| 1: Am
J Clin Oncol. 2005 Feb;28(1):105-6. |
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radiotherapy-induced ID reaction.
Lian
J, Dundas
G, Tron
V, Lauzon
G, Roa
W.
Department of Oncology, University of Alberta, Edmonton, Alberta, Canada.
To the authors' knowledge, there is a paucity of published accounts of
radiotherapy-induced ID reaction. We report a case of generalized dermatitis
pathologically defined as an ID reaction after a course of local
radiotherapy.
Publication Types:
PMID: 15685045 [PubMed - indexed for MEDLINE]
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| 2: Am
J Clin Oncol. 2005 Feb;28(1):81-90. |
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A phase III trial evaluating the combination of
cisplatin, etoposide, and radiation therapy with or without tamoxifen in
patients with limited-stage small cell lung cancer: Cancer and Leukemia
Group B Study (9235).
McClay
EF, Bogart
J, Herndon
JE 2nd, Watson
D, Evans
L, Seagren
SL, Green
MR; Cancer
and Leukemia Group B Study (9235).
San Diego Melanoma Research Center, Vista, California 92083, USA.
emcclay@sdcri.org
Based on both clinical and laboratory data that suggested that tamoxifen
(TAM) enhanced the effectiveness of cisplatin (DDP)-based chemotherapy
regimens, the Cancer and Leukemia Group B (CALGB) designed and initiated a
prospective, randomized phase III trial to test the efficacy of the addition
of high-dose TAM to a standard chemoradiation regimen of DDP and etoposide
(VP-16) in patients with limited-stage small cell lung cancer (LS-SCLC).
Between August 6, 1993, and January 15, 1999, 319 patients with LSSCLC were
accrued to CALGB 9235. Patients were randomized to receive chemotherapy with
or without high-dose TAM. Treatment on the non-TAM containing arm (arm 1)
included DDP (80 mg/m2 intravenously day 1 only) and VP-16 (80 mg/m2
intravenously days 1-3) given every 3 weeks for a total of 5 cycles.
Patients treated on arm 2 received the identical chemotherapy regimen as
described here with the addition of high-dose TAM (80 mg orally twice per
day), which was given for 5 days each cycle starting 1 day before the DDP.
Thoracic radiation (XRT) given at 200 cGy 5 days per week to a total dose of
50 Gy began on day 1 of cycle 4 of chemotherapy and overlapped with cycle 5.
Prophylactic cranial irradiation was offered to all patients who achieved a
complete response or near-complete response. A total of 307 patients are
evaluable for response. After the completion of the chemoradiation portion
of the treatment, the overall response rate (ORR) was 88% for 154 patients
treated without tamoxifen and 84% for 153 patients treated with tamoxifen
with complete response (CR) rates of 49% and 50%, respectively. The median
failure-free survivals of 12.3 months and 10.5 months and the overall
survivals of 20.6 months and 18.4 months, respectively, were not
statistically significant between the 2 arms. Toxicity was similar with and
without tamoxifen. This phase III trial failed to demonstrate a positive
effect on either the response or survival for the addition of TAM to
standard etoposide-cisplatin-radiation management for patients with LS-SCLC.
However, these data continue to support a positive effect of chemoradiation
in the treatment of patients with LS-SCLC.
Publication Types:
- Clinical Trial
- Clinical Trial, Phase III
- Randomized Controlled Trial
PMID: 15685040 [PubMed - indexed for MEDLINE]
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| 3: Cancer. 2005 Aug 8; [Epub
ahead of print] |
|
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Phase I trial of irinotecan plus temozolomide in adults
with recurrent malignant glioma.
Reardon
DA, Quinn
JA, Rich
JN, Desjardins
A, Vredenburgh
J, Gururangan
S, Sathornsumetee
S, Badruddoja
M, McLendon
R, Provenzale
J, Herndon
JE 2nd, Dowell
JM, Burkart
JL, Newton
HB, Friedman
AH, Friedman
HS.
Department of Surgery, Duke University Medical Center, Durham, North
Carolina.
BACKGROUND: The authors determined the maximum tolerated dose (MTD) and
dose-limiting toxicity (DLT) of irinotecan (CPT-11), a topoisomerase I
inhibitor, when administered with temozolomide among patients with recurrent
malignant glioma (MG). METHODS: Patients with MG at any recurrence received
temozolomide (TMZ) at a dose of 200 mg/m(2)/day on Days 1-5 plus CPT-11
administered as a 90-minute intravenous infusion during Weeks 1, 2, 4, and 5
of each 6-week cycle. Patients were stratified based on concurrent
administration of CYP3A4-inducing anticonvulsants (enzyme-inducing
antiepileptic drugs [EIAEDs]). The CPT-11 dose was escalated in successive
cohorts of patients independently for each stratum. RESULTS: CPT-11, at
doses ranging from 40 mg/m(2) to 375 mg/m(2), was administered with TMZ to
107 patients. Ninety-one patients (85%) had recurrent glioblastoma
multiforme (GBM) and 16 (15%) had recurrent anaplastic glioma. Sixty-eight
patients (64%) were given EIAEDs. The MTD of CPT-11 for patients
concurrently receiving and not receiving EIAEDs was 325 mg/m(2) and 125
mg/m(2), respectively. The DLTs were hematologic, gastrointestinal, and
hepatic. Fifteen patients (14%) achieved either a radiographic complete (n =
5) or partial (n = 10) response across a wide range of CPT-11 dose levels.
Patients with recurrent GBM who achieved radiographic response had a median
time to disease progression of 54.9 weeks. CONCLUSIONS: The current study
built on preclinical observations designed to increase the clinical activity
of topoisomerase I inhibitors. CPT-11, administered at full dose levels, was
well tolerated in combination with TMZ. Furthermore, durable responses were
observed in this recurrent population. Ongoing Phase II studies will
evaluate the efficacy of this regimen and its application to other
malignancies. Cancer 2005. (c) 2005 American Cancer Society.
PMID: 16088964 [PubMed - as supplied by publisher]
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| 4: Cancer. 2005 Jun
15;103(12):2598-605. |
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Supratentorial extraventricular ependymal neoplasms: a
clinicopathologic study of 32 patients.
Shuangshoti
S, Rushing
EJ, Mena
H, Olsen
C, Sandberg
GD.
Section of Neuropathology, Clinical Brain Disorders Branch, National
Institutes of Health, Bethesda, Maryland, USA.
BACKGROUND: Published research on the clinicopathologic features of
extraventricular ependymal neoplasms of the cerebral hemispheres has been
scant. METHODS: Thirty-two archival cases were studied to investigate the
prognostic impact of clinicopathologic parameters including flow cytometry,
the proliferation (Ki-67) labeling index, and p53 expression. RESULTS: Among
these 32 cases were 2 subependymomas, 19 ependymomas, and 11 anaplastic
ependymomas. No significant gender predilection was observed, and 45% of
patients were in their second or third decade of life. The left cerebral
hemisphere was 1.5 times more commonly involved. On available imaging
studies, lesions were often cystic, with or without a mural nodule. Tumors
expressed glial fibrillary acidic protein (87%), S-100 protein (77%),
cytokeratin (43%), and epithelial membrane antigen (17%). Ki-67
proliferation index paralleled tumor grade. Immunoreactivity for p53 protein
was observed in the 2 cases of subependymoma, in 10 of 11 anaplastic
ependymomas, and in 6 of 17 ependymomas. Flow cytometry performed in 27
tumors revealed diploidy in 20 cases and aneuploidy in 4 cases (3 anaplastic
and 1 classic ependymomas), with S-phase fraction ranging from 0.2-9.7.
Eleven subjects were additionally treated with radiotherapy, and 3 with
chemotherapy. Follow up was available in 25 (78%) patients. CONCLUSIONS: The
results of the current study suggest that there is no significant relation
between histopathology, Ki-67 proliferation index, p53 immunolabeling, tumor
ploidy, and biologic behavior. Published 2005 by the American Cancer
Society.
PMID: 15861411 [PubMed - indexed for MEDLINE]
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| 5: Cancer Res. 2005 Jun
15;65(12):5172-80. |
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Somatic induction of Pten loss in a preclinical
astrocytoma model reveals major roles in disease progression and avenues for
target discovery and validation.
Xiao
A, Yin
C, Yang
C, Di
Cristofano A, Pandolfi
PP, Van
Dyke T.
Department of Biochemistry and Biophysics, University of North Carolina at
Chapel Hill, Chapel Hill, North Carolina, USA.
High-grade astrocytomas are invariably deadly and minimally responsive to
therapy. Pten is frequently mutated in aggressive astrocytoma but not in
low-grade astrocytoma. However, the Pten astrocytoma suppression mechanisms
are unknown. Here we introduced conditional null alleles of Pten
(Pten(loxp/loxp)) into a genetically engineered mouse astrocytoma model
[TgG(deltaZ)T121] in which the pRb family proteins are inactivated
specifically in astrocytes. Pten inactivation was induced by localized
somatic retroviral (MSCV)-Cre delivery. Depletion of Pten function in adult
astrocytoma cells alleviated the apoptosis evoked by pRb family protein
inactivation and also induced tumor cell invasion. In primary astrocytes
derived from TgG(deltaZ)T121; Pten(loxp/loxp) mice, Pten deficiency resulted
in a marked increase in cell invasiveness that was suppressed by inhibitors
of protein kinase C (PKC) or of PKC-zeta, specifically. Finally, focal
induction of Pten deficiency in vivo promoted angiogenesis in affected
brains. Thus, we show that Pten deficiency in pRb-deficient astrocytoma
cells contributes to tumor progression via multiple mechanisms, including
suppression of apoptosis, increased cell invasion, and angiogenesis, all of
which are hallmarks of high-grade astrocytoma. These studies not only
provide mechanistic insight into the role of Pten in astrocytoma suppression
but also describe a valuable animal model for preclinical testing that is
coupled with a primary cell-based system for target discovery and drug
screening.
PMID: 15958561 [PubMed - indexed for MEDLINE]
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| 6: J Neurooncol.
2005 Jul 30; [Epub ahead of print] |
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Combined Razoxane and Radiotherapy for Melanoma Brain
Metastases. A Retrospective Analysis.
Rhomberg
W, Eiter
H, Boehler
F, Saely
C, Strohal
R.
Department of Radiooncology, Federal Academic Hospital of Feldkirch,
Austria.
We retrospectively compared the efficacy of razoxane and radiotherapy with
radiotherapy alone or in combination with a non-razoxane based medication in
patients with melanoma brain metastases. From 19 assessable patients
receiving whole brain irradiation with or without a boost (mean total dose
40.5 Gy) for measurable brain metastases, 8 patients underwent an additional
razoxane therapy with 125 mg per os twice daily started 5 days before
radiotherapy and given throughout the whole radiation period. The median
razoxane dose was 6.25 g (range 3.2-8.0 g). Endpoints included radiation
response rates, median survival time and 1-year survival rates. To generate
reliable prognostic parameters for this non-randomized study population, the
Score Index for Stereotactic Radiosurgery and the Radiation Therapy Oncology
Group Recursive Partitioning Analysis score were applied. Radiotherapy with
razoxane led to higher response rates (62% vs. 27%) and a lower percentage
of progressive disease (12.5% vs. 36%) if compared with radiotherapy alone
or with a non-razoxane based medication. This combination was associated
with a longer median survival (5 months vs. 2.2 months; P=0.052) and a
1-year survival rate of 37.5% vs. 0% (P=0.027). Both treatment groups
belonged to similar prognosis subsets. The treatment was well tolerated.
Taken together our data support the therapeutic concept of a combined
razoxane radiation therapy in melanoma patients with brain metastases. The
favorable treatment effects are probably due to the radiosensitizing and the
cytorallentaric mode of action of razoxane. Since the patient numbers are
low, confirmatory studies are certainly necessary.
PMID: 16086112 [PubMed - as supplied by publisher]
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| 7: J Neurosurg.
2005 Jun;102(6):1170; author reply 1170-1. |
|
Comment on:
Drug resistance.
Rovin
RA.
Publication Types:
PMID: 16028784 [PubMed - indexed for MEDLINE]
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| 8: J Neurosurg.
2005 Jun;102(6):1159-62. |
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Zebra sign: cerebellar bleeding pattern characteristic of
cerebrospinal fluid loss. Case report.
Brockmann
MA, Nowak
G, Reusche
E, Russlies
M, Petersen
D.
Department of Neuroradiology, University Hospital Schleswig-Holstein, Campus
Luebeck, Germany. brockmann@gmx.de
Supratentorial subdural hematoma is a well-known complication following
spinal interventions. Less often, spinal or supratentorial interventions
cause remote cerebellar hemorrhage (RCH). The exact pathomechanism
accounting for RCH remains unclear, but an interventional or
postinterventional loss of cerebrospinal fluid (CSF) seems to be involved in
almost all cases. Hemorrhage is often characterized by a typical, streaky
bleeding pattern due to blood spreading in the cerebellar sulci. Three
different cases featuring this bleeding pattern following spinal,
supratentorial, and thoracic surgery are presented. Possible pathomechanisms
leading to RCH are discussed. Based on data from the underlying cases and
the reviewed literature, the authors concluded that this zebra-pattern
hemorrhage seems to be typical in a postoperative loss of CSF, which should
always be considered on presentation of this bleeding pattern.
Publication Types:
PMID: 16028781 [PubMed - indexed for MEDLINE]
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| 9: J Neurosurg.
2005 Jun;102(6):1151-4. |
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Juvenile psammomatoid ossifying fibroma of the
neurocranium. Report of four cases.
Hasselblatt
M, Jundt
G, Greiner
C, Rama
B, Schmal
F, Iglesias-Rozas
JR, van
de Nes JA, Paulus
W.
Institute of Neuropathology, University Hospital Munster, Germany.
hasselblatt@uni-muenster.de
Juvenile psammomatoid ossifying fibroma (JPOF) is a benign fibroosseous
lesion predominantly arising within the paranasal sinuses in children and
young adults. Neurocranial occurrence is exceedingly rare and a location
within the neurocranial portion of the temporal bone has not been described.
The authors report on one case of sinonasal JPOF secondarily extending into
the cranial cavity and three cases primarily affecting the neurocranial
bones to increase clinical awareness of this uncommon tumor, which may be
easily mistaken for meningioma. Moreover, the absence of activating missense
mutations of the GNAS1 gene in two cases strongly argues against a
relationship between JPOF and fibrous dysplasia.
Publication Types:
PMID: 16028779 [PubMed - indexed for MEDLINE]
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| 10: J Neurosurg.
2005 Jun;102(6):1033-9. |
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The Ki-67 labeling index as a prognostic factor in Grade
II oligoastrocytomas.
Shaffrey
ME, Farace
E, Schiff
D, Larner
JM, Mut
M, Lopes
MB.
Department of Neurosurgery, University of Virginia, Charlottesville,
Virginia, USA.
OBJECT: This study was conducted to determine whether proliferative tumor
activity, as assessed using the Ki-67 immunohistochemical labeling index
(LI), has prognostic utility for patients with Grade II oligoastrocytomas.
METHODS: The study period spans the years 1988 to 2000. In a retrospective
analysis, the authors selected cases with biopsy-proven diagnoses of Grade
II oligoastrocytomas on initial presentation. The authors added new patients
to this group and followed all patients prospectively at the University of
Virginia Neuro-Oncology Center. Twenty-three adult patients were followed
for at least 1 year (median 40.3 months). Eleven patients with Grade II
tumors and initial Ki-67 LIs less than 10% had a significantly longer median
time to tumor progression (TTP, 51.8 months compared with 9.9 months) and a
longer median survival (93.1 months compared with 16.1 months) than 12
patients with initial Ki-67 LIs of 10% or greater. Twelve patients with
Grade III oligoastrocytomas had a mean TTP that was similar to the TTP of
patients with Grade II tumors and high Ki-67 LIs (mean 4 months compared
with 9.9 months) and duration of survival (13.3 months compared with 16.1
months). CONCLUSIONS: Patients with a Grade II oligoastrocytoma and a Ki-67
LI of 10% or greater have a much shorter TTP and potentially a poorer
disease prognosis than expected--more similar to patients with a Grade III
oligoastrocytoma. These results indicate that in the future a measure of
proliferative activity should be taken into consideration along with the
World Health Organization grading criteria for oligoastrocytomas.
PMID: 16028762 [PubMed - indexed for MEDLINE]
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| 11: J Neurosurg.
2005 Jun;102(6):1004-12. |
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Repeated transsphenoidal surgery to treat recurrent or
residual pituitary adenoma.
Benveniste
RJ, King
WA, Walsh
J, Lee
JS, Delman
BN, Post
KD.
Department of Neurosurgery, Mt. Sinai School of Medicine, New York, New York
10029, USA.
OBJECT: In this paper the authors describe the indications for and the
results and complications of repeated transsphenoidal surgery (RTSS) to
treat recurrent or residual pituitary adenoma. METHODS: A retrospective
review was conducted of 96 consecutive patients who underwent RTSS to treat
recurrent or residual pituitary adenoma. Ninety-six patients underwent RTSS:
42 to treat a recurrent or residual pituitary mass and 54 to treat a
recurrent or persistent hormone hypersecretion. There was no case of
perioperative death and there was a 1% incidence of major complications.
Postoperative endocrinological deficiencies were uncommon unless planned
total hypophysectomy was performed to treat Cushing disease. Clinical
remission occurred in 93% of patients undergoing RTSS to treat a tumor mass,
and 15% of patients initially experienced remission only to face a relapse
after a mean of 32 months. Endocrinological remission occurred in 57% of
patients undergoing RTSS to treat hormone hypersecretion; most of these
patients had Cushing disease. Thirty-five percent of patients with an
initial endocrinological remission experienced a relapse of their symptoms
after a mean of 31 months (thus, 37% of patients achieved sustained
endocrinological remission). We failed to identify factors that accurately
predicted initial symptom remission or delayed relapse following RTSS. Ten
patients in our series eventually underwent a third transsphenoidal surgery
without major complications. CONCLUSIONS: Repeated transsphenoidal surgery
is a more effective treatment for recurrent or residual mass than it is for
hormone hypersecretion and has acceptable rates of morbidity and mortality.
If hypophysectomy is not performed, endocrinological deficiencies are
unlikely following RTSS.
PMID: 16028758 [PubMed - indexed for MEDLINE]
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| 12: Pediatr Neurosurg.
2005 Jul-Aug;41(4):173-7. |
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Incidence of childhood brain tumors in syria (1993-2002).
Kadri
H, Mawla
AA, Murad
L.
Division of Pediatric Neurosurgery, Department of Neurosurgery, Moassat
University Hospital, Damascus, Syria.
Objective: To determine whether the incidence and location of childhood CNS
tumors in Syria follows the same pattern described in Western and Far
Eastern countries. Patients and Methods: We analyzed the data compiled from
367 children with brain tumors operated on in our Department of Neurosurgery
between 1993 and mid-2002. We excluded all vascular and metastatic lesions
and adopted the latest WHO classification in grouping all glial tumors.
Results: We found that 47% of brain tumors were located in the
supratentorial, and 53% in the infratentorial region. The ratio of male to
female occurrence was 1:1.2 (52% males, 48% females). For lesions in the
supratentorial space, the distribution was 56% males and 44% females, while
in the posterior fossa, the distribution was 61% males and 39% females.
Low-grade tumors (WHO I/II) constituted 53.5% of all lesions, and the rest
were high grade tumors (WHO III/IV) 46.5%.The most common tumor found in our
childhood population was medulloblastoma (27.5%), followed by astrocytoma
(25.8%), then craniopharyngioma (14.1%). The most common tumor in the
posterior fossa was medulloblastoma (53.5%), followed by astrocytoma
(22.5%), then ependymoma (17%). The most common tumors in the supratentorial
space were astrocytoma and craniopharyngioma. Conclusions: In our patient
population, the incidence and distribution of CNS tumors were somehow
different than those reported by authors from the Western and Far Eastern
countries. Whether these results are unique to Syria, or reflect a regional
difference in the disease distribution between the Middle East region and
the rest of the world, remains to be determined. Copyright (c) 2005 S.
Karger AG, Basel.
PMID: 16088251 [PubMed - in process]
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Volume 4, Number 34 - 16 August 2005