Abstract:
:This study investigated a single institution's experience with volumetric modulated arc therapy (VMAT) directed stereotactic ablative body radiotherapy (SABR) for vertebral metastases. From 2010 to 2014, 95 lesions of spinal metastases in 73 patients were treated with SABR using VMAT. Clinical local control, pain level, and use of steroid medication were employed to evaluate treatment responses. The majority (79%) of patients were treated with a radiation dose of 20 Gy in a single fraction. However, when normal tissue constraints could not be achieved, the dose was reduced to 18 Gy (11%) or 16 Gy (8%) in 1 fraction. At the median follow up of 12.7 months (mean 18.0, range 1-56 months), clinical local control was 97% (92 out of 95). There was a mean 81% (median 100%, range 28-100%) decrease in subjective pain score. Seventy-seven percent of patients had a decrease in narcotic pain medication use. Pain was completely resolved at the treatment site for 69% (66/95) of patients. Prior to the SABR treatment, 33% (31/95) of patients had epidural extension of tumor. Among patients with epidural involvement, 45% (14/31) exhibited neurologic impairment prior to treatment. Twenty-three percent (7/31) experienced spinal cord compression. Prior to treatment, 34 patients experienced some form of neurologic impairment. Of these patients, 24% (8/34) experienced improved motor functioning; the remaining 76% (26/34) of patients' neurological dysfunction were stable. Our results indicate the SABR regimen using VMAT technique is clinically effective in achieving clinical local control and palliation. This is the first publication reporting clinical outcomes of VMAT directed SABR.
journal_name
J Neurooncoljournal_title
Journal of neuro-oncologyauthors
Gestaut MM,Thawani N,Kim S,Gutti VR,Jhavar S,Deb N,Morrow A,Ward RA,Huang JH,Patel Mdoi
10.1007/s11060-017-2428-6subject
Has Abstractpub_date
2017-05-01 00:00:00pages
165-172issue
1eissn
0167-594Xissn
1573-7373pii
10.1007/s11060-017-2428-6journal_volume
133pub_type
杂志文章abstract::Glioblastoma is the most common and most aggressive primary brain tumor. Despite maximum treatment, patients only have a median survival time of 15 months, because of the tumor's resistance to current therapeutic approaches. Thus far, methylation of the O (6)-methylguanine-DNA methyltransferase (MGMT) promoter has bee...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章,评审
doi:10.1007/s11060-011-0793-0
更新日期:2012-05-01 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:SUBJECT:To date there is no established tumor marker for the clinical follow-up of glioblastoma, WHO grade IV, (GBM) which constitutes the most frequent and malignant primary brain tumor. However, since there is promising data that the serum glial fibrillary acidic protein (sGFAP) may serve as a biomarker for glial bra...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/s11060-018-2898-1
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Prior studies have highlighted infratentorial tumor location as a prognostic factor for solitary fibrous tumor (SFT) and hemangiopericytoma (HPC) of the central nervous system (CNS), and spinal location is considered a positive prognostic factor for other tumors of the CNS. While SFT/HPC of the CNS is known ...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/s11060-019-03177-0
更新日期:2019-07-01 00:00:00
abstract:PURPOSE:The purpose of this study is to describe the long-term toxicities of intracranial germ cell tumor (IGCT) in the adolescent and young adult (AYA) population. METHODS:We report late toxicities of a multi-center cohort of AYA patients treated for IGCT between 1975 and 2015. Charts were retrospectively reviewed fo...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/s11060-020-03642-1
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Recent studies suggest a relatively high prevalence of autoimmune disorders (AD) among primary CNS lymphoma (PCNSL) patients, however, the literature is limited to case reports. To gain a better understanding of AD-PCNSL we reviewed and analyzed all cases described in the literature. METHODS:We searched the...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/s11060-020-03583-9
更新日期:2020-08-01 00:00:00
abstract::A 44 year-old man with subcutaneous meningioma and rare combination of spinal lesions, consisting of dermal sinus and lipoma of the filum terminale. The literature concerning the subcutaneous meningioma is reviewed and the embryogenesis of these lesions is discussed. ...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1023/a:1005981110128
更新日期:1998-05-01 00:00:00
abstract::When SK-N-BE(2) human neuroblastoma cells were exposed for 1h to growth medium supplemented with [14C]arachidonic acid (AA) at final concentrations ranging from 1 microM to 100 microM, an amount of this fatty acid was uptaken ranging form a 2% to a 120% of that present in cells at steady state. As more [14C]AA was upt...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1023/a:1005714320865
更新日期:1997-01-01 00:00:00
abstract::Intravascular lymphomatosis (IL) is a rare entity only recently included in lymphoma classification, whose main feature is the exclusive or predominant growth of neoplastic cells within blood vessels. The vast majority of the patients affected by IL belong to the 7th or 8th decade of life and present with skin rash or...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1023/a:1006476701534
更新日期:2001-01-01 00:00:00
abstract::We describe a 61-year-old man with a multiple neurologic complication of Merkel cell carcinoma, a rare skin cancer. An enhancing brain mass, and cytologically proven leptomeningeal disease produced a succession of symptoms including seizures, bilateral radiculopathies, myoclonus, a cauda equina syndrome and altered me...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/BF01052924
更新日期:1994-01-01 00:00:00
abstract::Assessing central nervous system (CNS) involvement in patients with lymphoma or carcinoma is important in determining therapy and prognosis. Progranulin (PGRN) is a secreted glycosylated protein with roles in cancer growth and survival; it is highly expressed in aggressive cancer cell lines and specimens from many can...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/s11060-017-2742-z
更新日期:2018-05-01 00:00:00
abstract::Children with high-grade glioma (HGG) have a poor prognosis compared to those with low-grade glioma (LGG). Adjuvant chemotherapy may be beneficial, but its optimal use remains undetermined. Histology and extent of resection are important prognostic factors. We tested the hypothesis that patients with midline HGG treat...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11060-014-1669-x
更新日期:2015-02-01 00:00:00
abstract::The outcome of children less than 3 years of age with medulloblastoma has been poor in comparison to older children. The cure rates were below 30%, and the quality of life for cured children was frequently reduced by a complex syndrome of long-term sequelae including intellectual retardation and growth hormone deficie...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章,评审
doi:10.1023/a:1005924017460
更新日期:1998-06-01 00:00:00
abstract::Intra-cerebrospinal fluid chemotherapy (ICC) is used widely to treat or prevent neoplastic meningitis (NM), although its safety has not been thoroughly assessed. We aimed to analyse the incidence, severity and cause of the adverse reactions provoked by ICC in a cohort of onco-haematological patients. We retrospectivel...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/s11060-015-1922-y
更新日期:2015-11-01 00:00:00
abstract:PURPOSE:Meningiomas comprise up to 30% of primary brain tumors. The majority of meningioma patients enjoy high rates of control after conventional therapies. However, patients with recurrent disease previously treated with radiotherapy have few options for salvage treatment, and systemic interventions have proven large...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/s11060-018-03011-z
更新日期:2019-01-01 00:00:00
abstract::Once considered a "no man's land" especially when invaded by a diffuse low grade glioma (DLGG), the insula remains to this day a surgical challenge. Surgery for insular DLGG involves consideration of its hidden location under the potentially eloquent operculae, the proximity to vascular tree and high density of functi...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章,评审
doi:10.1007/s11060-016-2120-2
更新日期:2016-11-01 00:00:00
abstract::Glioblastomas are malignant brain tumors with poor prognosis. Lately, data from clinical studies assessing the role of co-medications in different cancer types suggested reduced mortality and potential anti-tumor activity for statins, angiotensin-I converting enzyme inhibitors (ACEI) and angiotensin II receptor blocke...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s11060-018-2786-8
更新日期:2018-05-01 00:00:00
abstract::Brain metastasis often has a poor prognosis in patients with advanced non-small cell lung cancer (NSCLC). Therefore, it is urgent to identify factors associated with lung cancer brain metastasis. Metastasis associated lung adenocarcinoma transcript 1 (MALAT1) also known as noncoding nuclear-enriched abundant transcrip...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/s11060-014-1613-0
更新日期:2015-01-01 00:00:00
abstract::In the following study, we present our experience in the treatment of PCNSL patients using a multi-step schedule combining chemotherapy and deferred radiotherapy. Patients were treated with two modified M-BACOD cycles and then differently according to radiological response For PR, SD and PD patients, chemotherapy was ...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/s11060-006-9276-0
更新日期:2007-05-01 00:00:00
abstract::Twenty-eight consecutive patients were given high-dose dexamethasone (96 mg i.v. loading dose, decreasing doses to zero in 14 days) and radiotherapy for epidural spinal cord compression due to malignant disease. There were eight events classified as side effects of the dexamethasone treatment. Four of these were consi...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/BF00172664
更新日期:1992-02-01 00:00:00
abstract::The EORTC trial which solidified the role of external beam radiotherapy (EBRT) plus temozolomide (TMZ) in the management of GBM excluded patients over age 70. Randomized studies of elderly patients showed that hypofractionated EBRT (HFRT) alone or TMZ alone was at least equivalent to conventionally fractionated EBRT (...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/s11060-017-2493-x
更新日期:2017-08-01 00:00:00
abstract::Radiation necrosis is a devastating complication following radiation to the central nervous system. The purpose of this study was to perform a comprehensive analysis of cases in the literature using bevacizumab, a monoclonal antibody against vascular endothelial growth factor, as treatment for radiation necrosis. A ME...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/s11060-014-1391-8
更新日期:2014-04-01 00:00:00
abstract::Thirty-six infants and children with brain stem glioma diagnosed between 1967 and 1980 were reviewed. Posterior fossa craniotomy was performed in 25, with biopsy or partial resection in 18, cyst aspiration in 2, and exploration alone in 5. The 19 surgical specimens obtained revealed neoplastic cells in 15 but only gli...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/BF00177896
更新日期:1984-01-01 00:00:00
abstract::The Hedgehog (Hh) signaling pathway has been implicated in the most common childhood brain tumor, medulloblastoma (MB). Given the toxicity of post-surgical treatments for MB, continued need exists for new, targeted therapies. Based upon our finding that Neuropilin (Nrp) transmembrane proteins are required for Hh signa...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/s11060-013-1216-1
更新日期:2013-11-01 00:00:00
abstract::Treatment of infant hypothalamic chiasmatic glioma (iCHG) is challenging, about 30% of the children progress during chemotherapy. Despite subsequent treatments the 5 year overall-survival rate is only 70%. This study investigates treatment strategies currently applied for progressive iCHG. A web-based questionnaire wa...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/s11060-017-2630-6
更新日期:2018-01-01 00:00:00
abstract::Six children (ages 2 to 14 years) with recurrent or poor risk primary brain tumors were treated with the '8 drugs in 1 day' chemotherapy regimen. As renal function deteriorated (median after five cycles), carboplatin was substituted in place of cisplatin at a median dose of 300 mg/m2 as a one hour infusion at hour thr...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/BF02427836
更新日期:1990-10-01 00:00:00
abstract:PURPOSE:To evaluate the hypothesis that adults with partially resected (PR<50% resection) supratentorial low-grade glioma (LGG) benefit from higher doses of radiation. METHODS:Patients receiving post-operative radiation for WHO grade I-II LGG at the University of Western Ontario between 1979 and 2001 were studied. Pat...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/s11060-006-9141-1
更新日期:2007-04-01 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: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::Diffuse invasion of the brain by tumor cells is a hallmark of human glioblastomas and a major cause for the poor prognosis of these tumors. This phenomenon is only partially reproduced by rodent models of gliomas that display a very high rate of proliferation and limited cell migration. We have analyzed the developmen...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1023/a:1010620420241
更新日期:2001-05-01 00:00:00