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https://www.readbyqxmd.com/read/28812301/changing-treatment-paradigms-for-brain-metastases-from-melanoma-part-1-diagnosis-prognosis-symptom-control-and-local-treatment
#1
REVIEW
Vyshak Alva Venur, Pauline Funchain, Rupesh Kotecha, Samuel T Chao, Manmeet S Ahluwalia
Melanoma is the third most common cause of brain metastases, after lung and breast cancer. The management of melanoma brain metastases can be broadly divided into symptom control and therapeutic strategies. Supportive treatments include corticosteroids to reduce peritumoral edema, antiepileptics for seizure control, and medications to preserve cognitive function. Until recently, therapeutic strategies consisted primarily of local treatments, including surgery, whole-brain radiation therapy (WBRT), and stereotactic radiosurgery (SRS)...
August 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/28795286/diagnostic-and-therapeutic-strategies-for-patients-with-malignant-epidural-spinal-cord-compression
#2
REVIEW
Dilan A Patel, Jian L Campian
Malignant epidural spinal cord compression (MESCC) is an oncologic emergency with the potential for devastating consequences for patients if not promptly diagnosed and treated. MESCC is diagnosed by imaging. MRI is by far the most sensitive test, preferably with gadolinium. Once the diagnosis of MESCC is suspected, patients with neurologic deficits should receive prompt administration of dexamethasone with a 10-mg IV loading dose followed by 4 mg every 6 h. Quick taper is recommended once the definitive treatment is established...
August 10, 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28791250/immunotherapy-combined-with-large-fractions-of-radiotherapy-stereotactic-radiosurgery-for-brain-metastases-implications-for-intraoperative-radiotherapy-after-resection
#3
REVIEW
Carsten Herskind, Frederik Wenz, Frank A Giordano
Brain metastases (BM) affect approximately a third of all cancer patients with systemic disease. Treatment options include surgery, whole-brain radiotherapy, or stereotactic radiosurgery (SRS) while chemotherapy has only limited activity. In cases where patients undergo resection before irradiation, intraoperative radiotherapy (IORT) to the tumor bed may be an alternative modality, which would eliminate the repopulation of residual tumor cells between surgery and postoperative radiotherapy. Accumulating evidence has shown that high single doses of ionizing radiation can be highly efficient in eliciting a broad spectrum of local, regional, and systemic tumor-directed immune reactions...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28777037/applications-of-a-robotic-stereotactic-arm-for-pediatric-epilepsy-and-neurooncology-surgery
#4
Brandon A Miller, Afshin Salehi, David D Limbrick, Matthew D Smyth
OBJECTIVE The ROSA device is a robotic stereotactic arm that uses a laser system to register the patient's head or spine with MR or CT images. In this study, the authors analyze their experience with this system in pediatric neurosurgical applications and present selected cases that exemplify the usefulness of this system. METHODS The authors reviewed all cases that utilized the ROSA system at their institution. Patient demographics, pathology, complications, electrode placement, laser ablation, and biopsy accuracy were analyzed...
August 4, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28775236/patient-derived-dipg-cells-preserve-stem-like-characteristics-and-generate-orthotopic-tumors
#5
Cheng Xu, Xiaoqing Liu, Yibo Geng, Qingran Bai, Changcun Pan, Yu Sun, Xin Chen, Hai Yu, Yuliang Wu, Peng Zhang, Wenhao Wu, Yu Wang, Zhen Wu, Juntin Zhang, Zhaohui Wang, Rui Yang, Jenna Lewis, Darell Bigner, Fangping Zhao, Yiping He, Hai Yan, Qin Shen, Liwei Zhang
Diffuse intrinsic pontine glioma (DIPG) is a devastating brain tumor, with a median survival of less than one year. Due to enormous difficulties in the acquisition of DIPG specimens and the sophisticated technique required to perform brainstem orthotopic injection, only a handful of DIPG pre-clinical models are available. In this study, we successfully established eight patient-derived DIPG cell lines, mostly derived from treatment-naïve surgery or biopsy specimens. These patient-derived cell lines can be stably passaged in serum-free neural stem cell media and displayed distinct morphologies, growth rates and chromosome abnormalities...
July 28, 2017: Oncotarget
https://www.readbyqxmd.com/read/28774708/epileptologist-s-view-laser-interstitial-thermal-ablation-for-treatment-of-temporal-lobe-epilepsy
#6
Joon Y Kang, Michael R Sperling
A procedure called laser interstitial thermal ablation has been utilized to treat drug resistant epilepsy. With this technique, a probe is stereotactically inserted into a target structure responsible for seizures, such as mesial temporal lobe, hypothalamic hamartoma, or a small malformation of cortical development, and the tip is then heated by application of laser energy to ablate structures adjacent to the probe tip. This procedure has the advantage of selectively targeting small lesions responsible for seizures, and is far less invasive than open surgery with shorter hospitalization, less pain, and rapid return to normal activities...
July 25, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28770553/perioperative-technical-complications-in-deep-brain-stimulation-surgeries
#7
Onur Alptekin, Ersoy Kocabicak, Felix S Gubler, Linda Ackermans, Pieter L Kubben, Yasin Temel
AIM: Deep brain stimulation (DBS) surgeries are multi-faceted and the various steps are interconnected. Since its first implementation, the method of DBS surgery has undergone changes. We have encountered several expected and also non-expected perioperative technical complications in the past seventeen years. Here, we describe the stereotactic frame, stereotactic localizer and planning station related complications and how we have managed them as much as possible. MATERIAL AND METHODS: This study is a retrospective qualitative analysis of the documented technical events encountered during DBS surgeries from 1999 onwards...
June 14, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28768920/neuronavigation-guided-frameless-stereoelectroencephalography-seeg
#8
Ayataka Fujimoto, Tohru Okanishi, Sotaro Kanai, Keishiro Sato, Mitsuyo Nishimura, Hideo Enoki
Stereoelectroencephalography (SEEG) is an invasive surgical procedure used to identify epileptogenic zones. The combination of both subdural grids and depth electrodes (DEs) is currently used for invasive intracranial monitoring in many epilepsy centers. To perform DE implantation, some centers use frame-based stereotactic techniques and others use stereotactic robotic techniques. However, not all epilepsy centers have access to these tools. We hypothesized that DE implantation using a neuronavigation system can be utilized for subsequent epilepsy surgery...
August 1, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28760464/low-accuracy-of-computed-tomography-and-positron-emission-tomography-to-detect-lung-and-lymph-node-metastases-of-colorectal-cancer
#9
Francesco Guerrera, Stéphane Renaud, Mickaël Schaeffer, Victor Nigra, Paolo Solidoro, Nicola Santelmo, Pier Luigi Filosso, Pierre-Emmanuel Falcoz, Enrico Ruffini, Alberto Oliaro, Gilbert Massard
BACKGROUND: Minimally invasive surgery, stereotactic radiotherapy, and radiofrequency ablation are commonly proposed in the case of pulmonary colorectal-metastasis as alternatives to conventional open surgery. Preoperative imaging assessment by computed tomography (CT) scan and fluorodeoxyglucose positron emission tomography (FDG-PET) are critical to guide oncologic radical treatment. Our aim was to investigate the accuracy of CT and FDG-PET for the evaluation of the number of pulmonary colorectal metastases and thoracic lymph nodal involvement (LNI)...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28758408/radiation-therapy-for-who-grade-i-meningioma
#10
Samuel E Day, Lia M Halasz
Maximal safe resection has long been the cornerstone of treatment for WHO grade I benign meningioma. However, as technology for both imaging and radiation delivery has advanced, radiation therapy has played an increasingly important role in the management of patients with WHO grade I meningioma. Radiation therapy, whether delivered as standard fractionated treatment over several weeks, stereotactic radiosurgery over 1 session, or multisession stereotactic radiation therapy, has been shown to provide excellent local control when used as an adjunct to surgery or as primary treatment...
July 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28754434/improved-method-for-cannula-fixation-for-long-term-intracerebral-brain-infusion
#11
Ádám Sike, Jonas Wengenroth, Jolanta Upīte, Thomas Brüning, Iván Eiriz, Petra Sántha, Henrik Biverstål, Baiba Jansone, Håvard Jostein Haugen, Markus Krohn, Jens Pahnke
BACKGROUND: Implanted osmotic minipumps are commonly used for long-term, brain-targeted delivery of a wide range of experimental agents by being connected to a catheter and a cannula. During the stereotactical surgery procedure, the cannula has to be placed correctly in the x-y directions and also with respect to the injection point in the z-direction (deepness). However, the flat fixation base of available cannula holders doesn't allow an easy, secure fixation onto the curve-shaped skull...
July 25, 2017: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/28741377/renal-cell-carcinoma-alternative-nephron-sparing-treatment-options-for-small-renal-masses-a-systematic-review
#12
Fieke M Prins, Linda G W Kerkmeijer, Anne A Pronk, Evert-Jan P A Vonken, Richard P Meijer, Axel Bex, Maurits M Barendrecht
<i>Background</i> The standard treatment of T1 renal cell carcinoma is (partial-) nephrectomy. For patients where surgery is not the treatment of choice, for example in the elderly, in case of severe comorbidity, inoperability or refusal of surgery, alternative treatment options are available. These treatment options include active surveillance, radiofrequency ablation, cryoablation, microwave ablation or stereotactic body radiotherapy. In the present overview, the efficacy, safety and outcome of these different options are summarized, particularly focusing on recent developments...
July 25, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28740933/18f-fdg-pet-response-and-clinical-outcomes-after-stereotactic-body-radiation-therapy-for-metastatic-melanoma
#13
Ryan S Youland, Ann T Packard, Miran J Blanchard, Andrea L Arnett, Gregory A Wiseman, Lisa A Kottschade, Roxana S Dronca, Svetomir N Markovic, Kenneth R Olivier, Sean S Park
BACKGROUND: Clinical data that support stereotactic body radiation therapy (SBRT) metastatic malignant melanoma (MM) are limited. Furthermore, functional imaging with 18F-fludeoxyglucose positron emission tomography (PET) may offer a more accurate post-SBRT assessment. Therefore, we assessed the clinical outcomes and metabolic response of metastatic MM after SBRT. METHODS AND MATERIALS: Patients with MM who were treated with SBRT and had pre- and post-PET scans (>1) were included in this study...
April 2017: Advances in Radiation Oncology
https://www.readbyqxmd.com/read/28740913/reirradiation-with-stereotactic-body-radiation-therapy-after-prior-conventional-fractionation-radiation-for-locally-recurrent-pancreatic-adenocarcinoma
#14
Amanda J Koong, Diego A S Toesca, Rie von Eyben, Erqi L Pollom, Daniel T Chang
PURPOSE: Locally recurrent pancreatic cancer after prior radiotherapy is a therapeutic challenge with limited treatment options. This study examines the safety and efficacy of stereotactic body radiation therapy (SBRT) for locally recurrent pancreatic adenocarcinoma after prior conventional fractionation radiotherapy (CRT). METHODS AND MATERIALS: Outcomes from all patients treated with SBRT for locally recurrent pancreatic adenocarcinoma after prior CRT at our institution were reviewed...
January 2017: Advances in Radiation Oncology
https://www.readbyqxmd.com/read/28740900/management-approach-for-recurrent-brain-metastases-following-upfront-radiosurgery-may-affect-risk-of-subsequent-radiation-necrosis
#15
Ali Rae, Daniel Gorovets, Paul Rava, Daniel Ebner, Deus Cielo, Timothy J Kinsella, Thomas A DiPetrillo, Jaroslaw T Hepel
PURPOSE: Many patients treated with stereotactic radiosurgery (SRS) alone as initial treatment require 1 or more subsequent salvage therapies. This study aimed to determine if commonly used salvage strategies are associated with differing risks of radiation necrosis (RN). METHODS AND MATERIALS: All patients treated with upfront SRS alone for brain metastases at our institution were retrospectively analyzed. Salvage treatment details were obtained for brain failures...
October 2016: Advances in Radiation Oncology
https://www.readbyqxmd.com/read/28739517/novel-use-of-the-leksell-gamma-frame-for-stereotactic-biopsy-of-posterior-fossa-lesions-technical-note
#16
Shiro Horisawa, Hiroshi Nakano, Takakzu Kawamata, Takaomi Taira
BACKGROUND: Stereotactic transcerebellar biopsies of brainstem tumors have often been reported. The Leksell frame or Cosman-Roberts-Wells frame is often used in transcerebellar approaches. However, to access lesions via the cerebellum, these frames should be secured as inferiorly on the cranium as possible, which can require exaggerated neck flexion and limit the flexible trajectory to the target. To overcome these disadvantages, we have devised a new way to use the Leksell frame for transcerebellar approaches...
July 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28736648/the-utility-of-positron-emission-tomography-computed-tomography-in-target-delineation-for-stereotactic-body-radiotherapy-for-liver-metastasis-from-primary-gastric-cancer-an-illustrative-case-report-and-literature-review
#17
Gary D Lewis, Stephen B Chiang, E Brian Butler, Bin S Teh
The liver is a common site for metastatic disease for many cancers. Radiation therapy is one means of treatment for liver metastases, especially for patients unable to undergo surgery or ineligible for systemic chemotherapy. In particular, stereotactic body radiotherapy (SBRT) has become an important option in the treatment of metastatic disease in the liver. SBRT delivers ablative doses of radiation in relatively few fractions. As such, precise and clear imaging plays an important role in maximizing disease control while minimizing normal tissue toxicity...
June 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28728152/use-of-the-putamen-as-a-surrogate-anatomical-marker-for-the-internal-segment-of-the-globus-pallidus-in-deep-brain-stimulation-surgery
#18
John A Thompson, Dali Yin, Steven G Ojemann, Aviva Abosch
OBJECTIVE: The success of deep brain stimulation (DBS) of the internal segment of the globus pallidus (GPi) depends on accurately placing the electrode into the GPi motor territory. Direct targeting can be difficult as GPi laminar borders are not always clearly identifiable on MRI. Here, we report a method for using the putamen (PUT) as a surrogate anatomical marker to target the GPi. METHODS: We developed a PUT-based GPi targeting using the FGATIR (fast gray matter acquisition T1-weighted inversion recovery) MRI sequence and compared it with consensus coordinate-based indirect targeting...
July 21, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28723716/refining-the-management-of-patients-with-hepatocellular-carcinoma-integrating-11c-choline-pet-ct-scan-into-the-multidisciplinary-team-discussion
#19
Ezio Lanza, Matteo Donadon, Paolo Felisaz, Antonio Mimmo, Arturo Chiti, Guido Torzilli, Luca Balzarini, Egesta Lopci
OBJECTIVE: The aim of this study was to report the impact of C-choline PET/CT on the management of patients with hepatocellular carcinoma (HCC) and incorporate into a refined algorithm combining diagnostic imaging and multidisciplinary team (MDT) discussion. PATIENTS AND METHODS: From February 2010 to February 2016, the charts of all patients discussed in the liver MDT were revised. Suspected or confirmed HCC lesions or Barcelona Clinic Liver Cancer stages A, B or C with a C-choline PET/CT performed in our hospital were included in the analyses...
July 18, 2017: Nuclear Medicine Communications
https://www.readbyqxmd.com/read/28723668/a-rare-case-of-esophageal-metastasis-from-pancreatic-ductal-adenocarcinoma-a-case-report-and-literature-review
#20
Lauren M Rosati, Megan N Kummerlowe, Justin Poling, Amy Hacker-Prietz, Amol K Narang, Eun J Shin, Dung T Le, Elliot K Fishman, Ralph H Hruban, Stephen C Yang, Matthew J Weiss, Joseph M Herman
PURPOSE: We report a very unique case of an esophageal metastasis from a pancreatic ductal adenocarcinoma (PDAC) primary. METHODS: After obtaining consent from the patient, all relevant records of the case were obtained and retrospectively reviewed. RESULTS: At presentation, the patient was diagnosed with synchronous pancreatic and esophageal cancer. He received six months of neoadjuvant therapy including FOLFIRINOX (5-fluorouracil, leucovorin, irinotecan, and oxaliplatin) and stereotactic body radiation therapy (SBRT) to the pancreatic tumor followed by a combined pancreaticoduodenectomy and Ivor Lewis esophagectomy...
June 13, 2017: Oncotarget
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