Wednesday, June 25, 2014

PET/CT imaging in cancer: Current applications and future directions

PET/CT imaging in cancer: Current applications and future directions
Cancer

Positron emission tomography (PET) is a radiotracer imaging method that yields quantitative images of regional in vivo biology and biochemistry. PET, now used in conjunction with computed tomography (CT) in PET/CT devices, has had its greatest impact to date on cancer and is now an important part of oncologic clinical practice and translational cancer research. In this review of current applications and future directions for PET/CT in cancer, the authors first highlight the basic principles of PET followed by a discussion of the biochemistry and current clinical applications of the most commonly used PET imaging agent, 18F-fluorodeoxyglucose (FDG). Then, emerging methods for PET imaging of other biologic processes relevant to cancer are reviewed, including cellular proliferation, tumor hypoxia, apoptosis, amino acid and cell membrane metabolism, and imaging of tumor receptors and other tumor-specific gene products. The focus of the review is on methods in current clinical practice as well as those that have been translated to patients and are currently in clinical trials. Cancer 2014. © 2014 American Cancer Society.



Original Article: http://onlinelibrary.wiley.com/resolve/doi?DOI=10.1002/cncr.28860
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The role of whole brain radiation therapy in the management of melanoma brain metastases

The role of whole brain radiation therapy in the management of melanoma brain metastases
Radiation Oncology - Latest Articles

Background: Brain metastases are common in patients with melanoma, and optimal management is not well defined. As melanoma has traditionally been thought of as "radioresistant," the role of whole brain radiation therapy (WBRT) in particular is unclear. We conducted this retrospective study to identify prognostic factors for patients treated with stereotactic radiosurgery (SRS) for melanoma brain metastases and to investigate the role of additional up-front treatment with whole brain radiation therapy (WBRT). Methods: We reviewed records of 147 patients who received SRS as part of initial management of their melanoma brain metastases from January 2000 through June 2010. Overall survival (OS) and time to distant intracranial progression were calculated using the Kaplan-Meier method. Prognostic factors were evaluated using the Cox proportional hazards model. Results: WBRT was employed with SRS in 27% of patients and as salvage in an additional 22%. Age at SRS > 60 years (hazard ratio [HR] 0.64, p = 0.05), multiple brain metastases (HR 1.90, p = 0.008), and omission of up-front WBRT (HR 2.24, p = 0.005) were associated with distant intracranial progression on multivariate analysis. Extensive extracranial metastases (HR 1.86, p = 0.0006), Karnofsky Performance Status (KPS) <=80% (HR 1.58, p = 0.01), and multiple brain metastases (HR 1.40, p = 0.06) were associated with worse OS on univariate analysis. Extensive extracranial metastases (HR 1.78, p = 0.001) and KPS (HR 1.52, p = 0.02) remained significantly associated with OS on multivariate analysis. In patients with absent or stable extracranial disease, multiple brain metastases were associated with worse OS (multivariate HR 5.89, p = 0.004), and there was a trend toward an association with worse OS when up-front WBRT was omitted (multivariate HR 2.56, p = 0.08). Conclusions: Multiple brain metastases and omission of up-front WBRT (particularly in combination) are associated with distant intracranial progression. Improvement in intracranial disease control may be especially important in the subset of patients with absent or stable extracranial disease, where the competing risk of death from extracranial disease is low. These results are hypothesis generating and require confirmation from ongoing randomized trials.

Original Article: http://www.ro-journal.com/content/9/1/143
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Making the right software choice for clinically used equipment in radiation oncology

Making the right software choice for clinically used equipment in radiation oncology
Radiation Oncology

The customer of a new system for clinical use in radiation oncology must consider many options in order to find the optimal combination of software tools. Many commercial systems are available and each system has a large number of technical features. However an appraisal of the technical capabilities, especially the options for clinical implementations, is hardly assessable at first view.The intention of this article was to generate an assessment of the necessary functionalities for high precision radiotherapy and their integration in ROKIS (Radiation oncology clinic information system) for future customers, especially with regard to clinical applicability. Therefore we analysed the clinically required software functionalities and divided them into three categories: minimal, enhanced and optimal requirements for high conformal radiation treatment.

Original Article: http://www.ro-journal.com/content/9/1/145
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Trends in Fluorescence Image-Guided Surgery for Gliomas

Trends in Fluorescence Image-Guided Surgery for Gliomas
Neurosurgery - Current Issue

image Mounting evidence suggests that a more extensive surgical resection is associated with an improved life expectancy for both low-grade and high-grade glioma patients. However, radiographically complete resections are not often achieved in many cases because of the lack of sensitivity and specificity of current neurosurgical guidance techniques at the margins of diffuse infiltrative gliomas. Intraoperative fluorescence imaging offers the potential to improve the extent of resection and to investigate the possible benefits of resecting beyond the radiographic margins. Here, we provide a review of wide-field and high-resolution fluorescence-imaging strategies that are being developed for neurosurgical guidance, with a focus on emerging imaging technologies and clinically viable contrast agents. The strengths and weaknesses of these approaches will be discussed, as well as issues that are being addressed to translate these technologies into the standard of care. ABBREVIATIONS: 5-ALA, 5-aminolevulinic acid BBB, blood-brain barrier FIGS, fluorescence image-guided surgery ICG, indocyanine green LGG, low-grade glioma PpIX, protoporphyrin IX

Original Article: http://journals.lww.com/neurosurgery/Fulltext/2014/07000/Trends_in_Fluorescence_Image_Guided_Surgery_for.8.aspx
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It Is Time to Reevaluate the Management of Patients With Brain Metastases

It Is Time to Reevaluate the Management of Patients With Brain Metastases
Neurosurgery - Most Popular Articles

image There are many elements to the science that drives the clinical care of patients with brain metastases. Although part of an understanding that continues to evolve, a number of key historical misconceptions remain that commonly drive physicians' and researchers' attitudes and approaches. By understanding how these relate to current practice, we can better comprehend our available science to provide both better research and care. These past misconceptions include: Misconception 1: Once a primary cancer spreads to the brain, the histology of that primary tumor does not have much impact on response to chemotherapy, sensitivity to radiation, risk of further brain relapse, development of additional metastatic lesions, or survival. All tumor primary histologies are the same once they spread to the brain. They are the same in terms of the number of tumors, radiosensitivity, chemoresponsiveness, risk of further brain relapse, and survival. Misconception 2: The number of brain metastases matters. This number matters in terms of subsequent brain relapse, survival, and cognitive dysfunction; the precise number of metastases can also be used as a limit in determining which patients might be eligible for a particular treatment option. Misconception 3: Cancer in the brain is always a diffuse problem due to the presence of micrometastases. Misconception 4: Whole-brain radiation therapy invariably causes disabling cognitive dysfunction if a patient lives long enough. Misconception 5: Most brain metastases are symptomatic. Thus, it is not worth screening patients for brain metastases, especially because the impact on survival is minimal. The conduct and findings of past clinical research have led to conceptions that affect clinical care yet appear limiting. ABBREVIATIONS: CI, confidence interval HVLT, Hopkins Verbal Learning Test SRS, stereotactic radiosurgery WBRT, whole-brain radiotherapy

Original Article: http://journals.lww.com/neurosurgery/Fulltext/2014/07000/It_Is_Time_to_Reevaluate_the_Management_of.1.aspx
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Trends in Fluorescence Image-Guided Surgery for Gliomas

Trends in Fluorescence Image-Guided Surgery for Gliomas
Neurosurgery - Most Popular Articles

image Mounting evidence suggests that a more extensive surgical resection is associated with an improved life expectancy for both low-grade and high-grade glioma patients. However, radiographically complete resections are not often achieved in many cases because of the lack of sensitivity and specificity of current neurosurgical guidance techniques at the margins of diffuse infiltrative gliomas. Intraoperative fluorescence imaging offers the potential to improve the extent of resection and to investigate the possible benefits of resecting beyond the radiographic margins. Here, we provide a review of wide-field and high-resolution fluorescence-imaging strategies that are being developed for neurosurgical guidance, with a focus on emerging imaging technologies and clinically viable contrast agents. The strengths and weaknesses of these approaches will be discussed, as well as issues that are being addressed to translate these technologies into the standard of care. ABBREVIATIONS: 5-ALA, 5-aminolevulinic acid BBB, blood-brain barrier FIGS, fluorescence image-guided surgery ICG, indocyanine green LGG, low-grade glioma PpIX, protoporphyrin IX

Original Article: http://journals.lww.com/neurosurgery/Fulltext/2014/07000/Trends_in_Fluorescence_Image_Guided_Surgery_for.8.aspx
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Thursday, June 19, 2014

Medical management of metastatic medullary thyroid cancer

Medical management of metastatic medullary thyroid cancer
Cancer

Medullary thyroid cancer (MTC) is an aggressive form of thyroid cancer that occurs in both heritable and sporadic forms. Discovery that mutations in the rearranged during transfection (RET) proto-oncogene predispose to familial cases of this disease has allowed for presymptomatic identification of gene carriers and prophylactic surgery to improve the prognosis of these patients. A significant number of patients with the sporadic type of MTC and even those with familial disease still present with lymph node or distant metastases, making surgical cure difficult. Over the past several decades, many different types of therapy for metastatic disease have been attempted with limited success. Improved understanding of the molecular defects and pathways involved in both familial and sporadic MTC has resulted in new hope for these patients with the development of drugs targeting the specific alterations responsible. This new era of targeted therapy with kinase inhibitors represents a significant step forward from previous trials of chemotherapy, radiotherapy, and hormone therapy. Although much progress has been made, additional agents and strategies are needed to achieve durable, long-term responses in patients with metastatic MTC. This article reviews the history and results of medical management for metastatic MTC from the early 1970s up until the present day. Cancer 2014. © 2014 American Cancer Society.



Original Article: http://onlinelibrary.wiley.com/resolve/doi?DOI=10.1002/cncr.28858
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Endoscopic Versus Microsurgical Resection of Colloid Cysts: A Systematic Review and Meta-Analysis of 1,278 Cases

Endoscopic Versus Microsurgical Resection of Colloid Cysts: A Systematic Review and Meta-Analysis of 1,278 Cases
ScienceDirect Publication: World Neurosurgery

Publication date:
Source:World Neurosurgery
Author(s): Ahmed B. Sheikh , Zachary S. Mendelson , James K. Liu




Original Article: http://rss.sciencedirect.com/action/redirectFile?&zone=main¤tActivity=feed&usageType=outward&url=http://www.sciencedirect.com/science?_ob=GatewayURL&_origin=IRSSSEARCH&_method=citationSearch&_piikey=S1878875014005701&_version=1&md5=6e754ac57cdf2ba18c8097e1ba02297e
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Wednesday, June 18, 2014

Confira "Neurosurgery" App

https://play.google.com/store/apps/details?id=com.sodavirtual.neurosurgery
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The epidemiology of glioma in adults: a "state of the science" review

The epidemiology of glioma in adults: a "state of the science" review
Neuro-Oncology - current issue

Gliomas are the most common primary intracranial tumor, representing 81% of malignant brain tumors. Although relatively rare, they cause significant mortality and morbidity. Glioblastoma, the most common glioma histology (~45% of all gliomas), has a 5-year relative survival of ~5%. A small portion of these tumors are caused by Mendelian disorders, including neurofibromatosis, tuberous sclerosis, and Li-Fraumeni syndrome. Genomic analyses of glioma have also produced new evidence about risk and prognosis. Recently discovered biomarkers that indicate improved survival include O6-methylguanine-DNA methyltransferase methylation, isocitrate dehydrogenase mutation, and a glioma cytosine–phosphate–guanine island methylator phenotype. Genome-wide association studies have identified heritable risk alleles within 7 genes that are associated with increased risk of glioma. Many risk factors have been examined as potential contributors to glioma risk. Most significantly, these include an increase in risk by exposure to ionizing radiation and a decrease in risk by history of allergies or atopic disease(s). The potential influence of occupational exposures and cellular phones has also been examined, with inconclusive results. We provide a "state of the science" review of current research into causes and risk factors for gliomas in adults.



Original Article: http://neuro-oncology.oxfordjournals.org/cgi/content/short/16/7/896?rss=1
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Youtube: No maior canal literário, resenha do Livro “Após um Tumor Cerebral”

Youtube: No maior canal literário, resenha do Livro "Após um Tumor Cerebral"
Neurosurgery Blog

No maior canal literário com Tatiana Feltrin. Comentário sobre o livro "Após um Tumor Cerebral" … começa aos 4:46 min https://www.youtube.com/watch?v=YuxW_2mdM2M

Screen Shot 2014-06-08 at 11.58.29 AM

The post Youtube: No maior canal literário, resenha do Livro "Após um Tumor Cerebral" appeared first on NEUROSURGERY BLOG.



Original Article: http://neurocirurgiabr.com/youtube-no-maior-canal-literario-resenha-do-livro-apos-um-tumor-cerebral/?utm_source=rss&utm_medium=rss&utm_campaign=youtube-no-maior-canal-literario-resenha-do-livro-apos-um-tumor-cerebral
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Oncolytic polio virotherapy of cancer

Oncolytic polio virotherapy of cancer
Cancer

Recently, the century-old idea of targeting cancer with viruses (oncolytic viruses) has come of age, and promise has been documented in early stage and several late-stage clinical trials in a variety of cancers. Although originally prized for their direct tumor cytotoxicity (oncolytic virotherapy), recently, the proinflammatory and immunogenic effects of viral tumor infection (oncolytic immunotherapy) have come into focus. Indeed, a capacity for eliciting broad, sustained antineoplastic effects stemming from combined direct viral cytotoxicity, innate antiviral activation, stromal proinflammatory stimulation, and recruitment of adaptive immune effector responses is the greatest asset of oncolytic viruses. However, it also is the source for enormous mechanistic complexity that must be considered for successful clinical translation. Because of fundamentally different relationships with their hosts (malignant or not), diverse replication strategies, and distinct modes of tumor cytotoxicity/killing, oncolytic viruses should not be referred to collectively. These agents must be evaluated based on their individual merits. In this review, the authors highlight key mechanistic principles of cancer treatment with the polio:rhinovirus chimera PVSRIPO and their implications for oncolytic immunotherapy in the clinic. Cancer 2014. © 2014 American Cancer Society.



Original Article: http://onlinelibrary.wiley.com/resolve/doi?DOI=10.1002/cncr.28862
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Thursday, June 12, 2014

Check out Headache App

Check out this app on iTunes:

artwork

Headache App

Soda Virtual

Medical, Health & Fitness

Aug 3, 2012

View Item

The best treatment for migraine and recurrent headache is the correct diagnosis with accurate crises follow-up. This is what Headache
App offers to you. With this application you can record days and times of headache crises, pain intensity and location, symptoms that
accompany crises, medications you are taking, and even an alarm to remind you to take your medication in the correct time.

The information is cloud-saved so as you won't take the risk of losing anything. What makes it possible for you to access your data in
any Apple® device connected to the internet.

All this becomes a complete report so that your doctor may accurately identify the cause of the problem and prescribe the optimal
treatment.

Functionalities
✓ Registry of medications used
✓ Alarm to remind you the medication time
✓ Diary of crises registration (day, time, intensity, symptoms, pain location)
✓ Cloud-synchronized data
✓ Registry of menstrual period (important factor for headache in women)
✓ History of crises
✓ Share history with your doctor

The application is signed by:
★ Dr. Mauro Cruz Machado Borgo (Resident in Neurosurgery in Santa Casa de Belo Horizonte) - Neurosurgery Blog

★ Gervásio Teles Cardoso de Carvalho (Assistant of Neurosurgery of Santa Casa de Belo Horizonte and Faculdade de Ciências Médicas
de MG)

★ Júlio Leonardo Barbosa Pereira (Neurosurgery of Santa Casa de Belo Horizonte) - Neurosurgery Blog

★ Marcello Penholate Faria - Assistant of Neurosurgery of da Santa Casa de Belo Horizonte

★ Dr. Ariovaldo Alberto da Silva Junior

You have not been added to any email lists.

Copyright © 2014 Apple Inc. All rights reserved.


Júlio Leonardo B. Pereira
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A minimally invasive treatment option for large metastatic brain tumors: long-term results of two-session Gamma Knife stereotactic radiosurgery

A minimally invasive treatment option for large metastatic brain tumors: long-term results of two-session Gamma Knife stereotactic radiosurgery
Radiation Oncology - Latest Articles

Background: Large brain metastases (BM) remain a significant cause of morbidity and death for cancer patients despite current advances in multimodality therapies. The goal of the present study was to evaluate the efficacy and limitations of 2-session Gamma Knife stereotactic radiosurgery (SRS) for patients with large BM. Methods: This is a prospective, open-label and single arm study analyzing 58 consecutive patients who received 2-session SRS for large BM (>= 10 mL). The median age was 66 years, and the median Karnofsky performance status (KPS) score was 70. SRS was the initial treatment in 51 large tumors (84%) and was used as salvage after failed prior treatments for 10 tumors (16%). The fraction protocol was 20-30 Gy given in 2 fractions with 3-4 weeks between fractions. Overall survival (OS) and neurological death (ND), local tumor control and KPS were analyzed. Results: The median follow-up time was 9.0 months. One- and 2-year OS rates were 47% and 20%, respectively. The median OS time was 11.8 months (95% CI: 5.5-15.6). The causes of death were intracranial local progression in 5 cases, meningeal carcinomatosis in 3 and progression of the primary lesion in 39. One- and 2-year ND-free survival rates were 91% and 84%, respectively. In 52 of 61 large BM (85%) with sufficient radiological follow-up data, 6- and 12-month local tumor control rates were 85% and 64%, respectively. The mean KPS improved from 70 at the 1st SRS to 82 at the 2nd; the first follow-up mean KPS was 87 (P < 0.001). Symptomatic radiation injury developed and required conservative treatment in 3 patients (5%). Conclusions: Long-term follow-up showed that two-session Gamma Knife SRS achieved durable tumor control rates as well as acceptable treatment-related morbidity. This treatment method may potentially merit being offered to patients with large BM who are in poor condition or are otherwise ineligible for standard care.

Original Article: http://www.ro-journal.com/content/9/1/132
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Cobalt, Linac, or Other: What Is the Best Solution for Radiation Therapy in Developing Countries?

Cobalt, Linac, or Other: What Is the Best Solution for Radiation Therapy in Developing Countries?
International Journal of Radiation Oncology * Biology * Physics

The international growth of cancer and lack of available treatment is en route to become a global crisis. With >60% of cancer patients needing radiation therapy at some point during their treatment course, the lack of available facilities and treatment programs worldwide is extremely problematic. The number of deaths from treatable cancers is projected to increase to 11.5 million deaths in 2030 because the international population is aging and growing. In this review, we present how best to answer the need for radiation therapy facilities from a technical standpoint. Specifically, we examine whether cobalt teletherapy machines or megavoltage linear accelerator machines are best equipped to handle the multitudes in need of radiation therapy treatment in the developing world.

Original Article: http://www.redjournal.org/article/S0360-3016(13)03678-X/abstract?rss=yes
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Decision Analysis of Stereotactic Radiation Surgery Versus Stereotactic Radiation Surgery and Whole-Brain Radiation Therapy for 1 to 3 Brain Metastases

Decision Analysis of Stereotactic Radiation Surgery Versus Stereotactic Radiation Surgery and Whole-Brain Radiation Therapy for 1 to 3 Brain Metastases
International Journal of Radiation Oncology * Biology * Physics

Purpose: Although whole-brain radiation therapy (WBRT) is effective for controlling intracranial disease, it is also associated with neurocognitive side effects. It is unclear whether a theoretically improved quality of life after stereotactic radiation surgery (SRS) alone relative to that after SRS with adjuvant WBRT would justify the omission of WBRT, given the higher risk of intracranial failure. This study compares SRS alone with SRS and WBRT, to evaluate the theoretical benefits of intracranial tumor control with adjuvant WBRT against its possible side effects, using quality-adjusted life expectancy (QALE) as a primary endpoint.Methods and Materials: A Markov decision analysis model was used to compare QALE in a cohort of patients with 1 to 3 brain metastases and Karnofsky performance status of at least 70. Patients were treated with SRS alone or with SRS immediately followed by WBRT. Patients treated with SRS alone underwent surveillance magnetic resonance imaging and received salvage WBRT if they developed intracranial relapse. All patients whose cancer relapsed after WBRT underwent simulation as dying of intracranial progression. Model parameters were estimated from published literature.Results: Treatment with SRS yielded 6.2 quality-adjusted life months (QALMs). The addition of initial WBRT reduced QALE by 1.2 QALMs. On one-way sensitivity analysis, the model was sensitive only to a single parameter, the utility associated with the state of no evidence of disease after SRS alone. At values greater than 0.51, SRS alone was preferred.Conclusions: In general, SRS alone is suggested to have improved quality of life in patients with 1 to 3 brain metastases compared to SRS and immediate WBRT. Our results suggest that immediate treatment with WBRT after SRS can be reserved for patients who would have a poor performance status regardless of treatment. These findings are stable under a wide range of assumptions.

Original Article: http://www.redjournal.org/article/S0360-3016(14)00288-0/abstract?rss=yes
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Neurochemical Evidence of Potential Neurotoxicity After Prophylactic Cranial Irradiation

Neurochemical Evidence of Potential Neurotoxicity After Prophylactic Cranial Irradiation
International Journal of Radiation Oncology * Biology * Physics

Purpose: To examine whether cerebrospinal fluid biomarkers for neuroaxonal damage, neuroglial activation, and amyloid β–related processes could characterize the neurochemical response to cranial radiation.Methods and Materials: Before prophylactic cranial irradiation (PCI) of patients with small cell lung cancer, each patient underwent magnetic resonance imaging of the brain, lumbar puncture, and Mini-Mental State Examination of cognitive function. These examinations were repeated at approximately 3 and 12 months after radiation.Results: The major findings were as follows. (1) Cerebrospinal fluid markers for neuronal and neuroglial injury were elevated during the subacute phase after PCI. Neurofilament and T-tau increased 120% and 50%, respectively, after PCI (P<.05). The same was seen for the neuroglial markers YKL-40 and glial fibrillary acidic protein, which increased 144% and 106%, respectively, after PCI (P<.05). (2) The levels of secreted amyloid precursor protein-α and -β were reduced 44% and 46%, respectively, 3 months after PCI, and the levels continued to decrease as long as 1 year after treatment (P<.05). (3) Mini-Mental State Examination did not reveal any cognitive decline, indicating that a more sensitive test should be used in future studies.Conclusion: In conclusion, we were able to detect radiation therapy–induced changes in several markers reflecting neuronal injury, inflammatory/astroglial activation, and altered amyloid precursor protein/amyloid β metabolism, despite the low number of patients and quite moderate radiation doses (20-30 Gy). These changes are hypothesis generating and could potentially be used to assess the individual risk of developing long-term symptoms of chronic encephalopathy after PCI. This has to be evaluated in large studies with extended clinical follow-up and more detailed neurocognitive assessments.

Original Article: http://www.redjournal.org/article/S0360-3016(14)00335-6/abstract?rss=yes
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Stereotactic Radiation Therapy for Benign Meningioma: Long-Term Outcome in 318 Patients

Stereotactic Radiation Therapy for Benign Meningioma: Long-Term Outcome in 318 Patients
International Journal of Radiation Oncology * Biology * Physics

Purpose: To investigate the long-term outcome of stereotactic-based radiation therapy in a large cohort of patients with benign intracranial meningiomas.Methods and Materials: Between 1997 and 2010, 318 patients with histologically confirmed (44.7%; previous surgery) or imaging-defined (55.3%) benign meningiomas were treated with either fractionated stereotactic radiation therapy (79.6%), hypofractionated stereotactic radiation therapy (15.4%), or stereotactic radiosurgery (5.0%), depending on tumor size and location. Local control (LC), overall survival (OS), cause-specific survival (CSS), prognostic factors, and toxicity were analyzed.Results: The median follow-up was 50 months (range, 12-167 months). Local control, OS, and CSS at 5 years were 92.9%, 88.7%, and 97.2%, and at 10 years they were 87.5%, 74.1%, and 97.2%, respectively. In the multivariate analysis, tumor location (P=.029) and age >66 years (P=.031) were predictors of LC and OS, respectively. Worsening of pre-existing neurologic symptoms immediately after radiation therapy occurred in up to 2%. Clinically significant acute toxicity (grade 3°) occurred in 3%. Only grade 1-2 late toxicity was observed in 12%, whereas no new neurologic deficits or treatment-related mortality were encountered.Conclusions: Patients with benign meningiomas predominantly treated with standard fractionated stereotactic radiation therapy with narrow margins enjoy excellent LC and CSS, with minimal long-term morbidity.

Original Article: http://www.redjournal.org/article/S0360-3016(14)00287-9/abstract?rss=yes
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Do patients with advanced cancer value the physical examination?

Do patients with advanced cancer value the physical examination?
Cancer

Patients with advanced cancer still value the physical examination, according to the study by Kadakia et al. The exam serves both pragmatic and symbolic purposes for patients.



Original Article: http://onlinelibrary.wiley.com/resolve/doi?DOI=10.1002/cncr.28678
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Patterns of failure for glioblastoma multiforme following limited-margin radiation and concurrent temozolomide

Patterns of failure for glioblastoma multiforme following limited-margin radiation and concurrent temozolomide
Radiation Oncology - Latest Articles

Background: To analyze patterns of failure in patients with glioblastoma multiforme (GBM) treated with limited-margin radiation therapy and concurrent temozolomide. We hypothesize that patients treated with margins in accordance with Adult Brain Tumor Consortium guidelines (ABTC) will demonstrate patterns of failure consistent with previous series of patients treated with 2-3 cm margins. Methods: A retrospective review was performed of patients treated at the University of Alabama at Birmingham for GBM between 2000 and 2011. Ninety-five patients with biopsy-proven disease and documented disease progression after treatment were analyzed. The initial planning target volume includes the T1-enhancing tumor and surrounding edema plus a 1 cm margin. The boost planning target volume includes the T1-enhancing tumor plus a 1 cm margin. The tumors were classified as in-field, marginal, or distant if greater than 80%, 20-80%, or less than 20% of the recurrent volume fell within the 95% isodose line, respectively. Results: The median progression-free survival from the time of diagnosis to documented failure was 8 months (range 3-46). Of the 95 documented recurrences, 77 patients (81%) had an in-field component of treatment failure, 6 (6%) had a marginal component, and 27 (28%) had a distant component. Sixty-three patients (66%) demonstrated in-field only recurrence. Conclusions: The low rate of marginal recurrence suggests that wider margins would have little impact on the pattern of failure, validating the use of limited margins in accordance ABTC guidelines.

Original Article: http://www.ro-journal.com/content/9/1/130
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Wednesday, June 11, 2014

Structure of membrane protein that plays a role in signaling cell death could be new target for anticancer drugs

Structure of membrane protein that plays a role in signaling cell death could be new target for anticancer drugs
Neurology News & Neuroscience News from Medical News Today

Sometimes a cell has to die - when it's done with its job or inflicted with injury that could otherwise harm an organism. Conversely, cells that refuse to die when expected can lead to cancer.

Original Article: http://www.medicalnewstoday.com/releases/277948.php
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Gene variants may promote overall health while increasing risk of gliomas

Gene variants may promote overall health while increasing risk of gliomas
Neurology News & Neuroscience News from Medical News Today

New genomic research led by UC San Francisco (UCSF) scientists reveals that two common gene variants that lead to longer telomeres, the caps on chromosome ends thought by many scientists to confer...

Original Article: http://www.medicalnewstoday.com/releases/277955.php
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Sunday, June 8, 2014

ASCO Oncologists: Why I Tweet

ASCO Oncologists: Why I Tweet
MedPage Today Neurology

(MedPage Today) -- Why do you tweet and how do you use Twitter at the ASCO meeting? That's the question we asked a group of oncologists at the 2014 meeting.

Original Article: http://www.medpagetoday.com/HematologyOncology/LungCancer/46176
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Patterns of failure for glioblastoma multiforme following limited-margin radiation and concurrent temozolomide

Patterns of failure for glioblastoma multiforme following limited-margin radiation and concurrent temozolomide
Radiation Oncology

Background: To analyze patterns of failure in patients with glioblastoma multiforme (GBM) treated with limited-margin radiation therapy and concurrent temozolomide. We hypothesize that patients treated with margins in accordance with Adult Brain Tumor Consortium guidelines (ABTC) will demonstrate patterns of failure consistent with previous series of patients treated with 2-3 cm margins. Methods: A retrospective review was performed of patients treated at the University of Alabama at Birmingham for GBM between 2000 and 2011. Ninety-five patients with biopsy-proven disease and documented disease progression after treatment were analyzed. The initial planning target volume includes the T1-enhancing tumor and surrounding edema plus a 1 cm margin. The boost planning target volume includes the T1-enhancing tumor plus a 1 cm margin. The tumors were classified as in-field, marginal, or distant if greater than 80%, 20-80%, or less than 20% of the recurrent volume fell within the 95% isodose line, respectively. Results: The median progression-free survival from the time of diagnosis to documented failure was 8 months (range 3-46). Of the 95 documented recurrences, 77 patients (81%) had an in-field component of treatment failure, 6 (6%) had a marginal component, and 27 (28%) had a distant component. Sixty-three patients (66%) demonstrated in-field only recurrence. Conclusions: The low rate of marginal recurrence suggests that wider margins would have little impact on the pattern of failure, validating the use of limited margins in accordance ABTC guidelines.

Original Article: http://www.ro-journal.com/content/9/1/130
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Thursday, June 5, 2014

Após um Tumor Cerebral (Livro Digital)

Confira livro no iTunes:

artwork

APÓS UM TUMOR CEREBRAL

Júlio Pereira

Medicina, Livros, Profissional e técnico

23/01/2010

Visualizar Item

Esta obra narra a história de um médico neurocirurgião que descobre que tem um tumor cerebral, após essa descoberta ele resolveu escrever um livro sobre seu dia-dia lidando com doentes graves. O livro vai revelando o médico e seus pacientes, cada um deles com seus medos e suas preocupações.

Você não foi adicionado a nenhuma lista de e-mail.

Copyright © 2014 Apple Inc. Todos os direitos reservados.
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Wednesday, June 4, 2014

Neurosurgery App – Android and iPhone (FREE)

Neurosurgery App – Android and iPhone (FREE)
Neurosurgery Blog

Neurosurgery App (FREE)

Captura-de-Tela-2013-01-13-às-20.11.27

 

https://itunes.apple.com/br/app/neurosurgery-app/id587505622?l=en&mt=8

https://play.google.com/store/apps/details?id=com.sodavirtual.neurosurgery

 

Description

Latest news, researches and blog about Neurology, Neuroscience and Neurosurgery.
To provide neurosurgeons with the most timely comprehensive and relevant clinical information to improve patient care.
The mission of Neurosurgery blog is to facilitate the equitable, global dissemination of high-quality health research; to promote international dialogue and collaboration on health issues; to improve clinical practice; and to expand and deepen the understanding of health and health care.

The post Neurosurgery App – Android and iPhone (FREE) appeared first on NEUROSURGERY BLOG.



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