scholarly journals MET-05 Clinical investigation of treatment results and recurrence patterns of metastatic brain tumors from the viewpoint of postoperative irradiation

2020 ◽  
Vol 2 (Supplement_3) ◽  
pp. ii19-ii19
Author(s):  
Tetsuo Hashiba ◽  
Haruka Kawano ◽  
Katsuya Ueno ◽  
Qiang Lee ◽  
Haruna Isozaki ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Brain Tumors ◽  
Clinical Investigation ◽  
Postoperative Radiotherapy ◽  
En Bloc Resection ◽  
Metastatic Brain Tumors ◽  
Treatment Results ◽  
En Bloc ◽  
Postoperative Radiation Therapy ◽  
Observation Period

Abstract While whole brain radiation therapy (WBRT) had been the standard postoperative radiation therapy for metastatic brain tumors for long time, recently local radiation therapy (LRT) has be become to be a new standard due to the accumulation of clinical evidences. Treatment results and pattern of recurrence were retrospectively analyzed from view point of postoperative radiotherapy. In this study, totally 69 patients were included and they were divided into WBRT group or LRT group. We analyzed the number of lesions, treated era, overall survival after diagnosis of metastasis (OS), recurrence free survival after RT (RFS), and patterns of recurrences. The subjects consisted of 37males and 32 females and average age was 61.7 years old. There were 49 cases in the WBRT group and 20 cases in the LRT group. While all cases before November 2017 had WBRT performed, LRT was adopted mainly in cases with a small number of metastases since December 2017. Although there was a difference in the observation period between the two groups, OS tended to be longer in the LRT group (P=0.08), while RFS tended to be shorter in the LRT group (P=0.08). Radiological recurrence after RT was observed in 7 cases in both groups, and in WBRT group, all cases were local recurrence, whereas in LRT group, all cases were new lesions or disseminated recurrence. Although there are biases such as the difference in observation period between the two groups and the tendency to adopt WBRT in cases with a large number of metastases, there is a possibility that postoperative LRT is not inferior to WBRT, especially for cases with a small number of metastases. However, we have experienced some cases of disseminated recurrence, and so it is necessary to consider the resection fashion such as whether en-bloc resection or piece meal resection when selecting postoperative RT.

scholarly journals Leptomeningeal dissemination of a low-grade lumbar paraganglioma: case report

2017 ◽  
Vol 26 (4) ◽  
pp. 501-506 ◽  
Author(s):  
Nick Thomson ◽  
Karel Pacak ◽  
Meic H. Schmidt ◽  
Cheryl A. Palmer ◽  
Karen L. Salzman ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Ct Scanning ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Chemotherapeutic Agents ◽  
Low Grade ◽  
Leptomeningeal Dissemination ◽  
Mri Findings ◽  
En Bloc ◽  
Pet Scanning

Leptomeningeal dissemination of paraganglioma is rare, with only 2 prior cases in the literature. The authors present the case of a metastatic low-grade lumbar paraganglioma via leptomeningeal dissemination. This report emphasizes the utility of 3,4-dihydroxy-6-18F-fluoro-l-phenylalanine (18F-FDOPA) PET scanning for diagnosis, as well as the combination of radiation therapy and alkylating chemotherapeutic agents for the treatment of this rare phenomenon. The patient was a 61-year-old woman who presented with low-back pain and was found to have an isolated L-3 intrathecal tumor on MRI. Sixteen months after gross-total en bloc resection of the paraganglioma, the patient again became symptomatic with new neurological symptoms. MRI findings revealed enhancing leptomeningeal nodules throughout the spine. 18F-FDOPA PET/CT scanning was used to confirm the diagnosis of disseminated paraganglioma. Intrathecal thiotepa, radiation therapy, and systemic therapy with capecitabine and temozolomide have been used sequentially over a 2-year period, with each able to stabilize tumor growth for several months. The authors also summarize the 2 other reports of leptomeningeal dissemination of paragangliomas in the literature and compare the course and management of the 3 cases.

Treatment Results of Postoperative Radiation Therapy for Malignant and Atypical Meningioma

2002 ◽  
Vol 34 (2) ◽  
pp. 139-144 ◽  
Author(s):  
Sang Min Yoon ◽  
Seung Do Ahn ◽  
Hyesook Chang ◽  
Eun Kyung Choi ◽  
Jong Hun Kim ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Atypical Meningioma ◽  
Postoperative Radiation ◽  
Treatment Results ◽  
Postoperative Radiation Therapy

Treatment results of stereotactic interstitial brachytherapy for primary and metastatic brain tumors

1991 ◽  
Vol 21 (3) ◽  
pp. 715-721 ◽  
Author(s):  
Gerald L. Lucas ◽  
Gary Luxton ◽  
Deirdre Cohen ◽  
Zbigniew Petrovich ◽  
Bryan Langholz ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Interstitial Brachytherapy ◽  
Metastatic Brain Tumors ◽  
Treatment Results

Outcome of High-Risk Stage IC, Grade 3, Compared With Stage I Endometrial Carcinoma Patients: The Postoperative Radiation Therapy in Endometrial Carcinoma Trial

2004 ◽  
Vol 22 (7) ◽  
pp. 1234-1241 ◽  
Author(s):  
Carien L. Creutzberg ◽  
Wim L.J. van Putten ◽  
Carla C. Wárlám-Rodenhuis ◽  
Alfons C.M. van den Bergh ◽  
Karin A.J. De Winter ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Endometrial Cancer ◽  
High Risk ◽  
Endometrial Carcinoma ◽  
Postoperative Radiotherapy ◽  
Risk Category ◽  
Postoperative Radiation ◽  
Postoperative Radiation Therapy ◽  
Stage Ib ◽  
Grade 3

Purpose Stage IC, grade 3 endometrial cancer is regarded as a high-risk category. Stage IC, grade 3 patients were not eligible for the randomized Postoperative Radiation Therapy in Endometrial Carcinoma (PORTEC) trial, but were registered and received postoperative radiotherapy. Patients and Methods The PORTEC trial included 715 patients with stage IC, grade 1 or 2, and stage IB, grade 2 or 3 endometrial cancer. Patients were randomly assigned after surgery to receive pelvic radiotherapy (RT) or no further treatment. A total of 104 patients with stage IC, grade 3 endometrial cancer were registered, of whom 99 could be evaluated. Patterns of relapse and survival were compared with PORTEC patients receiving RT. Median follow-up was 83 months. Results The actuarial 5-year rates of locoregional relapse were 1% to 3% for PORTEC patients who received RT, compared with 14% for stage IC, grade 3 patients. Five-year distant metastases rates were 3% to 8% for grade 1 and 2 tumors; 20% for stage IB, grade 3 tumors; and 31% for stage IC, grade 3 tumors. Overall survival rates were 83% to 85% for grades 1 and 2; 74% for stage IB, grade 3; and 58% for stage IC, grade 3 patients (P < .001). In multivariate analysis grade 3 was the most important adverse prognostic factor for relapse and death as a result of endometrial cancer (hazard ratios, 5.4 and 5.5; P < .0001). Conclusion Patients with stage IC, grade 3 endometrial carcinoma are at high risk of early distant spread and endometrial carcinoma-related death. Novel strategies for adjuvant therapy should be explored to improve survival for this patient group.

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