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https://www.readbyqxmd.com/read/29218626/treatment-related-changes-in-glioblastoma-a-review-on-the-controversies-in-response-assessment-criteria-and-the-concepts-of-true-progression-pseudoprogression-pseudoresponse-and-radionecrosis
#1
REVIEW
P D Delgado-López, E Riñones-Mena, E M Corrales-García
The assessment of response to therapy in glioblastoma remains a challenge, because the surrogate measures of survival are subject to radiographic misinterpretation. A solid and reliable definition of progression is needed for both clinical decision-making and for evaluating response within the clinical trials. Historically, assessment criteria have used radiologic and clinical features aimed to correctly classify patients into progressive or non-progressive disease. The widely used RANO criteria are a valuable tool in disease evaluation, both in the clinical setting and in the clinical trials...
December 7, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/29218301/long-term-outcomes-after-salvage-stereotactic-radiosurgery-srs-following-in-field-failure-of-initial-srs-for-brain-metastases
#2
Nitesh Rana, Praveen Pendyala, Ryan K Cleary, Guozhen Luo, Zhiguo Zhao, Lola B Chambless, Anthony J Cmelak, Albert Attia, Mark J Stavas
Purpose: The optimal treatment strategy following local recurrence after stereotactic radiosurgery (SRS) remains unclear. While upfront SRS has been extensively studied, few reports focus on outcomes after retreatment. Here, we report the results following a second course of SRS for local recurrence of brain metastases previously treated with SRS. Methods: Using institutional database, patients who received salvage SRS (SRS2) following in-field failure of initial SRS (SRS1) for brain metastases were identified...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/29203042/-treatment-of-radiation-induced-iliofemoral-arterial-complications-with-groin-radionecrosis
#3
J-M Fichelle
Long-term iliofemoral complications induced by radiation include vascular (arterial and venous) lesions, nervous lesions and soft tissue loss that can be cutaneous and subcutaneous and potentially lead to radionecrosis with vessel exposure. We present five cases of groin radionecrosis. There were three men and two women (age 30-73 years). Radiotherapy had been delivered 15 years earlier in three cases, and 2 years earlier in two cases. Symptoms were intermittent claudication (n=1), critical ischemia (n=1), and septic hemorrhage (n=1)...
December 2017: Journal de Médecine Vasculaire
https://www.readbyqxmd.com/read/29197712/radiotherapy-induced-reactivation-of-neurotrophic-human-herpes-viruses-overview-and-management
#4
REVIEW
Marigdalia K Ramirez-Fort, Jianying Zeng, Amir Feily, Luis A Ramirez-Pacheco, Joseph M Jenrette, David L Mayhew, Talal Syed, S Lewis Cooper, Craig Linden, Witney S Graybill, Lars E French, Christopher S Lange
PURPOSE: Infection by Human Herpes Viruses (HHV) types 1-3, are prevalent throughout the world. It is known that radiotherapy can reactivate HHVs, but it is unclear how and to what extent reactivations can interact with or affect radiotherapeutic efficacy, patient outcomes and mortality risk. Herein, we aim to summarize what is known about Herpes Simplex Virus (HSV)-1,2 and Varicella Zoster Virus (VZV) pathophysiology as it relates to tumor biology, radiotherapy, chemo-radiotherapy, diagnosis and management so as to optimize cancer treatment in the setting of active HHV infection...
November 22, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/29146179/soft-palate-reconstruction-after-radionecrosis-combined-anterolateral-thigh-adipofascial-and-nasoseptal-flaps
#5
Joseph Zenga, Jeffrey D Sharon, Jennifer Gross, Jay Gantz, Patrik Pipkorn
Although radiation-based treatment for nasopharyngeal cancer may achieve excellent long term oncologic results, late effects of therapy may lead to soft tissue radionecrosis and velopharyngeal insufficiency (VPI). Repair of these oro- and nasopharyngeal defects presents a complex reconstructive challenge. We present a case of a long-term survivor treated with chemoradiotherapy for nasopharyngeal cancer who developed progressive dysphagia, velopharyngeal insufficiency, and radionecrosis of the nasopharynx and soft palate, leading to tracheostomy and gastrostomy tube dependence...
November 13, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/29128197/reirradiation-of-gliomas-under-stereotactic-conditions-prognostic-factors-for-survival-without-relapse-or-side-effects-a-retrospective-study-at-tours-regional-university-hospital-france
#6
S Lévy, S Chapet, N Scher, K Debbi, A Ruffier, G Bernadou, Y Pointreau, G Calais
PURPOSE: To search for factors correlated with relapse-free survival following stereotactic reirradiation in patients with recurrent glioma following radiochemotherapy and evaluate tolerance to this treatment. PATIENTS AND METHODS: Initial radiotherapy was given according to the protocol of Stupp and al. Reirradiation was performed using the CyberKnife(®) system. Patients could have had surgical resection initially and at the time of recurrence. We analysed 13 patients treated between July 2010 and September 2014...
November 8, 2017: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/29114607/the-impact-of-different-stereotactic-radiation-therapy-regimens-for-brain-metastases-on-local-control-and-toxicity
#7
Rachel B Jimenez, Brian M Alexander, Anand Mahadevan, Andrzej Niemierko, Selvan Rajakesari, Nils D Arvold, Scott R Floyd, Kevin S Oh, Jay S Loeffler, Helen A Shih
Purpose: Stereotactic radiation therapy (SRT) enables focused, short course, high dose per fraction radiation delivery to brain tumors that are less ideal for single fraction treatment because of size, shape, or close proximity to sensitive structures. We sought to identify optimal SRT treatment regimens for maximizing local control while minimizing morbidity. Methods and materials: We performed a retrospective review of patients treated with SRT for solid brain metastases using variable dose schedules between 2001 and 2011 at 3 academic hospitals...
July 2017: Advances in Radiation Oncology
https://www.readbyqxmd.com/read/29105011/modern-robot-assisted-radiosurgery-of-cerebral-angiomas-own-experiences-system-comparisons-and-comprehensive-literature-overview
#8
Thomas Feutren, Andres Huertas, Julia Salleron, René Anxionnat, Serge Bracard, Olivier Klein, Didier Peiffert, Valérie Bernier-Chastagner
Cerebral arteriovenous malformations (AVMs) are rare vascular lesions potentially responsible for substantial neurological morbidity and mortality. Over the past four decades, radiosurgery has become a valid therapeutic option for many patients with small intracranial AVMs, but reports describing the use of robotic stereotactic radiosurgery (SRS) are rare. The purposes of this study are to describe the efficacy and toxicity of robotic SRS for AVMs and to review the literature. The reports of 48 consecutive patients treated with SRS were reviewed...
November 5, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/29070186/using-the-nasoseptal-flap-for-reconstruction-after-endoscopic-debridement-of-radionecrosis-in-nasopharyngeal-carcinoma
#9
(no author information available yet)
BACKGROUND: Radionecrosis is a complication of nasopharyngeal carcinoma (NPC) that is difficult to treat. Endoscopic debridement is the first-line treatment for radionecrosis. After debridement, however, either bone or the internal carotid artery is exposed and requires mucosal coverage. OBJECTIVES: This study sought to demonstrate the effectiveness of a nasoseptal flap (NSF) after endoscopic debridement of radionecrosis in the reconstruction of nasopharyngeal or skull base defects...
October 25, 2017: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/29054380/toxicity-and-efficacy-of-re-irradiation-of-high-grade-glioma-in-a-phase-i-dose-and-volume-escalation-trial
#10
Søren Møller, Per Munck Af Rosenschöld, Junia Costa, Ian Law, Hans Skovgaard Poulsen, Svend Aage Engelholm, Silke Engelholm
INTRODUCTION: The purpose of this study was to evaluate the safety and efficacy of PET and MRI guided re-irradiation of recurrent high-grade glioma (HGG) and to assess the impact of radiotherapy dose, fractionation and irradiated volume. MATERIAL AND METHODS: Patients with localized, recurrent HGG (grades III-IV) and no other treatment options were eligible for a prospective phase I trial. Gross tumor volumes for radiotherapy were defined using T1-contrast enhanced MRI and 18F-fluoro-ethyl tyrosine PET...
November 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28974415/hypofractionated-stereotactic-radiation-therapy-to-the-resection-bed-for-intracranial-metastases
#11
Audrey Keller, Mélanie Doré, Hélène Cebula, François Thillays, François Proust, Ioana Darié, Stéphane-André Martin, Gregory Delpon, François Lefebvre, Georges Noël, Delphine Antoni
PURPOSE: To retrospectively report the outcomes of a large multicenter cohort of patients treated with surgery and hypofractionated stereotactic radiation therapy (HFSRT) to the resection cavities of brain metastases (BMs). METHODS AND MATERIALS: Between March 2008 and February 2015, 181 patients with no prior whole-brain radiation therapy (WBRT) were treated by HFSRT to the surgical bed of BM at the dose of 33 Gy (3 × 11 Gy). The primary endpoint was local control...
December 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28973311/phase-i-trial-of-radiosurgery-dose-escalation-plus-bevacizumab-in-patients-with-recurrent-progressive-glioblastoma
#12
Mahmoud Abbassy, Symeon Missios, Gene H Barnett, Cathy Brewer, David M Peereboom, Manmeet Ahluwalia, Gennady Neyman, Samuel T Chao, John H Suh, Michael A Vogelbaum
BACKGROUND: The effectiveness of stereotactic radiosurgery (SRS) for recurrent glioblastoma (rGBM) remains uncertain. SRS has been associated with a high risk of radionecrosis in gliomas. OBJECTIVE: To determine the safety of dose escalation of single-fraction radiosurgery for rGBM in the setting of bevacizumab therapy. METHODS: We conducted a prospective trial to determine the safety and synergistic benefit of higher doses of SRS administered with bevacizumab for rGBM...
July 21, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28893524/-hippocampus-brainstem-and-brain-dose-volume-constraints-for-fractionated-3-d-radiotherapy-and-for-stereotactic-radiation-therapy-limits-and-perspectives
#13
REVIEW
M Gérard, R Jumeau, B Pichon, J Biau, E Blais, J Horion, G Noël
Cerebral radiation-induced toxicities after radiotherapy (RT) of brain tumors are frequent. The protection of organs at risk (OAR) is crucial, especially for brain tumors, to preserve cognition in cancer survivors. Dose constraints of cerebral OAR used in conventional RT, radiosurgery (SRS) and stereotactic radiotherapy (SRT) are debated. In fact, they are based on historical cohorts or calculated with old mathematical models. Values of α/β ratio of cerebral OAR are also controversial leading to misestimate the equivalent dose in 2Gy fractions or the biological equivalent dose, especially during hypofractionated RT...
October 2017: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/28879459/hypofractionated-radiotherapy-with-simultaneous-integrated-boost-sib-plus-temozolomide-in-good-prognosis-patients-with-glioblastoma-a-multicenter-phase-ii-study-by-the-brain-study-group-of-the-italian-association-of-radiation-oncology-airo
#14
Silvia Scoccianti, Marco Krengli, Livia Marrazzo, Stefano Maria Magrini, Beatrice Detti, Vincenzo Fusco, Luigi Pirtoli, Daniela Doino, Alba Fiorentino, Laura Masini, Daniela Greto, Michela Buglione, Giovanni Rubino, Federico Lonardi, Fernanda Migliaccio, Salvino Marzano, Riccardo Santoni, Umberto Ricardi, Lorenzo Livi
INTRODUCTION: A multicenter phase II study for assessing the efficacy and the toxicity of hypofractionated radiotherapy with SIB plus temozolomide in patients with glioblastoma was carried out by the Brain Study Group of the Italian Association of Radiation Oncology. METHODS: Twenty-four patients with newly diagnosed glioblastoma belonging to Recursive Partitioning Analysis classes III and IV were enrolled. The prescribed dose was 52.5 Gy in 15 fractions of 3.5 Gy and 67...
September 6, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28875373/differentiating-brain-radionecrosis-from-tumour-recurrence-a-role-for-contrast-enhanced-ultrasound
#15
Luca Mattei, Francesco Prada, Marcello Marchetti, Paola Gaviani, Francesco DiMeco
Differentiating radionecrosis from tumour recurrence is a major issue in neuro-oncology. Conventional imaging is far from being validated as an alternative to histological assessment. We report the case of a patient operated on for suspected recurrence of brain metastasis 9 months after cyberknife radiosurgery. While magnetic resonance imaging showed strong enhancement of the lesion, intraoperative contrast-enhanced ultrasonography (CEUS) surprisingly did not-different from what is expected for brain metastases...
September 5, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28870792/multicenter-phase-1-dose-escalation-study-of-hypofractionated-stereotactic-radiation-therapy-with-bevacizumab-for-recurrent-glioblastoma-and-anaplastic-astrocytoma
#16
MULTICENTER STUDY
Jennifer Clarke, Elizabeth Neil, Robert Terziev, Philip Gutin, Igor Barani, Thomas Kaley, Andrew B Lassman, Timothy A Chan, Josh Yamada, Lisa DeAngelis, Ase Ballangrud, Robert Young, Katherine S Panageas, Kathryn Beal, Antonio Omuro
PURPOSE: To establish the maximum tolerated dose of a 3-fraction hypofractionated stereotactic reirradiation schedule when delivered with concomitant bevacizumab to treat recurrent high-grade gliomas. METHODS AND MATERIALS: Patients with recurrent high-grade glioma with Karnofsky performance status ≥60, history of standard fractionated initial radiation, tumor volume at recurrence ≤40 cm(3), and absence of brainstem or corpus callosum involvement were eligible...
November 15, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28854994/brainstem-radionecrosis-in-a-patient-with-nasopharyngeal-carcinoma
#17
Theodora Afrantou, Konstantinos S Natsis, Aristomenis Angelou
No abstract text is available yet for this article.
August 31, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28841798/re-irradiation-for-recurrent-glioblastoma-multiforme
#18
Christian Barney, Gaurav Shukla, Deepak Bhamidipati, Joshua D Palmer
As our understanding of normal brain tissue tolerance and radiation technology have improved, central nervous system (CNS) re-irradiation has garnered more attention; whereas, in the past there had been hesitancy due to late toxicity concerns, particularly radionecrosis (RN). There is minimal prospective data evaluating repeat radiation in recurrent gliomas. In this review, the rationale for and different approaches to re-irradiation will be discussed, and the biology and clinical impact of late CNS toxicity will be reviewed...
August 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28818094/radiotoxicity-in-robotic-radiosurgery-proposing-a-new-quality-index-for-optimizing-the-treatment-planning-of-brain-metastases
#19
Alexandra Hellerbach, Klaus Luyken, Mauritius Hoevels, Andreas Gierich, Daniel Rueß, Wolfgang W Baus, Martin Kocher, Maximilian I Ruge, Harald Treuer
BACKGROUND: As irradiated brain volume at 12 Gy (V12) is a predictor for radionecrosis, the purpose of the study was to develop a model for Cyberknife (CK) plans that is able to predict the lowest achievable V12 at a given tumor size and prescription dose (PD), and to suggest a new quality index regarding V12 for optimizing the treatment planning of brain metastases. METHOD: In our model V12 was approximated as a spherical shell around the tumor volume. The radial distance between tumor surface and the 12 Gy isodose line was calculated using an approximation of the mean dose gradient in that area...
August 17, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28721889/clinical-outcomes-of-large-brain-metastases-treated-with-neurosurgical-resection-and-intraoperative-cesium-131-brachytherapy-results-of-a-prospective-trial
#20
A Gabriella Wernicke, Cole B Hirschfeld, Andrew W Smith, Shoshana Taube, Menachem Z Yondorf, Bhupesh Parashar, Lucy Nedialkova, Fridon Kulidzhanov, Samuel Trichter, Albert Sabbas, Rohan Ramakrishna, Susan Pannullo, Theodore H Schwartz
PURPOSE: Studies on adjuvant stereotactic radiosurgery to the cavity of resected brain metastases have suggested that larger tumors (>2.0 cm) have greater rates of recurrence and radionecrosis (RN). The present study assessed the effect of permanent low-dose (131)Cs brachytherapy on local control and RN in patients treated for large brain metastases. METHODS AND MATERIALS: After institutional review board approval, 42 patients with 46 metastases ≥2.0 cm in preoperative diameter were accrued to a prospective trial from 2010 to 2015...
August 1, 2017: International Journal of Radiation Oncology, Biology, Physics
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