. Pediatr Blood Cancer. 2007;48:285–91.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Krueger DA, Care MM, Agricola K, et al. Everolimus long-term safety and efficacy in subependymal giant cell astrocytoma. Neurology. 2013;80:574–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Larkin SJ, Preda V, Karavitaki N, et al. BRAF V600E mutations are characteristic for papillary craniopharyngioma and may coexist with CTNNB1-mutated adamantinomatous craniopharyngioma. Acta Neuropathol. 2014;127:927–9.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lo AC, Howard AF, Nichol A, et al. Long-term outcomes and complications in patients with craniopharyngioma: the British Columbia Cancer Agency experience. Int J Radiat Oncol Biol Phys. 2014;88:1011–8.

    Article  PubMed  Google Scholar 

  • Louis DN, Perry A, Reifenberger G, et al. The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol. 2016;131:803–20.

    Article  PubMed  Google Scholar 

  • Lunsford LD, Niranjan A, Flickinger JC, et al. Radiosurgery of vestibular schwannomas: summary of experience in 829 cases. J Neurosurg. 2013;119(Suppl):195–9.

    Google Scholar 

  • Luyken C, Blümcke I, Fimmers R, et al. Supratentorial gangliogliomas: histopathologic grading and tumor recurrence in 184 patients with a median follow-up of 8 years. Cancer. 2004;101:146–55.

    Article  PubMed  Google Scholar 

  • Malmström A, Grønberg BH, Marosi C, et al. Temozolomide versus standard 6-week radiotherapy versus hypofractionated radiotherapy in patients older than 60 years with glioblastoma: the Nordic randomised, phase 3 trial. Lancet Oncol. 2012;13:916–26.

    Article  PubMed  CAS  Google Scholar 

  • Maruyama K, Kawahara N, Shin M, et al. The risk of hemorrhage after radiosurgery for cerebral arteriovenous malformations. N Engl J Med. 2005;352:146–53.

    Article  CAS  PubMed  Google Scholar 

  • Mason WP, Grovas A, Halpern S, et al. Intensive chemotherapy and bone marrow rescue for young children with newly diagnosed malignant brain tumors. J Clin Oncol. 1998;16:210–21.

    Article  CAS  PubMed  Google Scholar 

  • Merchant TE, Kiehna EN, Sanford RA, et al. Craniopharyngioma: the St. Jude Children's Research Hospital experience 1984-2001. Int J Radiat Oncol Biol Phys. 2002;53:533–42.

    Article  PubMed  Google Scholar 

  • Merchant TE, Kun LE, Krasin MJ, et al. Multi-institution prospective trial of reduced-dose craniospinal irradiation (23.4 Gy) followed by conformal posterior fossa (36 Gy) and primary site irradiation (55.8 Gy) and dose-intensive chemotherapy for average-risk medulloblastoma. Int J Radiat Oncol Biol Phys. 2008;70:782–7.

    Article  PubMed  Google Scholar 

  • Merchant TE, Kun LE, Wu S, et al. Phase II trial of conformal radiation therapy for pediatric low-grade glioma. J Clin Oncol. 2009a;27:3598–604.

    Article  PubMed  PubMed Central  Google Scholar 

  • Merchant TE, Li C, Xiong X, et al. Conformal radiotherapy after surgery for paediatric ependymoma: a prospective study. Lancet Oncol. 2009b;10:258–66.

    Article  PubMed  PubMed Central  Google Scholar 

  • Michalski J, Vezina G, Burger P, et al. Preliminary results of COG ACNS0331: a phase III trial of Involved Field Radiotherapy (IFRT) and Low Dose Craniospinal Irradiation (LD-CSI) with chemotherapy in average risk medulloblastoma: a report from the Children's Oncology Group. Neuro-Oncology. 2016;18(suppl_3):iii122.

    Article  PubMed Central  Google Scholar 

  • Mirimanoff R-O, Gorlia T, Mason W, et al. Radiotherapy and temozolomide for newly diagnosed glioblastoma: recursive partitioning analysis of the EORTC 26981/22981-NCIC CE3 phase III randomized trial. J Clin Oncol. 2006;24:2563–9.

    Article  CAS  PubMed  Google Scholar 

  • Mohr JP, Parides MK, Stapf C, et al. Medical management with or without interventional therapy for unruptured brain arteriovenous malformations (ARUBA): a multicentre, non-blinded, randomised trial. Lancet. 2014;383:614–21.

    Article  CAS  PubMed  Google Scholar 

  • Negretti L, Bouchireb K, Levy-Piedbois C, et al. Hypofractionated radiotherapy in the treatment of diffuse intrinsic pontine glioma in children: a single institution's experience. J Neuro-Oncol. 2011;104:773–7.

    Article  Google Scholar 

  • Nelson DF, Diener-West M, Horton J, et al. Combined modality approach to treatment of malignant gliomas--re-evaluation of RTOG 7401/ECOG 1374 with long-term follow-up: a joint study of the Radiation Therapy Oncology Group and the Eastern Cooperative Oncology Group. NCI Monogr. 1988:279–84.

    Google Scholar 

  • Nelson DF, Martz KL, Bonner H, et al. Non-Hodgkin's lymphoma of the brain: can high dose, large volume radiation therapy improve survival? Report on a prospective trial by the Radiation Therapy Oncology Group (RTOG): RTOG 8315. Int J Radiat Oncol Biol Phys. 1992;23:9–17.

    Article  CAS  PubMed  Google Scholar 

  • Northcott PA, Jones DTW, Kool M, et al. Medulloblastomics: the end of the beginning. Nat Rev Cancer. 2012;12:818–34.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Northcott PA, Korshunov A, Witt H, et al. Medulloblastoma comprises four distinct molecular variants. J Clin Oncol. 2011;29:1408–14.

    Article  PubMed  Google Scholar 

  • Oikonomou E, Barreto DC, Soares B, et al. Beta-catenin mutations in craniopharyngiomas and pituitary adenomas. J Neuro-Oncol. 2005;73:205–9.

    Article  CAS  Google Scholar 

  • Ostrom QT, Gittleman H, Fulop J, et al. CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2008–2012. Neuro-Oncology. 2015;17 Suppl 4:iv1–iv62.

    Article  PubMed  Google Scholar 

  • Packer RJ, Ater J, Allen J, et al. Carboplatin and vincristine chemotherapy for children with newly diagnosed progressive low-grade gliomas. J Neurosurg. 1997;86:747–54.

    Article  CAS  PubMed  Google Scholar 

  • Packer RJ, Gajjar A, Vezina G, et al. Phase III study of craniospinal radiation therapy followed by adjuvant chemotherapy for newly diagnosed average-risk medulloblastoma. J Clin Oncol. 2006;24:4202–8.

    Article  CAS  PubMed  Google Scholar 

  • Packer RJ, Lange B, Ater J, et al. Carboplatin and vincristine for recurrent and newly diagnosed low-grade gliomas of childhood. J Clin Oncol. 1993;11:850–6.

    Article  CAS  PubMed  Google Scholar 

  • Packer RJ, Zhou T, Holmes E, et al. Survival and secondary tumors in children with medulloblastoma receiving radiotherapy and adjuvant chemotherapy: results of Children's Oncology Group trial A9961. Neuro-Oncology. 2013;15:97–103.

    Article  CAS  PubMed  Google Scholar 

  • Pajtler KW, Witt H, Sill M, et al. Molecular classification of ependymal tumors across all CNS compartments, histopathological grades, and age groups. Cancer Cell. 2015;27:728–43.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Perry JR, Laperriere N, O'Callaghan CJ, et al. Short-course radiation plus temozolomide in elderly patients with glioblastoma. NEJM. 2017;376(11):1027–37.

    Article  CAS  PubMed  Google Scholar 

  • Pollock BE. Management of vestibular schwannomas that enlarge after stereotactic radiosurgery: treatment recommendations based on a 15 year experience. Neurosurgery. 2006;58:241–8.

    Article  PubMed  Google Scholar 

  • Prados MD, Edwards MS, Rabbitt J, et al. Treatment of pediatric low-grade gliomas with a nitrosourea-based multiagent chemotherapy regimen. J Neuro-Oncol. 1997;32:235–41.

    Article  CAS  Google Scholar 

  • Ramaswamy V, Hielscher T, Mack SC, et al. Therapeutic impact of cytoreductive surgery and irradiation of posterior fossa ependymoma in the molecular era: a retrospective multicohort analysis. J Clin Oncol. 2016;34:2468–77.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Reijneveld JC, Taphoorn MJB, Coens C, et al. Health-related quality of life in patients with high-risk low-grade glioma (EORTC 22033-26033): a randomised, open-label, phase 3 intergroup study. Lancet Oncol. 2016;17(11):1533–42.

    Article  PubMed  Google Scholar 

  • Roa W, Brasher PMA, Bauman G, et al. Abbreviated course of radiation therapy in older patients with glioblastoma multiforme: a prospective randomized clinical trial. J Clin Oncol. 2004;22:1583–8.

    Article  CAS  PubMed  Google Scholar 

  • Roa W, Kepka L, Kumar N, et al. International atomic energy aency randomized phase III study of radiation therapy in elderly and/or frail patients with newly diagnosed glioblastoma multiforme. J Clin Oncol. 2015;33:4145–50.

    Article  PubMed  Google Scholar 

  • Rogers L, Barani I, Chamberlain M, et al. Meningiomas: knowledge base, treatment outcomes, and uncertainties. A RANO review. J Neurosurg. 2015a;122:4–23.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rogers L, Zhang P, Vogelbaum MA, et al. Intermediate-risk meningioma: initial outcomes from NRG oncology/RTOG-0539. Int J Radiat Oncol Biol Phys. 2015b;93:S139–40.

    Article  Google Scholar 

  • Rogers L, Zhang P, Vogelbaum MA, et al. Low-risk meningioma: initial outcomes from NRG oncology/RTOG 0539. Int J Radiat Oncol Biol Phys. 2016;96:939–40.

    Article  Google Scholar 

  • Rutkowski S, Bode U, Deinlein F, et al. Treatment of early childhood medulloblastoma by postoperative chemotherapy alone. N Engl J Med. 2005;352:978–86.

    Article  CAS  PubMed  Google Scholar 

  • Ryzenman JM, Pensak ML, Tew JM. Headache: a quality of life analysis in a cohort of 1,657 patients undergoing acoustic neuroma surgery, results from the acoustic neuroma association. Laryngoscope. 2005;115:703–11.

    Article  PubMed  Google Scholar 

  • Samii M, Matthies C. Management of 1000 vestibular schwannomas (acoustic neuromas): surgical management and results with an emphasis on complications and how to avoid them. Neurosurgery. 1997;40:11–21.

    CAS  PubMed  Google Scholar 

  • Sanson M, Marie Y, Paris S, et al. Isocitrate dehydrogenase 1 codon 132 mutation is an important prognostic biomarker in gliomas. J Clin Oncol. 2009;27:4150–4.

    Article  CAS  PubMed  Google Scholar 

  • Santacroce A, Walier M, Régis J, et al. Long-term tumor control of benign intracranial meningiomas after radiosurgery in a series of 4565 patients. Neurosurgery. 2012;70:32–9.

    Article  PubMed  Google Scholar 

  • Schultz C, Scott C, Sherman W, et al. Preirradiation chemotherapy with cyclophosphamide, doxorubicin, vincristine, and dexamethasone for primary CNS lymphomas: initial report of radiation therapy oncology group protocol 88-06. J Clin Oncol. 1996;14:556–64.

    Article  CAS  PubMed  Google Scholar 

  • Seymour ZA, Sneed PK, Gupta N, et al. Volume-staged radiosurgery for large arteriovenous malformations: an evolving paradigm. J Neurosurg. 2015:1–12.

    Google Scholar 

  • Shaw E, Arusell R, Scheithauer B, et al. Prospective randomized trial of low- versus high-dose radiation therapy in adults with supratentorial low-grade glioma: initial report of a North Central Cancer Treatment Group/Radiation Therapy Oncology Group/Eastern Cooperative Oncology Group study. J Clin Oncol. 2002;20:2267–76.

    Article  CAS  PubMed  Google Scholar 

  • Shaw EG, Berkey B, Coons SW, et al. Recurrence following neurosurgeon-determined gross-total resection of adult supratentorial low-grade glioma: results of a prospective clinical trial. J Neurosurg. 2008;109:835–41.

    Article  PubMed  Google Scholar 

  • Sheehan J, Pan H-C, Stroila M, et al. Gamma knife surgery for trigeminal neuralgia: outcomes and prognostic factors. J Neurosurg. 2005;102:434–41.

    Article  PubMed  Google Scholar 

  • Sheehan JP, Pouratian N, Steiner L, et al. Gamma Knife surgery for pituitary adenomas: factors related to radiological and endocrine outcomes. J Neurosurg. 2011;114:303–9.

    Article  PubMed  Google Scholar 

  • Smith SJ, Boddu S, Macarthur DC. Atypical meningiomas: WHO moved the goalposts? Br J Neurosurg. 2007;21:588–92.

    Article  CAS  PubMed  Google Scholar 

  • Smouha EE, Yoo M, Mohr K, et al. Conservative management of acoustic neuroma: a meta-analysis and proposed treatment algorithm. Laryngoscope. 2005;115:450–4.

    Article  PubMed  Google Scholar 

  • Sonneland PR, Scheithauer BW, Onofrio BM. Myxopapillary ependymoma. A clinicopathologic and immunocytochemical study of 77 cases. Cancer. 1985;56:883–93.

    Article  CAS  PubMed  Google Scholar 

  • Souhami L, Seiferheld W, Brachman D, et al. Randomized comparison of stereotactic radiosurgery followed by conventional radiotherapy with carmustine to conventional radiotherapy with carmustine for patients with glioblastoma multiforme: Report of Radiation Therapy Oncology Group 93-05 protocol. Int J Radiat Oncol Biol Phys. 2004;60:853–60.

    Article  PubMed  Google Scholar 

  • Souweidane MM, Krieger MD, Weiner HL, et al. Surgical management of primary central nervous system germ cell tumors: proceedings from the Second International Symposium on Central Nervous System Germ Cell Tumors. J Neurosurg Pediatr. 2010;6:125–30.

    Article  PubMed  Google Scholar 

  • Spetzler RF, Martin NA. A proposed grading system for arteriovenous malformations. J Neurosurg. 1986;65:476–83.

    Article  CAS  PubMed  Google Scholar 

  • Sposto R, Ertel IJ, Jenkin RD, et al. The effectiveness of chemotherapy for treatment of high grade astrocytoma in children: results of a randomized trial. A report from the Childrens Cancer Study Group. J Neuro-Oncol. 1989;7:165–77.

    Article  CAS  Google Scholar 

  • Stafford SL, Perry A, Suman VJ, et al. Primarily resected meningiomas: outcome and prognostic factors in 581 Mayo Clinic patients, 1978 through 1988. Mayo Clin Proc. 1998;73:936–42.

    Article  CAS  PubMed  Google Scholar 

  • Starke RM, Yen C-P, Ding D, et al. A practical grading scale for predicting outcome after radiosurgery for arteriovenous malformations: analysis of 1012 treated patients. J Neurosurg. 2013;119:981–7.

    Article  PubMed  Google Scholar 

  • Stripp DCH, Maity A, Janss AJ, et al. Surgery with or without radiation therapy in the management of craniopharyngiomas in children and young adults. Int J Radiat Oncol Biol Phys. 2004;58:714–20.

    Article  PubMed  Google Scholar 

  • Stupp R, Hegi ME, Mason WP, et al. Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial. Lancet Oncol. 2009;10:459–66.

    Article  CAS  PubMed  Google Scholar 

  • Stupp R, Mason WP, van den Bent MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med. 2005;352:987–96.

    Article  CAS  PubMed  Google Scholar 

  • Stupp R, Taillibert S, Kanner AA, et al. Maintenance therapy with tumor-treating fields plus temozolomide vs temozolomide alone for glioblastoma: a randomized clinical trial. JAMA. 2015;314:2535–43.

    Article  CAS  PubMed  Google Scholar 

  • Stupp R, Wong ET, Kanner AA, et al. NovoTTF-100A versus physician's choice chemotherapy in recurrent glioblastoma: a randomised phase III trial of a novel treatment modality. Eur J Cancer. 2012;48:2192–202.

    Article  PubMed  Google Scholar 

  • Sturm D, Bender S, Jones DTW, et al. Paediatric and adult glioblastoma: multiform (epi)genomic culprits emerge. Nat Rev Cancer. 2014;14:92–107.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Sughrue ME, Sanai N, Shangari G, et al. Outcome and survival following primary and repeat surgery for World Health Organization Grade III meningiomas. J Neurosurg. 2010;113:202–9.

    Article  PubMed  Google Scholar 

  • Sun S, Liu A. Long-term follow-up studies of Gamma Knife surgery for patients with neurofibromatosis Type 2. J Neurosurg. 2014;121(Suppl):143–9.

    Article  PubMed  Google Scholar 

  • Taal W, Brandsma D, de Bruin HG, et al. Incidence of early pseudo-progression in a cohort of malignant glioma patients treated with chemoirradiation with temozolomide. Cancer. 2008;113:405–10.

    Article  CAS  PubMed  Google Scholar 

  • Tait DM, Thornton-Jones H, Bloom HJ, et al. Adjuvant chemotherapy for medulloblastoma: the first multi-centre control trial of the International Society of Paediatric Oncology (SIOP I). Eur J Cancer. 1990;26:464–9.

    CAS  PubMed  Google Scholar 

  • Tao ML, Barnes PD, Billett AL, et al. Childhood optic chiasm gliomas: radiographic response following radiotherapy and long-term clinical outcome. Int J Radiat Oncol Biol Phys. 1997;39:579–87.

    Article  CAS  PubMed  Google Scholar 

  • Tarbell NJ, Friedman H, Polkinghorn WR, et al. High-risk medulloblastoma: a pediatric oncology group randomized trial of chemotherapy before or after radiation therapy (POG 9031). J Clin Oncol. 2013;31:2936–41.

    Article  PubMed  PubMed Central  Google Scholar 

  • Taylor RE, Bailey CC, Robinson K, et al. Results of a randomized study of preradiation chemotherapy versus radiotherapy alone for nonmetastatic medulloblastoma: the International Society of Paediatric Oncology/United Kingdom Children's Cancer Study Group PNET-3 Study. J Clin Oncol. 2003;21:1581–91.

    Article  CAS  PubMed  Google Scholar 

  • Thiel E, Korfel A, Martus P, et al. High-dose methotrexate with or without whole brain radiotherapy for primary CNS lymphoma (G-PCNSL-SG-1): a phase 3, randomised, non-inferiority trial. Lancet Oncol. 2010;11:1036–47.

    Article  CAS  PubMed  Google Scholar 

  • Thomas PR, Deutsch M, Kepner JL, et al. Low-stage medulloblastoma: final analysis of trial comparing standard-dose with reduced-dose neuraxis irradiation. J Clin Oncol. 2000;18:3004–11.

    Article  CAS  PubMed  Google Scholar 

  • Thompson EM, Hielscher T, Bouffet E, et al. Prognostic value of medulloblastoma extent of resection after accounting for molecular subgroup: a retrospective integrated clinical and molecular analysis. Lancet Oncol. 2016;17:484–95.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Tihan T, Ersen A, Qaddoumi I, et al. Pathologic characteristics of pediatric intracranial pilocytic astrocytomas and their impact on outcome in 3 countries: a multi-institutional study. Am J Surg Pathol. 2012;36:43–55.

    Article  PubMed  Google Scholar 

  • van den Bent MJ, Afra D, de Witte O, et al. Long-term efficacy of early versus delayed radiotherapy for low-grade astrocytoma and oligodendroglioma in adults: the EORTC 22845 randomised trial. Lancet. 2005;366:985–90.

    Article  PubMed  Google Scholar 

  • van den Bent MJ, Brandes AA, Taphoorn MJB, et al. Adjuvant procarbazine, lomustine, and vincristine chemotherapy in newly diagnosed anaplastic oligodendroglioma: long-term follow-up of EORTC Brain Tumor Group Study 26951. J Clin Oncol. 2013;31:344–50.

    Article  PubMed  CAS  Google Scholar 

  • van den Bent MJ, Erridge S, Vogelbaum MA, et al. Results of the interim analysis of the EORTC randomized phase III CATNON trial on concurrent and adjuvant temozolomide in anaplastic glioma without 1p/19q co-deletion: an Intergroup trial. J Clin Oncol 2016; 34(suppl; abstr LBA2000).

    Google Scholar 

  • Walker MD, Alexander E Jr, Hunt WE, et al. Evaluation of BCNU and/or radiotherapy in the treatment of anaplastic gliomas. J Neurosurg. 1978;49:333–43.

    Article  CAS  PubMed  Google Scholar 

  • Walker MD, Green SB, Byar DP, et al. Randomized comparisons of radiotherapy and nitrosoureas for the treatment of malignant glioma after surgery. N Engl J Med. 1980;303:1323–9.

    Article  CAS  PubMed  Google Scholar 

  • Walker MD, Strike TA, Sheline GE. Analysis of dose-effect relationship in the radiotherapy of malignant gliomas. Int J Radiat Oncol Biol Phys. 1979;5:1725–31.

    Article  CAS  PubMed  Google Scholar 

  • Weber DC, Wang Y, Miller R, et al. Long-term outcome of patients with spinal myxopapillary ependymoma: treatment results from the MD Anderson Cancer Center and institutions from the Rare Cancer Network. Neuro-Oncology. 2015;17:588–95.

    Article  PubMed  Google Scholar 

  • Weiner HL, Lichtenbaum RA, Wisoff JH, et al. Delayed surgical resection of central nervous system germ cell tumors. Neurosurgery. 2002;(50):727–33–discussion733–4.

    Article  PubMed  Google Scholar 

  • Wick W, Hartmann C, Engel C, et al. NOA-04 randomized phase III trial of sequential radiochemotherapy of anaplastic glioma with procarbazine, lomustine, and vincristine or temozolomide. J Clin Oncol. 2009;27:5874–80.

    Article  CAS  PubMed  Google Scholar 

  • Wick W, Meisner C, Hentschel B, et al. Prognostic or predictive value of MGMT promoter methylation in gliomas depends on IDH1 mutation. Neurology. 2013;81:1515–22.

    Article  CAS  PubMed  Google Scholar 

  • Wick W, Platten M, Meisner C, et al. Temozolomide chemotherapy alone versus radiotherapy alone for malignant astrocytoma in the elderly: the NOA-08 randomised, phase 3 trial. Lancet Oncol. 2012;13:707–15.

    Article  CAS  PubMed  Google Scholar 

  • Wick W, Roth P, Hartmann C, et al. Long-term analysis of the NOA-04 randomized phase III trial of sequential radiochemotherapy of anaplastic glioma with PCV or temozolomide. Neuro-Oncology. 2016;18(11):1529–37.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Wiemels J, Wrensch M, Claus EB. Epidemiology and etiology of meningioma. J Neuro-Oncol. 2010;99:307–14.

    Article  Google Scholar 

  • Witt H, Mack SC, Ryzhova M, et al. Delineation of two clinically and molecularly distinct subgroups of posterior fossa ependymoma. Cancer Cell. 2011;20:143–57.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Wolff JEA, Driever PH, Erdlenbruch B, et al. Intensive chemotherapy improves survival in pediatric high-grade glioma after gross total resection: results of the HIT-GBM-C protocol. Cancer. 2010;116:705–12.

    Article  PubMed  Google Scholar 

  • Yan H, Parsons DW, Jin G, et al. IDH1and IDH2Mutations in gliomas. N Engl J Med. 2009;360:765–73.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Yano S, Kuratsu J-I, Kumamoto Brain Tumor Research Group. Indications for surgery in patients with asymptomatic meningiomas based on an extensive experience. J Neurosurg. 2006;105:538–43.

    Article  PubMed  Google Scholar 

  • Zaghloul MS, Eldebawy E, Ahmed S, et al. Hypofractionated conformal radiotherapy for pediatric diffuse intrinsic pontine glioma (DIPG): a randomized controlled trial. Radiother Oncol. 2014;111:35–40.

    Article  PubMed  Google Scholar 

  • Zeltzer PM, Boyett JM, Finlay JL, et al. Metastasis stage, adjuvant treatment, and residual tumor are prognostic factors for medulloblastoma in children: conclusions from the Children’s Cancer Group 921 randomized phase III study. J Clin Oncol. 1999;17:832–45.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgment

We thank Charlotte Dai Kubicky MD, PhD, Linda W. Chan MD, Stuart Y. Tsuji MD, PhD, and David A. Larson MD, PhD for their work on the prior edition of this chapter.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jean L. Nakamura .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Yu, Y., Braunstein, S.E., Haas-Kogan, D.A., Nakamura, J.L. (2018). Central Nervous System. In: Hansen, E., Roach III, M. (eds) Handbook of Evidence-Based Radiation Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-62642-0_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-62642-0_2

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-62641-3

  • Online ISBN: 978-3-319-62642-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics