Abstract：
:With more rapid advances in potential treatments for brain tumours, the number of clinical trials for brain tumour patients is rising. In the context of the challenges of recruitment and enrollment of patients with brain tumors, the dichotomy between the paucity of subjects and abundance of clinical trials creates a unique ethical dilemma, whereby a single patient may be eligible for several studies. Here, we identify and present three approaches for recruiting and enrolling patients who may be eligible for several trials. The ethical implications of the full disclosure, paternalistic, and random approaches are discussed. The full disclosure approach presents information to patients regarding all ongoing concurrent trials, allowing them to make an informed decision, while the paternalistic approach allows the healthcare providers to select the trial for which they believe the patient is most suitable. These introduce the biases into circumstances where equipoise is necessary and risk selection bias in study design. The random approach randomly allocates patients to each trial, which may erode patient autonomy and decrease trial enrollment. Brain tumor patients comprise a vulnerable population and it remains incumbent on healthcare providers to maintain the highest ethical standards when approaching them for clinical research. Changes in clinical trial design are required to mitigate the conflicts created by competition for patients.
journal_name
J Neurooncoljournal_title
Journal of neuro-oncologyauthors
Ibrahim GM,Chung C,Bernstein Mdoi
10.1007/s11060-011-0536-2subject
Has Abstractpub_date
2011-09-01 00:00:00pages
623-7issue
3eissn
0167-594Xissn
1573-7373journal_volume
104pub_type
社论abstract：:Thrombin is known to play a role as regulator in tumor spreading and tumor growth. Proteinase-activated receptor 1 (PAR 1)-type thrombin receptors were identified in different cancer cells including human glioblastoma cells. Thus a function of PAR 1 in brain tumors may be suggested. In this study, the presence of PAR ...
journal_title：Journal of neuro-oncology
pub_type： 杂志文章
doi：10.1023/a:1006246219449
更新日期：1999-04-01 00:00:00
abstract：:The aim of this work was to determine the accuracy and precision of stereotactic localization and treatment delivery using a helical tomotherapy based stereotactic radiosurgery (SRS) system. A tomotherapy specific radiosurgery workflow was designed that exploits the system's on board megavotage CT (MVCT) imaging syste...
journal_title：Journal of neuro-oncology
pub_type： 杂志文章
doi：10.1007/s11060-010-0227-4
更新日期：2010-06-01 00:00:00
abstract：:Aberrant activation of Akt is a common finding in adult malignant gliomas, resulting in most cases from mutations or deletions involving PTEN, which allows constitutive Akt phosphorylation. In contrast, we have previously reported that pediatric malignant gliomas, which are morphologically similar to lesions arising i...
journal_title：Journal of neuro-oncology
pub_type： 杂志文章
doi：10.1007/s11060-010-0297-3
更新日期：2010-09-01 00:00:00
abstract：:Malignant primary spinal cord gliomas (PSCGs) are rare, and the optimal treatment for these lesions remains controversial. We report herein treatment outcomes of six malignant PSCGs managed with temozolomide (TMZ)-based multidisciplinary treatment. TMZ was administered concomitantly with fractionated radiotherapy for ...
journal_title：Journal of neuro-oncology
pub_type： 杂志文章,评审
doi：10.1007/s11060-010-0249-y
更新日期：2011-01-01 00:00:00
abstract：:The role of repeat resection in the multimodal treatment of gliomas is unclear. Repeat surgery theoretically carries a higher risk of inducing neurological deficits, which might even out any advantage of cytoreduction. We sought to determine whether the occurrence of perioperative infarction is higher for repeat surge...
journal_title：Journal of neuro-oncology
pub_type： 杂志文章
doi：10.1007/s11060-011-0784-1
更新日期：2012-05-01 00:00:00
abstract：:Levels of rhodamine 123 (Rh-123), a new antineoplastic drug, were measured using high performance liquid chromatography in normal brain, malignant glioma and brain adjacent to tumor after a single intravenous injection of drug into rats with intracerebral tumors. Consistently higher levels of Rh-123 were seen in tumor...
journal_title：Journal of neuro-oncology
pub_type： 杂志文章
doi：10.1007/BF00177430
更新日期：1988-12-01 00:00:00
abstract：INTRODUCTION:To evaluate the prognostic value of the Glasgow Prognostic Score (GPS), the combination of C-reactive protein (CRP) and albumin, in glioblastoma multiforme (GBM) patients treated with radiotherapy (RT) and concurrent plus adjuvant temozolomide (GPS). METHODS:Data of newly diagnosed GBM patients treated wi...
journal_title：Journal of neuro-oncology
pub_type： 杂志文章
doi：10.1007/s11060-018-2879-4
更新日期：2018-09-01 00:00:00
abstract：:A phase I study was conducted to evaluate the dose-limiting toxicities (DLTs) and to determine the maximum tolerated dose (MTD)/recommended phase II dose of bendamustine with concurrent whole brain radiation (WBR) in patients with brain metastases (BM) from solid tumors. Four doses of intravenous weekly bendamustine w...
journal_title：Journal of neuro-oncology
pub_type： 杂志文章
doi：10.1007/s11060-014-1510-6
更新日期：2014-09-01 00:00:00
abstract：:Children with recurrent high grade gliomas (HGG) have a dismal outcome with a median progression free survival (PFS) of 12 weeks. Adults with recurrent HGG treated with irinotecan and bevacizumab reportedly have a 63% response rate and a median PFS of 23 weeks. There is a paucity of corresponding published pediatric d...
journal_title：Journal of neuro-oncology
pub_type： 杂志文章
doi：10.1007/s11060-010-0444-x
更新日期：2011-07-01 00:00:00
abstract：:Antisense bcl-2 therapy combined with chemotherapy has been proved to be effective in various tumors. However, the role played by antisense bcl-2 therapy alone is not clear. In this study, we compared the apoptosis and the protein profiles of antisense bcl-2 transfected human neuroblastoma SK-N-MC cells to the control...
journal_title：Journal of neuro-oncology
pub_type： 杂志文章
doi：10.1007/s11060-004-3116-x
更新日期：2005-03-01 00:00:00
abstract：INTRODUCTION:There is growing evidence that the subventricular zone (SVZ) plays a key role in glioblastoma (GBM) tumorigenesis. However, little is known regarding how the SVZ, which is a harbor for adult neural stem cells, may be influenced by chemoradiation. The current diffusion-weighted imaging (DWI) study explored ...
journal_title：Journal of neuro-oncology
pub_type： 杂志文章
doi：10.1007/s11060-020-03460-5
更新日期：2020-05-01 00:00:00
abstract：OBJECT:There is little population-based data available on primary spinal cord tumors. Many of the existing statistics are not current or were obtained from surgical series. Historically, population-based data were collected only for malignant tumors, and only recently have data begun to be collected on non-malignant tu...
journal_title：Journal of neuro-oncology
pub_type： 杂志文章
doi：10.1007/s11060-007-9507-z
更新日期：2008-04-01 00:00:00
abstract：:Meningioma is a common intracranial tumor, originating from the meninges of the skull or spinal canal. Most meningiomas are benign tumors, however atypical or anaplastic tumors can be found in 6% of cases. Patients with asymptomatic small benign meningiomas can be followed without therapy, but in symptomatic patients ...
journal_title：Journal of neuro-oncology
pub_type： 杂志文章,评审
doi：10.1007/s11060-008-9734-y
更新日期：2009-03-01 00:00:00
abstract：:To investigate local control and radiation-induced brain necrosis in patients with melanoma brain metastases who received complete resection plus fractionated stereotactic radiosurgery (fSRS, 3 × 9 Gy) or fSRS alone. Factors associated with the clinical outcomes and the development of brain necrosis have been assessed...
journal_title：Journal of neuro-oncology
pub_type： 杂志文章
doi：10.1007/s11060-017-2394-z
更新日期：2017-05-01 00:00:00
abstract：:Gender-specific incidence patterns and the presence of hormonal receptors on tumor cells suggest that sex hormones may play a role in the onset of primary brain tumors. However, epidemiological studies on the relation of hormonal risk factors to the risk of brain tumors have been inconsistent. We examined the role of ...
journal_title：Journal of neuro-oncology
pub_type： 杂志文章
doi：10.1007/s11060-014-1427-0
更新日期：2014-06-01 00:00:00
abstract：:This review identifies the current literature on the use of bevacizumab for cerebral radiation necrosis in patients with high-grade gliomas, summarizes the clinical course and complications following bevacizumab, and discusses the relative costs and benefits of this therapeutic option. A Medline search was conducted o...
journal_title：Journal of neuro-oncology
pub_type： 杂志文章,评审
doi：10.1007/s11060-013-1233-0
更新日期：2013-12-01 00:00:00
abstract：:Disparities in American health care based on socially-defined patient characteristics such as race, ethnicity, and socioeconomic position are well-documented. We review differences and disparities in incidence, pathobiology, processes and outcomes of care, and survival based on social factors for brain tumors of all h...
journal_title：Journal of neuro-oncology
pub_type： 杂志文章,评审
doi：10.1007/s11060-009-9840-5
更新日期：2009-05-01 00:00:00
abstract：:Central neurocytoma was originally described as a rare benign neuronal tumor. However, progression and local recurrences after surgery are well recognized. Stereotactic radiosurgery is another option for treatment of CN. In order to evaluate the efficacy of SRS, we performed a quantitative systematic review of the ava...
journal_title：Journal of neuro-oncology
pub_type： 杂志文章,评审
doi：10.1007/s11060-012-0803-x
更新日期：2012-05-01 00:00:00
abstract：:Four cases of intracranial osteosarcoma are reported. In three cases the tumors were primary neoplasms arising from the sellar region, base of the occiput and the parieto-occipital area. One case represented osteosarcoma metastatic to the cerebellum, a site not previously described, from a primary tumor at the femur. ...
journal_title：Journal of neuro-oncology
pub_type： 杂志文章,评审
doi：10.1023/a:1006007411312
更新日期：1998-10-01 00:00:00
abstract：:A positron emission tomography study using [18F]-fluorodeoxyglucose was undertaken to identify and quantitate whether diaschisis occurred in cerebral cortex, basal ganglia, or thalamus, as well as in cerebellar cortex and dentate nuclei in patients with malignant glioma. The relationship between diaschisis in these ce...
journal_title：Journal of neuro-oncology
pub_type： 杂志文章
doi：10.1007/BF00177839
更新日期：1990-04-01 00:00:00
abstract：:The basement membrane collagen IV-degrading matrix metalloproteinases -2 and -9 (MMPs) are most often linked to the malignant phenotype of tumor cells by playing a critical role in invasion, metastasis, angiogenesis, and vasculogenesis. We verified the activity of these two MMPs in the sera of patients affected by bra...
journal_title：Journal of neuro-oncology
pub_type： 杂志文章
doi：10.1007/s11060-016-2297-4
更新日期：2017-01-01 00:00:00
abstract：:Chemotherapy is often omitted in elderly patients with glioblastoma multiforme due to a fear of side effects. We applied metronomic chemotherapy with low-dose temozolomide and celecoxib (LD-TEM/CEL) during and after external beam radiotherapy (EBRT) and here report on how this regimen compares to standard temozolomide...
journal_title：Journal of neuro-oncology
pub_type： 杂志文章
doi：10.1007/s11060-015-1834-x
更新日期：2015-09-01 00:00:00
abstract：:Glioblastoma Multiforme frequently metastasises from their original location by for example infiltration along white matter tracts [1]. GBM metastasis outside the central nervous system is distinctly rare though there are previous reports of spread to various organs [2-5]. We add an unusual case of a patient with aggr...
journal_title：Journal of neuro-oncology
pub_type： 信件
doi：10.1007/s11060-005-1480-9
更新日期：2005-09-01 00:00:00
abstract：:Chromatin modification through histone deacetylase inhibition has shown evidence of activity against malignancies. The mechanism of action of such agents are pleiotropic and potentially tumor specific. In this study, we studied the mechanisms of vorinostat-induced cellular effects in gliomas. The effects of vorinostat...
journal_title：Journal of neuro-oncology
pub_type： 杂志文章
doi：10.1007/s11060-011-0604-7
更新日期：2011-11-01 00:00:00
abstract：:Our objective was to explore the impact of the histopathological tumor type on affective symptoms before surgery among male and female patients with supratentorial primary brain tumors. A total of 44 adult patients were included in the study. Depression and anxiety were measured using the Beck Depression Inventory (BD...
journal_title：Journal of neuro-oncology
pub_type： 杂志文章
doi：10.1007/s11060-015-1950-7
更新日期：2016-01-01 00:00:00
abstract：:We used double-label quantitative autoradiography to measure blood flow (with 131I-iodoantipyrine) and blood-to-tissue transport of 14C-alpha aminoisobutyric acid, AIB) in thirteen 9L gliosarcomas transplanted intracerebrally into Fischer-344 rats. Microscopically, the typical pattern of 9L tumor growth was observed: ...
journal_title：Journal of neuro-oncology
pub_type： 杂志文章,评审
doi：10.1007/BF00165526
更新日期：1991-12-01 00:00:00
abstract：:A historically controlled phase II study was undertaken to investigate the efficacy and toxicity of a postoperative treatment consisting of high-dose continuous tamoxifen, carboplatin and radiotherapy in patients with newly diagnosed glioblastoma. Between 1995 and 1998, 50 patients with newly diagnosed glioblastomas u...
journal_title：Journal of neuro-oncology
pub_type： 临床试验,杂志文章
doi：10.1023/a:1026533016912
更新日期：2000-09-01 00:00:00
abstract：:Optimal treatment of anaplastic oligodendroglial tumors (AOT) in elderly patients is debatable. We report a retrospective study of 44 consecutive patients aged 70 years or older [median age: 74 years; median Karnofsky performance status (KPS): 70] treated with up-front chemotherapy using temozolomide (TMZ) at conventi...
journal_title：Journal of neuro-oncology
pub_type： 杂志文章
doi：10.1007/s11060-010-0264-z
更新日期：2011-02-01 00:00:00
abstract：:This adjunct to a prospective phase II blinded study of 48 patients with recurrent malignant glioma evaluated the predictive reliability of an extreme drug resistance (EDR) to identify clinical resistance to irinotecan (CPT-11), using fresh tumor biopsies obtained from recurrent patients immediately prior to their fir...
journal_title：Journal of neuro-oncology
pub_type： 临床试验,杂志文章
doi：10.1023/b:neon.0000014549.77646.f6
更新日期：2004-02-01 00:00:00
abstract：:Leptomeningeal dissemination of low-grade gliomas is an uncommon event. A 43-year old male presented with dizziness, gait ataxia, and diplopia. A nonenhancing lesion in the right cerebellar peduncle was identified, subtotally resected, and diagnosed as a grade II astrocytoma. After one year a nodular spread in the bra...
journal_title：Journal of neuro-oncology
pub_type： 杂志文章
doi：10.1007/s11060-009-0040-0
更新日期：2010-05-01 00:00:00
