{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T19:33:36Z","timestamp":1780515216720,"version":"3.54.1"},"reference-count":9,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:sec>\n<jats:title>OBJECT<\/jats:title>\n<jats:p>Because of their large size and high vascularity, complete removal of brain tumors in infants and young children is often difficult. In most cases the degree of resection is associated with prognosis. Neoadjuvant chemotherapy may facilitate resection by reducing the vascularity of the tumor. The authors evaluated the effectiveness of neoadjuvant chemotherapy in the management of these tumors.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The authors performed a retrospective review of infants and young children who underwent tumor removal after neoadjuvant chemotherapy.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Nine consecutive patients underwent resection after neoadjuvant chemotherapy during the period February 2004 to December 2012. The mean age at diagnosis was 18 months (range 2\u201350 months). The average largest tumor diameter was 71 mm (range 30\u2013130 mm) at initial surgery. Five patients underwent partial resection, and 4 underwent biopsy as the initial surgery. The histopathological diagnoses were ependymoma in 2 patients, anaplastic ependymoma in 1, primitive neuroectodermal tumor (PNET) in 2, choroid plexus carcinoma in 1, atypical teratoid\/rhabdoid tumor (AT\/RT) in 1, glioblastoma in 1, and embryonal tumor with abundant neuropil and true rosettes in 1. After 2\u20134 courses of multiagent chemotherapy (mainly with vincristine, cyclophosphamide, etoposide, and cisplatin), the second-look surgery was performed. In 1 patient with a PNET, intratumoral hemorrhage was observed after 2 courses of chemotherapy. The mean interval between the initial and the second-look surgery was 3 months. The tumor volume was reduced to varying degrees in 5 patients (56%) after chemotherapy. Intraoperatively, the vascularity of the tumor was considerably reduced, and the tumor was more circumscribed in all cases. Gross-total resection was achieved in 8 patients (89%) and neartotal resection in 1 (11%). Histopathological examination demonstrated fibrotic tissue circumscribing the tumor in 6 of 9 cases (67%). The average blood loss was 20% of the estimated blood volume, and 3 patients (33%) required a blood transfusion. There was no surgical mortality. One patient had transient dysphasia postoperatively. The mean follow-up period was 28 months. At the last follow-up, 2 patients (22%) had died (1 died of tumor progression and 1 of sepsis), and 4 patients (44%) had no tumor recurrence.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Neoadjuvant chemotherapy for brain tumors in infants and young children was effective in reduction of tumor vascularity and clarification of the tumor-brain interface, which significantly facilitated maximal tumor resection.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2014.11.peds14334","type":"journal-article","created":{"date-parts":[[2015,2,27]],"date-time":"2015-02-27T14:57:58Z","timestamp":1425049078000},"page":"488-492","source":"Crossref","is-referenced-by-count":21,"title":["Neoadjuvant chemotherapy for brain tumors in infants and young children"],"prefix":"10.3171","volume":"15","author":[{"given":"Junya","family":"Iwama","sequence":"first","affiliation":[{"name":"Divisions of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideki","family":"Ogiwara","sequence":"additional","affiliation":[{"name":"Divisions of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chikako","family":"Kiyotani","sequence":"additional","affiliation":[{"name":"Neuro-Oncology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keita","family":"Terashima","sequence":"additional","affiliation":[{"name":"Neuro-Oncology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kentaro","family":"Matsuoka","sequence":"additional","affiliation":[{"name":"Pathology, National Center for Child Health and Development, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideto","family":"Iwafuchi","sequence":"additional","affiliation":[{"name":"Pathology, National Center for Child Health and Development, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhito","family":"Morota","sequence":"additional","affiliation":[{"name":"Divisions of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-peds14334","series-title":"Pediatr Neurol","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1016\/0887-8994(91)90038-M","article-title":"Long-term consequences of CNS treatment for childhood cancer, Part II: Clinical consequences","volume":"7","author":"Duffner","year":"1991"},{"key":"b2-peds14334","series-title":"Neuro Oncol","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1093\/neuonc\/1.2.152","article-title":"The treatment of malignant brain tumors in infants and very young children: an update of the Pediatric Oncology Group 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Pediatr","doi-asserted-by":"publisher","first-page":"251","DOI":"10.3171\/2011.6.PEDS11158","article-title":"Resection of infantile brain tumors after neoadjuvant chemotherapy: the St. Jude experience","volume":"8","author":"Van Poppel","year":"2011"}],"container-title":["Journal of Neurosurgery: 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