Abstract:
:Over 90 000 people are expected to be diagnosed with melanoma in the United States this year. The development of brain metastases is particularly difficult to manage. Over the past few years, melanoma patients with multiple unresectable brain metastases for which stereotactic surgery might also not be a viable option have fortunately experienced a dramatic expansion in available management options given improvements made to targeted agents, immunotherapy, and radiotherapy. Whole-brain radiation therapy (WBRT) is a long-standing radiation technique that has become increasingly sophisticated. In this review, we summarize retrospective and prospective studies on individual advances in targeted agents, immunotherapy, and WBRT, highlighting important variables such as overall survival, intracranial progression-free survival, control and response rates, and toxicities. We also discuss the recent integration of these therapies into a multimodality approach, which has shown promise in the clinical setting although toxicities have not been insignificant. Finally, we describe ongoing prospective trials relevant to melanoma with brain metastases, and we conclude with our own thoughts on the optimal approach for these patients.
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Jiang C,Wallington DG,Anker CJ,Lawson DH,Yushak ML,Kudchadkar RR,Tarhini A,Khan MKdoi
10.1093/neuros/nyaa076subject
Has Abstractpub_date
2020-09-01 00:00:00pages
498-515issue
3eissn
0148-396Xissn
1524-4040pii
5823283journal_volume
87pub_type
杂志文章,评审相关文献
NEUROSURGERY文献大全abstract:OBJECTIVE:Our goal was to increase the safety of anterior cervical discectomy, a routine surgery performed by neurosurgeons worldwide, in the face of vertebral artery (VA) anomalies. CLINICAL PRESENTATION:A 59-year-old woman had an intraoperative injury of the left VA during elective anterior cervical discectomy and f...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000374858.18717.33
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVE:To describe a novel stent remodeling technique for the coiling of ruptured wide-neck cerebral aneurysms. CLINICAL PRESENTATION:A 46-year-old man presented with acute subarachnoid hemorrhage (Hunt and Hess grade IV), intracerebral hemorrhage, and hydrocephalus. Cerebral angiography revealed a wide-neck small ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000350984.86323.61
更新日期:2009-11-01 00:00:00
abstract::Of 345 patients with tuberous sclerosis complex evaluated at the Mayo Clinic from 1950 to 1989, 23 were identified as having brain tumors. In 20 of the 23, histological or clinical evidence showed the tumor to be a subependymal giant cell astrocytoma. A search of the Mayo Clinic tissue registry yielded 73 giant cell-c...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:1991-06-01 00:00:00
abstract:BACKGROUND:Biochemical alterations associated with mechanical stress have been explored as an initiating step in the pathological progression of ligamentum flavum hypertrophy (LFH); however, this mechanism remains poorly understood. Recently, the inflammation induced after mechanical stress and the subsequent response ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000000755
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Neuromodulation is used to restore neural function in disorders that stem from an imbalance in the activity of specific neural networks when they prove refractory to pharmacological therapy. The Kir2.1 gene contributes to stabilizing the resting potential below the threshold of activation of voltage-gated so...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e318283f59a
更新日期:2013-04-01 00:00:00
abstract::The authors present a case of the accidental puncture of a spinal ependymoma causing bleeding and an increase in the preexisting neurological deficits. ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198505000-00016
更新日期:1985-05-01 00:00:00
abstract:BACKGROUND:Approximately 20% of low-grade gliomas (LGG) display visible protoporphyrin fluorescence during surgery after 5-aminolevulinic acid (5-ALA) administration. OBJECTIVE:To determine if fluorescence represents a prognostic marker in LGG. METHODS:Seventy-four consecutive patients with LGG (World Health Organiza...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyy365
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:Brain responses from concussive impacts in National Football League football games were simulated by finite element analysis using a detailed anatomic model of the brain and head accelerations from laboratory reconstructions of game impacts. This study compares brain responses with physician determined signs ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000186950.54075.3b
更新日期:2005-11-01 00:00:00
abstract::Intraoperative ultrasound can aid the biopsy of deep intracranial lesions. It is, perhaps, less clear whether ultrasound could be useful in functional neurosurgery, where the target is not abnormal in echogenicity. As an example, we chose to investigate in a dog model the periventricular gray target, which is frequent...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198408000-00002
更新日期:1984-08-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Traditionally, thoracic fractures that require anterior stabilization are treated through an open thoracotomy approach. Thoracoscopic instrumentation avoids many of the complications associated with an open thoracotomy but is technically challenging. We report the first cases of dual-rod intern...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000119229.92157.66
更新日期:2004-05-01 00:00:00
abstract::High upper thoracic sympathectomy using microsurgical techniques aided by electrical stimulation of the sympathetic chain is described. Use of the microscope facilitates identification and dissection of the sympathetic chain and minimizes the risk of pleural damage. Electrical stimulation of the sympathetic chain esta...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198903000-00026
更新日期:1989-03-01 00:00:00
abstract:BACKGROUND:The existence of tethering tracts in spinal dysraphism, other than congenital dermal sinus (CDS), has been recognized and has been summated into an integrated concept of limited dorsal myeloschisis (LDM). OBJECTIVE:To elucidate the underlying embryology of LDM in relation to CDS by focusing on the pathologi...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyy058
更新日期:2019-02-01 00:00:00
abstract::External ventricular drainage (EVD) was used before and after posterior fossa operations in 62 children and adolescents. In all cases, the removal of the tumor (midline in 47 and laternal in 15) was attempted; total removal was achieved in 41. The overall mortality was 6.5% (4 patients). Only 25% of the survivors need...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:1982-01-01 00:00:00
abstract:BACKGROUND:Cavity stereotactic radiotherapy has emerged as a standard option following resection of brain metastases. However, the optimal approach with either single-fraction or hypofractionated stereotactic radiotherapy (HSRT) remains a significant question. OBJECTIVE:To report outcomes for 5-fraction HSRT to the su...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyz162
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:To determine the clinical presentation and morbidity of the surgical management of peripheral nerve sheath tumors (PNSTs). METHODS:We performed a retrospective chart review of surgically treated PNSTs at the University of Miami between 1991 and 2008. RESULTS:There were a total of 140 cases, including 87 sch...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000367636.91555.70
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVE:To determine whether low-grade gliomas contain functional cortical activity more often than high-grade gliomas within radiologically defined abnormal tissue. METHODS:Patients with intra-axial cerebral lesions located in the vicinity of eloquent brain cortex preoperatively underwent magnetic source imaging. A...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200112000-00005
更新日期:2001-12-01 00:00:00
abstract::The clinical and radiographic presentations of 3 patients with intraventricular cavernous hemangioma are described. The accumulated total of 19 cases from the literature are compared to determine whether there is a common clinical and radiographic presentation for this benign intraventricular lesion. The differential ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198502000-00011
更新日期:1985-02-01 00:00:00
abstract:BACKGROUND:Deep brain stimulation alleviates tremor of various origins. Several regions like the ventralis intermediate nucleus of thalamus, the caudal zona incerta, and the posterior subthalamic region are generally targeted. Previous work with fiber tractography has shown the involvement of the cerebello-thalamo-cort...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000000540
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Spinal cord injury is one of several devastating complications after operation in the sitting position. Young patients exhibiting extraordinary growth spurts demonstrate a higher risk for this complication. CLINICAL PRESENTATION:We describe a 7-year-old male patient with a pineal region chorio...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199705000-00039
更新日期:1997-05-01 00:00:00
abstract::The sciatic nerve is by far the most common nerve accidentally injured during intramuscular injection. Despite its close proximity to the sciatic nerve, however, injury to the posterior femoral cutaneous nerve is apparently quite rare. In this report, clinical features of a patient with isolated injection injury to th...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-198911000-00027
更新日期:1989-11-01 00:00:00
abstract:BACKGROUND:Stereotactic radiosurgery (SRS) is used commonly for patients with brain metastases (BM) to improve intracranial disease control. However, survival of these patients is often dictated by their systemic disease course. The value of SRS becomes less clear in patients with anticipated short survival. OBJECTIVE...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyx346
更新日期:2018-07-01 00:00:00
abstract::In an attempt to eliminate the many negative aspects of conventional extensive laminectomy, we originated in 1981 and have developed a new surgical technique called "suspension laminotomy." A basic principle of this operation is preservation and repair of the soft and bony tissue of the spine with osseous enlargement ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198712000-00033
更新日期:1987-12-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to describe clinical situations requiring repeat embolization in patients previously treated by endovascular coil embolization for intracranial aneurysms, and to report on our experiences of repeat embolization (RE). METHODS:A total of 466 patients harboring 522 intracranial ane...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000194188.51731.13
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:We report an unusual case of basal ganglia granulomas caused by Candida albicans that surrounded the proximal segment of a nonfunctional cerebrospinal fluid shunt in a previously healthy patient. CLINICAL PRESENTATION:A 22-year-old woman had undergone ventriculoatrial cerebrospinal fluid shunt...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200010000-00037
更新日期:2000-10-01 00:00:00
abstract:OBJECTIVE:The prognosis of giant aneurysms remains poor despite recent advances in microneurosurgery. Thick-walled and partially calcified giant aneurysms with an atheromatic base are difficult to clip safely. Special techniques allowing reshaping of the base and ensuring the stability of clips are often needed. We pre...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000330400.68015.88
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Cerebrovascular autoregulation (CA) is an important hemodynamic mechanism that protects the brain against inappropriate fluctuations in cerebral blood flow in the face of changing cerebral perfusion pressure. Temporal CA failure is associated with worse outcomes in various acute neurological diseases. An int...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000001192
更新日期:2016-07-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Origination of the temporopolar artery (TPA) from the supraclinoid internal carotid artery (ICA) represents a rare anatomic variation, and the presence of aneurysms at this uncommon site has never before been reported. CLINICAL PRESENTATION:Two patients presented with a sudden onset of headach...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:2003-05-01 00:00:00
abstract::We describe a case of spondylotic lumbar spinal stenosis in an infirm elderly patient successfully treated with multilevel laminotomies. This procedure is less stressful to patients than a full laminectomy. In a selected subgroup of patients with "hourglass" spondylotic stenosis, it may provide adequate decompression....
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198807000-00021
更新日期:1988-07-01 00:00:00
abstract::The natural history of intracranial arteriovenous malformations (AVMs) was studied in 131 patients. The 83 patients managed nonsurgically and the 48 patients treated surgically were followed for an average of 8 years. Hemorrhage occurred in 61.8% of all patients. A second hemorrhage occurred in 67.4% of the survivors ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198411000-00003
更新日期:1984-11-01 00:00:00
abstract::Two unusual cases of constrictive arachnoiditis localized to thoracic levels after Pantopaque myelography and unrelated to any operation, trauma, or disc disease at these levels are presented. The pertinent literature is reviewed. ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:1980-03-01 00:00:00