Nanoparticle-Mediated Radiation-Triggered Release Of Nitrate, Precursor Of Reactive Nitrogen Species, Improves Local Tumor Control

Object Resection and whole-brain radiation therapy (WBRT) have classically been the standard treatment for a single metastasis to the brain. The objective of this study was to evaluate the use of Gamma Knife surgery (GKS) as an alternative to WBRT in patients who had undergone resection and to evaluate patient survival and local tumor control. Methods The authors retrospectively reviewed the charts of 150 patients treated with a combination of stereotactic radiosurgery and resection of a cranial metastasis at their institution between April 1997 and September 2009. Patients who had multiple lesions or underwent both WBRT and GKS were excluded, as were patients for whom survival data beyond the initial treatment were not available. Clinical and imaging follow-up was assessed using notes from clinic visits and MR imaging studies when available. Follow-up data beyond the initial treatment and survival data were available for 68 patients. Results The study included 37 women (54.4%) and 31 men (45.6%) (mean age 60 years, range 28–89 years). In 45 patients (66.2%) there was systemic control of the primary tumor when the cranial metastasis was identified. The median duration between resection and radiosurgery was 15.5 days. The median volume of the treated cavity was 10.35 cm3 (range 0.9–45.4 cm3), and the median dose to the cavity margin was 15 Gy (range 14–30 Gy), delivered to the 50% isodose line (range 50%–76% isodose line). The patients' median preradiosurgery Karnofsky Performance Scale (KPS) score was 90 (range 40–100). During the follow-up period we identified 27 patients (39.7%) with recurrent tumor located either local or distant to the site of treatment. The median time from primary treatment of metastasis to recurrence was 10.6 months. The patients' median length of survival (interval between first treatment of cerebral metastasis and last follow-up) was 13.2 months. For the patient who died during follow-up, the median time from diagnosis of cerebral metastasis to death was 11.5 months. The median duration of survival from diagnosis of the primary cancer to last follow-up was 30.2 months. Patients with a pretreatment KPS score ≥ 90 had a median survival time of 23.2 months, and patients with a pretreatment KPS score < 90 had a median survival time of 10 months (p < 0.008). Systemic control of disease at the time of metastasis was not predictive of increased survival duration, although it did tend to improve survival. Conclusions Although the debate about the ideal form of radiation treatment after resection continues, these findings indicate that GKS combined with surgery offers comparable survival duration and local tumor control to WBRT for patients with a diagnosis of a single metastasis.

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Petroclival meningiomas: long-term outcomes of multimodal treatments and management strategies based on 30 years of experience at a single institution

Journal of Neurosurgery ◽

10.3171/2019.2.jns182604 ◽

2020 ◽

Vol 132 (6) ◽

pp. 1675-1682 ◽

Cited By ~ 5

Author(s):

Jin Wook Kim ◽

Hee-Won Jung ◽

Yong Hwy Kim ◽

Chul-Kee Park ◽

Hyun-Tai Chung ◽

...

Keyword(s):

Adjuvant Treatment ◽

Management Strategies ◽

Local Tumor Control ◽

Tumor Control ◽

Years Of Experience ◽

Local Tumor ◽

Long Term Outcomes ◽

Single Institution ◽

Petroclival Meningiomas

OBJECTIVEA thorough investigation of the long-term outcomes and chronological changes of multimodal treatments for petroclival meningiomas is required to establish optimal management strategies. The authors retrospectively reviewed the long-term clinical outcomes of patients with petroclival meningioma according to various treatments, including various surgical approaches, and they suggest treatment strategies based on 30 years of experience at a single institution.METHODSNinety-two patients with petroclival meningiomas were treated surgically at the authors’ institution from 1986 to 2015. Patient demographics, overall survival, local tumor control rates, and functional outcomes according to multimodal treatments, as well as chronological change in management strategies, were evaluated. The mean clinical and radiological follow-up periods were 121 months (range 1–368 months) and 105 months (range 1–348 months), respectively.RESULTSA posterior transpetrosal approach was most frequently selected and was followed in 44 patients (48%); a simple retrosigmoid approach, undertaken in 30 patients, was the second most common. The initial extent of resection and following adjuvant treatment modality were classified into 3 subgroups: gross-total resection (GTR) only in 13 patients; non-GTR treatment followed by adjuvant radiosurgery or radiation therapy (non-GTR+RS/RT) in 56 patients; and non-GTR without adjuvant treatment (non-GTR only) in 23 patients. The overall progression-free survival rate was 85.8% at 5 years and 81.2% at 10 years. Progression or recurrence rates according to each subgroup were 7.7%, 12.5%, and 30.4%, respectively.CONCLUSIONSThe authors’ preferred multimodal treatment strategy, that of planned incomplete resection and subsequent adjuvant radiosurgery, is a feasible option for the management of patients with large petroclival meningiomas, considering both local tumor control and postoperative quality of life.

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Prognostic significance of DNMT3a gene expression and reactive nitrogen species in newly diagnosed Egyptian de novo adult acute myeloid leukemia patients

Egyptian Journal of Medical Human Genetics ◽

10.1186/s43042-020-00066-4 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Inas A. Asfour ◽

Hany M. Hegab ◽

Walaa A. El-Salakawy ◽

Mohamed T. Hamza ◽

Dina A. Mansour ◽

...

Keyword(s):

Gene Expression ◽

Acute Myeloid Leukemia ◽

Reactive Nitrogen Species ◽

Myeloid Leukemia ◽

De Novo ◽

Prognostic Significance ◽

Reactive Nitrogen ◽

Nitrogen Species ◽

Newly Diagnosed ◽

Acute Myeloid

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Azanone (HNO): generation, stabilization and detection

Chemical Science ◽

10.1039/d1sc02236a ◽

2021 ◽

Author(s):

Cecilia Mariel Gallego ◽

Agostina Mazzeo ◽

Paola Vargas ◽

Sebastián Suárez ◽

Juan Pellegrino ◽

...

Keyword(s):

Reactive Nitrogen Species ◽

High Reactivity ◽

Reactive Nitrogen ◽

Nitrogen Species ◽

Biologically Relevant

HNO (nitroxyl, azanone), joined the ‘biologically relevant reactive nitrogen species’ family in the 2000s. Azanone is impossible to store due to its high reactivity and inherent low stability. Consequently, its...

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Plasmonic Enhancement of Nitric Oxide Generation

Nanoscale ◽

10.1039/d1nr02126e ◽

2021 ◽

Author(s):

Rachael Knoblauch ◽

Chris Geddes

Keyword(s):

Nitric Oxide ◽

Reactive Oxygen Species ◽

Reactive Nitrogen Species ◽

Reactive Oxygen ◽

Reactive Nitrogen ◽

Oxygen Species ◽

Nitrogen Species ◽

Plasmonic Enhancement ◽

Cancer Treatments

While the utility of reactive oxygen species in photodynamic therapies for both cancer treatments and antimicrobial applications has received much attention, the inherent potential of reactive nitrogen species (RNS) including...

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A Generator of Peroxynitrite Activatable with Red Light

Chemical Science ◽

10.1039/d0sc06970a ◽

2021 ◽

Author(s):

Cristina Parisi ◽

Mariacristina Failla ◽

Aurore Fraix ◽

Luca Menilli ◽

Francesca Moret ◽

...

Keyword(s):

Reactive Oxygen Species ◽

Reactive Nitrogen Species ◽

Red Light ◽

Reactive Oxygen ◽

Reactive Nitrogen ◽

Oxygen Species ◽

Nitrogen Species ◽

New Horizons ◽

Light Stimuli ◽

Spatiotemporal Control

The generation of reactive oxygen species (ROS) and reactive nitrogen species (RNS) as “unconventional” therapeutics with precise spatiotemporal control by using light stimuli may open entirely new horizons for innovative...

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