This is a general overview of pediatric brain tumors and a look at Dr. Peter Phillips’ role at CHOP. I have had many conversations with Dr. Phillips and he is the doctor/researcher who is guiding me on where our funds can do the most good in the pediatric brain tumor research at CHOP.
Peter C. Phillips, M.D.
Department: Pediatrics
Division: Neurology
Address: 516 Abramson
Philadelphia, PA 19104
RESEARCH SUMMARY
I am the Director of the Neuro-Oncology at Children's Hospital. As a pediatric neuro-oncologist, my major research interest is in exploring new therapeutic approaches to treating children with brain tumors. The incidence of pediatric brain tumors has increased over the past two decades, yet increasingly intensive therapeutic strategies to treat children with brain tumors has not led to major improvements in survival. My research also involves efforts to identify new therapeutic targets for brain tumors treatment. I am investigating several new therapeutic strategies for treating children with brain tumors. These strategies include novel cytotoxic drugs, drug resistance inhibitors, radiosurgery techniques, antiangiogenic agents and new approaches to gene therapy. In addition, my colleagues and I are working to identify the biological characteristics of childhood primitive neuroectodermal tumors that have clinical prognostic significance.
The estimate costs of conducting research for the neuro-oncology research program at The Children's Hospital of Philadelphia (CHOP) are as follows:
As per Dr. Phillips:
"The rule of thumb is that each person in research requires about $100,000 per year to conduct research. For our current neuro-oncology research program it is closer to a figure of $10,000 per month. And no one works 40 hour weeks - 50 hours is the minimum."
When asked to give a summary of pediatric brain tumors in August of 2006, Dr. Phillips responded:
“There are over 10 different types of brain tumors. Depending on how many sub-divisions of tumor types you want to make, there are, in fact, more than 200 different types.
The Big 10 in Children are:
- Astrocytomas
- Malignant Gliomas (Anaplastic, Astrocytoma and Gioblastoma)
- Oligodendrogliomas (low and high grade)
- Craniopharyngiomas
- Ependymomas
- Germ Cell Tumors
- Primitive Neuro-Ectodermal Tumors (PNETs)
- Atypical Teratoid/Rhabdoid Tumors
- Chroroid Plexus Papilloma/Carncinoma
- Meningioma
Each of these categories has layers and layers of sub-categories.
As for the number of pediatric brain tumor patients per year, the most accurate figures from SEER (Surveillance, Epidemiology, and End Result, NIH) indicate an annual incidence of 2.9/100,000 children per year. The number 3,000 is based on (1) children age 0 to 15 but not including 15-19 years of age; (2) year 2000 census data on how many children age 0-15 were counted. Based on population growth extrapolation from the rate of increase in the number of children 0-15 years between 1990 and 2000, it is now estimated that there are at least 3,300 children, annually, diagnosed with brain tumor. When you include children 15-19 years of age (who we treat at CHOP) the number is well over 3,500 annually.
Out of the 3,500 it is estimated that 8-12% are brainstem glioma. At CHOP last year, 8.5% of our brain tumor patients had brainstem gliomas. Brain tumors are the largest cause of cancer-related death in children. There are brain tumors that are more common than brainstem gliomas; however, the complexity and intensity of care required for brainstem glioma patients and the degree of disability it causes in these children is disproportionately high compared to the overall number of cases.”
Medullablastoma tumors are in the cerebellum and represent 25% of all childhood brain tumors. They are the most common malignant brain tumor in children. Twenty years ago the survival rate for this type of tumor was <50% and today doctors are closing in on a 90% survival rate thanks to 20 years of research.
While low grade astrocytomas are almost as common as medullablastoma surgery can usually be performed. Combined with radiation and long term chemotherapy use, these kids can live a long time.
Janss AJ, Cnaan A., Spilsky A, Levow C, Yao Y, Phillips PC. ; Synergistic cytotoxic effects of camptothecin and topotecan with alkylating agents are drug-specific and dose-dependent in human brain tumor cell lines. Cancer Research, In Press.
Selected Publications
Grotzer MA, Janss AJ, Phillips PC, Trojanowski JQ.;
Neurotrophin receptor TrkC predicts good clinical outcome in medulloblastoma and other primitive neuroectodermal brain tumors. Klin Padiatr. 2000 Jul-Aug;212(4):196-9.
Geoerger B, Tang CB, Cesano A, Visonneau S, Marwaha S, Judy KD, Sutton LN, Santoli D, Phillips PC.;
Antitumor activity of a human cytotoxic T-cell line (TALL
For more information on brain tumors visit:
www.cancer.gov
www.nih.gov
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