Abstract:
BACKGROUND:Increasingly, biomarkers have been identified that correlate with improved overall and progression-free survival (OS and PFS) in glioblastoma, including MGMT methylation status and mutations in the IDH1 gene. In this study, we investigated the clinical and biological factors associated with long-term survival in glioblastoma patients treated with chemoradiotherapy. METHOD:Demographic and clinical data were collected for all patients with glioblastoma diagnosed between May 2004 and September 2007, treated with chemoradiotherapy and with associated tissue samples available for biomarker analysis. MGMT methylation was determined by pyrosequencing. IDH1 mutation was identified by R132H immunohistochemistry. Univariate Cox regression analysis of factors associated with survival and Kaplan-Meier survival analysis was performed using the SPSS statistics package. RESULTS:One hundred patients were included in the study. Median follow-up was 12.2 months (range 1.6-102.4). Median OS was 12.1 months (95 % CI: 10.8-13.3) and median PFS was 8.2 months (95 % CI: 6.8-9.5). The 2-, 3- and 5-year survival was 18, 9 and 6 % respectively. Three patients are still alive at 7.4, 8.3 and 8.5 years after diagnosis. Cox proportional-hazards regression identified independent prognostic factors for OS, female (p = 0.019), MGMT methylation (p < 0.0001) and IDH1 mutation (p = 0.023), and for PFS, MGMT methylation (p = 0.001) and IDH1 mutation (p = 0.018). Kaplan-Meier survival analysis showed that MGMT(methylated)/IDH1(+ve) was associated with a significantly longer OS 66.8 months (95 % CI: 0.0-167.8) and PFS 16.9 months (95 % CI: 11.1-22.7) when compared with MGMT(methylated)/IDH1(-ve) OS 15.5 months (95 % CI: 11.6-19.4) and PFS 9.4 months (95 % CI: 8-10.8) (log-rank, P = 0.000) and MGMT(unmethylated)/IDH1(-ve) OS 11.1 months (95 % CI: 8.5-13.7) and PFS 6.3 months (95 % CI: 4.4-8.3) (log-rank, p = 0.000). CONCLUSIONS:While the importance of MGMT methylation is well established, we demonstrate that the combination of MGMT(methylated)/IDH1(+ve) is associated with considerably longer OS and PFS in this series of chemoradiotherapy-treated glioblastoma tumours. The long-term cognitive function and quality of life in these long-term survivors warrant investigation.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Millward CP,Brodbelt AR,Haylock B,Zakaria R,Baborie A,Crooks D,Husband D,Shenoy A,Wong H,Jenkinson MDdoi
10.1007/s00701-016-2928-8subject
Has Abstractpub_date
2016-10-01 00:00:00pages
1943-53issue
10eissn
0001-6268issn
0942-0940pii
10.1007/s00701-016-2928-8journal_volume
158pub_type
杂志文章abstract:BACKGROUND:Major artery aneurysms may be found incidentally while evaluating moyamoya disease (MMD). The purpose of this study was to delineate the prevalence and characteristics of these uncommon aneurysms with a brief mention of their management and outcomes. METHODS:We conducted a retrospective review of 249 adult ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-011-0948-y
更新日期:2011-06-01 00:00:00
abstract::The cerebral pareses occurring in early childhood or produced subsequently by trauma or spontaneous cerebral haemorrhages, present a heterogenous symptomatic picture. In the forefront we find the spastic pareses associated with extra-pyramidal motor hyperkinesia (athetosis, dystonia, ballism). 36 C.P.-patients were su...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/978-3-7091-8482-0_2
更新日期:1977-01-01 00:00:00
abstract:OBJECT:Parafalcine subdural empyema and those along the superior and inferior surface of the tentorium are rare entities. We present a series of 10 patients where we have attempted to describe the pathophysiology, clinical features, and management of subdural empyema. METHODS:The study group included 10 cases of falco...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-010-0695-5
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:To investigate whether patients with critical emergency conditions are seeking or receiving the medical care that they require, we characterized the reality of care for patients presenting with neuro-emergencies during the first phase of the COVID-19 pandemic. METHODS:In this observational, longitudinal coh...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04437-z
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Deep brain stimulation (DBS) is an effective treatment for essential tremor (ET). Currently the ventrolateral thalamus is the target of choice, but the posterior subthalamic area (PSA), including the caudal zona incerta (cZi), has demonstrated promising results, and the subthalamic nucleus (STN) has been sug...
journal_title:Acta neurochirurgica
pub_type: 临床试验,杂志文章
doi:10.1007/s00701-011-1157-4
更新日期:2011-12-01 00:00:00
abstract::Firstly, 14 patients are described who developed either an acquired Chiari malformation (ACM) alone (7 cases) or ACM and syringomyelia (7 cases) after lumbar subarachnoid space (SAS) shunting or in one case, epidural anaesthesia with SAS penetration. Four groups are considered: 3 cases with craniofacial dysostosis and...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050119
更新日期:1998-01-01 00:00:00
abstract::Bilateral chylothorax following anterior cervical spine surgery is very rare. This report documents the first case of chylothorax after anterior cervical spine surgery through a right-side surgical approach. Unidentified chyle leakage can easily remain unrecognized and, thus, is difficult to treat. For early diagnosis...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-017-3294-x
更新日期:2017-10-01 00:00:00
abstract::For treatment of spasmodic torticollis (s.T.) microsurgical decompression of the intraspinal-intracranial portion of the accessory nerve (a.N.) has been performed in 11 patients with proved neurogenic lesions of the accessory nerve-dependent muscles. Neurogenic lesions were discovered by meticulous electromyographic (...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01406346
更新日期:1981-01-01 00:00:00
abstract:BACKGROUND:We used [F-18] FDG microPET imaging as part of a longitudinal study to investigate changes in the brain. METHODS:Glucose metabolism during the development of neuropathic pain after tibial and sural nerve transection (TST) model rats. MicroPET images were obtained 1 week before operation and then weekly for ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-015-2415-7
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVES:Ballistic injuries to peripheral nerves pose special challenges in terms of indications, timing and type of surgical intervention. The aim of the present work was to analyze our experience in the surgical treatment of peripheral nerve ballistic injuries with respect to the mechanism of injury (gunshot versus...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-014-2139-0
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Percutaneous radiofrequency trigeminal rhizotomy (RF-TR) is a well-established treatment for patients suffering from trigeminal neuralgia (TN) as a primary modality or for those refractory to medical treatment. However, few existing studies have identified intraoperative parameter or navigation technique tha...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-03941-1
更新日期:2019-07-01 00:00:00
abstract::After clipping of intracranial aneurysms, postoperative vasospasm may occur remote from the distribution area of the artery and may cause death. The authors report two cases and give the clinical, neuroradiological, and neuroanatomical findings. ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01773115
更新日期:1978-01-01 00:00:00
abstract::Three cases of surgically treated non-neoplastic diseases of the sella (two arachnoid cysts and one empty sella) are reported. All three patients had visual deficits but no gross endocrine disturbances. The study of these three clinical cases and an analysis of the relevant literature suggest a possible unitary hypoth...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01401097
更新日期:1977-01-01 00:00:00
abstract::We present a retrospective study of 41 patients treated by simple decompression for ulnar neuropathy. Pre- and postoperatively, patients were evaluated clinically and electrophysiologically. The median follow-up was 2 years (minimum: 0.5 years, maximum: 5.1 years). The leading pre-operative sign was motor loss in the ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01411742
更新日期:1996-01-01 00:00:00
abstract::The accuracy of CAT in the diagnosis of infratentorial expanding lesions is analysed on the basis of 224 personal cases. The posterior fossa lesions are classified in four groups according to the reliability of CAT as the only pre-operative examination. The present indications for conventional neuroadiological procedu...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01811344
更新日期:1978-01-01 00:00:00
abstract::An association between fibromuscular dysplasia (FMD) and intracranial aneurysms has been proposed but the occurrence of multiple aneurysms on the trunk of basilar artery (BA) associated with FMD has not been previously reported. ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-003-0163-6
更新日期:2004-01-01 00:00:00
abstract::We report 2 cases with haemorrhagic complications following percutaneous transluminal angioplasty (PTA) for carotid stenosis. Computed tomography (CT) scanning of these cases demonstrated diffuse subarachnoid haemorrhage in 1 case, and intracerebral haemorrhage in the other case on the next day after PTA. In the latte...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010070006
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:The Woven EndoBridge (WEB) device has been increasingly used for the treatment of intracranial aneurysms after aneurysmal subarachnoid hemorrhage (SAH). Still, recent major clinical trials on patient management after SAH have defined WEB embolization as an exclusion criterion. In an analysis of an unselected...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-03992-4
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:The wide variety of intraspinal cystic lesions necessitates different elaborate diagnostic procedures to choose the right therapeutic management in symptomatic patients. Based on the case reports of seven patients with symptomatic spinal arachnoid cysts we discuss the aetiology, diagnostic procedures and the...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010170102
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVE:Early repair of myelomeningocoele (MM) is associated with decreased morbidity and mortality. In sub-Saharan Africa, the peculiar harsh economic and social realities make late presentation, malnutrition and sepsis at presentation prevalent. As these factors may affect surgical repair, the aim of this study was...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-008-0002-x
更新日期:2008-09-01 00:00:00
abstract::In the present note, the cause of root compression in cases with degenerative lumbar spondylolisthesis is discussed in order to clarify the best method of surgery and to avoid iatrogenic damage of the cauda equina if a transpedicular fusion is going to be performed. The root compression is due to osteophytes growing o...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02187192
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:We developed a new simple therapeutic method for the treatment of chronic subdural hematoma (CSDH) without irrigation and drainage. This method is characterized by replacement of the hematoma with oxygen. METHODS:Seventy patients (seventy-eight sides) with CSDH were treated with this method from May 1994 to...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-005-0689-x
更新日期:2006-05-01 00:00:00
abstract::A computer system, based on IBM PC, was designed for the cerebrospinal compensatory model identification. The intracranial pressure (ICP) signal, registered during the lumbo-lumbar infusion test is analyzed by means of the spectral analysis algorithm in order to measure precisely the pulse wave amplitude. The amplitud...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01669992
更新日期:1990-01-01 00:00:00
abstract::The feasibility of diagnosing the malignancy and viability of intraparenchymal brain tumours using Gd-DTPA, enhanced and unenhanced T1-weighted MRIs was investigated. The relationship between the Gd-DTPA enhancement pattern, the growth fraction (GF) determined by using the anti-bromide-oxyuridine (BrdU) monoclonal ant...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01400619
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:Spinal cord stimulation (SCS) is a technique used worldwide to treat several types of chronic neuropathic pain refractory to any conservative treatment. The aim of this data collection is to enforce evidence of SCS effectiveness on neuropathic chronic pain reported in the literature and to speculate on the u...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,多中心研究
doi:10.1007/s00701-015-2352-5
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Subdural effusions (SDEs) can complicate arachnoid cysts of the middle cranial fossa (ACMFs). While there is a consensus that at least in adults asymptomatic ACMFs should not be operated, those with concomitant subdural and/or intracystic effusions are clinically apparent in the majority of cases and should ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-010-0820-5
更新日期:2011-01-01 00:00:00
abstract::The authors describe a seventeen-years-old girl suffering from partial seizures with complex symptomatology. The neuroradiological studies demonstrated a slow-growing glial tumour seated deeply in the right temporo-occipital region. Scalp EEG demonstrated a bilateral asynchronous temporal focus without definite latera...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01774387
更新日期:1978-01-01 00:00:00
abstract:OBJECTIVE:To study an effective method for surgical management of vertebral and basilar artery aneurysms. METHODS:Forty-one patients with 43 aneurysms of the vertebral and basilar arteries were managed by microsurgical clipping. Cerebral angiography revealed basilar apex aneurysms in 17 patients, basilar trunk in six ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-013-1656-6
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:The external ventricular drain (EVD) placement is one of the most common neurosurgical procedures. This operation is performed by freehand technique in the majority of cases; therefore, the operator's experience plays an important role in success and possible morbidity of this procedure. OBJECTIVE:To evalua...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04671-5
更新日期:2021-01-06 00:00:00
abstract::Thirteen of 145 patients with post-traumatic subdural hygroma (SDHy) developed chronic subdural haematoma (CSDH) at the involved site over a period of 6 years. CSDHs were found at the site of SDHys with no history of further head injury at a mean interval of 56 days. It appeared that these 13 patients did not have any...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01808545
更新日期:1994-01-01 00:00:00