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Brain radiation

Isabella Zhang, Silvia C Formenti, Jonathan P S Knisely
The brain has long been considered an immunologically privileged site, and the role of immunotherapy in treating intracranial disease has only recently been revived-with preclinical evidence showing that the systemic immune system responds to immunotherapy for intracranial disease, and with clinical evidence demonstrating improved locoregional control and survival compared with historical outcomes when immune-directed therapies are combined with radiation. Pharmaceutical industry-supported multi-institutional drug efficacy studies routinely exclude patients with brain metastases, so current evidence for treatment of brain metastases using stereotactic radiosurgery combined with immunotherapy comes from single-institution studies...
March 15, 2018: Oncology (Williston Park, NY)
Nancy Wang, Matthias Osswald
The majority of meningiomas, the most common primary brain tumor, are considered to be benign, and characteristic magnetic resonance imaging features allow a preliminary diagnosis. Meningiomas can be classified in the World Health Organization system as grade I, II, or III, depending on various histological features. In many cases, observation is the preferred management option, although this means the absence of a histological diagnosis. If necessary, standard therapy consists of surgery with or without adjuvant radiation, depending on the tumor grade and the degree of resection...
February 2018: Seminars in Neurology
Sarah Löw, Tracy T Batchelor
Primary central nervous system lymphoma (PCNSL) is an extranodal non-Hodgkin lymphoma limited to the brain, spinal cord, leptomeninges, and eyes. The majority of patients are immunocompetent, with a median age of 65 years at diagnosis. Historically, whole-brain radiation therapy (WBRT) was the first and sole treatment for PCNSL. Today, due to the recognized neurotoxicity of WBRT, this modality is usually avoided in the treatment. Most chemotherapy regimens are based on high-dose methotrexate plus the anti-CD20 monoclonal antibody rituximab, leading to high response rates, but 5-year survival is still poor at approximately 30% compared with other extranodal lymphomas...
February 2018: Seminars in Neurology
Martha Nowosielski, Patrick Y Wen
The identification of more effective therapies for brain tumors has been limited in part by the lack of reliable criteria for determining response and progression. Since its introduction in 1990, the MacDonald criteria have been used in neuro-oncology clinical trials to determine response, but they fail to address issues such as pseudoprogression, pseudoresponse, and nonenhancing tumor progression that have arisen with more recent therapies. The Response Assessment in Neuro-Oncology (RANO) working group, a multidisciplinary international group consisting of neuro-oncologists, medical oncologists, neuroradiologists, neurosurgeons, radiation oncologists, and neuropsychologists, was formed to improve response assessment and clinical trial endpoints in neuro-oncology...
February 2018: Seminars in Neurology
Elizabeth G Mosher, John A Butman, Les R Folio, Nadia M Biassou, Choonsik Lee
OBJECTIVE: Radiation exposure of the lens during neck CT may increase a patient's risk of developing cataracts. Radiologists at the National Institutes of Health worked with technicians to modify the neck CT scanning procedure to include a reduction in the scanning range, a reduction in the tube potential (kilovoltage), and a change in neck positioning using a head tilt. We objectively quantified the organ dose changes after this procedure modification using a computer simulation. MATERIALS AND METHODS: We retrospectively analyzed CT images of 40 patients (20 men and 20 women) scanned before and after the procedure change...
March 16, 2018: AJR. American Journal of Roentgenology
Brent D Weinberg, Lauren Boreta, Steve Braunstein, Soonmee Cha
Glioblastomas are aggressive brain tumors that frequently recur in the subventricular zone (SVZ) despite maximal treatment. The purpose of this study was to evaluate imaging patterns of subventricular progression and impact of recurrent subventricular tumor involvement and radiation dose to patient outcome. Retrospective review of 50 patients diagnosed with glioblastoma and treated with surgery, radiation, and concurrent temozolomide from January 2012 to June 2013 was performed. Tumors were classified based on location, size, and cortical and subventricular zone involvement...
March 15, 2018: Journal of Neuro-oncology
Andrzej T Slominski, Michal A Zmijewski, Przemyslaw M Plonka, Jerzy P Szaflarski, Ralf Paus
The skin, a self-regulating protective barrier organ, is empowered with sensory and computing capabilities to counteract the environmental stressors to maintain/restore disrupted cutaneous homeostasis. These complex functions are coordinated by a cutaneous neuro-endocrine system that also communicates in a bidirectional fashion with the central nervous, endocrine and immune systems, all acting in concert to control body homeostasis. While ultraviolet energy (UV) has played an important role in the origin and evolution of life, UV absorption by the skin not only triggers mechanisms that defend skin integrity and regulate global homeostasis, but also induces skin pathology (e...
March 12, 2018: Endocrinology
Melissa L Kirkwood, Gary M Arbique, Jeffrey B Guild, Katie Zeng, Yin Xi, John Rectenwald, Jon A Anderson, Carlos Timaran
OBJECTIVE: Radiation to the interventionalist's brain during fluoroscopically guided interventions (FGIs) may increase the incidence of cerebral neoplasms. Lead equivalent surgical caps claim to reduce radiation brain doses by 50% to 95%. We sought to determine the efficacy of the RADPAD (Worldwide Innovations & Technologies, Lenexa, Kan) No Brainer surgical cap (0.06 mm lead equivalent at 90 kVp) in reducing radiation dose to the surgeon's and trainee's head during FGIs and to a phantom to determine relative brain dose reductions...
March 12, 2018: Journal of Vascular Surgery
Krzysztof Slosarek, Barbara Bekman, Jacek Wendykier, Aleksandra Grządziel, Antonella Fogliata, Luca Cozzi
BACKGROUND: To appraise the dosimetric features and the quality of the treatment plan for radiosurgery of multiple brain metastases optimized with a novel automated engine and to compare with plans optimized for robotic-based delivery. METHODS: A set of 15 patients with multiple brain metastases was selected for this in silico study. The technique under investigation is the recently introduced HyperArc. For all patients, three treatment plans were computed and compared: i: a HyperArc; ii: a standard VMAT; iii) a CyberKnife...
March 15, 2018: Radiation Oncology
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
Altaf Ali Laghari, Syed Ijlal Ahmed, Adnan Jabbar, Muhammad Shahzad Shamim
Primary CNS lymphoma (PCNSL) is a rare and aggressive brain tumour that is uniformly fatal. The rarity of the disease and the poor response to treatment makes it difficult to reach a consensus with regards to treatment options. In this review, the authors have discussed different treatment modalities used in the management of PCNSL including chemotherapy, surgery and radiation, as well as the results of recent clinical trials on treatment options for PCNSL.
March 2018: JPMA. the Journal of the Pakistan Medical Association
Vipan K Parihar, Mattia Maroso, Amber Syage, Barrett D Allen, Maria C Angulo, Ivan Soltesz, Charles L Limoli
Of the many perils associated with deep space travel to Mars, neurocognitive complications associated with cosmic radiation exposure are of particular concern. Despite these realizations, whether and how realistic doses of cosmic radiation cause cognitive deficits and neuronal circuitry alterations several months after exposure remains unclear. In addition, even less is known about the temporal progression of cosmic radiation-induced changes transpiring over the duration of a time period commensurate with a flight to Mars...
March 11, 2018: Experimental Neurology
Yingxuan Chen, Fang-Fang Yin, Yawei Zhang, You Zhang, Lei Ren
Compressed sensing reconstruction using total variation (TV) tends to over-smooth the edge information by uniformly penalizing the image gradient. The goal of this study is to develop a novel prior contour based TV (PCTV) method to enhance the edge information in compressed sensing reconstruction for CBCT. 
 Methods: The edge information is extracted from prior planning-CT via edge detection. Prior CT is first registered with on-board CBCT reconstructed with TV method through rigid or deformable registration...
March 14, 2018: Physics in Medicine and Biology
Kenneth A Schwartz, Mary Noel, Michele Nikolai, Howard T Chang
Survival of glioblastoma multiforme (GBM) with the current recommended treatment is poor. Reported median survivals are approximately 8-15 months. Based on recent publications from animal models, combining cancer drugs, radiation, and diet-metabolic treatments may be a new route to better survivals. To investigate this possibility, we have begun a clinical trial that has enrolled 15 subjects using a ketogenic diet (KD) as an addition to current standard treatments that include surgery, radiation therapy, and chemotherapy...
2018: Frontiers in Nutrition
Sahaja Acharya, Clifford G Robinson, Jeff M Michalski, Dan Mullen, Todd A DeWees, Jian L Campian, Anupama Chundury, Beth Bottani, Dennis E Hallahan, Jeffrey D Bradley, Jiayi Huang
PURPOSE: To analyze the incidence of and risk factors for clinically significant radiation necrosis (cRN) in adult cranial oligodendrogliomas and astrocytomas treated with proton or photon therapy. METHODS AND MATERIALS: Between 2007 and 2015, 160 patients with grade 2 or 3 oligodendrogliomas (with 1p/19q codeletion, n = 53) or astrocytomas (without 1p/19q codeletion, n = 107) were treated with proton (n = 37) or photon (n = 123) therapy. Clinically significant radiation necrosis (RN) was defined as symptomatic RN or asymptomatic RN that resulted in surgery or bevacizumab administration...
February 9, 2018: International Journal of Radiation Oncology, Biology, Physics
João Ferreira, Ana Franco, Tiago Teodoro, Miguel Coelho, Luísa Albuquerque
Vernet syndrome is a unilateral palsy of glossopharyngeal, vagus, and accessory nerves. Varicella zoster virus (VZV) infection has rarely been described as a possible cause. A 76-year-old man presented with 1-week-long symptoms of dysphonia, dysphagia, and weakness of the right shoulder elevation, accompanied by a mild right temporal parietal headache with radiation to the ipsilateral ear. Physical examination showed signs compatible with a right XI, X, and XI cranial nerves involvement and also several vesicular lesions in the right ear's concha...
March 12, 2018: Journal of Neurovirology
Joshua T Prickett, Brendan J Klein, Christopher M Busch, Joshua A Cuoco, Lisa S Apfel, Eric A Marvin
Intraventricular meningiomas are uncommon intracranial tumors and infrequently present with hemorrhage. With only 10 reported cases in the literature, it is exceedingly rare for meningiomas of the ventricular system to present with hemorrhage. To our knowledge, this is the first report of a patient presenting with an acute intraventricular hemorrhage in relation to a ventricular meningioma suspected to be radiation induced. In addition, we review the current literature on hemorrhagic intraventricular meningiomas and review the natural history of radiation-induced meningiomas...
January 2018: Journal of Neurological Surgery Reports
Sanuji Gajamange, David Raffelt, Thijs Dhollander, Elaine Lui, Anneke van der Walt, Trevor Kilpatrick, Joanne Fielding, Alan Connelly, Scott Kolbe
Long term irreversible disability in multiple sclerosis (MS) is thought to be primarily driven by axonal degeneration. Axonal degeneration leads to degenerative atrophy, therefore early markers of axonal degeneration are required to predict clinical disability and treatment efficacy. Given that additional pathologies such as inflammation, demyelination and oedema are also present in MS, it is essential to develop axonal markers that are not confounded by these processes. The present study investigated a novel method for measuring axonal degeneration in MS based on high angular resolution diffusion magnetic resonance imaging...
2018: NeuroImage: Clinical
Cheima Bouziane, Matthan W A Caan, Hyke G H Tamminga, Anouk Schrantee, Marco A Bottelier, Michiel B de Ruiter, Sandra J J Kooij, Liesbeth Reneman
Several diffusion tensor imaging (DTI) studies in attention deficit hyperactivity disorder (ADHD) have shown a delay in brain white matter (WM) development. Because these studies were mainly conducted in children and adolescents, these WM abnormalities have been assumed, but not proven to progress into adulthood. To provide further insight in the natural history of WM maturation delay in ADHD, we here investigated the modulating effect of age on WM in children and adults. 120 stimulant-treatment naive male ADHD children (10-12 years of age) and adults (23-40 years of age) with ADHD (according to DSM-IV; all subtypes) were included, along with 23 age and gender matched controls...
2018: NeuroImage: Clinical
Satoshi Ichikawa, Noriko Fukuhara, Shunsuke Hatta, Masahito Himuro, Hiroki Katsushima, Kentaro Nasu, Koya Ono, Kyoko Inokura, Masahiro Kobayashi, Yasushi Onishi, Hiroshi Fujii, Kenichi Ishizawa, Ryo Ichinohasama, Hideo Harigae
A 16-year-old boy, who had been initially examined for bilateral blepharedema and slight eruption, presented with rapidly deteriorating symptoms in associating with headache and consciousness disturbance. He was diagnosed to have primary cutaneous CD8-positive aggressive epidermotropic cytotoxic T-cell lymphoma (PCAE-CTL) by a biopsy of the skin and brain. After whole-brain radiation and some courses of chemotherapy, cord blood transplantation was performed with myeloablative conditioning. After transplantation, the cerebral dysfunction gradually improved...
March 9, 2018: Internal Medicine
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