Abstract:
OBJECTIVE:Glioblastoma (GBM) is the most malignant form of astrocytoma. The average survival is 6-10 months in patients with recurrent GBM (rGBM). In this study, the authors evaluated the role of stereotactic radiosurgery (SRS) in patients with rGBMs. METHODS:The authors performed a retrospective review of their brain tumor database (1997-2016). Overall survival (OS) and progression-free survival (PFS) after salvage SRS were the primary endpoints evaluated. Response to SRS was assessed using volumetric MR images. RESULTS:Fifty-three patients with rGBM underwent salvage SRS targeting 75 lesions. The median tumor diameter and volume were 2.55 cm and 3.80 cm3, respectively. The median prescription dose was 18 Gy (range 12-24 Gy) and the homogeneity index was 1.90 (range 1.11-2.02). The median OS after salvage SRS was estimated to be 11.0 months (95% CI 7.1-12.2) and the median PFS after salvage SRS was 4.4 months (95% CI 3.7-5.0). A Karnofsky Performance Scale score ≥ 80 was independently associated with longer OS, while small tumor volume (< 15 cm3) and less homogeneous treatment plans (homogeneity index > 1.75) were both independently associated with longer OS (p = 0.007 and 0.03) and PFS (p = 0.01 and 0.002, respectively). Based on these factors, 2 prognostic groups were identified for PFS (5.4 vs 3.2 months), while 3 were identified for OS (median OS of 15.2 vs 10.5 vs 5.2 months). CONCLUSIONS:SRS is associated with longer OS and/or PFS in patients with good performance status, small-volume tumor recurrences, and heterogeneous treatment plans. The authors propose a prognostic model to identify a cohort of rGBM patients who may benefit from SRS.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Sharma M,Schroeder JL,Elson P,Meola A,Barnett GH,Vogelbaum MA,Suh JH,Chao ST,Mohammadi AM,Stevens GHJ,Murphy ES,Angelov Ldoi
10.3171/2018.4.JNS172909subject
Has Abstractpub_date
2018-10-19 00:00:00pages
489-499issue
2eissn
0022-3085issn
1933-0693pii
2018.4.JNS172909journal_volume
131pub_type
杂志文章abstract::OBJECTIVE Meige syndrome is characterized by blepharospasm and varied subphenotypes of craniocervical dystonia. Current literature on pallidal surgery for Meige syndrome is limited to case reports and a few small-scale studies. The authors investigated the clinical outcomes of deep brain stimulation (DBS) of the globu...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.7.JNS17323
更新日期:2018-01-19 00:00:00
abstract::The supplementary motor area (SMA) is a region located within each cerebral hemisphere at the posterior mesial border of the frontal lobe adjacent to the falx. The functional significance of this area has been somewhat unclear, and information regarding its influence on motor output has largely been based on evoked re...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1991.75.1.0062
更新日期:1991-07-01 00:00:00
abstract:OBJECT:The aim of this study was to determine the anatomical limitations of the transcallosal transchoroidal approach to the third ventricle. METHODS:Twenty-six formalin-fixed specimens were studied. Sagittal dissections were used to determine the anatomical relationships of the foramen of Monro, the angle of approach...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2008.7.JNS08124
更新日期:2009-09-01 00:00:00
abstract::Four-vessel angiography was repeated in 56 patients with confirmed subarachnoid hemorrhage in whom the initial investigation was negative. Only one aneurysm was demonstrated. The results suggested that, with good technique, careful observation, and a complete four-vessel cerebral angiography, a false negative rate of ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1978.48.5.0712
更新日期:1978-05-01 00:00:00
abstract:OBJECT:Intracerebral microdialysis has attracted increasing interest as a monitoring technique during neurological/neurosurgical intensive care. The purpose of this study was to compare cerebral energy metabolism, an indicator of secondary excitotoxic injury and cell membrane degradation close to focal traumatic lesion...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2005.102.3.0460
更新日期:2005-03-01 00:00:00
abstract::The authors describe a case of subarachnoid hemorrhage from moyamoya-like vessels associated with an arteriovenous malformation (AVM) in a 44-year-old Hispanic man who presented with severe headache. The AVM was located in the left parietal lobe and the ipsilateral middle cerebral artery was occluded. Although the pat...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2004.101.5.0869
更新日期:2004-11-01 00:00:00
abstract::Some intracranial aneurysms that might be considered inoperable by open craniotomy are readily treatable by stereotaxic thrombosis. This is possible because the stereotaxic technique requires only that some point on the fundus of the aneurysm can be punctured with a needle. Illustrative cases are given describing the ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1977.47.6.0833
更新日期:1977-12-01 00:00:00
abstract::OBJECTIVE Patients with poor-grade aneurysmal subarachnoid hemorrhage (aSAH) (World Federation of Neurosurgical Societies Grade IV or V) are often considered for decompressive craniectomy (DC) as a rescue therapy for refractory intracranial hypertension. The authors performed a systematic review and meta-analysis to a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,meta分析
doi:10.3171/2016.9.JNS161383
更新日期:2017-12-01 00:00:00
abstract:OBJECT:The Wilms tumor 1 (WT1) protein-a developmentally regulated transcription factor-is aberrantly expressed in gliomas and promotes their malignant phenotype. However, little is known about the molecular allies that help it mediate its oncogenic functions in glioma cells. METHODS:The authors used short interfering...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2011.11.JNS111455
更新日期:2012-04-01 00:00:00
abstract::To investigate the alteration of endothelium-dependent responses in chronic vasospasm after subarachnoid hemorrhage (SAH), experiments were carried out in the double-hemorrhage canine model. After the presence of vasospasm was confirmed by cerebral angiography on Days 0 and 7, pharmacological studies on the basilar ar...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1988.69.2.0239
更新日期:1988-08-01 00:00:00
abstract::Increasing evidence suggests that disturbances in the modulatory influence of the vasoactive peptide, calcitonin gene-related peptide (CGRP), contribute to the pathogenesis of cerebral vasospasm after subarachnoid hemorrhage (SAH). However, only limited success has been achieved in trials attempting to ameliorate vaso...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.82.1.0091
更新日期:1995-01-01 00:00:00
abstract:OBJECT:The authors have treated intractable pain, particularly cancer pain related to bone metastasis, with various protocols. Cancer pain has been treated by gamma knife radiosurgery (GKS), targeted to the pituitary gland-stalk, as an alternative new pain control method. The purpose of this study was to investigate a ...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.3171/jns.2002.97.supplement
更新日期:2002-12-01 00:00:00
abstract::A new technique is presented in which expandable compressed Ivalon sponge emboli were used to obliterate an intramedullary arteriovenous malformation of the spinal cord by intraparenchymal embolization. A case is described in which this method was used. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1977.47.1.0119
更新日期:1977-07-01 00:00:00
abstract::Cranial and spinal trauma resulted in disseminated intravascular coagulation (DIC) in a 78-year-old man, causing widespread bleeding and incoagulable blood. Traumatized brain tissue was found in the lumina of dural venous sinuses. The mechanisms of DIC are reviewed. It is suggested that intravascular release of potent...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.52.2.0266
更新日期:1980-02-01 00:00:00
abstract::This study provides an objective assessment of the reliability of histological grading of astrocytoma specimens obtained using stereotactic biopsy. Pathological diagnosis of brain tumors provides an index of disease severity and guides clinical practice in their treatment. It also functions as the gold standard in ass...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1996.85.6.1091
更新日期:1996-12-01 00:00:00
abstract::Metrizamide computerized tomographic cisternography (MCTC) has proved 100% successful in documenting the precise anatomic location of the dural osseous defect in three patients with sphenoethmoidal rhinorrhea. In each patient, direct surgical approach to the site indicated by MCTC terminated the leakage in a single pr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.53.2.0222
更新日期:1980-08-01 00:00:00
abstract:OBJECTIVE:Stereotactic radiosurgery (SRS) is a commonly employed treatment modality for brain arteriovenous malformations (AVMs). However, due to the low frequency of delayed cyst formation after AVM SRS, as well as the prolonged time interval between treatment and its occurrence, the characteristics of post-SRS cyst f...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.6.JNS17559
更新日期:2018-10-01 00:00:00
abstract:OBJECT:Botulinum toxin injections are the best therapeutic option in patients with spasmodic torticollis. Although a small number of patients do not benefit from such therapy, the majority respond well but may develop antibodies to the toxin after repeated applications. In those termed primary nonresponders, no improve...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2002.97.2.0207
更新日期:2002-09-01 00:00:00
abstract:OBJECT:The aim of this study was to evaluate different types of sensory stimulation used to distinguish between microvasculature and venous drainage on functional magnetic resonance (fMR) images with blood oxygen level-dependent (BOLD) contrast. METHODS:Seven volunteers received three sensory stimulations. One consist...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2000.93.3.0427
更新日期:2000-09-01 00:00:00
abstract::Although in several histological studies of arteriovenous malformation (AVM) nidi the presence of compartments has been documented, no clinical study has been published. The present study was conducted to determine the presence of nidus compartments in clinical cases by using a new radiographic method. Two patients wi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2002.96.4.0770
更新日期:2002-04-01 00:00:00
abstract::Clinical assessment of patients with subarachnoid hemorrhage (SAH) is important both in determining management and in predicting outcome. A previous report showed considerable observer inconsistency when patients were graded with either the Hunt and Hess or the Nishioka system. This study evaluates observer variabilit...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.58.1.0057
更新日期:1983-01-01 00:00:00
abstract::Pathological and experimental studies have shown that cerebral aneurysms develop in part as a result of injury to the blood vessel wall. One of the peculiar aspects of aneurysm development is a defective proliferative or healing response to such injury. To examine this phenomenon, blood coagulation Factor XIII, which ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1990.73.2.0242
更新日期:1990-08-01 00:00:00
abstract:OBJECT:In the preceding article, the authors described the Hydrocephalus Outcome Questionnaire (HOQ), a simple, reliable, and valid measure of health status in children with hydrocephalus. In the present study, they present their initial experience in using the HOQ to quantify the health status in a typical cohort of c...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2004.101.2.0141
更新日期:2004-11-01 00:00:00
abstract::Adults and children with low-grade gliomas often present with medically refractory epilepsy. Currently, controversy exists regarding the need for intraoperative electrocorticography (ECoG) to identify and, separately, resect seizure foci versus tumor removal alone to yield maximum seizure control in this patient popul...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1993.79.1.0062
更新日期:1993-07-01 00:00:00
abstract:OBJECT:There is increasing evidence that simulation provides high-quality, time-effective training in an era of resident duty-hour restrictions. Simulation may also permit trainees to acquire key skills in a safe environment, important in a specialty such as neurosurgery, where technical error can result in devastating...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,meta分析,评审
doi:10.3171/2014.5.JNS131766
更新日期:2014-08-01 00:00:00
abstract:OBJECT:Subarachnoid hemorrhage (SAH) with simultaneous acute subdural hematoma (SDH) is a severe disease. The authors' objective was to analyze the incidence, prognosis, and clinical outcome of patients suffering from aneurysm-related SAH and space-occupying acute SDH. METHODS:Between June 1999 and June 2011, data fro...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/2012.11.JNS121435
更新日期:2013-05-01 00:00:00
abstract::OBJECT Current recommendations stress the need for cognitive parameters to be integrated in the evaluation of outcomes for intracranial meningioma surgery. The aim of this prospective study was to examine neurocognitive function in meningioma patients pre- and postoperatively. METHODS Patients with skull base (anterio...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.6.JNS1549
更新日期:2016-06-01 00:00:00
abstract:OBJECT:The authors investigated whether HydroCoils decreased coil compaction and aneurysm recanalization in a canine model of a large, wide-necked, high-flow bifurcation aneurysm. METHODS:Eleven experimental aneurysms were created. Two aneurysms were untreated (Group 1); three were treated with standard platinum coils...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2004.101.6.0996
更新日期:2004-12-01 00:00:00
abstract::A meningioma occurred 36 years after surgical removal of a craniopharyngioma. No radiation therapy was instituted after the initial surgery. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.58.6.0947
更新日期:1983-06-01 00:00:00
abstract:OBJECT:Gliomatosis cerebri (GC), a rare entity characterized by a widespread infiltration of brain by tumor, lacks objective and quantitative diagnostic criteria. Single-voxel spectroscopy and chemical shift imaging (two-dimensional proton magnetic resonance [MR] spectroscopy) were performed using both short (20- or 22...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2003.98.2.0269
更新日期:2003-02-01 00:00:00