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Effects of adjuvant chemotherapy and radiation on overall survival in children with choroid plexus carcinoma

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Abstract

Choroid plexus carcinoma (CPCs) is a rare, malignant, primary brain tumor with a poor prognosis. Currently, there is no consensus on the use of adjuvant therapy, and few large-scale studies focus exclusively on the pediatric population. We performed a comprehensive systematic review of pediatric CPCs to determine the effects of various adjuvant therapy modalities on overall survival (OS). A literature search was performed to identify studies reporting children with CPC who underwent surgical resection. Only patients who had clearly received adjuvant therapy, or were described as not selected for adjuvant therapy were analyzed in our comparison groups. Kaplan–Meier and multivariate Cox regression survival analyses were performed to determine the effects of different types of adjuvant therapies on OS. A total of 135 children (age ≤ 18 years) with CPC who had known adjuvant therapy status and OS were identified from 53 articles. Kaplan–Meier analysis showed that while adjuvant therapy overall improved OS (p = 0.001), different modes of adjuvant therapies had varying effects on OS (p = 0.034). Specifically, combined chemo-radiotherapy as well as chemotherapy alone improved OS (p = 0.001), but radiation did not (p = 0.129). Multivariate Cox proportional hazard model adjusting for confounding factors showed that combined therapy was associated with better OS compared to chemotherapy alone (HR: 0.291, p = 0.027). Both chemotherapy alone and combined chemo-radiation improved OS independent of age, gender, tumor location and extent of resection, while radiation alone did not.

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Abbreviations

CPC:

Choroid plexus carcinoma

OS:

Overall survival

EOR:

Extent of resection

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Acknowledgments

None.

Disclosure

The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

Funding

M.Z. Sun is a Howard Hughes Medical Institute Medical Research Fellow. M. Safaee was supported by a grant from the Doris Duke Charitable Foundation. Dr. Oh received a National Research Service Award from the National Institutes of Health (F32NS073326-01). Dr. Ivan is funded by the National Research Education Foundation through the American Association of Neurological Surgeons. Dr. Parsa is currently the Michael J. Marchese Professor and Chair at Northwestern University, Feinberg School of Medicine.

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Authors and Affiliations

  1. Department of Neurological Surgery, University of California, San Francisco, 505 Parnassus Ave., San Francisco, CA, 94117, USA

    Matthew Z. Sun, Michael E. Ivan, Michael C. Oh, Arthur R. Delance, Aaron J. Clark, Michael Safaee, Taemin Oh, Annette Molinaro & Nalin Gupta

  2. Department of Pediatrics, University of California, San Francisco, 505 Parnassus Ave., San Francisco, CA, 94117, USA

    Nalin Gupta

  3. Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, 676 N. St. Clair Street, Suite 2210, Chicago, IL, 60611-2922, USA

    Gurvinder Kaur & Andrew T. Parsa

Authors
  1. Matthew Z. Sun
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  2. Michael E. Ivan
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  3. Michael C. Oh
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  4. Arthur R. Delance
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  5. Aaron J. Clark
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  6. Michael Safaee
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  7. Taemin Oh
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  8. Gurvinder Kaur
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  9. Annette Molinaro
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  10. Nalin Gupta
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  11. Andrew T. Parsa
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Corresponding author

Correspondence to Andrew T. Parsa.

Additional information

Michael E. Ivan and Michael C. Oh have contributed equally to this work.

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Sun, M.Z., Ivan, M.E., Oh, M.C. et al. Effects of adjuvant chemotherapy and radiation on overall survival in children with choroid plexus carcinoma. J Neurooncol 120, 353–360 (2014). https://doi.org/10.1007/s11060-014-1559-2

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  • DOI: https://doi.org/10.1007/s11060-014-1559-2

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