Abstract:
:Glioblastoma multiforme (GBM) continues to be a difficult therapeutic challenge. Our study was conducted to determine whether improved survival and tumor control could be achieved with modern delivery of fast neutron radiation using three-dimensional treatment planning. Ten patients were enrolled. Eligibility criteria included pathologic diagnosis of GBM, age >or=18 years, and KPS >or=60. Patients underwent MRI and (18)F-fluorodeoxyglucose PET (FDG PET) as part of initial three-dimensional treatment planning. Sequential targets were treated with noncoplanar fields to a total dose of 18 Gy in 16 fractions over 4 weeks. Median and 1-year overall survival were 55 weeks and 60%, respectively. One patient remains alive at last follow-up 255 weeks after diagnosis. Median progression-free survival was 16 weeks, and all patients had tumor progression by 39 weeks. Treatment was clinically well tolerated, but evidence of mild to moderate gliosis and microvascular sclerosis consistent with radiation injury was observed at autopsy in specimens taken from regions of contralateral brain that received approximately 6-10 Gy. Fast neutron radiation using modern imaging, treatment planning, and beam delivery was feasible to a total dose of 18 Gy, but tumor control probability was poor in comparison to that predicted from a dose-response model based on older studies. Steep dose-response curves for both tumor control and neurotoxicity continue to present a challenge to establishing a therapeutic window for fast neutron radiation in GBM, even with modern techniques.
journal_name
Neuro Oncoljournal_title
Neuro-oncologyauthors
Stelzer KJ,Douglas JG,Mankoff DA,Silbergeld DL,Krohn KA,Laramore GE,Spence AMdoi
10.1215/15228517-2007-044subject
Has Abstractpub_date
2008-02-01 00:00:00pages
88-92issue
1eissn
1522-8517issn
1523-5866pii
15228517-2007-044journal_volume
10pub_type
临床试验,杂志文章相关文献
NEURO-ONCOLOGY文献大全abstract:BACKGROUND:Targeting immune checkpoint proteins has recently gained substantial attention due to the dramatic success of this strategy in clinical trials for some cancers. Inducible T-cell co-stimulator ligand (ICOSLG) is a member of the B7 family of immune regulatory ligands, expression of which in cancer is implicate...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/noz204
更新日期:2020-03-05 00:00:00
abstract::Histone deacetylase inhibitors that increase histone acetylation on transformed cells are being investigated as unique anticancer drugs. The aim of this investigation was to evaluate an antiproliferative activity of the histone deacetylase inhibitors sodium butyrate (NaBT) and trichostatin A on 5 glioma cell lines, T9...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/4.2.95
更新日期:2002-04-01 00:00:00
abstract::Tobacco products are major contributors of exogenous N-nitroso compounds, a group of potent neurocarcinogens. Overall results from studies of smoking and brain tumors have been null, but have provided little information on duration, age at smoking initiation, and latency. We prospectively examined the relation between...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1215/15228517-2007-005
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:Glioblastomas with a specific mutation in the isocitrate dehydrogenase 1 (IDH1) gene have a better prognosis than gliomas with wild-type IDH1. METHODS:Here we compare the IDH1 mutational status in 172 contrast-enhancing glioma patients with the invasion profile generated by a patient-specific mathematical m...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/nou027
更新日期:2014-06-01 00:00:00
abstract::The Atlas of Cancer Mortality in the United States, 1950-94 (Devesa et al.) published in 1999 by the National Institutes of Health suggests that there are elevated rates of brain and other nervous system cancer in the northwestern, north central, and southeastern parts of the country. Being descriptive in nature, the ...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1215/S1152851703000450
更新日期:2004-07-01 00:00:00
abstract::Meningiomas are the most common primary intracranial neoplasm. The current World Health Organization (WHO) classification categorizes meningiomas based on histopathological features, but emerging molecular data demonstrate the importance of genomic and epigenomic factors in the clinical behavior of these tumors. Treat...
journal_title:Neuro-oncology
pub_type: 杂志文章,评审
doi:10.1093/neuonc/noy178
更新日期:2019-01-14 00:00:00
abstract:Background:Previous reports have shown that overall incidence of malignant brain and other central nervous system (CNS) tumors varied significantly by country. The aim of this study was to estimate histology-specific incidence rates by global region and assess incidence variation by histology and age. Methods:Using da...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/nox091
更新日期:2017-10-19 00:00:00
abstract::Glioblastoma multiforme (GBM) is a lethal primary malignant brain tumor in adults. R115777 (tipifarnib) is an oral agent with antiproliferative effects, being a potent and selective inhibitor of farnesyltransferase. This multicenter, open-label phase II study was designed to evaluate the efficacy and safety of R115777...
journal_title:Neuro-oncology
pub_type: 杂志文章,多中心研究
doi:10.1215/15228517-2008-070
更新日期:2008-12-01 00:00:00
abstract:Background:Copy number alterations form prognostic molecular subtypes of glioblastoma with clear differences in median overall survival. In this study, we leverage molecular data from several glioblastoma cohorts to define the distribution of copy number subtypes across random cohorts as well as cohorts with selection ...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/noy108
更新日期:2018-09-03 00:00:00
abstract::In patients with parenchymal brain masses of uncertain origin responsive to corticosteroids, primary CNS lymphoma (PCNSL) should be considered. PCNSL is a rare but aggressive brain tumor that is highly sensitive to high-dose methotrexate (HDMTX)-based chemotherapy. We report a series of six patients with brain masses ...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1215/15228517-2006-037
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:Primary central nervous system lymphomas, predominantly diffuse large B-cell lymphomas (PCNS-DLBCL), are aggressive malignancies, and no histopathological variables with independent prognostic value are currently available. The aim of this study is to determine the prognostic value of histopathological varia...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/not012
更新日期:2013-06-01 00:00:00
abstract::Malignant gliomas are the most common and lethal primary intracranial tumors. To date, no reliable biomarkers for the detection and risk stratification of gliomas have been identified. Recently, we demonstrated significant levels of microRNAs (miRNAs) to be present in cerebrospinal fluid (CSF) samples from patients wi...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/nor169
更新日期:2012-01-01 00:00:00
abstract::The objective of this study was to ascertain the duration of tumor control and the toxicities of dose-intense myeloablative chemotherapy for patients with recurrent oligodendrogliomas. Patients with previously irradiated oligodendrogliomas, either pure or mixed, that were contrast enhancing, measurable, and behaving a...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/2.2.114
更新日期:2000-04-01 00:00:00
abstract::The vasculature of 24 primary CNS B-cell lymphomas that were not related to acquired immunodeficiency syndrome was systematically studied by electron microscopy. Seven low-grade astrocytic tumors were included for comparison. Classical electron microscopy features of apoptosis were found in lymphoma cells of 21 of 22 ...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/1.2.89
更新日期:1999-04-01 00:00:00
abstract::Patients with the most common and aggressive form of high-grade glioma, glioblastoma multiforme, have poor prognosis and few treatment options. In 2 immunocompetent mouse brain tumor models (CT26-BALB/c and Tu-2449-B6C3F1), we showed that a nonlytic retroviral replicating vector (Toca 511) stably delivers an optimized...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/nor199
更新日期:2012-02-01 00:00:00
abstract::A 67-year-old man presented with a 7-month history of insidiously progressive chorea, ataxia, and vertigo. Neurologic examination revealed deficits referable to the basal nuclei, cerebellar vermis, and vestibular nuclei. Small-cell lung cancer was diagnosed by fine-needle biopsy of a parahilar mass. After chemotherapy...
journal_title:Neuro-oncology
pub_type: 杂志文章,评审
doi:10.1093/neuonc/4.3.192
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND:Altered expression of micro(mi)RNAs has been shown to be associated with tumorigenesis and tumor progression. The expression of phosphatase and tensin homolog (PTEN) plays an important role in glioma and is regarded as a prognostic marker of glioma patients. The goal of this study was to investigate the func...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/not107
更新日期:2013-11-01 00:00:00
abstract::The individualized care of glioma patients ought to benefit from imaging biomarkers as precocious predictors of therapeutic efficacy. Contrast enhanced MRI and [(18)F]-fluorodeoxyglucose (FDG)-PET are routinely used in clinical settings; their ability to forecast the therapeutic response is controversial. The objectiv...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/nos260
更新日期:2013-01-01 00:00:00
abstract:Background:Depending on the level, differentiation state, and tumor stage, reactive nitrogen and oxygen species inhibit or increase cancer growth and tumor initiating cell maintenance. The rate-limiting enzyme in a pathway that can regulate reactive species production but has not been thoroughly investigated in gliobla...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/noy012
更新日期:2018-07-05 00:00:00
abstract:BACKGROUND:Anaplastic oligodendroglial tumors are rare, and median survival varies widely. Analysis of 1p19q deletion is performed commonly and is an important prognostic factor. However, age and other clinical variables also carry prognostic value, and it is unclear how to incorporate them into clinical decision makin...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/nou083
更新日期:2014-11-01 00:00:00
abstract::This study estimated the maximum tolerated dose (MTD) of imatinib with irradiation in children with newly diagnosed brainstem gliomas, and those with recurrent malignant intracranial gliomas, stratified according to use of enzyme-inducing anticonvulsant drugs (EIACDs). In the brainstem glioma stratum, imatinib was ini...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1215/15228517-2006-031
更新日期:2007-04-01 00:00:00
abstract:Background:Advances from glioma stemlike cell (GSC) research, though increasing our knowledge of glioblastoma (GBM) biology, do not influence clinical decisions yet. We explored the translational power of GSC-enriched cultures from patient-derived tumorspheres (TS) in predicting treatment response. Methods:The relatio...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/now304
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:More than 90% of patients with diffuse intrinsic pontine glioma (DIPG) will die within 2 years of diagnosis. Patients deteriorate rapidly during the disease course, which severely impairs their quality of life. To date, no specific research on this clinically important subject has been conducted. This study ...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/nov250
更新日期:2016-04-01 00:00:00
abstract::Death receptor targeting has emerged as one of the promising novel approaches of cancer therapy. The activation of one such prototypic death receptor, CD95 (Fas/APO-1), has remained controversial because CD95 agonistic molecules have exhibited either too strong toxicity or too little activity. The natural CD95 ligand ...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/noq176
更新日期:2011-02-01 00:00:00
abstract::Karenitecin is a highly lipophilic camptothecin analogue with a lactone ring that is relatively resistant to inactivating hydrolysis under physiologic conditions. This phase I clinical trial was conducted to determine the maximum tolerated dose (MTD) of karenitecin in adults with recurrent malignant glioma (MG), to de...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1215/15228517-2008-030
更新日期:2008-08-01 00:00:00
abstract::Grade II gliomas are morphologically and clinically heterogeneous tumors for which histopathological typing remains the major tool for clinical classification. To what extent the major histological subtypes - astrocytomas, oligodendrogliomas, and oligoastrocytomas - constitute true biological entities is largely unres...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1215/15228517-2007-041
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:Resection of motor pathway gliomas requires the intraoperative recognition of essential cortical-subcortical motor structures. The degree of involvement of motor structures is variable, and increases as result of treatments patients are submitted to. Intraoperative neurophysiology offers various stimulation ...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/not327
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:We recently demonstrated that brain endothelial cells and astrocytes protect cancer cells from chemotherapy through an endothelin-dependent signaling mechanism. Here, we evaluated the efficacy of macitentan, a dual endothelin receptor (ETAR and ETBR) antagonist, in the treatment of experimental breast and lu...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/now037
更新日期:2016-04-01 00:00:00
abstract::The subventricular zone (SVZ) lines the lateral ventricles and represents the origin of neural and some cancer stem cells. Tumors contacting the SVZ may be more invasive with higher potential to recruit migratory progenitor cells. Our specific aim was to determine whether SVZ involvement in glioblastoma multiforme (GB...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1093/neuonc/nos268
更新日期:2013-01-01 00:00:00
abstract::We investigated the activation of platelet-derived growth factor (PDGF) receptor A (PDGFRA), PDGF receptor B (PDGFRB), epidermal growth factor receptor (EGFR), and their downstream pathways in malignant peripheral nerve sheath tumors (MPNSTs). PDGFRA, PDGFRB, and EGFR were immunohistochemically, biochemically, cytogen...
journal_title:Neuro-oncology
pub_type: 杂志文章
doi:10.1215/15228517-2009-003
更新日期:2009-12-01 00:00:00