Chemotherapy for diffuse pontine gliomasCChemotherapy for diffuse pontine gliomasChemotherapy for diffuse pontine gliomasEnglishNeurology;OncologyChild (0-12 years);Teen (13-18 years)BrainNervous systemDrug treatment;Non-drug treatmentAdult (19+)NA2009-07-10T04:00:00ZEric Bouffet, MD, FRCPCUte Bartels, MD8.0000000000000061.00000000000002871.00000000000Flat ContentHealth A-Z<p>An in-depth look at the option of chemotherapy used to treat childhood diffuse pontine gliomas.<br></p><p>Chemotherapy is the use of drugs to destroy tumour cells. These drugs are also called anticancer drugs or chemotherapeutic agents. So far, clinical trials have failed to show a benefit of chemotherapy in the treatment of diffuse pontine glioma, when given before, during, or after radiation therapy. In diffuse pontine glioma, chemotherapy is given at the time of tumour progression. Generally, children tolerate chemotherapy better than adults. They can usually carry on their normal activities.</p><h2>Key points</h2> <ul><li>Chemotherapy is given as part of a clinical trial or at a later stage when the tumour is progressing.</li> <li>Side effects of chemotherapy can include: nausea and vomiting; allergic reaction; fatigue; low blood counts;digestive issues; hair loss; and behaviour changes.</li> <li>Drugs can be prescribed to improve the side effects of chemotherapy.</li></ul>
Chimiothérapie des gliomes infiltrants du tronc cérébralCChimiothérapie des gliomes infiltrants du tronc cérébralChemotherapy for diffuse pontine gliomasFrenchNeurology;OncologyChild (0-12 years);Teen (13-18 years)BrainNervous systemDrug treatment;Non-drug treatmentAdult (19+)NA2009-07-10T04:00:00ZEric Bouffet, MD, FRCPCUte Bartels, MD8.0000000000000061.00000000000002871.00000000000Flat ContentHealth A-Z<p>Aperçu approfondi de l’option d’utiliser la chimiothérapie afin de traiter les gliomes infiltrants du tronc cérébral chez les enfants.<br></p><p>La chimiothérapie s'entend de l'utilisation de médicaments afin de détruire les cellules tumorales. On appelle aussi ces médicaments des anticancéreux ou des agents chimiothérapeutiques. Jusqu’à ce jour, les essais cliniques n’ont pas montré les bienfaits de la chimiothérapie dans le traitement d’un gliome infiltrants du tronc cérébral quand elle est administrée avant, pendant et après la radiothérapie. Pour les gliomes infiltrants du tronc cérébral, on administre la chimiothérapie au moment de la progression d’une tumeur. En règle générale, les enfants tolèrent mieux la chimiothérapie que les adultes. Ils peuvent habituellement poursuivre leurs activités normales.</p><h2>À retenir</h2> <ul><li>La chimiothérapie est administrée dans le cadre d’un essai clinique ou à une étape ultérieure lorsque la tumeur montre des signes de progression.</li> <li>Les effets indésirables de la chimiothérapie peuvent comprendre : des nausées et des vomissements, une réaction allergique, de la fatigue, une faible numération globulaire, des troubles digestifs, la perte des cheveux et des changements de comportements.</li> <li>Des médicaments peuvent être prescrits afin d’atténuer les effets indésirables de la chimiothérapie.</li></ul>

 

 

Chemotherapy for diffuse pontine gliomas1361.00000000000Chemotherapy for diffuse pontine gliomasChemotherapy for diffuse pontine gliomasCEnglishNeurology;OncologyChild (0-12 years);Teen (13-18 years)BrainNervous systemDrug treatment;Non-drug treatmentAdult (19+)NA2009-07-10T04:00:00ZEric Bouffet, MD, FRCPCUte Bartels, MD8.0000000000000061.00000000000002871.00000000000Flat ContentHealth A-Z<p>An in-depth look at the option of chemotherapy used to treat childhood diffuse pontine gliomas.<br></p><p>Chemotherapy is the use of drugs to destroy tumour cells. These drugs are also called anticancer drugs or chemotherapeutic agents. So far, clinical trials have failed to show a benefit of chemotherapy in the treatment of diffuse pontine glioma, when given before, during, or after radiation therapy. In diffuse pontine glioma, chemotherapy is given at the time of tumour progression. Generally, children tolerate chemotherapy better than adults. They can usually carry on their normal activities.</p><h2>Key points</h2> <ul><li>Chemotherapy is given as part of a clinical trial or at a later stage when the tumour is progressing.</li> <li>Side effects of chemotherapy can include: nausea and vomiting; allergic reaction; fatigue; low blood counts;digestive issues; hair loss; and behaviour changes.</li> <li>Drugs can be prescribed to improve the side effects of chemotherapy.</li></ul><h2>Why does my child need chemotherapy?</h2><p>In diffuse pontine glioma, chemotherapy is given in one of the following circumstances:</p><ul><li>as part of a clinical trial to evaluate the benefits of new chemotherapy drugs or drug combinations in addition to radiation, or </li><li>at a later stage when the child's tumour shows signs of progression. The aim in this case is to decrease the symptoms of progression and to help improve quality of life. </li></ul><p>The treatment team is led by a doctor called a neuro-oncologist. He takes the responsibility for your child’s care during chemotherapy, and makes the decisions about your child’s treatment plan. </p><h2>How is chemotherapy given?</h2><p>There are a number of options that neuro-oncologists may consider when giving chemotherapy to treat diffuse pontine glioma. Over the last 10 years, there have been clinical trials with a drug called temozolide. However, this drug has not shown a clear benefit in diffuse pontine glioma. Temozolide is still used by many neuro-oncologists at the time of progression of the tumour. </p><p>There are other drugs currently being tested, for example, a combination of <a href="/Article?contentid=163&language=English">irinotecan</a> and bevcizumab (Avastin).</p><h2>How do chemotherapy drugs work?</h2><p>Tumour cells grow very quickly. Chemotherapy drugs damage tumour cells as they are dividing and making new cells. The drugs are carried in the blood to all parts of the body. </p><p>Some types of normal cells also grow quickly, and they may also be damaged. This includes cells in the mouth, stomach, hair, and bone marrow, where blood cells are made. This can cause side effects. The damage to normal cells does not last long. Most of these side effects will go away after chemotherapy ends. </p><h2>Using antibiotics</h2><p>During chemotherapy, your child may need to take antibiotics to prevent a lung infection called <em>Pneumocystis carinii</em> pneumonia (PCP). The antibiotic is a combination of two medicines called <a href="/Article?contentid=257&language=English">trimethoprim</a> and sulfamethoxazole. It is called <a href="/Article?contentid=112&language=English">Cotrimoxazole​</a>, and is commonly known as Septra or Bactrim, its brand names. </p><h3>Why does my child need to take antibiotics?</h3><p>PCP is believed to be caused by bacteria that is probably present in most healthy children’s lungs. When your child’s immune system is weakened during chemotherapy, their body loses the ability to cope with infections. As a result your child may be at higher risk of developing this type of pneumonia. </p><p>Taking antibiotics is effective at preventing PCP from developing. This is called preventive or prophylactic use of antibiotics. </p><p>The antibiotics are usually given by mouth in a tablet or liquid form. They are taken once or twice a day, three days a week throughout treatment, and for three to six months after treatment. </p><h2>Mouth care before and during treatment</h2><p>Radiation therapy and chemotherapy drugs can affect the teeth and mouth. Some of the side effects are a sore mouth or throat, and a dry mouth. There may be a higher risk of your child developing cavities. If possible, arrange a checkup with your child’s dentist before treatment begins. During treatment, regular brushing may not be possible. If this is the case, the treatment team will provide you with alternate options for mouth care. </p><h2>Monitoring during chemotherapy</h2><p>While your child is getting chemotherapy, they will have regular checkups. It is important to tell the treatment team about all of the changes or symptoms they have while at home. The treatment team will ask about your child's appetite, daily activities, pain, bowel movements, weakness in their fingers or toes, headaches, and vision problems. There will also be a physical exam. A complete blood count will be checked. If your child is getting certain medicines, they will be sent for a hearing test. They may be given other medicines also, such as antibiotics to prevent pneumonia, pain medicines, and others. </p><h2>Side effects of chemotherapy</h2><p>Some medicines have unwanted effects on the body. These are called side effects.</p><p>The side effects from chemotherapy drugs depend on the type of drugs, the dose of drug, and your child’s reaction. Some children may not have any side effects. </p><h3>Within 30 minutes to a day</h3><ul><li> nausea </li><li> vomiting</li><li> allergic reaction</li></ul><h3>Within two or three weeks</h3><ul><li> fatigue </li><li> low blood counts (myelosuppression): There are three main types of blood cells. All three types can be affected. </li><li> low number of white blood cells (<a href="/article?contentid=1398&language=English">neutropenia</a>) </li><li> low number of platelets (<a href="/article?contentid=842&language=English">thrombocytopenia</a>)</li><li> low number of red blood cells (<a href="/article?contentid=841&language=English">anemia</a>)<br></li><li> loss of appetite</li><li> sore mouth or throat</li><li> diarrhea</li><li> constipation </li><li> taste changes</li><li> pain and damage to the ends of nerves in hands, feet, or jaw (neuropathy)<br></li><li> hearing loss</li><li> hair loss</li><li> possible changes in mood or behaviour</li></ul><h2>How will chemotherapy lower your child’s blood counts?</h2><p>Chemotherapy may damage your child’s normal cells that are quickly multiplying. One type of cell that is affected is bone marrow. This is the soft fatty material in the middle of bones where new blood cells are being made. Chemotherapy damages the new blood cells that are made in the bone marrow, but not the older blood cells that are already in the rest of the body. </p><h2>How long does it take to lower your child’s blood counts?</h2><p>It takes one to two weeks after your child starts chemotherapy to lower the blood counts. That is how long it takes for the older blood cells to die and the newer blood cells to be made. </p><p>Usually, your child's blood counts should return to normal within three to four weeks after starting chemotherapy.</p><h2>Understanding your child’s blood</h2><p>Your child’s blood is made up of billions of tiny cells that you cannot see.</p><p>The three main types of blood cells are red blood cells, white blood cells, and platelets.</p><p>Red blood cells are the part of the blood that carries oxygen to the rest of your child’s body. The part of the red blood cell that carries the oxygen is called haemoglobin. Red blood cells give your child energy and make their skin a healthy colour. </p><p>White blood cells protect your child from infection. They find and kill the germs called bacteria in your child’s blood. There are many types of white blood cells. The type you will hear about most is the neutrophil. The number of neutrophils in your child’s blood is called the poly count. </p><p>Platelets are the small round flat cells in the blood. They look like plates. Platelets help the blood clump, or clot.</p><h2>What is a complete blood count?<br></h2><p>When your child is having chemotherapy, the treatment team will check each type of blood cell in your child to see how they are being affected. To do this, they will take blood from your child. Then they will do a complete blood count, also called a CBC, to look at these four blood counts: </p><ol><li> a white blood cell count</li><li> a neutrophil count, also called a poly count</li><li> a red blood cell count and a hemoglobin count </li><li> a platelet count </li></ol><h2>What can be done to deal with the side effects of chemotherapy?</h2><p>The doctor may recommend several drugs to improve the side effects. Some of these drugs are used specially for chemotherapy. If you notice side effects or changes in mood or behaviour, let your treatment team know. </p><p>For more information, see the page entitled "<a href="/Article?contentid=1379&language=English">Side Effects of Chemotherapy</a>."<br></p><h2>What is informed choice or informed consent?</h2><p>Informed choice is the option a person has to allow or not allow something to happen, like diagnostic procedures or treatment, after they have been informed of the benefits and risks of the options involved. If the person agrees, they give informed consent. Informed consent is required before beginning chemotherapy. </p>Chemotherapy for diffuse pontine gliomas

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