臺北醫學大學 臺北神經醫學中心 校級神經醫學研究中心

     
       In terms of integrated multidisciplinary medical care organized by the pediatric neuroscience team, specialists contribute their expertise that include pediatric neurologists for early diagnosis, treatment of epilepsy, and environment friendly diagnostics; pediatric neurosurgeons for safe and precision surgery and post-operative care; pathologists for precise histological and IHC staining diagnosis, pediatric hematologists/ oncologists for anti-tumor drug toxicity surveillance and quality of life monitoring; radiation oncologists for protective optimal volume and dose radiation; pediatric neuroimaging specialists provide high quality diagnosis and prolonged follow-up imaging service; neuroendocrinologists evaluate hormonal and monitor growth and development for interventional therapy, physiotherapy specialists rehabilitate children with physical deficits and assess neuropsychosocial function of children along with intervention. Nutrition evaluation, relevant nursing care in pediatric ICU, protect isolation ward, pediatric ward, child friendly healthcare, and nurse navigator all contribute to the children treated in Division of Pediatric Neuroscience in TNI/TMU。

       The pediatric neuroscience team at TNI (Taipei Neuroscience Institute) of TMU has been a dedicated team care for each type of neurosurgical and neurological diseases. The team involved clinician, nursing, and other expertise for multidisciplinary integrated care. With IRB approval, the team is also developing a multimodality platform integrating clinical, education, research, and biostatistics for live-long high-quality care of patients and survivors, for the reference of future therapy modification, and for translational research on less toxic but effective new therapies.

       PBTL leading by Prof. Tai-Tong Wong was established in the campus of TMU since 104. Collaborative members included tutors in TMU, Dr. Shian-Ying Sung, Dr. Cha-Ling Hsieh, and Dr. Che-Cheng Chang; associated researcher in Agricultural Biotechnological Research Center, Academia Sinica, Dr. yu-Ling Lin; Department of Chemistry and Biochemistry, National Chung Cheng University, Dr. Chiun-Chin Lin; Department of Medical Research, Taipei Veteran General Hospital (Taipei VGH), associated researcher, Dr. Kung-Hao Liang; Postdoc researcher, Dr. Kuo-Sheng Wu, and research assistants. For clinical research, we collaborative physicians and experts in Taipei VGH and other institutes in Taiwan. Weekly PBTL meeting has been held since 104 at 9:00-11:00 am on Friday for the report of research progressing, phased results, and discussion. Molecular diagnosis of pediatric brain tumors and standard treatment regimens establishment The research on molecular diagnosis of pediatric brain tumors was initiated by Academician of Academia Sinia, Dr. Alice Lin-Tsing Yu in the Third Term Cancer Research Project of Ministry of Health and Welfare (MOHW). She was the PI of the project ‘Integration of treatment strategies and molecular diagnosis for childhood cancers in Taiwan’. Dr. Tai-Tong Wong in TMUH/TMU was the PI of the SP1 (Assembly of pediatric oncology groups in domestic institutes for the establishment of molecular diagnosis and standard treatment regimens on pediatric brain tumors). The implemented strategy was the integration of clinical diagnosis, clinical analysis, molecular diagnosis, and molecular analysis in pediatric brain tumors in the order of CNS embryonal tumors (medulloblastoma, ATRT), CNS germ cell tumors (GCT), and gliomas. The first achieved result was the establishment of molecular subtypes diagnosis in medulloblastoma (MB) and the adoption of standard treatment regimens by TPOG (Taiwan Pediatric Oncology Group) as guideline for MB therapy in Taiwan. The standard treatment regimens for CNS GCT therapy comes to final discussion before sending to TPOG for adoption and implementation. Translational research on pediatric brain tumors Translational research of pediatric brain tumors began in TMUH since 2018 through the leading of the subproject (pediatric brain tumors) by Dr. Tai-Tong Wong in the project ‘Integration of treatment strategies and molecular diagnosis for childhood cancers in Taiwan, in the third term (107-110) of Cancer Research Project of MOHW. Translational researches for pediatric brain tumors in the Division of Pediatric Neuroscience, TNI and TCC, TMU are ATRT (atypical teratoid rhabdoid tumors), MB, and CNS GCT were performed since 107. The first achieved result was in ATRT, in 109, we found therapeutic target genes PSMB4 and PSMD4 in ATRT-MYC and its targeted drug ‘Bortezomib’. A 3-year IIT phase 2 clinical trial was approved and executed since 2020. In the ongoing translational research on high-risk MB-SHH in an integrated NSTC project from 111-114, the present achievements were the identification of therapeutic targets, relevant inhibitors, and drug discovery. Alsos, there is progressing on MSC exosome targeted MB cells with enhanced delivery of siRNA. Part of the research results were recently published or in the status of submission for publication. On the other hand, for the research on targeted treatment of radioresistance in nongeminomatous malignant GCT (NGMGCT). We have identified several radioresistance relevant genes. Among them, one gene is selected for further radiosensitivity and IC50 assay. Radiation-induced resistance of this gene and therapeutic effect on relevant inhibitor were observed. A door is hopefully opened for deescalated radiotherapy for NGMGCT through targeted radioresistant gene inhibition.