Impact of preexisting tumor necrosis on the efficacy of stereotactic radiosurgery in the treatment of brain metastases in women with breast cancer.


BACKGROUND:Breast cancer is the second most common source of brain metastasis. Stereotactic radiosurgery (SRS) can be an effective treatment for some patients with brain metastasis (BM). Necrosis is a common feature of many brain tumors, including BM; however, the influence of tumor necrosis on treatment efficacy of SRS in women with breast cancer metastatic to the brain is unknown. METHODS:A cohort of 147 women with breast cancer and BM treated consecutively with SRS over 10 years were studied. Of these, 80 (54.4%) had necrosis identified on pretreatment magnetic resonance images and 67 (46.4%) did not. Survival times were computed using the Kaplan-Meier method. Log-rank tests were used to compare groups with respect to survival times, Cox proportional hazards regression models were used to perform univariate and multivariate analyses, and chi-square and Fisher exact tests were used to compare clinicopathologic covariates. RESULTS:Neurological survival (NS) and survival after SRS were decreased in BM patients with necrosis at the time of SRS compared with patients without necrosis by 32% and 27%, respectively (NS median survival, 25 vs 17 months [log-rank test, P = .006]; SRS median survival, 15 vs 11 months [log-rank test, P = .045]). On multivariate analysis, HER2 amplification status and necrosis influenced NS and SRS after adjusting for standard clinical features, including BM number, size, and volume as well as Karnofsky performance status. CONCLUSION:Neuroimaging evidence of necrosis at the time of SRS significantly diminished the efficacy of therapy and was a potent prognostic marker.






Xu Z,Marko NF,Angelov L,Barnett GH,Chao ST,Vogelbaum MA,Suh JH,Weil RJ




Has Abstract


2012-03-01 00:00:00














  • Ultrasound-guided fine-needle aspiration cytology of nonpalpable breast lesions: Institut Curie's experience with 198 histologically correlated cases.

    abstract:BACKGROUND:The value of ultrasound-guided fine-needle aspiration cytology (FNAC) in the diagnosis of nonpalpable breast lesions remains a subject of debate. To determine the accuracy of this procedure in these lesions, a comparative analysis with open surgical biopsy in 188 patients was performed. METHODS:Six hundred ...


    pub_type: 临床试验,杂志文章


    authors: Klijanienko J,Côté JF,Thibault F,Zafrani B,Meunier M,Clough K,Asselain B,Vielh P

    更新日期:1998-02-25 00:00:00

  • Cytologic results of fine-needle aspiration biopsies of the central nervous system.

    abstract::The cytologic results of 34 fine-needle aspiration (FNA) biopsies of the central nervous system (CNS) are reported. There were 31 intraoperative biopsies performed at the time of craniotomy. All the cases were diagnosed using direct smear preparations stained with Papanicolaou and Diff-Quik (Harleco, NJ) stains. The s...


    pub_type: 杂志文章


    authors: Silverman JF,Timmons RL,Leonard JR 3rd,Hardy IM,Harris LS,O'Brien K,Norris HT

    更新日期:1986-09-01 00:00:00

  • The prevalence of variant alkaline phosphatase in hepatocellular carcinoma in southern African blacks.

    abstract::The prevalence of variant alkaline phosphatase in the serum of 335 southern African blacks with hepatocellular carcinoma was determined using polyacrylamide gel electrophoresis. The isoenzyme was detected in 2% (seven of 335) of the patients: it could not be found in the serum of 300 matched, healthy individuals or in...


    pub_type: 杂志文章


    authors: Bukofzer S,Kew MC,Rowe P

    更新日期:1988-09-01 00:00:00

  • Percutaneous placement of two single-lumen Silastic catheters for long-term venous access. Lessons learned with experience in over 200 patients.

    abstract::A simple, fast technique for percutaneous insertion of two single-lumen, large-bore Silastic catheters for long-term venous access is described. Helpful technical points are discussed. Recent experience with insertion of 102 catheters using this technique yielded no major complications. ...


    pub_type: 杂志文章


    authors: Carroll C,Sarr MG,Stewart JR

    更新日期:1985-06-01 00:00:00

  • Adrenal adenomas and adrenal carcinomas in association with hereditary adenomatosis of the colon and rectum.

    abstract::Hereditary adenomatosis of the colon and rectum (HACR) is associated with a wide variety of extracolonic manifestations. Two cases of neoplasia involving the adrenal gland are reported, one adenoma and one carcinoma. The literature relating these lesions to HACR and other syndromes of malignant and nonmalignant growth...


    pub_type: 杂志文章


    authors: Painter TA,Jagelman DG

    更新日期:1985-05-01 00:00:00

  • Amsacrine is safe and effective therapy for patients with myocardial dysfunction and acute leukemia.

    abstract::The role of amsacrine in inducing remission in patients with cardiac disease and acute leukemia was evaluated. There were 17 patients with acute myelogenous leukemia (AML), six with acute lymphocytic leukemia (ALL), and one with biphenotypic leukemia. In this series of 24 patients whose disease had relapsed and who ha...


    pub_type: 杂志文章


    authors: Arlin ZA,Feldman EJ,Mittelman A,Ahmed T,Puccio C,Chun HG,Cook P,Baskind P,Marboe C,Mehta R

    更新日期:1991-09-15 00:00:00

  • The occurrence of soft tissue sarcomas in three siblings with Werner's syndrome.

    abstract::Werner's syndrome, a relatively rare and autosomal recessive disorder, is well known to be characterized by a high frequency of malignant neoplasm. The occurrence of familial neoplasm in patients with this condition, however, has been recorded only once before in the literature. Reported are the findings with regard t...


    pub_type: 杂志文章


    authors: Usui M,Ishii S,Yamawaki S,Hirayama T

    更新日期:1984-12-01 00:00:00

  • Cerebral metastases as first symptom of bronchogenic carcinoma. A prospective study of 37 cases.

    abstract::Among the patients showing evidence of cerebral metastases without previously known cancer history, lung cancer has been found 37 times as the primary tumor in our institution. There were 34 men and three women and all but two were heavy smokers. Only one presented at diagnosis with thoracic symptoms but the chest rad...


    pub_type: 杂志文章


    authors: Trillet V,Catajar JF,Croisile B,Turjman F,Aimard G,Bourrat C,Bret P,Carrie C,Chassard JL,Chauvin F

    更新日期:1991-06-01 00:00:00

  • Separate primary carcinomas of the esophagus and head and neck region in the same patient.

    abstract::From 1949 to 1972 at Memorial Sloan-Kettering Cancer Center, 60 patients with primary cancers of both the oral cavity, pharynx, larynx (OPL) and esophagus were studied. In 15, the cancers occurred synchronously, and in 68% they occurred within 2 years of each other, the longest interval being 27 years. The tongue and ...


    pub_type: 杂志文章


    authors: Cahan WG,Castro EB,Rosen PP,Strong EW

    更新日期:1976-01-01 00:00:00

  • Screening young adult cancer survivors with the PROMIS Depression Short Form (PROMIS-D-SF): Comparison with a structured clinical diagnostic interview.

    abstract:BACKGROUND:The current study was conducted to evaluate the Patient-Reported Outcomes Measurement Information System Depression Short Form (PROMIS-D-SF) as a screening measure for young adult cancer survivors (YACS) compared with a structured diagnostic interview. METHODS:A total of 249 YACS (aged 18-40 years) complete...


    pub_type: 杂志文章


    authors: Recklitis CJ,Blackmon JE,Chang G

    更新日期:2020-04-01 00:00:00

  • Cancer risks among Missouri farmers.

    abstract::A series of case-control studies was conducted to investigate cancer risks among farmers. These studies were based on Missouri Cancer Registry data for 15,000 white male patients, including 1720 subjects classified as farmers, registered between 1984 and 1988. For each cancer site, all other cancer registrations forme...


    pub_type: 杂志文章


    authors: Brownson RC,Reif JS,Chang JC,Davis JR

    更新日期:1989-12-01 00:00:00

  • Sarcomas (other than Ewing's) of flat bones in children and adolescents. A clinicopathologic study.

    abstract::The clinicopathologic features and response to therapy of 28 patients with non-Ewing's flat bone sarcoma treated at St. Jude Children's Research Hospital, Memphis, Tennessee, over a 25-year period were reviewed. Twenty-two patients had osteosarcoma, four malignant fibrous histiocytoma, one chondrosarcoma, and one fibr...


    pub_type: 杂志文章


    authors: Kellie SJ,Pratt CB,Parham DM,Fleming ID,Meyer WH,Rao BN

    更新日期:1990-02-15 00:00:00

  • Nutrition and diet.

    abstract::During recent years there has been a growing awareness among both the oncologic and nutrition communities about an association between nutrition and cancer causation with the practical implication of manipulating nutrition as a means of preventing cancer. Epidemiologic correlations, prospective studies of selected pop...


    pub_type: 杂志文章


    authors: Newell GR

    更新日期:1983-06-15 00:00:00

  • Therapy-related leukemia: a panmyelosis.

    abstract::Fifteen patients developed acute nonlymphocytic leukemia (ANLL) 31 to 182 months following chemotherapy and/or radiotherapy for various malignancies and one non-neoplastic disorder. The ANLL was commonly heralded by a brief preleukemic phase consisting of cytopenias and a variety of morphologic abnormalities. At diagn...


    pub_type: 杂志文章


    authors: Foucar K,McKenna RW,Bloomfield CD,Bowers TK,Brunning RD

    更新日期:1979-04-01 00:00:00

  • Antigenic markers of hepatocellular carcinoma.

    abstract::One hundred thirty-five hepatocellular carcinomas were examined for the presence of antigenic tumor markers by the avidin-biotin-peroxidase complex method. Ninety-seven were from the US and 38 came from Argentina. The following markers were tested: alpha-fetoprotein (AFP), alpha-1-antitrypsin (AAT), hepatitis B surfac...


    pub_type: 杂志文章


    authors: Chedid A,Chejfec G,Eichorst M,Villamil F,Terg R,Telenta M,Hojman R

    更新日期:1990-01-01 00:00:00

  • Long-term trends in the incidence rates of upper digestive tract cancer in the Netherlands Antilles.

    abstract::Data from the Cancer Registry in the Netherlands Antilles made clear that the incidence rate of cancer of the upper digestive tract in this country was among the highest in the world. To study the long-term trends in the incidence rate a retrospective population-based case-finding survey was performed. The author pres...


    pub_type: 杂志文章


    authors: Freni SC

    更新日期:1984-04-01 00:00:00

  • Barriers to effective treatment of pediatric solid tumors in middle-income countries: can we make sense of the spectrum of nonbiologic factors that influence outcomes?

    abstract:BACKGROUND:The delivery of effective treatment for pediatric solid tumors poses a particular challenge to centers in middle-income countries (MICs) that already are vigorously addressing pediatric cancer. The objective of this study was to improve the current understanding of barriers to effective treatment of pediatri...


    pub_type: 杂志文章,多中心研究


    authors: Friedrich P,Ortiz R,Fuentes S,Gamboa Y,Ah Chu-Sanchez MS,Arambú IC,Montero M,Báez F,Rodríguez-Galindo C,Antillón-Klussmann F,Central American Association of Pediatric Hematologists and Oncologists (AHOPCA).

    更新日期:2014-01-01 00:00:00

  • Second solid malignancies among children, adolescents, and young adults diagnosed with malignant bone tumors after 1976: follow-up of a Children's Oncology Group cohort.

    abstract:BACKGROUND:The growing number of individuals surviving childhood cancer has increased the awareness of adverse long-term sequelae. One of the most worrisome complications after cancer therapy is the development of second malignant neoplasms (SMNs). METHODS:The authors describe the incidence of solid organ SMN in survi...


    pub_type: 杂志文章


    authors: Goldsby R,Burke C,Nagarajan R,Zhou T,Chen Z,Marina N,Friedman D,Neglia J,Chuba P,Bhatia S

    更新日期:2008-11-01 00:00:00

  • Relationship of glycolytic enzyme activities and response of breast cancer patients to chemotherapy: A preliminary report.

    abstract::Activities of glucosephosphate isomerase, lactate dehydrogenase, and NADP-isocitrate dehydrogenase were significantly elevated in breast cancer specimens from patients who responded favorably to combination cytotoxic chemotherapy regimens compared with those in carcinomas from patients failing to respond to the same c...


    pub_type: 杂志文章


    authors: Hilf R,Savlov ED,Rector WD,Wittliff JL

    更新日期:1976-08-01 00:00:00

  • The role of tumor resection in the treatment of glioblastoma multiforme in adults.

    abstract:BACKGROUND:The therapeutic impact of tumor resection is poorly defined. Therefore the current study was conducted. METHODS:A retrospective, 2-institutional study was conducted (1991-1994) to compare the treatment results of stereotactic biopsy plus radiation therapy (99 patients; tumor dose: 60 gray [Gy]) with those o...


    pub_type: 杂志文章,多中心研究


    authors: Kreth FW,Berlis A,Spiropoulou V,Faist M,Scheremet R,Rossner R,Volk B,Ostertag CB

    更新日期:1999-11-15 00:00:00

  • Flow cytometry of breast carcinoma: I. Relation of DNA ploidy level to histology and estrogen receptor.

    abstract::Flow cytometry studies of the DNA distribution of tumor cells from 92 human breast cancers showed measurable aneuploidy (hyperploidy) in 83 cases (92%). The DNA ploidy values were unimodal in each case, but there was a bimodal distribution for the entire series. One group of tumors had a diploid or near diploid DNA di...


    pub_type: 杂志文章


    authors: Olszewski W,Darzynkiewicz Z,Rosen PP,Schwartz MK,Melamed MR

    更新日期:1981-08-15 00:00:00

  • Increasing levels of hypoxia in prostate carcinoma correlate significantly with increasing clinical stage and patient age: an Eppendorf pO(2) study.

    abstract:BACKGROUND:The purpose of this study was to analyze the extent of hypoxia in prostate carcinoma tumors using the Eppendorf pO(2) microelectrode and correlate this with pretreatment characteristics and prognostic factors. METHODS:Custom-made Eppendorf pO(2) microelectrodes were used to obtain pO(2) measurements from th...


    pub_type: 杂志文章


    authors: Movsas B,Chapman JD,Greenberg RE,Hanlon AL,Horwitz EM,Pinover WH,Stobbe C,Hanks GE

    更新日期:2000-11-01 00:00:00

  • Prognostic factors in gliomas. A multivariate analysis of clinical, pathologic, flow cytometric, cytogenetic, and molecular markers.

    abstract:BACKGROUND:The ability to divide subsets of patients with glial neoplasms into prognostic groups currently is limited because only a few clinical and pathologic variables are available. The goal of this investigation was to identify biologic factors of potential prognostic value in patients with cerebral gliomas. METH...


    pub_type: 杂志文章


    authors: Ganju V,Jenkins RB,O'Fallon JR,Scheithauer BW,Ransom DT,Katzmann JA,Kimmel DW

    更新日期:1994-08-01 00:00:00

  • p16(INK4A) immunohistochemical staining may be helpful in distinguishing branchial cleft cysts from cystic squamous cell carcinomas originating in the oropharynx.

    abstract:BACKGROUND:We investigated p16(INK4A) expression in branchial cleft cysts and its utility in distinguishing branchial cleft cysts from metastatic head and neck squamous cell carcinomas (SCCs) in fine-needle aspiration biopsies (FNABs). METHODS:A study set comprising 41 resections (15 SCC and 26 branchial cleft cysts) ...


    pub_type: 杂志文章


    authors: Pai RK,Erickson J,Pourmand N,Kong CS

    更新日期:2009-04-25 00:00:00

  • A Web-based communication aid for patients with cancer: the CONNECT Study.

    abstract:BACKGROUND:Cancer patients and their oncologists often report differing perceptions of consultation discussions and discordant expectations regarding treatment outcomes. CONNECT, a computer-based communication aid, was developed to improve communication between patients and oncologists. METHODS:CONNECT includes assess...


    pub_type: 杂志文章,随机对照试验


    authors: Meropol NJ,Egleston BL,Buzaglo JS,Balshem A,Benson AB 3rd,Cegala DJ,Cohen RB,Collins M,Diefenbach MA,Miller SM,Fleisher L,Millard JL,Ross EA,Schulman KA,Silver A,Slater E,Solarino N,Sulmasy DP,Trinastic J,Weinfurt K

    更新日期:2013-04-01 00:00:00

  • Hidden barriers between knowledge and behavior: the North Carolina prostate cancer screening and treatment experience.

    abstract:BACKGROUND:Prostate cancer (PC) mortality is much greater for African American than for Caucasian men. To identify patient factors that might account for some of this disparity, men within 6 months of diagnosis were surveyed about health attitudes and behavior. METHODS:Using Rapid Identification in the North Carolina ...


    pub_type: 杂志文章


    authors: Talcott JA,Spain P,Clark JA,Carpenter WR,Do YK,Hamilton RJ,Galanko JA,Jackman A,Godley PA

    更新日期:2007-04-15 00:00:00

  • Lymphokines, monoclonal antibodies, and other biological response modifiers in the treatment of cancer.

    abstract::Biologicals and biological response modifiers (BRMs) represent a new class of agents for cancer therapy. Historically, there have been many attempts to stimulate the immune response with nonspecific immunomodulators in the form of bacterial extracts, viruses, and chemicals. Although these approaches have occasionally ...


    pub_type: 杂志文章


    authors: Oldham RK,Thurman GB,Talmadge JE,Stevenson HC,Foon KA

    更新日期:1984-12-01 00:00:00

  • Influence of private practice setting and physician characteristics on the use of breast cancer adjuvant chemotherapy for elderly women.

    abstract:BACKGROUND:Although >70% of younger women with nonmetastatic breast cancer (BC) received adjuvant chemotherapy, only approximately 15% to 20% of elderly women with BC received chemotherapy. The decision to treat may be associated with nonmedical factors, such as patient, physician, or practice characteristics. In the c...


    pub_type: 杂志文章


    authors: Hershman DL,Buono D,McBride RB,Tsai WY,Neugut AI

    更新日期:2009-09-01 00:00:00

  • Evaluation of chromosome aneuploidy in tissue sections of preinvasive breast carcinomas using interphase cytogenetics.

    abstract:BACKGROUND:Little is known about cellular level genetic alterations in preinvasive breast lesions, particularly lobular carcinoma in situ. METHODS:We employed fluorescence in situ hybridization (FISH) using pericentromeric (alpha satellite) probes to assess numerical alterations of chromosomes 1, 7, 8, 16, 17, and X i...


    pub_type: 杂志文章


    authors: Visscher DW,Wallis TL,Crissman JD

    更新日期:1996-01-15 00:00:00

  • Expression of beta1 and beta4 integrins in normal arachnoid membrane and meningiomas.

    abstract:BACKGROUND:The aim of this work was to study the expression of alpha, beta1, and beta4 integrin subunits in meningiomas. METHODS:Seventeen atypical or anaplastic meningiomas were retrieved from the files of Hôpital de Bellevue, Saint-Etienne, France. They were compared with 17 benign meningiomas consecutively examined...


    pub_type: 杂志文章


    authors: Beschet I,Brunon J,Scoazec JY,Mosnier JF

    更新日期:1999-12-15 00:00:00