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OBJECTIVERecurrent meningiomas are primarily managed with radiation therapy or repeat resection. Surgical morbidity after reoperation for recurrent meningiomas is poorly understood. Thus, the objective of this study was to report surgical outcomes after reoperation for recurrent non-skull base meningiomas.METHODSA retrospective review of patients was performed. Inclusion criteria were patients with recurrent meningioma who had prior resection and supratentorial non-skull base location. Univariate and multivariate logistic regression and recursive partitioning analysis were used to identify risk factors for surgical complications...
November 1, 2018: Journal of Neurosurgery
Paul Lesueur, Valentin Calugaru, Catherine Nauraye, Dinu Stefan, Kim Cao, Evelyne Emery, Yves Reznik, Jean Louis Habrand, Thomas Tessonnier, Abdulhamid Chaikh, Jacques Balosso, Juliette Thariat
INTRODUCTION: The depth-dose distribution of a proton beam, materialized by the Bragg peak makes it an attractive radiation modality as it reduces exposure of healthy tissues to radiations, compared with photon therapy Prominent indications, based on a long-standing experience are: intraocular melanomas, low-grade skull-base and spinal canal malignancies. However, many others potential indications are under investigations such as the benign morbid conditions that are compatible with an extended life-expectancy: low grade meningiomas, paragangliomas, pituitary adenomas, neurinomas craniopharyngioma or recurrent pleomorphic adenomas...
December 1, 2018: Cancer Treatment Reviews
Egle Cekanaviciute, Susanna Rosi, Sylvain V Costes
In preparation for lunar and Mars missions it is essential to consider the challenges to human health that are posed by long-duration deep space habitation via multiple stressors, including ionizing radiation, gravitational changes during flight and in orbit, other aspects of the space environment such as high level of carbon dioxide, and psychological stress from confined environment and social isolation. It remains unclear how these stressors individually or in combination impact the central nervous system (CNS), presenting potential obstacles for astronauts engaged in deep space travel...
November 20, 2018: International Journal of Molecular Sciences
Christina K Cramer, Neil McKee, L Doug Case, Michael D Chan, Tiffany L Cummings, Glenn J Lesser, Edward G Shaw, Stephen R Rapp
INTRODUCTION: There is no accepted classification of cognitive impairment in cancer survivors. We assess the extent of mild cognitive impairment (MCI) syndrome in brain tumor survivors using criteria adapted from the National Institute on Aging and the Alzheimer's Association (NIA-AA). METHODS: We retrospectively reviewed the cognitive data of brain tumor survivors post-radiation therapy (RT) enrolled from 2008 to 2011 in a randomized trial of donepezil versus placebo for cognitive impairment...
November 7, 2018: Journal of Neuro-oncology
Wietske C M Schimmel, Karin Gehring, Daniëlle B P Eekers, Patrick E J Hanssens, Margriet M Sitskoorn
Purpose: Stereotactic radiation surgery (SRS) is increasingly applied in patients with brain metastases (BM) and is expected to have fewer adverse effects on cognitive functioning than whole brain radiation therapy (WBRT). Patients with BM are often confronted with a relatively short life expectancy, and the prevention or delay of cognitive decline to maintain quality of life is a clinically and highly relevant treatment goal. This review systematically and specifically evaluates the current literature on the cognitive effects of SRS in patients with BM...
October 2018: Advances in Radiation Oncology
Tyler P Robin, Chad G Rusthoven
Brain metastases are common to the natural history of many advanced malignancies. Historically, whole brain radiation therapy (WBRT) has played a key role in the management of brain metastases, especially for patients with multiple lesions. However, prospective trials have demonstrated consistent neurocognitive toxicities after WBRT, and various pharmacologic and anatomic strategies designed to mitigate these toxicities have been studied in recent years. Memantine, an NMDA receptor antagonist, taken during and after WBRT improved cognitive preservation in a randomized trial over placebo...
2018: Frontiers in Oncology
Moira O'Connor, Georgia Kb Halkett
OBJECTIVE: Radiation therapy (RT) is a cornerstone for management of pediatric cancer. For younger patients, unintended radiation to critical organs is a concern and children need to remain immobile. Distress in children is common so many centres sedate pediatric patients. Children often are unable to remain still, due to anxiety. Interventions to reduce distress could also reduce sedation rates. The objectives of this systematic review were to: review the interventions used to address pediatric RT patients' distress and anxiety and assess their effectiveness...
September 29, 2018: Patient Education and Counseling
Ron J Leavitt, Charles L Limoli, Janet E Baulch
PURPOSE: This review compiles what is known about extracellular vesicles (EVs), their bioactive cargo, and how they might be used to treat radiation-induced brain injury. Radiotherapy (RT) is effective in cancer treatment, but can cause substantial damage to normal central nervous system tissue. Stem cell therapy has been shown to be effective in treating cognitive dysfunction arising from RT, but there remain safety concerns when grafting foreign stem cells into the brain (i.e. immunogenicity, teratoma)...
September 25, 2018: International Journal of Radiation Biology
Leslie Chang, Lauren S Weiner, Sheri J Hartman, Steve Horvath, Dilip Jeste, Paul S Mischel, Deborah M Kado
Breast cancer is the most common cancer of women in the United States. It is also proving to be one of the most treatable. Early detection, surgical intervention, therapeutic radiation, cytotoxic chemotherapies and molecularly targeted agents are transforming the lives of patients with breast cancer, markedly improving their survival. Although current breast cancer treatments are largely successful in producing cancer remission and extending lifespan, there is concern that these treatments may have long lasting detrimental effects on cancer survivors, in part, through their impact on non-tumor cells...
August 2, 2018: Journal of Geriatric Oncology
Julian Jacob, Thomas Durand, Loïc Feuvret, Jean-Jacques Mazeron, Jean-Yves Delattre, Khê Hoang-Xuan, Dimitri Psimaras, Hassen Douzane, Monica Ribeiro, Laurent Capelle, Alexandre Carpentier, Damien Ricard, Philippe Maingon
Life expectancy of patients treated for brain tumors has lengthened due to the therapeutic improvements. Cognitive impairment has been described following brain radiotherapy, but the mechanisms leading to this adverse event remain mostly unknown. Technical evolutions aim at enhancing the therapeutic ratio. Sparing of the healthy tissues has been improved using various approaches; however, few dose constraints have been established regarding brain structures associated with cognitive functions. The aims of this literature review are to report the main brain areas involved in cognitive adverse effects induced by radiotherapy as described in literature, to better understand brain radiosensitivity and to describe potential future improvements...
August 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Caroline Chung, Andrew Bryant, Paul D Brown
BACKGROUND: Brain radionecrosis (tissue death caused by radiation) can occur following high-dose radiotherapy to brain tissue and can have a significant impact on a person's quality of life (QoL) and function. The underlying pathophysiological mechanism remains unclear for this condition, which makes establishing effective treatments challenging. OBJECTIVES: To assess the effectiveness of interventions used for the treatment of brain radionecrosis in adults over 18 years old...
July 9, 2018: Cochrane Database of Systematic Reviews
Roberta Rudà, Francesco Bruno, Riccardo Soffietti
PURPOSE OF REVIEW: The management of low-grade gliomas (grade II WHO) is still controversial, due to the rarity of these tumors and continuous advances in molecular diagnosis and new technologies for treatment. This article reviews the current understanding of management of grade II gliomas in light of the recent clinical and translational studies. RECENT FINDINGS: The role of an extensive surgery at onset is now fully recognized. Recent clinical trials in the USA and Europe have demonstrated the importance of chemotherapy either in association with radiotherapy or as initial treatment to delay the risk of cognitive defects following radiation...
July 4, 2018: Current Treatment Options in Neurology
Michael Grunert, Rebecca Kassubek, Burkhardt Danz, Burkhard Klemenz, Sebastian Hasslacher, Sebastien Stroh, Lukas Schneele, Julia Langhans, Stephanie Ströbele, Sara E Barry, Shaoxia Zhou, Klaus-Michael Debatin, Mike-Andrew Westhoff
The use of radiation is an essential part of both modern cancer diagnostic assessment and treatment. Next-generation imaging devices create 3D visualizations, allowing for better diagnoses and improved planning of precision treatment. This is particularly important for primary brain cancers such as diffuse intrinsic pontine glioma or the most common primary brain tumor, glioblastoma, because radiotherapy is often the only treatment modality that offers a significant improvement in survival and quality of life...
2018: Critical Reviews in Oncogenesis
Jessica C Santos, Leah M Pyter
Behavioral comorbidities (depression, anxiety, fatigue, cognitive disturbances, and neuropathic pain) are prevalent in cancer patients and survivors. These mental and neurological health issues reduce quality-of-life, which is a significant societal concern given the increasing rates of long-term survival after various cancers. Hypothesized causes of behavioral comorbidities with cancer include tumor biology, stress associated with the cancer experience, and cancer treatments. A relatively recent leading mechanism by which these causes contribute to changes in neurobiology that underlie behavior is inflammation...
2018: Frontiers in Immunology
Yohtaro Sakakibara, Yoshio Taguchi, Homare Nakamura, Hidetaka Onodera, Daisuke Wakui, Tetsuya Ikeda, Yoshio Aida
OBJECTIVES: Primary meningiomas arising outside the intracranial component are rather rare and have been termed primary extradural meningiomas(PEMs). We present a case of an intraosseous-type PEM occurring at a high convexity location and discuss the clinical characteristics of PEMs. CASE: An 80-year-old woman presented with a soft and painless subcutaneous mass of approximately 10 cm in diameter in the right parietal region, which had appeared 1 year previously...
June 2018: No Shinkei Geka. Neurological Surgery
Feng Ru Tang, Konstantin Loganovsky
The extensive literature review on human epidemiological studies suggests that low dose ionizing radiation (LDIR) (≤100 mSv) or low dose rate ionizing radiation (LDRIR) (<6mSv/H) exposure could induce either negative or positive health effects. These changes may depend on genetic background, age (prenatal day for embryo), sex, nature of radiation exposure, i.e., acute or chronic irradiation, radiation sources (such as atomic bomb attack, fallout from nuclear weapon test, nuclear power plant accidents, 60 Co-contaminated building, space radiation, high background radiation, medical examinations or procedures) and radionuclide components and human epidemiological experimental designs...
December 2018: Journal of Environmental Radioactivity
David A Woodrum, Krzysztof R Gorny, Lance A Mynderse
Prostate cancer is the most commonly diagnosed noncutaneous cancer and second leading cause of death in men. Many patients with clinically organ-confined prostate cancer undergo definitive treatment of the whole gland, including radical prostatectomy, radiation therapy, and cryosurgery. Active surveillance is a growing alternative option for patients with documented low-volume and low-grade prostate cancer. However, many patients are wanting a less morbid focal treatment alternative. With recent advances in software and hardware of magnetic resonance imaging (MRI), multiparametric MRI of the prostate has been shown to improve the accuracy in detecting and characterizing clinically significant prostate cancer...
June 2018: Topics in Magnetic Resonance Imaging: TMRI
Mingmei Li, Karen Caeyenberghs
In addition to the burden of a life-threatening diagnosis, cancer patients are struggling with adverse side-effects from cancer treatment. Chemotherapy has been linked to an array of cognitive impairments and alterations in brain structure and function ("chemobrain"). In this review, we summarized the existing evidence that evaluate the changes in cognitive functioning and brain with chemotherapy, as assessed using structural and functional MRI-based techniques in a longitudinal design. This review followed the latest PRISMA guidelines using Embase, Medline, PsychINFO, Scopus, and Web of Science databases with date restrictions from 2012 to 2017...
September 2018: Neuroscience and Biobehavioral Reviews
Euripedes C Miguel, Antonio C Lopes, Nicole C R McLaughlin, Georg Norén, André F Gentil, Clement Hamani, Roseli G Shavitt, Marcelo C Batistuzzo, Edoardo F Q Vattimo, Miguel Canteras, Antonio De Salles, Alessandra Gorgulho, João Victor Salvajoli, Erich Talamoni Fonoff, Ian Paddick, Marcelo Q Hoexter, Christer Lindquist, Suzanne N Haber, Benjamin D Greenberg, Sameer A Sheth
For more than half a century, stereotactic neurosurgical procedures have been available to treat patients with severe, debilitating symptoms of obsessive-compulsive disorder (OCD) that have proven refractory to extensive, appropriate pharmacological, and psychological treatment. Although reliable predictors of outcome remain elusive, the establishment of narrower selection criteria for neurosurgical candidacy, together with a better understanding of the functional neuroanatomy implicated in OCD, has resulted in improved clinical efficacy for an array of ablative and non-ablative intervention techniques targeting the cingulum, internal capsule, and other limbic regions...
May 9, 2018: Molecular Psychiatry
E Doger de Spéville, V Kieffer, C Dufour, J Grill, M Noulhiane, L Hertz-Pannier, M Chevignard
BACKGROUND: Children who have been treated for a medulloblastoma often suffer long-term cognitive impairments that often negatively affect their academic performance and quality of life. In this article, we will review the neuropsychological consequences of childhood medulloblastoma and discuss the risk factors known to influence the presence and severity of these cognitive impairments and possible interventions to improve their quality of life. METHODS: This narrative review was based on electronic searches of PubMed to identify all relevant studies...
April 28, 2018: Neuro-Chirurgie
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