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Brain metastases guidelines

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https://www.readbyqxmd.com/read/28839327/role-of-surgery-in-brain-metastases
#1
Altaf Ali Laghari, Syed Ijlal Ahmed, Muhammad Shahzad Shamim
Brain metastases remain the commonest type of brain tumour, being four times more common than primary brain tumours. Although surgical intervention may be recommended for one of various reasons in the management of these tumours, including but not limited to conformation of diagnosis, relief of mass effect, improvement of neurological status and prolongation of survival, the guidelines for management of brain metastases remain largely subjective and therefore controversial. Herein the authors have attempted to review some of the existing evidence on role of surgery in the management of brain metastases and have presented their selected guidelines for the readers...
August 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28836150/anticoagulation-for-the-treatment-of-venous-thromboembolism-in-patients-with-brain-metastases-a-meta-analysis-and-systematic-review
#2
Bradley D Hunter, Tracy Minichiello, Stephen Bent
The risk benefit decision in providing anticoagulation for patients with brain metastases is amongst the most difficult decisions faced by clinicians. The purpose of our study was to evaluate both the risk of intracerebral hemorrhage (ICH) associated with anticoagulation therapy and the effect of anticoagulation on survival in patients with brain metastases and venous thromboembolism (VTE). A systematic review of the literature was performed via the PubMed, EMBASE, and the Cochrane databases. Our initial search resulted in 1304 unique citations, and 5 studies satisfied all eligibility criteria and were included for analysis...
August 23, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28835132/two-year-experience-of-multi-disciplinary-team-mdt-outcomes-for-brain-metastases-in-a-tertiary-neuro-oncology-centre
#3
Daniel Loh, Florence Hogg, Penelope Edwards, Jillian MacColl, Christian Brogna, Ranjeev Bhangoo, Keyoumars Ashkan, Francesco Vergani
Brain metastases (BMs) are the most common intracranial tumour in adults and form a significant proportion of the neuro-oncology workload. Their management has progressed significantly in the last few decades but a gold-standard evidence-based management strategy has not been defined to date and several guidelines based on available evidence exist to support clinical decision-making. This paper evaluates the decision-making process of the neuro-oncology multi-disciplinary team (MDT) in a tertiary neuro-oncology centre over a two-year period...
August 24, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28762600/assessing-the-practice-of-palliative-care-doctors-what-driving-advice-do-they-give-patients-with-advanced-disease
#4
Nashringi Weir, Amanda Fischer, Phillip Good
BACKGROUND: There is little research and no clear guidelines for clinicians to follow when instructing patients with advanced disease about driving. AIMS: To investigate current practice in providing advice to patients with advanced disease and identify areas of consensus or variation with the Australian driving guidelines. METHODS: An online survey was distributed to Australian members of the Australian and New Zealand Society of Palliative Medicine (ANZSPM)...
August 1, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28759295/preventing-discontinuation-of-radiation-therapy-predictive-factors-to-improve-patient-selection-for-palliative-treatment
#5
Lindsay L Puckett, Eric Luitweiler, Louis Potters, Sewit Teckie
PURPOSE: Approximately one third of patients with cancer require palliative radiation therapy (PRT), yet no guidelines exist for optimal patient selection. We have observed that many patients who begin PRT do not complete their prescribed treatment. Our study sought to identify factors associated with discontinuation of PRT, assess for a relationship with survival, and inform patient selection. METHODS: We performed an institutional review board-approved retrospective analysis of patients with cancer treated in a multicenter radiation oncology department in 2014...
September 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28757800/case-report-recurrent-mucoepidermoid-carcinoma-of-the-tongue-in-adult-female-patient-with-lung-cancer
#6
Arielle Rubin, John Davis, Karim Jreije, Henry Wu, Randy Oppenheimer
There is a steady rise in incidence of malignant salivary gland tumors in the United States, with mucoepidermoid carcinoma (MEC) the most frequent. Although 40% of MECs are found in the parotid gland, these lesions possess the capacity to develop anywhere along the aerodigestive tract. Here, we present a case of recurrent tongue MEC in a young adult female patient with history of lung malignancy and multiple brain metastases. Without a universally accepted management protocol for recurrent MECs, the current clinical practice uses tumor grade, location, and clinical progression to determine both prognosis and goals of care...
2017: Clinical Medicine Insights. Ear, Nose and Throat
https://www.readbyqxmd.com/read/28748331/eligibility-for-phase-3-clinical-trials-of-systemic-therapy-in-real-world-patients-with-metastatic-renal-cell-cancer-managed-in-a-rural-region
#7
Carsten Nieder, Mohsan A Syed, Astrid Dalhaug, Adam Pawinski, Jan Norum
Previous research has identified disparities between urban and rural cancer care, including clinical trial access. Therefore, we addressed three different questions in patients with metastatic renal cell cancer managed according to national guidelines in a rural Norwegian standard practice setting. (1) How many patients would have been eligible for three recent landmark randomized clinical trials? (2) Is survival different between eligible and non-eligible patients receiving first-line systemic therapy? (3) Is survival different between eligible patients and published trial results? We performed a retrospective analysis of 101 consecutive patients (2006-2016)...
September 2017: Medical Oncology
https://www.readbyqxmd.com/read/28391295/diagnosis-and-treatment-of-brain-metastases-from-solid-tumors-guidelines-from-the-european-association-of-neuro-oncology-eano
#8
Riccardo Soffietti, Ufuk Abacioglu, Brigitta Baumert, Stephanie E Combs, Sara Kinhult, Johan M Kros, Christine Marosi, Philippe Metellus, Alexander Radbruch, Salvador S Villa Freixa, Michael Brada, Carmine M Carapella, Matthias Preusser, Emilie Le Rhun, Roberta Rudà, Joerg C Tonn, Damien C Weber, Michael Weller
The management of patients with brain metastases has become a major issue due to the increasing frequency and complexity of the diagnostic and therapeutic approaches. In 2014, the European Association of Neuro-Oncology (EANO) created a multidisciplinary Task Force to draw evidence-based guidelines for patients with brain metastases from solid tumors. Here, we present these guidelines, which provide a consensus review of evidence and recommendations for diagnosis by neuroimaging and neuropathology, staging, prognostic factors, and different treatment options...
February 1, 2017: Neuro-oncology
https://www.readbyqxmd.com/read/28216937/renal-cell-carcinoma-atypical-metastasis-to-inguinal-lymph-nodes
#9
Qamar Saeed Chaudhry, Tanweer Ahmed Naveed Bhatty, Ziauddin Khan, Elsawi Medani Osman
Renal cell carcinoma (RCC) is a common tumor of the urinary tract. It is known to have variable presentations due to the extremely vascular nature of the organ. RCC are known to metastasize to lungs, bone, and brain commonly but atypical metastasis to various sites are reported in literature but as very rare pathology. We report a case of a 60-year-old female who presented with multiple inguinal and axillary lymph node enlargements which on excision biopsy showed metastatic RCC. RCC can present with synchronous metastatic deposits in the various organs...
January 2017: Urology Annals
https://www.readbyqxmd.com/read/28178376/treatment-trends-for-patients-with-brain-metastases-does-practice-reflect-the-data
#10
Kiri A Sandler, Narek Shaverdian, Ryan R Cook, Amar U Kishan, Christopher R King, Isaac Yang, Michael L Steinberg, Percy Lee
BACKGROUND: Published guidelines regarding the optimal treatment strategies for brain metastases focus on patients with ≤3 lesions. As delivery techniques for stereotactic radiosurgery (SRS) improve, radiation oncologists are increasingly using it for patients with >3 metastases. In the current study, the authors sought to characterize practice patterns among practitioners to identify areas of controversy. METHODS: A survey of practicing radiation oncologists was distributed via e-mail...
February 8, 2017: Cancer
https://www.readbyqxmd.com/read/28059560/dose-specification-for-hippocampal-sparing-whole-brain-radiotherapy-hs-wbrt-considerations-from-the-uk-hippo-trial-qa-programme
#11
RANDOMIZED CONTROLLED TRIAL
Daniel Megias, Mark Phillips, Laura Clifton-Hadley, Elizabeth Harron, David J Eaton, Paul Sanghera, Gillian Whitfield
OBJECTIVE: The HIPPO trial is a UK randomized Phase II trial of hippocampal sparing (HS) vs conventional whole-brain radiotherapy after surgical resection or radiosurgery in patients with favourable prognosis with 1-4 brain metastases. Each participating centre completed a planning benchmark case as part of the dedicated radiotherapy trials quality assurance programme (RTQA), promoting the safe and effective delivery of HS intensity-modulated radiotherapy (IMRT) in a multicentre trial setting...
March 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28051122/kras-mutation-incidence-and-prognostic-value-are-metastatic-site-specific-in-lung-adenocarcinoma-poor-prognosis-in-patients-with-kras-mutation-and-bone-metastasis
#12
Zoltan Lohinai, Thomas Klikovits, Judit Moldvay, Gyula Ostoros, Erzsebet Raso, Jozsef Timar, Katalin Fabian, Ilona Kovalszky, István Kenessey, Clemens Aigner, Ferenc Renyi-Vamos, Walter Klepetko, Balazs Dome, Balazs Hegedus
Current guidelines lack comprehensive information on the metastatic site-specific role of KRAS mutation in lung adenocarcinoma (LADC). We investigated the effect of KRAS mutation on overall survival (OS) in this setting. In our retrospective study, 500 consecutive Caucasian metastatic LADC patients with known KRAS mutational status were analyzed after excluding 32 patients with EGFR mutations. KRAS mutation incidence was 28.6%. The most frequent metastatic sites were lung (45.6%), bone (26.2%), adrenal gland (17...
January 4, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28047933/su-f-t-401-three-dimensional-conformal-planning-using-low-segment-multi-criteria-optimization-for-hippocampal-avoidance-whole-brain-radiotherapy
#13
X Zhang, J Penagaricano, G Narayanasamy, R Griffin, S Maraboyina, N Paudel, C Peter, S Morrill
PURPOSE: Hippocampus avoidance whole brain radiotherapy (HA-WBRT) has been shown to reduce the risk of neurocognitive dysfunction. This type of treatment has the potential of insurance company payment denial due to increased cost of intensity modulated radiotherapy (IMRT), while the accepted modality for WBRT is three-dimensional conformal radiotherapy (3DCRT). The purpose of this study is to assess HA-WBRT treatment plans using 3DCRT and multi-criteria optimization (MCO) that meets the RTOG 0933 criteria...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28044054/pituitary-metastasis-from-renal-cell-carcinoma-description-of-a-case-report
#14
Chloé Wendel, Marco Campitiello, Francesca Plastino, Nada Eid, Laurent Hennequin, Philippe Quétin, Raffaele Longo
BACKGROUND Pituitary metastasis is uncommon, breast and lung cancers being the most frequent primary tumors. Renal cell carcinoma (RCC) is a rare cause of pituitary metastases, with only a few cases described to date. CASE REPORT We report a case of a 61-year-old man who presented with a progressive deterioration of visual acuity and field associated with a bitemporal hemianopsia. Two years ago, he underwent radical right nephrectomy for a clear cell RCC (ccRCC). The biological tests showed pan-hypopituitarism and diabetes insipidus...
January 3, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/27878663/prevention-and-treatment-of-venous-thromboembolism-in-patients-with-solid-brain-neoplasms-results-of-a-survey-among-italian-physicians
#15
Nicola Mumoli, Stefano Barco, Marco Cei, Matteo Giorgi-Pierfranceschi, Mauro Campanini, Andrea Fontanella, Walter Ageno, Francesco Dentali
The decision concerning the introduction of primary and secondary prophylaxis of venous thromboembolism (VTE) in patients with solid brain neoplasms and brain metastases is often challenging due to the concomitant increased risk of intracranial hemorrhage and to limited evidence from available literature. A standardized questionnaire composed of nine multiple-choice questions regarding primary VTE prevention in non-surgical patients during high-risk conditions and VTE secondary prevention in patients with a solid brain neoplasm or cerebral metastases was sent via electronic mail to all the members (n = 2420) of the Italian Federation of the Internal Medicine Hospital Executives' Associations (FADOI) in June 2015...
November 23, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27814824/acr-appropriateness-criteria-%C3%A2-stage-i-breast-carcinoma
#16
Phan Tuong Huynh, Sergy V Lemeshko, Mary C Mahoney, Mary S Newell, Lisa Bailey, Lora D Barke, Carl D'Orsi, Jennifer A Harvey, Mary K Hayes, Peter M Jokich, Su-Ju Lee, Constance D Lehman, Martha B Mainiero, David A Mankoff, Samir B Patel, Handel E Reynolds, M Linda Sutherland, Bruce G Haffty
Stage I breast carcinoma is classified when an invasive breast carcinoma is ≤2 cm in diameter (T1), with no regional (axillary) lymph node metastases (N0) and no distant metastases (M0). The most common sites for metastases from breast cancer are the skeleton, lung, liver, and brain. In general, women and health care professionals prefer intensive screening and surveillance after a diagnosis of breast cancer. Screening protocols include conventional imaging such as chest radiography, bone scan, ultrasound of the liver, and MRI of brain...
November 2016: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/27802190/breast-cancer-brain-metastases-molecular-subtype-treatment-and-survival
#17
Jennifer A Crozier, Lauren F Cornell, Bhupendra Rawal, Edith A Perez
BACKGROUND: No clear guidelines exist for management of breast cancer brain metastases (BCBM). OBJECTIVE: We assessed the relationship between patient and tumor characteristics, treatment, and overall survival (OS). METHODS: We conducted a retrospective review of 196 patients who received brain radiation for BCBM between 2009-2013 at Mayo Clinic. Primary tumor characteristics were collected, including simplified molecular subtype. Other characteristics included patient's ECOG, number of brain lesions at BCBM diagnosis, and treatment received, including neurosurgery, whole-brain radiation therapy (WBRT), and stereotactic radiosurgery (SRS)...
2016: Breast Disease
https://www.readbyqxmd.com/read/27797223/hippocampal-sparing-whole-brain-radiotherapy-and-integrated-simultaneous-boost-vs-stereotactic-radiosurgery-boost-a-comparative-dosimetric-planning-study
#18
Soon Keat Cheah, Thomas Matthews, Bin Sing Teh
BACKGROUND: Whole brain radiotherapy (WBRT) and stereotactic radiosurgery were frequently used to palliate patients with brain metastases. It remains controversial which modality or combination of therapy is superior especially in the setting of limited number of brain metastases. The availability of newer medical therapy that improves survival highlighted the importance of reducing long term radiation toxicity associated with WBRT. In this study, we aim to demonstrate the hippocampal sparing technique with whole brain and integrated simultaneous boost Materials and Methods: Planning data from 10 patients with 1-5 brain metastases treated with SRS were identified...
2016: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/27692518/treatment-planning-strategy-for-whole-brain-radiotherapy-with-hippocampal-sparing-and-simultaneous-integrated-boost-for-multiple-brain-metastases-using-intensity-modulated-arc-therapy
#19
Damodar Pokhrel, Sumit Sood, Christopher McClinton, Xinglei Shen, Christopher Lominska, Habeeb Saleh, Rajeev Badkul, Hongyu Jiang, Melissa Mitchell, Fen Wang
PURPOSE: To retrospectively evaluate the accuracy, plan quality and efficiency of intensity-modulated arc therapy (IMAT) for hippocampal sparing whole-brain radiotherapy (HS-WBRT) with simultaneous integrated boost (SIB) in patients with multiple brain metastases (m-BM). MATERIALS AND METHODS: A total of 5 patients with m-BM were retrospectively replanned for HS-WBRT with SIB using IMAT treatment planning. The hippocampus was contoured on diagnostic T1-weighted magnetic resonance imaging (MRI) which had been fused with the planning CT image set...
January 2016: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/27658472/the-diagnosis-treatment-and-follow-up-of-renal-cell-carcinoma
#20
Christian Doehn, Viktor Grünwald, Thomas Steiner, Markus Follmann, Heidrun Rexer, Susanne Krege
BACKGROUND: In 2014, 15 500 persons in Germany were given the diagnosis of renal cell carcinoma. This disease is the third most common cancer of the urogenital system. The mean age at diagnosis is 68 years in men and 71 in men. METHODS: Pertinent publications up to 2014 were retrieved by a systematic literature search and reviewed in a moderated, formalized consensus process. Key questions were generated and answered by the adaptation of existing international guidelines, on the basis of an independent literature review, and by expert consensus...
September 5, 2016: Deutsches Ärzteblatt International
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