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whole brain radiotherapy

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https://www.readbyqxmd.com/read/28638456/temozolomide-and-bevacizumab-induction-before-chemoradiotherapy-in-patients-with-bulky-glioblastoma-and-or-with-severe-neurological-impairment
#1
Ilan Darmon, Mony Chenda Morisse, Alexandre Coutte, Marie Blonski, Emilie Le Rhun, Luc Taillandier, Diana Bello Roufai, Christine Desenclos, Stéphanie Trudel, Jean-Christophe Faivre, Nicolas Blanchard, Bruno Chauffert, Mathieu Boone
Background. New approaches are needed for patients newly diagnosed with bulky glioblastoma (GB) and/or with severe neurological impairment that cannot benefit from first line temozolomide (TMZ)-based chemoradiotherapy. Bevacizumab (BEV), an antiangiogenic anti-VEGF-R monoclonal antibody, has a rapid impact on tumor-related brain edema in recurrent GB. The present study reports the feasibility and efficacy of an induction treatment with TMZ and BEV to alleviate the initial neurological impairment and/or to reduce the tumor volume before a delayed chemoradiotherapy...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28626600/distant-brain-recurrence-in-patients-with-five-or-more-newly-diagnosed-brain-metastases-treated-with-focal-stereotactic-radiotherapy-alone
#2
Olivia Claire Barrett, Andrew M McDonald, Jonathan W Thompson, Markus Bredel, Gerald McGwin, Kristen O Riley, John B Fiveash
BACKGROUND: To assess the clinical outcomes in patients with greater than 4 newly diagnosed brain metastases treated with focal stereotactic radiotherapy alone. METHODS: All patients with five or more brain metastases who received focal radiotherapy without whole brain radiation or resection were included in this retrospective analysis. Distant brain failure (DBF), overall survival (OS) and toxicity were reported. RESULTS: Thirty-six patients met inclusion with median clinical follow-up of 6...
2017: Journal of Radiosurgery and SBRT
https://www.readbyqxmd.com/read/28616720/quality-of-life-after-whole-brain-radiotherapy-compared-with-radiosurgery-of-the-tumor-bed-results-from-a-randomized-trial
#3
L Kepka, D Tyc-Szczepaniak, K Osowiecka, A Sprawka, B Trąbska-Kluch, B Czeremszynska
BACKGROUND: A recent randomized trial (NCT01535209) demonstrated no difference in neurocognitive function between stereotactic radiotherapy of the tumor bed (SRT-TB) and whole brain radiotherapy (WBRT) in patients with resected single brain metastasis. Patients treated with SRT-TB had lower overall survival compared with the WBRT arm. Here, we compared the health-related quality of life (HRQOL) in patients who received WBRT vs. SRT-TB. METHODS: A self-reported questionnaire was used to assess HRQOL (EORTC QLQ-C30 with the QLQ-BN20 module) before RT, 2 months after RT, and every 3 months thereafter...
June 14, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28591062/extracranial-bone-metastases-from-recurrent-anaplastic-astrocytoma-on-fdg-pet-ct-a-case-report-a-care-compliant-article
#4
Zu-Gui Li, Hai-Yu Mu
OBJECTIVE: Extracranial bone metastases from astrocytoma are rare and frequently detected as part of multiorgan metastases. It is extremely rare for astrocytoma to have extracranial bone metastases alone. The importance of whole-body fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) imaging in evaluating extracranial metastasis (ECMs) has not been described effectively due to the rarity of this event. The purpose of our case report is to emphasize the role of FDG PET/CT in the assessment of tumor recurrence and extracranial bone metastases from anaplastic astrocytoma...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28586934/brain-metastases-of-non-small-cell-lung-cancer-prognostic-factors-in-patients-with-surgical-resection
#5
Aida Ramos Antuña, Marco Alvarez Vega, Carmen Rodriguez Sanchez, Vanesa Martin Fernandez
Background and Study Aims Bronchogenic carcinoma is the cancer that most commonly metastasizes to the brain. The standard treatment schedule for these patients is still unclear, although recommendation level 1 class I advocates for surgical resection together with postoperative whole-brain radiotherapy for patients with good Karnofsky performance status (KPS). We performed a study to identify prognostic factors for the long-term survival of patients with brain metastases from non-small cell lung cancer (NSCLC)...
June 6, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28585732/cost-effective-immobilization-for-whole-brain-radiation-therapy
#6
Ashley E Rubinstein, W Scott Ingram, Brian M Anderson, Skylar S Gay, Xenia J Fave, Rachel B Ger, Rachel E McCarroll, Constance A Owens, Tucker J Netherton, Kelly D Kisling, Laurence E Court, Jinzhong Yang, Yuting Li, Joonsang Lee, Dennis S Mackin, Carlos E Cardenas
To investigate the inter- and intra-fraction motion associated with the use of a low-cost tape immobilization technique as an alternative to thermoplastic immobilization masks for whole-brain treatments. The results of this study may be of interest to clinical staff with severely limited resources (e.g., in low-income countries) and also when treating patients who cannot tolerate standard immobilization masks. Setup reproducibility of eight healthy volunteers was assessed for two different immobilization techniques...
June 6, 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28581466/high-dose-chemotherapy-and-autologous-stem-cell-transplantation-for-primary-central-nervous-system-lymphoma-a-multi-centre-retrospective-analysis-from-the-united-kingdom
#7
S Kassam, E Chernucha, A O'Neill, C Hemmaway, T Cummins, S Montoto, A Lennard, G Adams, K Linton, P McKay, D Davies, C Rowntree, S Easdale, T A Eyre, R Marcus, K Cwynarski, C P Fox
The prognosis of patients with primary central nervous system lymphoma (PCNSL) has improved in recent years. This has partly been achieved by remission induction protocols incorporating high-dose methotrexate (HD-MTX) and rituximab. Given the high rates of relapse, consolidation therapy is usually considered in first response. Whole brain radiotherapy may prolong PFS but appears to confer no long-term survival advantage and is associated with significant neurocognitive dysfunction. Attempts to improve efficacy and reduce neurotoxicity of consolidation therapy have included thiotepa-based high-dose chemotherapy and autologous stem cell transplant (HDC-ASCT)...
June 5, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28577030/stereotactic-radiosurgery-for-small-brain-metastases-and-implications-regarding-management-with-systemic-therapy-alone
#8
Daniel M Trifiletti, Colin Hill, Or Cohen-Inbar, Zhiyuan Xu, Jason P Sheehan
While stereotactic radiosurgery (SRS) has been shown effective in the management of brain metastases, small brain metastases (≤10 mm) can pose unique challenges. Our aim was to investigate the efficacy of SRS in the treatment of small brain metastases, as well as elucidate clinically relevant factors impacting local failure (LF). We utilized a large, single-institution cohort to perform a retrospective analysis of patients with brain metastases up to 1 cm in maximal dimension. Clinical and radiosurgical parameters were investigated for an association with LF and compared using a competing risk model to calculate cumulative incidence functions, with death and whole brain radiotherapy serving as competing risks...
June 2, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28560833/use-of-microwave-ablation-in-the-treatment-of-patients-with-multiple-primary-malignant-tumors
#9
Yue Han, Na Shao, Xiaoming Xi, Xuezhi Hao
A 56-year-old man was admitted to our hospital in 2007, complaining of an irritating cough. Computed tomography examination demonstrated a mass in the right lung and enlargement of the hilar and mediastinal lymph nodes. Small cell lung cancer was confirmed by pathological examination after fibro-bronchoscope biopsy. The patient was treated with received sequential chemotherapy and radiotherapy. Preventive radiotherapy of the whole brain was performed after complete remission of the lung disease. Seven years after diagnosis, follow-up computed tomography revealed masses in both the liver and kidney...
May 31, 2017: Thoracic Cancer
https://www.readbyqxmd.com/read/28560661/outcome-and-prognostic-factors-in-patients-with-brain-metastases-from-small-cell-lung-cancer-treated-with-whole-brain-radiotherapy
#10
Denise Bernhardt, Sebastian Adeberg, Farastuk Bozorgmehr, Nils Opfermann, Juliane Hoerner-Rieber, Laila König, Jutta Kappes, Michael Thomas, Felix Herth, Claus Peter Heußel, Arne Warth, Jürgen Debus, Martin Steins, Stefan Rieken
The purpose of this study was to evaluate prognostic factors associated with overall survival (OS) and neurological progression free survival (nPFS) in small-cell lung cancer (SCLC) patients with brain metastases who received whole-brain radiotherapy (WBRT). From 2003 to 2015, 229 SCLC patients diagnosed with brain metastases who received WBRT were analyzed retrospectively. In this cohort 219 patients (95%) received a total photon dose of 30 Gy in 10 fractions. The prognostic factors evaluated for OS and nPFS were: age, Karnofsky Performance Status (KPS), number of brain metastases, synchronous versus metachronous disease, initial response to chemotherapy, the Radiation Therapy Oncology Group recursive partitioning analysis (RPA) class and thoracic radiation...
May 30, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28559537/high-dose-chemotherapy-with-autologous-haematopoietic-stem-cell-support-for-relapsed-or-refractory-primary-cns-lymphoma-a-prospective-multicentre-trial-by-the-german-cooperative-pcnsl-study-group
#11
B Kasenda, G Ihorst, R Schroers, A Korfel, I Schmidt-Wolf, G Egerer, L von Baumgarten, A Röth, J Bloehdorn, R Möhle, M Binder, U Keller, M Lamprecht, M Pfreundschuh, E Valk, H Fricker, E Schorb, K Fritsch, J Finke, G Illerhaus
To investigate safety and efficacy of high-dose chemotherapy followed by autologous stem cell transplantation (HCT-ASCT) in relapsed/refractory (r/r) primary CNS lymphoma (PCNSL). We conducted a single-arm multicentre study for immunocompetent patients (<66 years) with PCNSL failing high-dose methotrexate (HD-MTX) based chemotherapy. Induction consisted of 2 courses of rituximab (375 mg/m(2)), high-dose cytarabine (2 × 3 g/m(2)) and thiotepa (40 mg/m(2)) with collection of stem cells in between. Conditioning for HCT-ASCT consisted of rituximab 375 mg/m(2), carmustine 400 mg/m(2) and thiotepa (4 × 5 mg/kg)...
May 31, 2017: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
https://www.readbyqxmd.com/read/28555261/paradigm-shift-of-therapeutic-management-of-brain-metastases-in-egfr-mutant-non-small-cell-lung-cancer-in-the-era-of-targeted-therapy
#12
REVIEW
Akimasa Sekine, Hiroaki Satoh
Non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutations commonly present brain metastases (BM) at the time of NSCLC diagnosis or during the clinical course. Conventionally, the prognosis of BM has been extremely poor, but the advent of EGFR-tyrosine kinase inhibitors (TKIs) has drastically improved the prognosis in these patients. Despite the presence of the blood-brain barrier, EGFR-TKIs have dramatic therapeutic effects on both BM and extracranial disease. In addition, recent systemic chemotherapies reportedly play a role in controlling BM...
July 2017: Medical Oncology
https://www.readbyqxmd.com/read/28551018/-risk-of-radionecrosis-after-hypofractionated-stereotactic-radiotherapy-targeting-the-postoperative-resection-cavity-of-brain-metastases
#13
A Keller, M Doré, D Antoni, I Menoux, F Thillays, J B Clavier, G Delpon, D Jarnet, C Bourrier, F Lefebvre, S Chibbaro, I Darié, F Proust, G Noël
PURPOSE: To investigate the factors that potentially lead to brain radionecrosis after hypofractionated stereotactic radiotherapy targeting the postoperative resection cavity of brain metastases. METHODS AND MATERIALS: A retrospective analysis conducted in two French centres, was performed in patients treated with trifractionated stereotactic radiotherapy (3×7.7Gy prescribed to the 70% isodose line) for resected brain metastases. Patients with previous whole-brain irradiation were excluded of the analysis...
May 24, 2017: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/28547593/radiotherapy-for-cranial-and-brain-metastases-from-prostate-cancer-a-systematic-review
#14
Timothy L Sita, Katarina G Petras, Q Eileen Wafford, Mark A Berendsen, Tim J Kruser
Intracranial metastasis from prostate cancer is rare. As treatment of castration-resistant prostate cancer improves, the incidence of men with intracranial metastasis from prostate cancer is increasing. Radiation therapy for treatment of intracranial metastasis from prostate cancer is systematically reviewed. A comprehensive review examining peer-reviewed, English language articles from 1990 to 2015 was performed on multiple databases, yielding 1274 articles. These articles were reviewed and selected for studies that met the following inclusion criteria: (1) patients with intracranial metastases from prostate cancer; (2) patients underwent radiation therapy as primary or adjuvant therapy; (3) the sample size of patients was larger than 2...
May 25, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28547589/stereotactic-radiosurgery-for-brain-metastases-from-primary-head-and-neck-carcinomas-a-retrospective-analysis
#15
Rajal A Patel, Jonathan B Bell, Thomas Kim, Mark Agulnik, James P Chandler, Bharat B Mittal, Tim J Kruser
Patients with head and neck malignancies commonly develop metastatic disease, yet rarely do these carcinomas metastasize to the brain. Stereotactic radiosurgery (SRS) is routinely employed to treat brain metastases (BM). This study was undertaken to examine the efficacy of SRS for BM from primary head and neck carcinomas. From 2000 to 2016, a total of 19 patients with 38 lesions were retrospectively identified. All patients presented with a primary head and neck malignancy and subsequently developed metastatic disease to the brain treated with SRS at our institution...
May 25, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28545957/irradiation-in-a-flash-unique-sparing-of-memory-in-mice-after-whole-brain-irradiation-with-dose-rates-above-100gy-s
#16
Pierre Montay-Gruel, Kristoffer Petersson, Maud Jaccard, Gaël Boivin, Jean-François Germond, Benoit Petit, Raphaël Doenlen, Vincent Favaudon, François Bochud, Claude Bailat, Jean Bourhis, Marie-Catherine Vozenin
This study shows for the first time that normal brain tissue toxicities after WBI can be reduced with increased dose rate. Spatial memory is preserved after WBI with mean dose rates above 100Gy/s, whereas 10Gy WBI at a conventional radiotherapy dose rate (0.1Gy/s) totally impairs spatial memory.
May 22, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28540256/concurrent-afatinib-and-whole-brain-radiotherapy-in-exon-19-del-egfr-mutant-lung-adenocarcinoma-a-case-report-and-mini-review-of-the-literature
#17
Chukwuka Eze, Nina-Sophie Hegemann, Olarn Roengvoraphoj, Maurice Dantes, Farkhad Manapov
Leptomeningeal metastases (LM) are found in approximately 3.8% of non-small cell lung cancer cases with an increased incidence in adenocarcinoma, and approximately one-third of patients will present with concomitant brain metastases. We report the case of a 50-year-old male patient with stage IV exon 19-del-EGFR mutant lung adenocarcinoma who progressed on second-generation TKI therapy with manifestation of symptomatic simultaneous diffuse brain and LM. Whole-brain radiotherapy with concurrent afatinib resulted in an almost complete regression of neurological symptoms as well as good, durable radiological response...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28538229/treatment-outcome-in-patients-with-primary-central-nervous-system-germ-cell-tumour-clinical-experience-from-a-regional-cancer-centre-in-north-india
#18
Ahitagni Biswas, Pramod Kumar Julka, Sameer Bakhshi, Manmohan Singh, Goura Kishor Rath
BACKGROUND: Primary intracranial germ cell tumour is a rare entity and constitutes 2-3% of all paediatric brain tumours in Western countries. We herein intend to report the clinical features and treatment outcome of patients with primary central nervous system germ cell tumour treated at our institute. METHODS: Clinical data were collected by retrospective chart review from 2006 to 2012. Histopathology slides were reviewed and relevant immunohistochemistry stains were done...
May 25, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28524161/efficacy-of-anti-pd-1-therapy-in-patients-with-melanoma-brain-metastases
#19
Sagun Parakh, John J Park, Shehara Mendis, Rajat Rai, Wen Xu, Serigne Lo, Martin Drummond, Catherine Rowe, Annie Wong, Grant McArthur, Andrew Haydon, Miles C Andrews, Jonathan Cebon, Alex Guminski, Richard F Kefford, Georgina V Long, Alexander M Menzies, Oliver Klein, Matteo S Carlino
BACKGROUND: There is limited data on the efficacy of anti-programmed death 1 (PD-1) antibodies in patients (pts) with melanoma brain metastasis (BM), particularly those which are symptomatic. METHOD: We retrospectively assessed pts with melanoma BM treated with PD-1 antibodies, nivolumab and pembrolizumab. Clinicopathologic and treatment parameters were collected and outcomes determined for intracranial (IC) response rate (RR) using a modified RECIST criteria, with up to five IC target lesions used to determine IC response, disease control rate (DCR) and progression-free survival (PFS)...
June 6, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28520828/targeted-therapy-as-an-alternative-to-whole-brain-radiotherapy-in-egfr-mutant-or-alk-positive-non-small-cell-lung-cancer-with-brain-metastases
#20
Pablo Martínez, Raymond H Mak, Geoffrey R Oxnard
Clinical Question: Is up-front whole-brain radiotherapy required to treat multiple brain metastases from non-small-cell lung cancer when highly active targeted therapies are available? Clinical Application: Patients with EGFR-mutant or ALK-positive non-small-cell lung cancer with brain metastases now have the potential to achieve a prolonged survival. Through use of highly active targeted therapies, whole-brain radiotherapy can be safely postponed, diminishing toxic effects that could impair quality of life...
May 18, 2017: JAMA Oncology
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