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Mutation, Plus Radiation, May Harm Children with Brain Cancer

March 26, 2010
Written by: , Filed in: Nuclear Medicine, Pediatric Radiology
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Part 2 of 2 on gene mutations and radiation:

Children with a mutated TP53 gene in a choroid plexus carcinoma (CPC) may be harmed by radiation treatments. The gene, also known as P53, is evident in other cancers besides CPC, which usually strikes very young children and counts as three to four percent of brain tumors in that age group.

 Physicians from Toronto’s Hospital for Sick Children and the Children’s Hospital of Los Angeles worked with and genetically tested 64 young CPC subjects. They found that children with the mutated gene had a more aggressive form of the cancer and had the potential, as well, to have severe complications, particularly if they received radiation treatments. “And those can include significant developmental delay, learning difficulties, neurocognitive difficulties and thinking and memory,” said David Mulkin, MD, an oncologist and researcher at the Toronto hospital, as quoted in an article in CTV News. “There can be significant growth problems, because the radiation often will end up affecting…the pituitary gland…In the pediatric ward, those are the things that we worry about constantly, because as the survival rate for childhood cancer improves…whatever the tumor is, we’re faced 20, 30 years down the road with the side effects of the treatments that were given,” he said.

The researchers found, on the other hand, that children without the mutation had lesser forms of CPC and often did not need radiation at all, but improved after surgery and chemotherapy.

Although some children have no known cause for the altered gene, some of them have inherited the mutation and have also inherited Li-Fraumeni syndrome, which is associated with other childhood and adult cancers. The researchers, then, suggest that doctors use family histories to determine if there is a high incidence of certain cancers and if parents and their children should be DNA tested for the mutation before radiation treatments are considered for CPC treatment.

“The prognosis for children with brain tumors is quite variable,” said Doug Strother, MD, a pediatric oncologist at the Alberta Children’s Hospital in Calgary. “The oncologist’s ultimate goal is to give each child exactly what she or he needs to be cured of the tumor…Because of this [research], the neurooncologist, like me, is aided in developing recommendations to families on how their child can best be cured with the fewest side effects.”

Related seminar: Pediatric Radiology Review

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