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https://www.readbyqxmd.com/read/29628629/comparison-of-volumetric-modulated-arc-therapy-and-intensity-modulated-radiation-therapy-for-whole-brain-hippocampal-sparing-treatment-plans-based-on-radiobiological-modeling
#1
Ethan Kendall, Ozer Algan, Salahuddin Ahmad
Introduction: In this article, we report the results of our investigation on comparison of radiobiological aspects of treatment plans with linear accelerator-based intensity-modulated radiation therapy and volumetric-modulated arc therapy for patients having hippocampal avoidance whole-brain radiation therapy. Materials and Methods: In this retrospective study using the dose-volume histogram, we calculated and compared biophysical indices of equivalent uniform dose, tumor control probability, and normal tissue complication probability (NTCP) for 15 whole-brain radiotherapy patients...
January 2018: Journal of Medical Physics
https://www.readbyqxmd.com/read/29622046/complete-intracranial-response-to-talimogene-laherparepvec-t-vec-pembrolizumab-and-whole-brain-radiotherapy-in-a-patient-with-melanoma-brain-metastases-refractory-to-dual-checkpoint-inhibition
#2
Zoë Blake, Douglas K Marks, Robyn D Gartrell, Thomas Hart, Patti Horton, Simon K Cheng, Bret Taback, Basil A Horst, Yvonne M Saenger
BACKGROUND: Immunotherapy, in particular checkpoint blockade, has changed the clinical landscape of metastatic melanoma. Nonetheless, the majority of patients will either be primary refractory or progress over follow up. Management of patients progressing on first-line immunotherapy remains challenging. Expanded treatment options with combination immunotherapy has demonstrated efficacy in patients previously unresponsive to single agent or alternative combination therapy. CASE PRESENTATION: We describe the case of a patient with diffusely metastatic melanoma, including brain metastases, who, despite being treated with stereotactic radiosurgery and dual CTLA-4/PD-1 blockade (ipilimumab/nivolumab), developed systemic disease progression and innumerable brain metastases...
April 6, 2018: Journal for Immunotherapy of Cancer
https://www.readbyqxmd.com/read/29621341/second-course-of-stereotactic-radiosurgery-for-locally-recurrent-brain-metastases-safety-and-efficacy
#3
Juliette Moreau, Toufic Khalil, Guillaume Dupic, Emmanuel Chautard, Jean-Jacques Lemaire, Florian Magnier, Véronique Dedieu, Michel Lapeyre, Pierre Verrelle, Julian Biau
In the present study, we have evaluated the efficacy and toxicity of repeated brain metastases (BM) stereotactic radiosurgery (SRS2) following local failure of a prior radiosurgical procedure (SRS1). Between December 1996 and August 2015, 30 patients with 36 BM underwent SRS2 with a median dose of 18Gy. All BM were located outside critical structures. Following SRS2, local control at 6 months and one year were respectively 82.9% (IC 95%: 67.6-91.9) and 67.8% (IC 95%: 51-81). On multivariate analysis, planning target volume (PTV) < 3cc (HR: 0...
2018: PloS One
https://www.readbyqxmd.com/read/29604975/primary-cns-lymphoma-in-hiv-infection
#4
Dieta Brandsma, Jacoline E C Bromberg
Primary CNS lymphoma (PCNSL) has been designated an acquired immune deficiency syndrome (AIDS)-defining disease since 1983 and accounts for up to 15% of non-Hodgkin lymphomas in human immunodeficiency virus (HIV) patients. The majority of HIV patients are Epstein-Barr virus (EBV)-related. The most likely etiology is ineffective immunoregulation of EBV, inducing oncogenic protein expression, and subsequent loss of apoptosis and increased proliferation of lymphocytes. PCNSL generally presents with supratentorial, single or multiple, contrast-enhancing lesions...
2018: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/29599366/performance-status-and-number-of-metastatic-extra-cerebral-sites-predict-survival-after-radiotherapy-of-brain-metastases-from-thyroid-cancer
#5
Liesa Dziggel, Niklas Gebauer, Tobias Bartscht, Steven E Schild, Dirk Rades
BACKGROUND/AIM: Patients with brain metastases from thyroid cancer are extremely rare. This study evaluated clinical factors for survival following whole-brain radiotherapy (WBRT) alone. PATIENTS AND METHODS: In six patients, the following factors were analyzed for survival: Regimen of WBRT (5×4 Gy vs. 10×3 Gy), gender, age (≤55 vs. ≥56 years), Karnofsky performance score (KPS) (60% vs. 70-80%), number of brain lesions (2-3 vs. ≥4) and number of extra-cranial metastatic sites (one vs...
April 2018: Anticancer Research
https://www.readbyqxmd.com/read/29581768/characteristics-and-treatment-of-brain-metastases-from-esophageal-squamous-cell-carcinoma
#6
Qiaoqiao Li, Meiling Deng, Mian Xi, Yujia Zhu, Yonghong Hu
Brain metastasis is very rare in esophageal squamous cell carcinoma (ESCC). We retrospectively analyzed 4494 patients diagnosed with ESCC between 2010 and 2015 at a single institute; 15 of these patients developed brain metastases. All 15 patients had neurologic symptoms and were diagnosed by imaging or biology. Of the 15 patients, 67% had a solitary brain lesion and 73% had lesions larger than 3 cm. After treatment of the brain lesions, including surgery (53%) or stereotactic radiotherapy with or without whole brain radiation (20%), the median progression free survival time and the 2-year overall survival rate calculated from diagnosis of brain metastasis were 14...
2018: Journal of Cancer
https://www.readbyqxmd.com/read/29557535/the-breast-graded-prognostic-assessment-is-associated-with-the-survival-outcomes-in-breast-cancer-patients-receiving-whole-brain-re-irradiation
#7
Shih-Fan Lai, Yu-Hsuan Chen, Tony Hsiang-Kuang Liang, Che-Yu Hsu, Huang-Chun Lien, Yen-Sen Lu, Chiun-Sheng Huang, Sung-Hsin Kuo
INTRODUCTION: Whole brain (WB) re-irradiation for breast cancer patients with progressive brain metastasis after first-course WB radiotherapy (WBRT) is controversial. In this study, we sought to investigate the association between the molecular sub-classifications and breast-specific Graded Prognostic Assessment (GPA, which includes the Karnofsky performance status, molecular subtypes, and age as its indices) and the outcomes of breast cancer patients who received WB re-irradiation. METHODS: Twenty-three breast cancer patients who received WB re-irradiation for relapsed and progressive intracranial lesions after first-course WBRT between 2004 and 2016 were retrospectively reviewed...
March 20, 2018: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29554321/robotic-radiosurgery-for-brain-metastases-diagnosed-with-either-space-or-mprage-sequence-cyber-space-a-single-center-prospective-randomized-trial
#8
Rami A El Shafie, Angela Paul, Denise Bernhardt, Kristin Lang, Thomas Welzel, Tanja Sprave, Adriane Hommertgen, Johannes Krisam, Daniela Schmitt, Sebastian Klüter, Kai Schubert, Christina Klose, Meinhard Kieser, Jürgen Debus, Stefan Rieken
BACKGROUND: Stereotactic radiosurgery (SRS) of brain metastases (BM) is recommended in oligometastatic scenarios as a less toxic treatment alternative to whole-brain radiotherapy. Recent findings support SRS for patients with multiple (>3) BM. Furthermore, advances in MR imaging have facilitated the detection of very small BM, as advances in SRS technology have facilitated the highly conformal and simultaneous treatment of multiple target lesions. OBJECTIVE: To compare efficacy and toxicity of repeated frameless robotic SRS of up to 10 simultaneous BM through a single-center prospective randomized trial...
March 15, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29552691/impact-of-radiotherapy-in-atypical-meningioma-recurrence-literature-review
#9
REVIEW
Benedito Jamilson Araújo Pereira, Antônio Nogueira de Almeida, Wellingson Silva Paiva, Manoel Jacobsen Teixeira, Suely Kazue Nagahashi Marie
Evaluate whether radiotherapy (RT) after the neurosurgical treatment of atypical meningiomas (AM) has an impact on the reduction rate of recurrence. A Medline search through October 2017 using "atypical meningioma" returned 1277 papers for initial review. Inclusion criteria were as follows. We analyzed the database and included articles in which the anatomic pathological classification of atypical meningiomas was in accordance with WHO 2007 or WHO 2016 criteria, patients > 18 years of age, and there was postoperative external beam radiation to the tumor bed...
March 19, 2018: Neurosurgical Review
https://www.readbyqxmd.com/read/29548056/toward-precision-medicine-in-brain-metastases
#10
Anna S Berghoff, Priscilla K Brastianos
Brain metastases (BMs) reflect an area of high clinical need, as up to 40% of patients with metastatic cancer will develop this morbid and highly fatal complication. Historically, treatment strategies have relied on local approaches including radiosurgery, whole-brain radiotherapy, and neurosurgical resection. Recently, targeted and immune-modulating therapies have shown promising responses and have been introduced in the clinical management of patients with BMs. Recent improvements in genomic technologies have enriched our understanding of BMs and have demonstrated that BMs present with significant genetic divergence from the originating primary tumor, such that potentially targetable genetic alterations are detected only in the BMs...
February 2018: Seminars in Neurology
https://www.readbyqxmd.com/read/29541558/radiation-necrosis-a-growing-problem-in-a-case-of-brain-metastases-following-whole-brain-radiotherapy-and-stereotactic-radiosurgery
#11
Yee Pei Song, Rovel J Colaco
Stereotactic radiosurgery (SRS) provides excellent control in the treatment of brain metastases (BM). The use of newer, targeted and immunotherapy treatments have resulted in improved overall survival in patients even with an extensive metastatic disease. Hence, it is increasingly important to consider the potential for late toxicities like radiation-induced necrosis (RN) of the brain. We present a case of a patient with stage IV anaplastic lymphoma kinase (ALK) positive adenocarcinoma of the lung who underwent stereotactic radiosurgery to her brain metastases and received targeted treatment...
January 8, 2018: Curēus
https://www.readbyqxmd.com/read/29541469/a-rare-case-of-advanced-lung-cancer-presenting-as-a-symptomatic-gastric-tumor
#12
Cornelia Nitipir, Octav Ginghina, Liliana Popa, Florin Andrei, Nicolaie Tudor, Irina Radu, Cristian Iaciu, Cristina Orlov, Florina Vasilescu, Cristian Balalau, Grigoris Leon, Carolina Negrei, Maria Alexandra Barbu
Although gastric metastases have been estimated to occur in less than 2% of cancer patients, an increased use of upper digestive tract endoscopy allows for a higher detection of secondary gastric tumors. We describe the case of a 66-year-old male patient presenting with mild pain in the sternum and upper abdominal area. Physical examination revealed a right parietal skull tumor, with no other significant clinical changes. Upon exclusion of an acute coronary syndrome, upper digestive tract endoscopy was performed, showing the presence of an ulcerated tumor located in the gastric fundus...
April 2018: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29528419/evaluation-of-stereotactic-radiotherapy-of-the-resection-cavity-after-surgery-of-brain-metastases-compared-to-postoperative-whole-brain-radiotherapy-estron-a-single-center-prospective-randomized-trial
#13
Rami A El Shafie, Angela Paul, Denise Bernhardt, Henrik Hauswald, Thomas Welzel, Tanja Sprave, Adriane Hommertgen, Johannes Krisam, Daniela Schmitt, Sebastian Klüter, Kai Schubert, Christina Klose, Meinhard Kieser, Jürgen Debus, Stefan Rieken
BACKGROUND: Neurosurgical resection is recommended for symptomatic brain metastases, in oligometastatic patients or for histology acquisition. Without adjuvant radiotherapy, roughly two-thirds of the patients relapse at the resection site within 24 mo, while the risk of new metastases in the untreated brain is around 50%. Adjuvant whole-brain radiotherapy (WBRT) can reduce the risk of both scenarios of recurrence significantly, although the associated neurocognitive toxicity is substantial, while stereotactic radiotherapy (SRT) improves local control at comparably low toxicity...
March 8, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29516684/meta-analysis-of-whole-brain-radiotherapy-plus-temozolomide-compared-with-whole-brain-radiotherapy-for-the-treatment-of-brain-metastases-from-non-small-cell-lung-cancer
#14
Yong Xin, WenWen Guo, Chun Sheng Yang, Qian Huang, Pei Zhang, Long Zhen Zhang, Guan Jiang
The aim of this meta-analysis was to compare the efficiency of whole-brain radiotherapy (WBRT) plus temozolomide (TMZ) with WBRT for the treatment of brain metastases from non-small-cell lung cancer (NSCLC). For dichotomous variables, outcomes were reported as relative risk ratio (RR) and 95% confidence interval (CI) was used to investigate the following outcome measures: overall response rate, headache, gastrointestinal adverse reactions, and hematological adverse reactions. Twelve randomized controlled trials involving 925 participants (480 received WBRT plus TMZ; 445 received WBRT) were included in the meta-analysis...
March 7, 2018: Cancer Medicine
https://www.readbyqxmd.com/read/29507851/non-small-cell-lung-cancer-with-multiple-brain-metastases-treated-with-radiosurgery-and-erlotinib-a-case-report
#15
Bilgehan Sahin, Teuta Mustafayev, Gokhan Aydin, Gorkem Gungor, Bulend Yapici, Banu Atalar, Enis Ozyar
Brain metastases are commonly seen complications in non-small cell lung cancer (NSCLC) patients. The incidence of brain metastases is increasing as a result of more effective systemic targeted therapies with prolonged survival. The prognosis is usually poor, and up to six months of median survivals were reported with different therapeutic options. Here, we present an NSCLC case with multiple brain metastases treated with radiosurgery and systemic erlotinib therapy with prolonged survival. The use of tyrosine kinase inhibitors (TKI) in conjunction with either stereotactic radiosurgery or whole brain radiotherapy is not well established in terms of efficiency and toxicity...
December 29, 2017: Curēus
https://www.readbyqxmd.com/read/29499963/damage-to-the-left-uncinate-fasciculus-is-associated-with-heightened-schizotypal-traits-a-multimodal-lesion-mapping-study
#16
Anne-Laure Lemaitre, Gilles Lafargue, Hugues Duffau, Guillaume Herbet
A growing body of evidence suggests that individuals with pronounced schizotypal traits also display particular neurophysiological and morphological features - notably with regard to left frontotemporal connectivity. However, the studies published to date have focused on subclinical subjects and psychiatric patients, rather than brain-damaged patients. Here, we used the French version of the Schizotypal Personality Questionnaire to assess schizotypal traits in a sample of 97 patients having undergone surgical resection of a diffuse low-grade glioma...
February 27, 2018: Schizophrenia Research
https://www.readbyqxmd.com/read/29499878/applying-the-quartz-trial-results-in-clinical-practice-development-of-a-prognostic-model-predicting-poor-outcomes-for-non-small-cell-lung-cancers-with-brain-metastases
#17
J P Agarwal, S Chakraborty, S G Laskar, N Mummudi, V M Patil, M Upasani, K Prabhash, V Noronha, A Joshi, N Purandare, S Tandon, J Arora, R Badhe
AIMS: The role of whole brain radiotherapy (WBRT) in patients with brain metastases from non-small cell lung cancers (NSCLC) has been questioned. However, no reliable criteria exist to identify patients who do not benefit from WBRT. The objective of the current study was to develop a prognostic model to identify such patients whose survival matches that of the Quality of Life after Treatment for Brain Metastases (QUARTZ) study. MATERIALS AND METHODS: Outcome data of patients with NSCLC with brain metastases undergoing WBRT enrolled in a prospective observational study in a tertiary cancer centre were used to develop a prognostic model...
February 27, 2018: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/29499085/left-hippocampal-dosimetry-correlates-with-visual-and-verbal-memory-outcomes-in-survivors-of-pediatric-brain-tumors
#18
Andrew H Zureick, Casey L Evans, Andrzej Niemierko, Julie A Grieco, Alexandra J Nichols, Barbara C Fullerton, Clayton B Hess, Claire P Goebel, Sara L Gallotto, Elizabeth A Weyman, Dillon E Gaudet, Jessica A Nartowicz, David H Ebb, Robin M Jones, Shannon M MacDonald, Nancy J Tarbell, Torunn I Yock, Margaret B Pulsifer
BACKGROUND: Radiotherapy (RT) in the pediatric brain tumor population causes late neurocognitive effects. In the current study, the authors investigated associations between clinical and dosimetric risk factors and memory outcomes in a cohort of patients treated with proton radiotherapy (PRT). METHODS: A total of 70 patients (median age at PRT, 12.1 years [range, 5.0-22.5 years]) who were treated with PRT were identified with baseline and follow-up evaluations of visual and verbal memory (Children's Memory Scale and the third edition of the Wechsler Memory Scale)...
March 2, 2018: Cancer
https://www.readbyqxmd.com/read/29493009/cranial-irradiation-increases-tumor-growth-in-experimental-breast-cancer-brain-metastasis
#19
Amanda M Hamilton, Suzanne M Wong, Eugene Wong, Paula J Foster
Whole-brain radiotherapy is the standard of care for patients with breast cancer with multiple brain metastases and, although this treatment has been essential in the management of existing brain tumors, there are many known negative consequences associated with the irradiation of normal brain tissue. In our study, we used in vivo magnetic resonance imaging analysis to investigate the influence of radiotherapy-induced damage of healthy brain on the arrest and growth of metastatic breast cancer cells in a mouse model of breast cancer brain metastasis...
March 1, 2018: NMR in Biomedicine
https://www.readbyqxmd.com/read/29487766/case-report-of-extended-survival-and-quality-of-life-in-a-melanoma-patient-with-multiple-brain-metastases-and-review-of-literature
#20
William Sperduto, David M King, Yoichi Watanabe, Emil Lou, Paul W Sperduto
Long-term survival for melanoma patients with multiple brain metastases is rare. A review of the literature reveals only three reported melanoma patients with multiple brain metastases who survived more than 10 years. We present a patient who is recurrence-free 11 years after the diagnosis of three brain metastases. Her treatment consisted of cytokine (interferon and interleukin-2) and chemotherapy nine months prior to developing brain and soft tissue metastases, which were treated with stereotactic radiosurgery and stereotactic ablative radiotherapy, respectively, followed by six months of chemotherapy...
December 14, 2017: Curēus
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