Pub Date : 2019-03-01Epub Date: 2019-02-28DOI: 10.2217/cns-2018-0012
Sagar Bhalerao, Rajnish Nagarkar, Aditya Adhav
Astroblastoma is an uncommon neuroepithelial primary tumor of the brain which is of uncertain origin. We present a case of high-grade astroblastoma in an 18-year-old female with a severe headache, loss of appetite, vomiting and generalized weakness. The patient had undergone a right frontoparietal craniotomy. Large subfalcine meningioma was excised. The lesion was suspected to be a meningioma. Primary radiological investigation revealed a 6.8 cm × 5.8 cm × 5.4 cm lesion. Although the radiological and intraoperative findings were of an extra-axial tumor, the histology and immunophenotype was of an astroblastoma. The patient was treated with cyclophosphamide, cisplatin and etoposide chemotherapy regimen. The patient was later treated with bi-weekly bevacizumab. The patient had improved symptomatically post-chemotherapy. However, there was no significant difference in lesion size. The patient died after 2 weeks. The prognosis of patients with astroblastoma is extremely poor as observed in our case.
星形母细胞瘤是一种罕见的脑神经上皮原发肿瘤，来源不明。我们报告一例高级别星形母细胞瘤在一个18岁的女性严重头痛，食欲不振，呕吐和全身无力。患者接受了右侧额顶开颅手术。切除大的垂体下脑膜瘤。病变被怀疑是脑膜瘤。初步放射检查显示一个6.8 cm × 5.8 cm × 5.4 cm的病变。虽然放射学和术中发现是轴外肿瘤，但组织学和免疫表型是星形母细胞瘤。患者给予环磷酰胺、顺铂、依托泊苷化疗方案。患者随后接受双周贝伐单抗治疗。患者化疗后症状有所改善。但两组在病变大小上无明显差异。患者于2周后死亡。在我们的病例中观察到，星形母细胞瘤患者的预后非常差。
{"title":"A case report of high-grade astroblastoma in a young adult.","authors":"Sagar Bhalerao, Rajnish Nagarkar, Aditya Adhav","doi":"10.2217/cns-2018-0012","DOIUrl":"https://doi.org/10.2217/cns-2018-0012","url":null,"abstract":"<p><p>Astroblastoma is an uncommon neuroepithelial primary tumor of the brain which is of uncertain origin. We present a case of high-grade astroblastoma in an 18-year-old female with a severe headache, loss of appetite, vomiting and generalized weakness. The patient had undergone a right frontoparietal craniotomy. Large subfalcine meningioma was excised. The lesion was suspected to be a meningioma. Primary radiological investigation revealed a 6.8 cm × 5.8 cm × 5.4 cm lesion. Although the radiological and intraoperative findings were of an extra-axial tumor, the histology and immunophenotype was of an astroblastoma. The patient was treated with cyclophosphamide, cisplatin and etoposide chemotherapy regimen. The patient was later treated with bi-weekly bevacizumab. The patient had improved symptomatically post-chemotherapy. However, there was no significant difference in lesion size. The patient died after 2 weeks. The prognosis of patients with astroblastoma is extremely poor as observed in our case.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"8 1","pages":"CNS29"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2018-0012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37006672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-01Epub Date: 2019-02-26DOI: 10.2217/cns-2018-0007
Ugonma N Chukwueke, Patrick Y Wen
Between 2010 and 2014, the incidence rate of primary brain tumors in persons (aged >20 years) was 29.2 per 100,000; in children (aged <20 years), the rate was 5.81 per 100,000 [1]. Metastatic CNS tumors are known to be the most commonly occurring malignancy of the brain, although reporting for this disease is limited. Likely owing to multiple factors including improving survival from systemic malignancies, better tolerability of treatments, as well as timely and effective integration of supportive care, the incidence of CNS metastatic disease is expected to continue to increase [2]. Newer therapies and emphasis on clinical trial enrollment has made the need for effective approaches to assessing disease response even more critical. The Response Assessment in Neuro-Oncology (RANO) working group was established to improve the assessment of tumor response and selection of end points, specifically in the context of clinical trial [3]. There has been an evolution in determining which endpoints and criteria are most important in determining therapeutic response, specifically with advances in imaging modalities. In the era of computed tomography (CT), Levin et al. conducted a retrospective analysis of 100 brain tumor patients, in which they reviewed the predictive value of specific factors and its impact upon response to treatment. In this study, the combination of radionuclide and CT scans, as well as diligent monitoring of changes in dexamethasone dose were thought to be predictive of clinical deterioration and response to chemotherapy [4]. In the following decades, the field of neuro-oncology relied upon methods derived from the extracranial solid tumor oncology, notably the MacDonald criteria and the Response Evaluation Criteria in Solid Tumors (RECIST), both methods presenting shortcoming and challenges to effective response assessment in CNS tumors. In 1990, the MacDonald criteria were proposed as the standard for assessment of response and progression, specifically in patients with high-grade glioma. These criteria used the product of the maximal perpendicular diameters but also incorporated changes in corticosteroid doses as well as neurologic function [5]. In this scheme, adopting standards from medical oncology, four categories were recommended: complete response, in which there is disappearance of all enhancing disease concomitant with neurological improvement or stability AND absence of steroids, partial response or ≥50% reduction in enhancing disease as well as stable neurologic status and steroid use; progressive disease (PD) or ≥ 25% increase in enhancing disease or worsening neurologic status in the setting of stable or increasing steroid use and last, stable disease (SD) defined as all other scenarios [5]. RECIST was used occasionally for evaluation of treatment response in primary and metastatic brain tumors but most brain tumor trials used the MacDonald criteria preferentially, since it was felt that use of two orthogonal diameters (2D
{"title":"Use of the Response Assessment in Neuro-Oncology (RANO) criteria in clinical trials and clinical practice.","authors":"Ugonma N Chukwueke, Patrick Y Wen","doi":"10.2217/cns-2018-0007","DOIUrl":"10.2217/cns-2018-0007","url":null,"abstract":"Between 2010 and 2014, the incidence rate of primary brain tumors in persons (aged >20 years) was 29.2 per 100,000; in children (aged <20 years), the rate was 5.81 per 100,000 [1]. Metastatic CNS tumors are known to be the most commonly occurring malignancy of the brain, although reporting for this disease is limited. Likely owing to multiple factors including improving survival from systemic malignancies, better tolerability of treatments, as well as timely and effective integration of supportive care, the incidence of CNS metastatic disease is expected to continue to increase [2]. Newer therapies and emphasis on clinical trial enrollment has made the need for effective approaches to assessing disease response even more critical. The Response Assessment in Neuro-Oncology (RANO) working group was established to improve the assessment of tumor response and selection of end points, specifically in the context of clinical trial [3]. There has been an evolution in determining which endpoints and criteria are most important in determining therapeutic response, specifically with advances in imaging modalities. In the era of computed tomography (CT), Levin et al. conducted a retrospective analysis of 100 brain tumor patients, in which they reviewed the predictive value of specific factors and its impact upon response to treatment. In this study, the combination of radionuclide and CT scans, as well as diligent monitoring of changes in dexamethasone dose were thought to be predictive of clinical deterioration and response to chemotherapy [4]. In the following decades, the field of neuro-oncology relied upon methods derived from the extracranial solid tumor oncology, notably the MacDonald criteria and the Response Evaluation Criteria in Solid Tumors (RECIST), both methods presenting shortcoming and challenges to effective response assessment in CNS tumors. In 1990, the MacDonald criteria were proposed as the standard for assessment of response and progression, specifically in patients with high-grade glioma. These criteria used the product of the maximal perpendicular diameters but also incorporated changes in corticosteroid doses as well as neurologic function [5]. In this scheme, adopting standards from medical oncology, four categories were recommended: complete response, in which there is disappearance of all enhancing disease concomitant with neurological improvement or stability AND absence of steroids, partial response or ≥50% reduction in enhancing disease as well as stable neurologic status and steroid use; progressive disease (PD) or ≥ 25% increase in enhancing disease or worsening neurologic status in the setting of stable or increasing steroid use and last, stable disease (SD) defined as all other scenarios [5]. RECIST was used occasionally for evaluation of treatment response in primary and metastatic brain tumors but most brain tumor trials used the MacDonald criteria preferentially, since it was felt that use of two orthogonal diameters (2D","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"8 1","pages":"CNS28"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2018-0007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36999734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-01Epub Date: 2019-02-07DOI: 10.2217/cns-2018-0017
Michael Murphy, Anthony Dowling, Christopher Thien, Emma Priest, Donna Morgan Murray, Santosh Kesari
Aim: Evaluation of the Nativis Voyager®, an investigational medical device, as monotherapy for recurrent glioblastoma (rGBM).
Materials & methods: A total of 15 patients with rGBM were treated with one of two Voyager ultra-low radio frequency energy cognates: A1A or A2HU. Safety and clinical utility were assessed every 2-4 months.
Results: Median overall survival was 8.04 months in the A1A arm and 6.89 months in the A2HU arm. No serious adverse events associated with Voyager were reported. No clinically relevant trends were noted in clinical laboratory parameters or physical exams.
Conclusion: The data suggest that the Voyager is safe and feasible for the treatment of rGBM.
{"title":"A feasibility study of the Nativis Voyager<sup>®</sup> device in patients with recurrent glioblastoma in Australia.","authors":"Michael Murphy, Anthony Dowling, Christopher Thien, Emma Priest, Donna Morgan Murray, Santosh Kesari","doi":"10.2217/cns-2018-0017","DOIUrl":"https://doi.org/10.2217/cns-2018-0017","url":null,"abstract":"<p><strong>Aim: </strong>Evaluation of the Nativis Voyager<sup>®</sup>, an investigational medical device, as monotherapy for recurrent glioblastoma (rGBM).</p><p><strong>Materials & methods: </strong>A total of 15 patients with rGBM were treated with one of two Voyager ultra-low radio frequency energy cognates: A1A or A2HU. Safety and clinical utility were assessed every 2-4 months.</p><p><strong>Results: </strong>Median overall survival was 8.04 months in the A1A arm and 6.89 months in the A2HU arm. No serious adverse events associated with Voyager were reported. No clinically relevant trends were noted in clinical laboratory parameters or physical exams.</p><p><strong>Conclusion: </strong>The data suggest that the Voyager is safe and feasible for the treatment of rGBM.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"8 1","pages":"CNS31"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2018-0017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36936361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-01Epub Date: 2019-02-15DOI: 10.2217/cns-2018-0019
Victor A Levin
Need for better treatments for glioblastoma Overall survival of people afflicted with glioblastoma (GBM) has improved modestly over the past 30 years and ranges between a median overall survival of 10 and 16 months depending on factors such as age, gender, extent of surgery, molecular-genetic features of resected tumors, radiation therapy and chemotherapy. Treatment options for people afflicted with GBM have changed somewhat based on molecular-genetic profiles that define worst-case scenarios [1–3] and improvements in radiation therapy that have also reduced CNS toxicity somewhat [4]. Based on patient convenience and outcomes, temozolomide has become the major anticancer drug therapy for these tumors [5]. Most recently, chronic treatment with alternating electric tumor treating fields to the head has gained US FDA approval for the treatment of GBM [6,7]. New therapies, especially new chemotherapy drugs, have been limited to brain penetrant alkylating agents (i.e., carmustine, lomustine, and temozolomide) since the 1970s. There are several reasons for this, which relate to drug delivery to infiltrative tumor cells behind the blood–brain barrier (BBB), drug residence time on tumor cell target, appropriateness of cellular target and the need to inhibit more than one cellular target, drug pharmacokinetics and drug safety [8,9].
{"title":"How far will the Voyager<sup>®</sup> take us?","authors":"Victor A Levin","doi":"10.2217/cns-2018-0019","DOIUrl":"https://doi.org/10.2217/cns-2018-0019","url":null,"abstract":"Need for better treatments for glioblastoma Overall survival of people afflicted with glioblastoma (GBM) has improved modestly over the past 30 years and ranges between a median overall survival of 10 and 16 months depending on factors such as age, gender, extent of surgery, molecular-genetic features of resected tumors, radiation therapy and chemotherapy. Treatment options for people afflicted with GBM have changed somewhat based on molecular-genetic profiles that define worst-case scenarios [1–3] and improvements in radiation therapy that have also reduced CNS toxicity somewhat [4]. Based on patient convenience and outcomes, temozolomide has become the major anticancer drug therapy for these tumors [5]. Most recently, chronic treatment with alternating electric tumor treating fields to the head has gained US FDA approval for the treatment of GBM [6,7]. New therapies, especially new chemotherapy drugs, have been limited to brain penetrant alkylating agents (i.e., carmustine, lomustine, and temozolomide) since the 1970s. There are several reasons for this, which relate to drug delivery to infiltrative tumor cells behind the blood–brain barrier (BBB), drug residence time on tumor cell target, appropriateness of cellular target and the need to inhibit more than one cellular target, drug pharmacokinetics and drug safety [8,9].","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"8 1","pages":"CNS26"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2018-0019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36561995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Journal Watch: our panel of experts highlight the most important research articles across the spectrum of topics relevant to the field of CNS oncology.","authors":"W. Ng, L. Qiu, Jia Xu Lim, N. Primalani","doi":"10.2217/cns-2019-0005","DOIUrl":"https://doi.org/10.2217/cns-2019-0005","url":null,"abstract":"","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"3 1","pages":"CNS32"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75741391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01Epub Date: 2018-12-13DOI: 10.2217/cns-2018-0002
Paul MacMahon, Collin M Labak, Sarah E Martin-Bach, Ahmad Issawi, Kiran Velpula, Andrew J Tsung
Background: Transformation to glioblastoma following recurrent epidermoid cyst resection has not been reported. Chronic inflammation can underlie malignant transformation of epidermoid cysts. Astrogliosis following repeated resections may have induced the rare transformation to glioblastoma.
Clinical presentation: A patient presenting with left lower extremity weakness was found to harbor a parietal mass lesion. Histopathology demonstrated an epidermoid cyst. Following multiple re-resections, an intra-axial mass was discovered within the operative bed, confirmed as glioblastoma.
Conclusion: This is the first report of glioblastoma associated with a resected epidermoid cyst. Subsequent to resection, the chronic inflammatory milieu propagated by astrogliosis is thought to have induced malignancy. The progression to glioblastoma draws attention to neoplastic transformation in the context of recurrent epidermoids.
{"title":"Glioblastoma formation in a recurrent intracranial epidermoid cyst: a case report.","authors":"Paul MacMahon, Collin M Labak, Sarah E Martin-Bach, Ahmad Issawi, Kiran Velpula, Andrew J Tsung","doi":"10.2217/cns-2018-0002","DOIUrl":"https://doi.org/10.2217/cns-2018-0002","url":null,"abstract":"<p><strong>Background: </strong>Transformation to glioblastoma following recurrent epidermoid cyst resection has not been reported. Chronic inflammation can underlie malignant transformation of epidermoid cysts. Astrogliosis following repeated resections may have induced the rare transformation to glioblastoma.</p><p><strong>Clinical presentation: </strong>A patient presenting with left lower extremity weakness was found to harbor a parietal mass lesion. Histopathology demonstrated an epidermoid cyst. Following multiple re-resections, an intra-axial mass was discovered within the operative bed, confirmed as glioblastoma.</p><p><strong>Conclusion: </strong>This is the first report of glioblastoma associated with a resected epidermoid cyst. Subsequent to resection, the chronic inflammatory milieu propagated by astrogliosis is thought to have induced malignancy. The progression to glioblastoma draws attention to neoplastic transformation in the context of recurrent epidermoids.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"7 4","pages":"CNS25"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2018-0002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36820977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01Epub Date: 2018-10-02DOI: 10.2217/cns-2018-0004
Christian Brogna, José Pedro Lavrador, Sabina Patel, Eduardo C Ribas, Miren Aizpurua, Francesco Vergani, Keyoumours Ashkan, Ranjeev Bhangoo
Sylvian fissure meningiomas (SFMs) represent a rare subgroup of nondural-based tumors arising from the meningothelial cells within the arachnoid of the Sylvian fissure. SFMs are more frequent in young males, usually manifest with seizures and display the same radiological features of meningiomas in other locations. Although the absence of dural attachment makes these tumors suitable for a complete resection, their anatomical relationships with the middle cerebral artery branches have impaired its achievement in half of them. To the best of our knowledge, only five atypical WHO grade II SFMs have been previously described. We provide a literature review of SFMs WHO grades I-II and discuss common characteristics and surgical challenges we found in a similar case.
{"title":"Grade II Sylvian fissure meningiomas without dural attachment: case report and review of the literature.","authors":"Christian Brogna, José Pedro Lavrador, Sabina Patel, Eduardo C Ribas, Miren Aizpurua, Francesco Vergani, Keyoumours Ashkan, Ranjeev Bhangoo","doi":"10.2217/cns-2018-0004","DOIUrl":"10.2217/cns-2018-0004","url":null,"abstract":"<p><p>Sylvian fissure meningiomas (SFMs) represent a rare subgroup of nondural-based tumors arising from the meningothelial cells within the arachnoid of the Sylvian fissure. SFMs are more frequent in young males, usually manifest with seizures and display the same radiological features of meningiomas in other locations. Although the absence of dural attachment makes these tumors suitable for a complete resection, their anatomical relationships with the middle cerebral artery branches have impaired its achievement in half of them. To the best of our knowledge, only five atypical WHO grade II SFMs have been previously described. We provide a literature review of SFMs WHO grades I-II and discuss common characteristics and surgical challenges we found in a similar case.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"7 4","pages":"CNS20"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2018-0004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36547749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01Epub Date: 2018-10-09DOI: 10.2217/cns-2017-0037
Enrique Orrego, Carlos A Castaneda, Miluska Castillo, Luis A Bernabe, Sandro Casavilca, Arnab Chakravarti, Wei Meng, Pamela Garcia-Corrochano, Maria R Villa-Robles, Rocio Zevallos, Omar Mejia, Pedro Deza, Carolina Belmar-Lopez, Luis Ojeda
Aim: Evaluation of features related to infiltrating immune cell level in glioblastoma.
Methods: Tumor-infiltrating lymphocytes (TILs) through H&E staining, and TILs (CD3, CD4, CD8 and CD20) and macrophage (CD68 and CD163) levels through immunohistochemistry were evaluated through digital analysis.
Results: CD68 (9.1%), CD163 (2.2%), CD3 (1.6%) and CD8 (1.6%) had the highest density. Higher CD4+ was associated with unmethylated MGMT (p = 0.016). Higher CD8+ was associated with larger tumoral size (p = 0.027). Higher CD163+ was associated with higher age (p = 0.044) and recursive partitioning analysis = 4. Women (p < 0.05), total resection (p < 0.05), MGMT-methylation (p < 0.001), radiotherapy (p < 0.001), chemotherapy (p < 0.001) and lower CD4+ (p < 0.05) were associated with longer overall survival.
Conclusion: Macrophages are more frequent than TILs. Some subsets are associated with clinical features.
{"title":"Distribution of tumor-infiltrating immune cells in glioblastoma.","authors":"Enrique Orrego, Carlos A Castaneda, Miluska Castillo, Luis A Bernabe, Sandro Casavilca, Arnab Chakravarti, Wei Meng, Pamela Garcia-Corrochano, Maria R Villa-Robles, Rocio Zevallos, Omar Mejia, Pedro Deza, Carolina Belmar-Lopez, Luis Ojeda","doi":"10.2217/cns-2017-0037","DOIUrl":"https://doi.org/10.2217/cns-2017-0037","url":null,"abstract":"<p><strong>Aim: </strong>Evaluation of features related to infiltrating immune cell level in glioblastoma.</p><p><strong>Methods: </strong>Tumor-infiltrating lymphocytes (TILs) through H&E staining, and TILs (CD3, CD4, CD8 and CD20) and macrophage (CD68 and CD163) levels through immunohistochemistry were evaluated through digital analysis.</p><p><strong>Results: </strong>CD68 (9.1%), CD163 (2.2%), CD3 (1.6%) and CD8 (1.6%) had the highest density. Higher CD4<sup>+</sup> was associated with unmethylated MGMT (p = 0.016). Higher CD8<sup>+</sup> was associated with larger tumoral size (p = 0.027). Higher CD163<sup>+</sup> was associated with higher age (p = 0.044) and recursive partitioning analysis = 4. Women (p < 0.05), total resection (p < 0.05), MGMT-methylation (p < 0.001), radiotherapy (p < 0.001), chemotherapy (p < 0.001) and lower CD4<sup>+</sup> (p < 0.05) were associated with longer overall survival.</p><p><strong>Conclusion: </strong>Macrophages are more frequent than TILs. Some subsets are associated with clinical features.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"7 4","pages":"CNS21"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f0/58/cns-07-21.PMC6331699.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36557853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ming Y Chong, C. Lorimer, S. Mehta, Ehab Ibrahim, J. Brock, C. Mcbain, P. McLoone, A. Chalmers
Aim: We investigated uptake of short-course chemo-radiotherapy and compared outcomes with other treatment schedules in elderly patients with glioblastoma (GBM). Methods: Patients aged 65 or over with a diagnosis of GBM were identified from an 18-month period from three centers in the UK. The primary end point of this study was overall survival from the date of diagnosis. Results: The analysis included 210 patients. Overall median survival was 5.0 months. Approximately 31.9% of patients received combined chemoradiation; multivariate analysis showed that patients who received standard chemoradiation were at a reduced risk of death than those receiving hypofractionated chemoradiation. Discussion: In this retrospective study, patients treated with standard chemoradiation experienced better outcomes than patients receiving hypofractionated chemoradiation. Patient selection likely contributed to these findings.
{"title":"An audit of the management of elderly patients with glioblastoma in the UK: have recent trial results changed treatment?","authors":"Ming Y Chong, C. Lorimer, S. Mehta, Ehab Ibrahim, J. Brock, C. Mcbain, P. McLoone, A. Chalmers","doi":"10.2217/cns-2019-0017","DOIUrl":"https://doi.org/10.2217/cns-2019-0017","url":null,"abstract":"Aim: We investigated uptake of short-course chemo-radiotherapy and compared outcomes with other treatment schedules in elderly patients with glioblastoma (GBM). Methods: Patients aged 65 or over with a diagnosis of GBM were identified from an 18-month period from three centers in the UK. The primary end point of this study was overall survival from the date of diagnosis. Results: The analysis included 210 patients. Overall median survival was 5.0 months. Approximately 31.9% of patients received combined chemoradiation; multivariate analysis showed that patients who received standard chemoradiation were at a reduced risk of death than those receiving hypofractionated chemoradiation. Discussion: In this retrospective study, patients treated with standard chemoradiation experienced better outcomes than patients receiving hypofractionated chemoradiation. Patient selection likely contributed to these findings.","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74189495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-07-01Epub Date: 2018-09-17DOI: 10.2217/cns-2018-0001
Lisa Modelevsky, Richard Tizon, Samantha N Reiss, Marcel Smith, Rachel Garonce, Thomas Kaley
Aim: To establish the safety and feasibility of rapidly infusing rituximab over 90 min in patients with primary CNS lymphoma (PCNSL).
Patients & methods: We retrospectively reviewed all patients with PCNSL who received rapid rituximab infusions (RRI) from January 2016 to January 2017. Primary end point was incidence of infusion reactions.
Results & conclusion: 11 patients received a total of 44 RRIs. Rituximab was dosed at 500 or 750 mg/m2. Premedication included acetaminophen and diphenhydramine. No infusion reactions occurred during any RRI. Two infusions were administered with steroids for neurologic symptoms at baseline (4.5%). Rapid administration of rituximab was safe and feasible for patients with PCNSL and at the higher doses received.
{"title":"Rapid infusion rituximab is well tolerated in patients with primary CNS lymphoma.","authors":"Lisa Modelevsky, Richard Tizon, Samantha N Reiss, Marcel Smith, Rachel Garonce, Thomas Kaley","doi":"10.2217/cns-2018-0001","DOIUrl":"https://doi.org/10.2217/cns-2018-0001","url":null,"abstract":"<p><strong>Aim: </strong>To establish the safety and feasibility of rapidly infusing rituximab over 90 min in patients with primary CNS lymphoma (PCNSL).</p><p><strong>Patients & methods: </strong>We retrospectively reviewed all patients with PCNSL who received rapid rituximab infusions (RRI) from January 2016 to January 2017. Primary end point was incidence of infusion reactions.</p><p><strong>Results & conclusion: </strong>11 patients received a total of 44 RRIs. Rituximab was dosed at 500 or 750 mg/m<sup>2</sup>. Premedication included acetaminophen and diphenhydramine. No infusion reactions occurred during any RRI. Two infusions were administered with steroids for neurologic symptoms at baseline (4.5%). Rapid administration of rituximab was safe and feasible for patients with PCNSL and at the higher doses received.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"7 3","pages":"CNS19"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2018-0001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36497917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号