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https://www.readbyqxmd.com/read/29045710/radiation-induced-cognitive-toxicity-pathophysiology-and-interventions-to-reduce-toxicity-in-adults
#1
Christopher Wilke, David Grosshans, Joseph Duman, Paul Brown, Jing Li
Radiotherapy is ubiquitous in the treatment of patients with both primary brain tumors as well as disease which is metastatic to the brain. This therapy is not without cost, however, as cognitive decline is frequently associated with cranial radiation, particularly with whole brain radiotherapy (WBRT). The precise mechanisms responsible for radiation-induced morbidity remain incompletely understood and continue to be an active area of ongoing research. In this article, we review the hypothetical means by which cranial radiation induces cognitive decline as well as potential therapeutic approaches to prevent, minimize or reverse treatment-induced cognitive deterioration...
October 14, 2017: Neuro-oncology
https://www.readbyqxmd.com/read/29045549/emerging-treatment-paradigms-in-brain-metastasis-in-non-small-cell-lung-cancer-an-overview-of-the-current-landscape-and-challenges-ahead
#2
D Ulahannan, J Khalifa, C Faivre-Finn, S M Lee
Advances in the last decade in genomic profiling and the identification of druggable targets amenable to biological agents, has transformed the management and survival of a subgroup of patients with brain metastasis in non-small cell lung cancer. In parallel, clinicians have re-evaluated the role of whole brain radiotherapy in selected patients with brain metastases to reduce neurocognitive toxicity. Continual progress in this understudied field is required: optimisation of the sequence of schedules for therapies in patients with brain metastases of differing genomic profiles, focusing on new strategies to overcome mechanisms of biological resistance and increasing drug penetrability into the central nervous system...
October 17, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/29043230/advances-in-the-treatment-of-newly-diagnosed-primary-central-nervous-system-lymphomas
#3
REVIEW
Liren Qian, Ciprian Tomuleasa, Ioan-Alexandru Florian, Jianliang Shen, Ioan-Stefan Florian, Mihnea Zdrenghea, Delia Dima
Primary central nervous system lymphoma (PCNSL) is a type of highly invasive non-Hodgkin lymphoma. With a growing number of organ transplantation and immunosuppressant therapy, the incidence of PCNSL has been growing rapidly in recent years, which is attributed to the increased incidence of HIV/AIDS, a prominent risk factor for developing PCNSL. The rising rate of PCNSL incidence is the highest among the intracranial tumors. In the past 20 years, dozens of clinical trials related to PCNSL have been registered, but adequate therapeutics are still challenging...
September 2017: Blood Research
https://www.readbyqxmd.com/read/29016812/brain-volume-reduction-after-whole-brain-radiotherapy-quantification-and-prognostic-relevance
#4
Christian Hoffmann, Luitpold Distel, Stefan Knippen, Thomas Gryc, Manuel Alexander Schmidt, Rainer Fietkau, Florian Putz
Background: Recent studies have questioned the value of adding whole-brain radiotherapy (WBRT) to stereotactic radiosurgery (SRS) for brain metastasis treatment. Neurotoxicity, including radiation-induced brain volume reduction, could be one reason why not all patients benefit from the addition of WBRT. In this study, we quantified brain volume reduction after WBRT and assessed its prognostic significance. Methods: Brain volumes of 91 patients with cerebral metastases were measured during a 150-day period after commencing WBRT, and were compared to their pretreatment volumes...
August 8, 2017: Neuro-oncology
https://www.readbyqxmd.com/read/28990810/cns-metastasis-secondary-to-malignant-mixed-m%C3%A3-llerian-tumor-case-report-and-review-of-therapeutics
#5
Vincent Healy, Sorca O'Brien, Philip O'Halloran, Alan Beausang, John Caird
This paper reviews CNS involvement secondary to malignant-mixed Müllerian tumor or uterine carcinosarcoma, a rare aggressive biphasic Müllerian tumor. We report a cerebellar metastasis with epithelial and mesenchymal components, demonstrating heterologous rhabdomyogenic and chondroblastic differentiation. The patient had undergone total abdominal hysterectomy and bilateral salpingo-oophorectomy for palliation of symptomatic chemotherapy-resistant node-positive disease. CNS involvement is rare, and prognostically poor, and suggestively poorer in predominantly sarcomatous metastases...
October 9, 2017: CNS Oncology
https://www.readbyqxmd.com/read/28984752/intensity-modulated-radiation-therapy-for-patients-with-1-to-3-brain-metastases-in-recursive-partitioning-analysis-class-3
#6
Jia Yang, Wenming Zhan, Haibo Zhang, Tao Song, Yongshi Jia, Hongen Xu, Baihua Lin, Shiliang Lv, Xiaodong Liang
The prognosis is extremely poor for patients with brain metastases in recursive partitioning analysis (RPA) class 3. It is not clear whether dose elevation for brain lesions in addition to whole-brain radiotherapy could improve survival for those patients. This study aimed to assess the efficacy and safety of dose elevation with intensity-modulated radiation therapy (IMRT) for patients with 1 to 3 brain metastases in RPA class 3.From January 2013 to December 2015, 24 patients with 1 to 3 brain metastases in RPA class 3 were included in this study...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28984492/prognostic-factors-affecting-survival-after-whole-brain-radiotherapy-in-patients-with-brain-metastasized-lung-cancer
#7
Georgios Tsakonas, Fatou Hellman, Michael Gubanski, Signe Friesland, Salomon Tendler, Rolf Lewensohn, Simon Ekman, Luigi de Petris
BACKGROUND: Whole-brain radiotherapy (WBRT) has been the standard of care for multiple NSCLC brain metastases but due to its toxicity and lack of survival benefit, its use in the palliative setting is being questioned. PATIENT AND METHODS: This was a single institution cohort study including brain metastasized lung cancer patients who received WBRT at Karolinska University Hospital. Information about Recursive Partitioning Analysis (RPA) and Graded Prognostic Assessment (GPA) scores, demographics, histopathological results and received oncological therapy were collected...
October 6, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28980762/case-report-of-18-f-fluorodeoxyglucose-positron-emission-tomography-computed-tomography-imaging-of-a-patient-with-multiple-endocrine-gland-metastases-from-small-cell-lung-cancer
#8
Hongguang Zhao, Chenghe Lin, Benzheng Jiao, Ri Sa, Sen Hou, Songbai Xu
Synchronous multiple endocrine gland metastasis caused by small cell lung cancer (SCLC) is rare. A patient was investigated for primary cancer because of suspected brain metastasis on computed tomography (CT). Baseline (18) F-fluorodeoxyglucose (FDG) positron emission tomography (PET)-CT was positive in the lung and multiple endocrine glands (right thyroid, right breast, pancreatic body, right adrenal gland, and left ovary). Histopathology confirmed small cell lung cancer. The patient's symptoms were alleviated after chemotherapy and brain radiotherapy...
October 5, 2017: Thoracic Cancer
https://www.readbyqxmd.com/read/28974863/a-feasibility-study-on-the-use-of-tomotherapy-megavoltage-computed-tomography-images-for-palliative-patient-treatment-planning
#9
Yunfei Hu, Mikel Byrne, Ben Archibald-Heeren, Matthew Squires, Amy Teh, Kylie Seiffert, Sonja Cheers, Yang Wang
Dedicated rapid access palliative radiation therapy improves patients' access to care, allowing more timely treatment which would positively impact on quality of life. The TomoTherapy (Accuray, Sunnyvale, CA) system provides megavoltage (MV) fan-beam computed tomography (FBCT) as the image guidance technique, and a module called "statRT" that allows the use of these MV FBCT images for direct planning. The possibility of using this imaging modality for palliative radiotherapy treatment planning is assessed against accepted planning CT standards by performing tests following AAPM TG 66 and an end-to-end measurement...
July 2017: Journal of Medical Physics
https://www.readbyqxmd.com/read/28973509/whole-brain-radiation-dose-reduction-for-primary-central-nervous-system-lymphoma-patients-who-achieved-partial-response-after-high-dose-methotrexate-based-chemotherapy
#10
Jun Su Park, Do Hoon Lim, Yong Chan Ahn, Won Park, Seok Jin Kim, Won Seog Kim, Kihyun Kim
Background: The whole brain radiotherapy (WBRT) dose for primary central nervous system lymphoma (PCNSL) patients who achieved complete response after induction chemotherapy was recently reduced to 23.4 Gy, but the optimal radiation dose for patients who achieved partial response (PR) is controversial. The aim of this study was to investigate the feasibility of reduced-dose WBRT for patients who achieved PR. Method: We retrospectively reviewed the medical records of PCNSL patients who were treated with high-dose methotrexate based chemotherapy...
August 30, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28969706/improved-plan-quality-with-automated-radiotherapy-planning-for-whole-brain-with-hippocampus-sparing-a-comparison-to-the-rtog-0933-trial
#11
J Krayenbuehl, M Di Martino, M Guckenberger, N Andratschke
BACKGROUND: Whole-brain radiation therapy (WBRT) with hippocampus sparing (HS) has been investigated by the radiation oncology working group (RTOG) 0933 trial for patients with multiple brain metastases. They showed a decrease of adverse neurocognitive effects with HS WBRT compared to WBRT alone. With the development of automated treatment planning system (aTPS) in the last years, a standardization of the plan quality at a high level was achieved. The goal of this study was to evaluate the feasibility of using an aTPS for the treatment of HS WBRT and see if the RTOG 0933 dose constraints could be achieved and improved...
October 2, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28968585/treatment-and-prognosis-of-leptomeningeal-disease-secondary-to-metastatic-breast-cancer-a-single-centre-experience
#12
Belinda Kingston, Hamzeh Kayhanian, Chloe Brooks, Nicola Cox, Narda Chaabouni, Stefania Redana, Eleftheria Kalaitzaki, Ian Smith, Mary O'Brien, Stephen Johnston, Marina Parton, Jill Noble, Susie Stanway, Alistair Ring, Nicholas Turner, Alicia Okines
PURPOSE: Leptomeningeal disease (LMD) is an uncommon complication of advanced breast cancer. The prognosis is poor, and although radiotherapy (RT), systemic and intra-thecal (IT) chemotherapy are accepted treatment modalities, efficacy data are limited. This study was designed to evaluate potential predictors of survival in this patient group. METHODS: Breast cancer patients with LMD diagnosed by MRI in a 10-year period (2004-2014) were identified from electronic patient records...
September 29, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28961826/whole-brain-radiotherapy-after-stereotactic-radiosurgery-or-surgical-resection-among-patients-with-one-to-three-brain-metastases-and-favorable-prognoses-a-secondary-analysis-of-eortc-22952-26001
#13
T M Churilla, E Handorf, S Collette, L Collette, Y Dong, A A Aizer, M Kocher, R Soffietti, B M Alexander, S E Weiss
Background: The absence of a survival benefit for whole brain radiotherapy (WBRT) among randomized trials has been attributed to a competing risk of death from extracranial disease. We re-analyzed EORTC 22952 to assess the impact of WBRT on survival for patients with controlled extracranial disease or favorable prognoses. Patients and methods: We utilized Cox regression, landmark analysis, and the Kaplan-Meier method to evaluate the impact of WBRT on survival accounting for (i) extracranial progression as a time-dependent covariate in all patients and (ii) diagnosis-specific graded prognostic assessment (GPA) score in patients with primary non-small-cell lung cancer (NSCLC)...
October 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28950405/diagnosis-and-management-of-primary-central-nervous-system-lymphoma
#14
REVIEW
Catherine H Han, Tracy T Batchelor
Primary central nervous system lymphoma (PCNSL) is a rare and aggressive extranodal non-Hodgkin lymphoma (NHL) that is confined to the brain, eyes, spinal cord, or leptomeninges without systemic involvement. The overall prognosis, diagnosis, and management of PCNSL differ from those for other types of NHL. Prompt diagnosis and initiation of treatment are vital for improving clinical outcomes. PCNSL is responsive to radiation therapy; however, whole-brain radiotherapy (WBRT) inadequately controls the disease when it is used alone, and its delayed neurotoxicity causes neurocognitive impairment, especially in elderly patients...
September 26, 2017: Cancer
https://www.readbyqxmd.com/read/28939931/role-of-radiation-therapy-in-primary-central-nervous-system-lymphoma-krog-14-20-collaborative-study-of-brain-and-lymphoma-committee
#15
Hyeon Kang Koh, Il Han Kim, Tae Min Kim, Do Hoon Lim, Dongryul Oh, Jae Ho Cho, Woo-Chul Kim, Jin Hee Kim, Woong-Ki Chung, Bae-Kwon Jeong, Ki Mun Kang, Semie Hong, Chang-Ok Suh, In Ah Kim
We analyzed patterns of care and outcomes for patients with primary central nervous system lymphoma (PCNSL) in this multi-institutional retrospective study. Between January 2000 and December 2011, 220 patients with PCNSL received radiotherapy (RT). Among these patients, 26 patients received RT alone; 179 patients were treated with chemotherapy and radiotherapy; the rest of the patients (N = 15) initially underwent chemotherapy alone, then received RT as a salvage treatment. Most of the patients (N = 188) received methotrexate-based chemotherapy...
September 22, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28923217/current-challenges-in-the-management-of-breast-cancer-brain-metastases
#16
REVIEW
Ciara C O'Sullivan, Nicole N Davarpanah, Jame Abraham, Susan E Bates
Approximately 50% of patients with advanced human epidermal growth factor 2 (HER2)-positive breast cancer and triple-negative breast cancer (TNBC) ultimately develop breast cancer brain metastases (BCBM), which are associated with significant morbidity and mortality. The advent of HER2-directed therapy resulted in greatly improved survival outcomes, but unfortunately at the price of an increased cumulative incidence of BCBM. We review challenges in the management of BCBM, and potential treatment strategies, including novel agents such as poly-adenosine diphosphate (ADP) ribose polymerase (PARP) inhibitors (olaparib, veliparib), cyclin-dependent kinase 4/6 (CDK4/6) inhibitors (palbociclib, abemaciclib), and taxane derivatives (eg, ANG1005 and TPI-287)...
April 2017: Seminars in Oncology
https://www.readbyqxmd.com/read/28902402/safety-net-versus-private-hospital-setting-for-brain-metastasis-patients-treated-with-radiosurgery-alone-disparities-in-follow-up-care-and-outcomes
#17
Kevin Diao, Yanqing Sun, Stella K Yoo, Cheng Yu, Jason C Ye, Nicholas Trakul, Richard L Jennelle, Paul E Kim, Gabriel Zada, John P Gruen, Eric L Chang
BACKGROUND: Stereotactic radiosurgery (SRS) alone is an increasingly accepted treatment for brain metastases, but it requires adherence to frequently scheduled follow-up neuroimaging because of the risk of distant brain metastasis. The effect of disparities in access to follow-up care on outcomes after SRS alone is unknown. METHODS: This retrospective study included 153 brain metastasis patients treated consecutively with SRS alone from 2010 through 2016 at an academic medical center and a safety-net hospital (SNH) located in Los Angeles, California...
September 13, 2017: Cancer
https://www.readbyqxmd.com/read/28893026/superior-vena-cava-as-gateway-to-heart-metastatic-breast-carcinoma-causing-ball-in-a-loop-metastasis-to-right-atrium
#18
Harpreet Singh Sandhu, Sampath Kumar Mahadevappa Mahendrakar, Sulaiman Sadruddin Ladhani, Azizullah Hafizullah Khan, Yunus Shafi Loya
Breast carcinoma is the most common invasive cancer in women worldwide. It metastasizes commonly to bone, lungs, regional lymph nodes and brain. Cardiac metastasis of lung and breast cancers is a known but rare complication of advanced disease with tumour metastasising to pericardium via the locoregional lymphatic system. Here we present a case of 59-year-old female presenting with right upper limb oedema, facial puffiness and features of Superior Vena Cava (SVC) syndrome 15 years after mastectomy and adjuvant chemotherapy, radiotherapy for carcinoma of the right breast...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28866900/patient-preference-for-stereotactic-radiosurgery-plus-or-minus-whole-brain-radiotherapy-for-the-treatment-of-brain-metastases
#19
K Liang Zeng, Srinivas Raman, Arjun Sahgal, Hany Soliman, May Tsao, Carole Wendzicki, Edward Chow, Simon S Lo
BACKGROUND: Optimal management for limited, non-resectable brain metastases is an evolving area in radiation oncology. Previous data show no difference in survival between stereotactic radiosurgery (SRS) and SRS plus whole-brain radiotherapy (WBRT). Neurocognitive toxicities, treatment duration and tumor recurrence differ and therefore patient values play an important role in decision making. We aim to elicit patient preferences and understand factors important in deciding which treatment to pursue...
August 8, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28860082/memantine-derived-drugs-as-potential-antitumor-agents-for-the-treatment-of-glioblastoma
#20
Ivana Cacciatore, Erika Fornasari, Lisa Marinelli, Piera Eusepi, Michele Ciulla, Ozlem Ozdemir, Abdulgani Tatar, Hasan Turkez, Antonio Di Stefano
Glioblastoma is one of the most aggressive malignant primary brain cancer in adults. To date, surgery, radiotherapy and current pharmacological treatments are not sufficient to manage this pathology that has a high mortality rate (median survival 12-15months). Recently, anticancer multi-targeted compounds have attracted much attention with the aim to obtain new drugs able to hit different biological targets that are involved in the onset and progression of the disease. Here, we report the synthesis of novel memantine-derived drugs (MP1-10) and their potential antitumor activities in human U87MG glioblastoma cell line...
August 30, 2017: European Journal of Pharmaceutical Sciences
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