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Article: Ewing sarcoma bone metastases: 'you see one, you've seen them all': (commentary on Furth et al., page 607).

Wharam, Moody D

2006 Volume 47, Issue 5, Page(s) 533–534

MeSH term(s)	Adolescent ; Bone Neoplasms/diagnosis ; Bone Neoplasms/secondary ; Bone Neoplasms/therapy ; Female ; Humans ; Magnetic Resonance Imaging ; Neoplasm Staging ; Positron-Emission Tomography ; Predictive Value of Tests ; Sarcoma, Ewing/diagnosis ; Sarcoma, Ewing/secondary ; Sarcoma, Ewing/therapy ; Sensitivity and Specificity ; Treatment Outcome
Language	English
Publishing date	2006-10-15
Publishing country	United States
Document type	Comment ; Journal Article
ZDB-ID	2131448-2
ISSN	1545-5017 ; 1545-5009
ISSN (online)	1545-5017
ISSN	1545-5009
DOI	10.1002/pbc.20734
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Article ; Online: A prospective study of corpus callosum regional volumes and neurocognitive outcomes following cranial radiation for pediatric brain tumors.

Rashid, Arif / Ram, Ashwin N / Kates, Wendy R / Redmond, Kristin J / Wharam, Moody / Mark Mahone, E / Horska, Alena / Terezakis, Stephanie

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

2017 Volume 33, Issue 6, Page(s) 965–972

Abstract: Purpose/objective(s): Cranial radiation therapy (CRT) may disrupt the corpus callosum (CC), which plays an important role in basic motor and cognitive functions. The aim of this prospective longitudinal study was to assess changes in CC mid-sagittal ... ...

Abstract	Purpose/objective(s): Cranial radiation therapy (CRT) may disrupt the corpus callosum (CC), which plays an important role in basic motor and cognitive functions. The aim of this prospective longitudinal study was to assess changes in CC mid-sagittal areas, CC volumes, and performance on neuropsychological (NP) tests related to the CC in children following CRT. Materials/methods: Twelve pediatric patients were treated with CRT for primary brain malignancies. Thirteen age-matched healthy volunteers served as controls. Brain MRIs and NP assessment emphasizing motor dexterity, processing speed, visuomotor integration, and working memory (visual and verbal) were performed at baseline and at 6, 15, and 27 months following completion of CRT. Linear mixed effects (LME) analyses were used to evaluate patient NP performance and changes in regional CC volumes (genu, anterior body, mid-body, posterior body, and splenium) and mid-sagittal areas over time and with radiation doses, correcting for age at CRT start. Results: The mean age at CRT was 9.41 (range 1.2-15.7) years. The median prescription dose was 54 (range 18-59.4) Gy. LME analysis revealed a significant decrease in overall CC volumes over time (p < 0.00001), with no overall effect of radiation dose. Analysis of individual CC regions demonstrated a significant decrease in all regional volumes over time (p < 0.00001) in patients, with no effect of radiation dose. Only in the splenium was there a trend toward a dose-dependent effect (p = 0.093). Patients had significantly reduced NP performance across visits-most notably in motor dexterity and visual working memory (both p < 0.0001). Conclusions: These prospective data demonstrate a significant decrease in CC regional volumes after CRT, with associated decline in neurocognitive function, most notably in manual dexterity, attention, and working memory. Further prospective study of larger cohorts of patients is needed to establish the relationship between CRT dose, neuroanatomical, and functional changes in the CC.
MeSH term(s)	Adolescent ; Brain Neoplasms/diagnostic imaging ; Brain Neoplasms/psychology ; Brain Neoplasms/radiotherapy ; Child ; Child, Preschool ; Cognition/physiology ; Cognitive Dysfunction/diagnostic imaging ; Cognitive Dysfunction/etiology ; Cognitive Dysfunction/psychology ; Corpus Callosum/diagnostic imaging ; Cranial Irradiation/adverse effects ; Cranial Irradiation/trends ; Female ; Humans ; Infant ; Male ; Neuropsychological Tests ; Organ Size ; Prospective Studies ; Treatment Outcome
Language	English
Publishing date	2017-04-28
Publishing country	Germany
Document type	Journal Article
ZDB-ID	605988-0
ISSN	1433-0350 ; 0302-2803 ; 0256-7040
ISSN (online)	1433-0350
ISSN	0302-2803 ; 0256-7040
DOI	10.1007/s00381-017-3412-3
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Article ; Online: Correction to: A prospective study of corpus callosum regional volumes and neurocognitive outcomes following cranial radiation for pediatric brain tumors.

Rashid, Arif / Ram, Ashwin N / Kates, Wendy R / Redmond, Kristin J / Wharam, Moody / Mahone, E Mark / Horska, Alena / Terezakis, Stephanie

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

2017 Volume 33, Issue 12, Page(s) 2215

Abstract: AbstractThe published version of this article unfortunately contained an error. Author "E. Mark Mahone" has been published incorrectly by capturing "Mark Mahone" as family name when it should only be "Mahone". Given in this article is the corrected name. ...

Abstract	AbstractThe published version of this article unfortunately contained an error. Author "E. Mark Mahone" has been published incorrectly by capturing "Mark Mahone" as family name when it should only be "Mahone". Given in this article is the corrected name.
Language	English
Publishing date	2017-10-14
Publishing country	Germany
Document type	Journal Article ; Published Erratum
ZDB-ID	605988-0
ISSN	1433-0350 ; 0302-2803 ; 0256-7040
ISSN (online)	1433-0350
ISSN	0302-2803 ; 0256-7040
DOI	10.1007/s00381-017-3607-7
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Article ; Online: Management of pediatric intracranial low-grade gliomas: long-term follow-up after radiation therapy.

Huynh-Le, Minh-Phuong / Walker, Amanda J / Burger, Peter C / Jallo, George I / Cohen, Kenneth J / Wharam, Moody D / Terezakis, Stephanie A

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

2016 Volume 32, Issue 8, Page(s) 1425–1430

Abstract: Introduction: The treatment of pediatric intracranial low-grade gliomas (LGG) generally begins with maximal safe resection. Radiation therapy (RT) and chemotherapy are typically reserved for patients with incomplete resection and/or disease progression. ...

Abstract	Introduction: The treatment of pediatric intracranial low-grade gliomas (LGG) generally begins with maximal safe resection. Radiation therapy (RT) and chemotherapy are typically reserved for patients with incomplete resection and/or disease progression. We report long-term treatment outcomes and toxicities in a cohort of pediatric patients with LGG after RT. Methods: Thirty-four patients <21 years old with intracranial LGG who were treated with RT at the Johns Hopkins Hospital were included in this retrospective analysis. Patients were evaluated for overall survival (OS), progression-free survival (PFS), recurrence patterns, and treatment toxicities using descriptive statistics, Kaplan-Meier curves, and Cox proportional hazard regressions. Results: The mean age at diagnosis was 7.9 years (range 1.2-18.3 years) and mean age at RT was 9.8 years (range 3.0-28.9 years). The median follow-up time was 9.8 years after radiation (range 0.8-33.3 years). The estimated 10-year OS and PFS after RT were 92 and 74 %, respectively. Twelve patients had disease progression after RT, and all recurrences were local. Two patients died due to disease progression 2.3 and 9.1 years after RT. One patient had malignant transformation of LGG to high-grade glioma. No significant predictors of PFS were identified on uni- or multivariate analysis. Late effects of LGG and treatment seen were endocrine deficiencies in 16 patients, visual problems in 10 patients, hearing loss in 4 patients, special education requirements for 5 patients, and a vascular injury/demyelination secondary to RT in 1 patient. Conclusion: Our study suggests that the use of radiation in patients with intracranial LGG results in excellent OS and PFS with acceptable toxicity at long-term follow-up.
MeSH term(s)	Adolescent ; Adult ; Brain Neoplasms/diagnostic imaging ; Brain Neoplasms/radiotherapy ; Child ; Child, Preschool ; Disease Management ; Disease-Free Survival ; Female ; Glioma/diagnosis ; Glioma/radiotherapy ; Humans ; Infant ; Longitudinal Studies ; Male ; Proportional Hazards Models ; Young Adult
Language	English
Publishing date	2016-08
Publishing country	Germany
Document type	Journal Article
ZDB-ID	605988-0
ISSN	1433-0350 ; 0302-2803 ; 0256-7040
ISSN (online)	1433-0350
ISSN	0302-2803 ; 0256-7040
DOI	10.1007/s00381-016-3100-8
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Article ; Online: Association of Neuronal Injury in the Genu and Body of Corpus Callosum After Cranial Irradiation in Children With Impaired Cognitive Control: A Prospective Study.

Redmond, Kristin J / Hildreth, Meghan / Sair, Haris I / Terezakis, Stephanie / McNutt, Todd / Kleinberg, Lawrence / Cohen, Kenneth J / Wharam, Moody / Horska, Alena / Mahone, E Mark

International journal of radiation oncology, biology, physics

2018 Volume 101, Issue 5, Page(s) 1234–1242

Abstract: Purpose: Brain radiation is associated with functional deficits in children. The purpose of this study was to examine white matter integrity as measured by diffusion tensor imaging and associations with region-specific radiation dose and ... ...

Abstract	Purpose: Brain radiation is associated with functional deficits in children. The purpose of this study was to examine white matter integrity as measured by diffusion tensor imaging and associations with region-specific radiation dose and neuropsychological functioning in children treated with cranial irradiation. Methods and materials: A total of 20 patients and 55 age- and sex-matched controls were included in the present study. Diffusion tensor imaging and neuropsychological assessments were conducted at baseline and 6, 15, and 27 months after treatment. The neuropsychological assessment included motor dexterity, working memory, and processing speed. White matter regions were contoured, and the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were recorded for each participant. Linear mixed effects regression models were used to prospectively compare the associations among ADC, FA, radiation dose to contoured structures, and performance on the neuropsychological assessments over time. Results: The mean prescription dose was 44 Gy (range 12-54). Across visits, compared with the controls, the patients showed a significantly increased ADC across all selected regions and alterations in FA in the dorsal midbrain and corpus callosum (genu, splenium, body). An increased radiation dose to the genu and body of the corpus callosum was associated with alterations in ADC and FA and reduced neuropsychological performance, most notably motor speed and processing. Conclusions: These prospective data suggest that subcortical white matter, especially the genu and body of the corpus callosum, could be regions with increased susceptibility to radiation-induced injury, with implications for cognitive function.
MeSH term(s)	Adolescent ; Anisotropy ; Behavior ; Brain/diagnostic imaging ; Brain/radiation effects ; Brain Neoplasms/radiotherapy ; Case-Control Studies ; Child ; Child, Preschool ; Cognition/radiation effects ; Corpus Callosum/pathology ; Corpus Callosum/radiation effects ; Diffusion Tensor Imaging ; Female ; Humans ; Male ; Neurons/pathology ; Neurons/radiation effects ; Neuropsychological Tests ; Prospective Studies ; White Matter/diagnostic imaging ; White Matter/radiation effects
Language	English
Publishing date	2018-04-22
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	197614-x
ISSN	1879-355X ; 0360-3016
ISSN (online)	1879-355X
ISSN	0360-3016
DOI	10.1016/j.ijrobp.2018.04.037
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Article ; Online: Management of pediatric myxopapillary ependymoma: the role of adjuvant radiation.

Agbahiwe, Harold C / Wharam, Moody / Batra, Sachin / Cohen, Kenneth / Terezakis, Stephanie A

International journal of radiation oncology, biology, physics

2012 Volume 85, Issue 2, Page(s) 421–427

Abstract: Introduction: Myxopapillary ependymoma (MPE) is a rare tumor in children. The primary treatment is gross total resection (GTR), with no clearly defined role for adjuvant radiation therapy (RT). Published reports, however, suggest that children with MPE ... ...

Abstract	Introduction: Myxopapillary ependymoma (MPE) is a rare tumor in children. The primary treatment is gross total resection (GTR), with no clearly defined role for adjuvant radiation therapy (RT). Published reports, however, suggest that children with MPE present with a more aggressive disease course. The goal of this study was to assess the role of adjuvant RT in pediatric patients with MPE. Methods: Sixteen patients with MPE seen at Johns Hopkins Hospital (JHH) between November 1984 and December 2010 were retrospectively reviewed. Fifteen of the patients were evaluable with a mean age of 16.8 years (range, 12-21 years). Kaplan-Meier curves and descriptive statistics were used for analysis. Results: All patients received surgery as the initial treatment modality. Surgery consisted of either a GTR or a subtotal resection (STR). The median dose of adjuvant RT was 50.4 Gy (range, 45-54 Gy). All patients receiving RT were treated at the involved site. After a median follow-up of 7.2 years (range, 0.75-26.4 years), all patients were alive with stable disease. Local control at 5 and 10 years was 62.5% and 30%, respectively, for surgery alone versus 100% at both time points for surgery and adjuvant RT. Fifty percent of the patients receiving surgery alone had local failure. All patients receiving STR alone had local failure compared to 33% of patients receiving GTR alone. One patient in the surgery and adjuvant RT group developed a distant site of recurrence 1 year from diagnosis. No late toxicity was reported at last follow-up, and neurologic symptoms either improved or remained stable following surgery with or without RT. Conclusions: Adjuvant RT improved local control compared to surgery alone and should be considered after surgical resection in pediatric patients with MPE.
MeSH term(s)	Adolescent ; Child ; Child, Preschool ; Disease-Free Survival ; Ependymoma/mortality ; Ependymoma/radiotherapy ; Ependymoma/surgery ; Humans ; Infant ; Male ; Neoplasm Recurrence, Local ; Radiotherapy Dosage ; Radiotherapy, Adjuvant/methods ; Rare Diseases/mortality ; Rare Diseases/radiotherapy ; Rare Diseases/surgery ; Retrospective Studies ; Spinal Neoplasms/mortality ; Spinal Neoplasms/radiotherapy ; Spinal Neoplasms/surgery ; Young Adult
Language	English
Publishing date	2012-06-17
Publishing country	United States
Document type	Evaluation Study ; Journal Article
ZDB-ID	197614-x
ISSN	1879-355X ; 0360-3016
ISSN (online)	1879-355X
ISSN	0360-3016
DOI	10.1016/j.ijrobp.2012.05.001
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Article: Chemotherapy-refractory cutaneous Langerhans cell histiocytosis treated with radiotherapy.

Hristov, Boris / Hristov, Alexandra C / Lin, Steven H / Arceci, Robert J / Wharam, Moody D

Practical radiation oncology

2011 Volume 1, Issue 3, Page(s) 204–207

Language	English
Publishing date	2011-07
Publishing country	United States
Document type	Journal Article
ISSN	1879-8500
ISSN	1879-8500
DOI	10.1016/j.prro.2010.12.001
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Article ; Online: Patterns of failure after involved field radiation therapy for pediatric and young adult Hodgkin lymphoma.

Huynh-Le, Minh-Phuong / Walker, Amanda J / Kominers, Scott Duke / Paz-Priel, Ido / Wharam, Moody D / Terezakis, Stephanie A

Pediatric blood & cancer

2014 Volume 61, Issue 7, Page(s) 1210–1214

Abstract: Background: Involved field radiation therapy (IFRT) is integral in curative therapy for Hodgkin lymphoma (HL), although primarily used in patients with intermediate/high-risk HL. We present failure patterns and clinical outcomes in a cohort of pediatric ...

Abstract	Background: Involved field radiation therapy (IFRT) is integral in curative therapy for Hodgkin lymphoma (HL), although primarily used in patients with intermediate/high-risk HL. We present failure patterns and clinical outcomes in a cohort of pediatric and young adult patients with HL treated with IFRT at the Johns Hopkins Hospital. Procedure: Patients ≤40 years old with intermediate/high-risk HL who received chemotherapy and IFRT from 1997 to 2012 were included in this retrospective analysis. Patients were evaluated for failure patterns, overall survival (OS), and event-free survival (EFS) using Kaplan-Meier curves, descriptive statistics, and Cox proportional hazard regressions. Results: We reviewed 74 patients (45 pediatric and 29 young adult) with a median follow-up of 4.4 years. The mean age at diagnosis was 21.4 years. Patients received a median of 29.75 Gy of IFRT (range 15-39.6 Gy). The majority of pediatric patients received ABVE-PC chemotherapy (n = 25) and <30 Gy of radiation (n = 33) while most young adults received ABVD chemotherapy (n = 24) and ≥30 Gy (n = 25). Estimated 5-year OS and EFS were 96% and 81%, respectively. Thirteen patients had recurrence; eight were pediatric. Distant relapse alone comprised 83% of failures in patients receiving ≥30 Gy. Of the seven patients who received <30 Gy and had recurrence, six had local failure as a component of their recurrence. Caucasian race (P = 0.02) and nodular sclerosing histology (P = 0.01) predicted for increased EFS. Late effects were minimal and all deaths (n = 4) were from HL. Conclusions: In this series, pediatric and young adult patients were treated with differing chemoradiation and had distinct recurrence patterns.
MeSH term(s)	Adolescent ; Adult ; Age Factors ; Chemoradiotherapy ; Child ; Child, Preschool ; Disease-Free Survival ; Female ; Hodgkin Disease/diagnosis ; Hodgkin Disease/mortality ; Hodgkin Disease/therapy ; Humans ; Male ; Recurrence ; Retrospective Studies ; Survival Rate ; Time Factors
Language	English
Publishing date	2014-02-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	2131448-2
ISSN	1545-5017 ; 1545-5009
ISSN (online)	1545-5017
ISSN	1545-5009
DOI	10.1002/pbc.24968
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Article: Risk of second tumor in intracranial germinoma patients treated with radiation therapy: the Johns Hopkins experience.

Jabbour, Salma K / Zhang, Zhe / Arnold, Dagmar / Wharam, Moody D

Journal of neuro-oncology

2008 Volume 91, Issue 2, Page(s) 227–232

Abstract: Background: We reviewed the risk of second tumor (ST), both malignant and benign, in germinoma survivors followed at the Johns Hopkins Hospital (JHH).: Methods: Between 1977 and 2002, 27 patients with intracranial germinoma were treated with ... ...

Abstract	Background: We reviewed the risk of second tumor (ST), both malignant and benign, in germinoma survivors followed at the Johns Hopkins Hospital (JHH). Methods: Between 1977 and 2002, 27 patients with intracranial germinoma were treated with radiation therapy (RT). In the presence of competing events, a cumulative incidence function of ST was estimated using the minimal time interval from the date of diagnosis to the date of ST, date of death, or date of last follow-up. Results: Five patients (18%) developed a ST of which 4 (15%) were malignant. One developed a benign falcine meningioma. The cumulative incidence of ST was 9% at 11 years (95% CI, 0-22%). Conclusions: The relative contributions of RT and patient susceptibility to a ST cannot be determined but suggests the need for long-term surveillance, including testicular self-exams in male germinoma survivors. Current trials of chemotherapy and reduced RT dose and volume offer the prospect of a lower risk of treatment-induced ST.
MeSH term(s)	Adolescent ; Adult ; Brain Neoplasms/radiotherapy ; Child ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Germinoma/radiotherapy ; Humans ; Incidence ; Male ; Neoplasms, Radiation-Induced/epidemiology ; Neoplasms, Radiation-Induced/etiology ; Neoplasms, Second Primary/epidemiology ; Neoplasms, Second Primary/etiology ; Radiotherapy/adverse effects ; Retrospective Studies ; Risk ; Risk Assessment ; Time Factors ; Treatment Outcome
Language	English
Publishing date	2008-09-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	604875-4
ISSN	1573-7373 ; 0167-594X
ISSN (online)	1573-7373
ISSN	0167-594X
DOI	10.1007/s11060-008-9703-5
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Article ; Online: A prospective study of cerebral, frontal lobe, and temporal lobe volumes and neuropsychological performance in children with primary brain tumors treated with cranial radiation.

Agbahiwe, Harold / Rashid, Arif / Horska, Alena / Mahone, E Mark / Lin, Doris / McNutt, Todd / Cohen, Kenneth / Redmond, Kristin / Wharam, Moody / Terezakis, Stephanie

Cancer

2017 Volume 123, Issue 1, Page(s) 161–168

Abstract: Background: Cranial radiation therapy (RT) is an important component in the treatment of pediatric brain tumors. However, it can result in long-term effects on the developing brain. This prospective study assessed the effects of cranial RT on cerebral, ... ...

Abstract	Background: Cranial radiation therapy (RT) is an important component in the treatment of pediatric brain tumors. However, it can result in long-term effects on the developing brain. This prospective study assessed the effects of cranial RT on cerebral, frontal lobe, and temporal lobe volumes and their correlation with higher cognitive functioning. Methods: Ten pediatric patients with primary brain tumors treated with cranial RT and 14 age- and sex-matched healthy children serving as controls were evaluated. Quantitative magnetic resonance imaging and neuropsychological assessments (language, memory, auditory and visual processing, and vocabulary) were performed at the baseline and 6, 15, and 27 months after RT. The effects of age, the time since RT, and the cerebral RT dose on brain volumes and neuropsychological performance were analyzed with linear mixed effects model analyses. Results: Cerebral volume increased significantly with age in both groups (P = .01); this increase in volume was more pronounced in younger children. Vocabulary performance was found to be significantly associated with a greater cerebral volume (P = .05) and a lower RT dose (P = .003). No relation was observed between the RT dose and the cerebral volume. There was no difference in the corresponding neuropsychological tests between the 2 groups. Conclusions: This prospective study found significant relations among the RT dose, cerebral volumes, and rate of vocabulary development among children receiving RT. The results of this study provide further support for clinical trials aimed at reducing cranial RT doses in the pediatric population. Cancer 2017;161-168. © 2016 American Cancer Society.
MeSH term(s)	Adolescent ; Brain Neoplasms/physiopathology ; Brain Neoplasms/radiotherapy ; Child ; Child, Preschool ; Cognition/radiation effects ; Cranial Irradiation/adverse effects ; Female ; Frontal Lobe/physiopathology ; Frontal Lobe/radiation effects ; Humans ; Infant ; Magnetic Resonance Imaging/methods ; Male ; Memory/radiation effects ; Neuropsychological Tests ; Prospective Studies ; Temporal Lobe/physiopathology ; Temporal Lobe/radiation effects
Language	English
Publishing date	2017-01-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	1429-1
ISSN	1097-0142 ; 0008-543X ; 1934-662X
ISSN (online)	1097-0142
ISSN	0008-543X ; 1934-662X
DOI	10.1002/cncr.30313
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