OTHR-04. Gynecological Malignancies With Metastasis To The Central Nervous System: A Case Series and Systematic Review of the Literature

Abstract Introduction Gynecologic malignancies are an increasingly common proportion of central nervous system metastatic disease. As genetic sequencing technology improves and becomes more accessible, mutations associated with CNS metastasis are easier to elucidate. The aims of this case series and systematic literature review are to describe the patient population with CNS metastatic disease from a gynecologic primary, and to investigate why the proportion of CNS metastasis from gynecologic malignancies is increasing. Ultimately, we hope to improve understanding of this subset of metastatic CNS malignancies and improve management strategies. Methods A literature review of articles describing patients from 1990–2020 who were diagnosed with CNS metastasis from a known gynecologic primary malignancy was performed. Demographics, cancer type, mutation characteristics, management for metastatic disease, progression free survival, number of CNS metastases, and location of metastatic disease were assessed. Inclusion criteria were age>18 years, diagnosis of primary ovarian, uterine, or cervical cancer with confirmed metastatic disease to the CNS, including brain parenchyma, leptomeninges, or intradural spinal cord or dural metastases. Exclusion criteria included pediatric population and bony metastases (e.g., bony spine metastases without evidence of meningeal/parenchymal invasion). Results Our review showed that patients with gynecological metastasis to the CNS generally have worse outcomes regarding overall survival, progression free survival, and quality of life than patients without CNS metastasis. Discussion Our results infer that the reported increase in incidence of CNS metastasis from gynecologic malignancies is a reflection of improvement of detection given advances in technology, improved patient follow up, and increased overall survival of patients with gynecologic malignancies. Further characterization of mutations from gynecologic malignancies associated with brain metastasis could result in development of more treatment options for patients in the future and help determine factors that contribute to developing metastasis to the CNS of various degrees, thus, potentially inform treatment strategies.

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Fotemustine-Based in Combination with Rituximab As First-Line Induction Chemotherapy for Newly Diagnosed Primary Central Nervous System Lymphoma:a Prospective Phaseii Trial

Blood ◽

10.1182/blood-2020-137449 ◽

2020 ◽

Vol 136 (Supplement 1) ◽

pp. 5-5

Author(s):

Jingjing Wu ◽

Fenghua Gao ◽

Lei Zhang ◽

Xin Li ◽

Ling Li ◽

...

Keyword(s):

Central Nervous System ◽

Overall Survival ◽

Nervous System ◽

Median Overall Survival ◽

Conflicts Of Interest ◽

Objective Response ◽

Central Nervous System Lymphoma ◽

Progression Free Survival ◽

Newly Diagnosed ◽

Free Survival

Objective:To evaluate the safety, efficacy, and feasibility of rituximab, fotemustine, pemetrexed and dexamethasone (R-FPD) regimen for primary central nervous system lymphoma (PCNSL) patients. Methods:A prospective, single-center, single-arm, phase II clinical trial. Patients with newly diagnosed PCNSL diagnosed from the First Affiliated Hospital of Zhengzhou University from July 2018 to July 2020. R-FPD regimen consisted of rituximab (375 mg/m2 i.v. on D0), fotemustine (100mg/m2 i.v. on D1) ,pemetrexed (600mg/m2 i.v. on D1), and dexamethasone (40 mg i.v. on D1).(NCT04083066) Results: 30 patients were included. After two cycles, the objective response rate(ORR) was 96.4%(27/28,26 PR,1 CR,0 SD,0 PD,2 Censored),the disease control rate(DCR) was 96.4%(27/28); After four cycles, the ORR was 71.4% (15/21, 5PR,10 CR,1SD,5PD,7NR,2 Censored),DCR was 76.2%(16/21). The median progression-free survival (PFS) was 20.3 months (95%CI:5.2--35.4),The median overall survival (OS) was 22.0 months (95%CI:16.1-27.9).The grade III-IV toxicities were mainly leukopenia(17.9%), thrombocypenia(25%) and anemia(10.7%). Conclusion: Fotemustine-based in combination with Rituximab chemotherapy can improve outcomes with the progress free survival and the overall survival benefits, as well as with better tolerability for newly diagnosed PCNSL patients. Keywords: rituximab; primary central nervous system lymphoma; pemetrexed; fotemustine; efficacy Disclosures No relevant conflicts of interest to declare.

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SARS coronavirus 2 and central nervous system manifestations: causation, relation, or coexistence? a case series study and literature review

British Journal of Neurosurgery ◽

10.1080/02688697.2020.1861433 ◽

2020 ◽

pp. 1-6

Author(s):

Seyed Abdolhadi Daneshi ◽

Morteza Taheri ◽

Arash Fattahi

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Literature Review ◽

Case Series ◽

Sars Coronavirus ◽

Case Series Study ◽

Series Study

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A retrospective study of primitive neuroectodermal tumor (PNET) of the kidney in a tertiary cancer center in India.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.6_suppl.361 ◽

2021 ◽

Vol 39 (6_suppl) ◽

pp. 361-361

Author(s):

Nandini Sharrel Menon ◽

Devanshi Kalra ◽

Kumar Prabhash ◽

Vanita Noronha ◽

Santosh Menon ◽

...

Keyword(s):

Overall Survival ◽

Retrospective Study ◽

Metastatic Disease ◽

Tumor Size ◽

Progression Free Survival ◽

Adjuvant Radiation ◽

Pathological Feature ◽

Free Survival ◽

Rare Tumours ◽

Multimodality Approach

361 Background: Primitive neuroectodermal tumours (PNET) of the kidney are rare tumours with aggressive behaviour. This study was conducted to review the diagnosis and management of patients with renal PNET at our centre. Methods: This was a retrospective study conducted at a tertiary cancer care centre in Mumbai, India. The demographic and clinical data of 17 patients treated by the uro-oncology services were retrieved from electronic medical records. Descriptive analysis was performed for baseline characteristics.Overall & progression-free survival was determined using the Kaplan Meier method. Cox regression was used for multivariate analysis. Results: There were 12 male and 5 female patients in this cohort with a median age of 27 years. At diagnosis 2 patients had metastatic disease and 15 patients had non-metastatic disease. Median follow up in this cohort was 22 months (range 2-30 months). Presenting complaints were hematuria, abdominal pain, flank pain, fever, bone pain, and incidentally detected renal mass. All patients were Mic -2 positive and 13 were FLI-1 positive on immunohistochemistry. Fourteen patients underwent radical nephrectomy. One (5.9%) patient received both neoadjuvant and adjuvant chemotherapy, 8 (47.1%) received adjuvant and 2 (11.8%) received palliative chemotherapy upfront. Eight patients received adjuvant radiation to the renal bed.There was disease progression in12 patients,10 of 15 patients with non metastatic disease at diagnosis eventually developed metastasis.The median progression free survival (PFS) was 10.55 months.The pathological feature that was associated with a shorter PFS was tumor size ⩾10 cm(p = 0.044).The median overall survival was 20.04 months (95% CI 9.49 -not reached). The presence of metastasis and treatment received significantly impacted overall survival (OS). Median OS in patients with non-metastatic disease was not reached versus 14.1 months in those with metastatic disease (p = .019).The median OS in patients treated with multimodality approach was 20.11 months. Patients did not undergo surgery had a median OS of 5.45 months (p < .001) and those who did not receive any chemotherapy had a median OS of 4.57 months (p = .024).Thus, patients who received multimodality treatment had better outcomes. Conclusions: PNET kidney is an aggressive tumor which should be treated with a multimodality approach. Tumor size ⩾10 cm was an adverse prognostic factor.

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Electromyographic Findings in Central Nervous System Disorders: Case Series and Literature Review

Journal of Clinical Neurophysiology ◽

10.1097/wnp.0b013e31817f367d ◽

2008 ◽

Vol 25 (4) ◽

pp. 222-224 ◽

Cited By ~ 3

Author(s):

Brent P. Goodman ◽

Benn E. Smith ◽

Mark A. Ross

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Literature Review ◽

Case Series ◽

Central Nervous System Disorders

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Evaluation of The Effectiveness and Side Effects of Radiotherapy in Patients With Primary Nervous System Lymphoma. A Single Center Experience

Integrative Journal of Medical Sciences ◽

10.15342/ijms.7.252 ◽

2020 ◽

Vol 7 ◽

Author(s):

Timur Koca ◽

Aylin Fidan Korcum ◽

Yasemin Şengün ◽

Melek Gamze Aksu ◽

Mine Genç

Keyword(s):

Central Nervous System ◽

Overall Survival ◽

Nervous System ◽

Side Effects ◽

Disease Free Survival ◽

Central Nervous System Lymphoma ◽

Field Size ◽

High Dose ◽

Free Survival ◽

Significant Difference

Aim: In this study, we aimed to evaluate the overall and progression-free survival, the radiotherapy process and the early and late adverse effects in patients who underwent radiotherapy (RT) for primary nervous system lymphoma in our clinic.Method: Between January 2010 and September 2019, 16 patients who received radiotherapy due to primary central nervous system lymphoma in our clinic were examined according to their statistically significant differences in terms of survival and side effects.Results: The median disease-free survival of the patients was 6 months, and the median overall survival was 12.5 months. 18.75% of the patients could not receive chemotherapy but only radiotherapy. Radiotherapy doses were range from 2600 to 5000 cGy. When patients were evaluated in terms of radiotherapy dose, field size and chemotherapy, no statistically significant difference in overall survival was detected. Cognitive disorders were observed as the most common late side effects while the most common acute side effects in patients were headaches.Conclusion: In the treatment of primary central nervous system lymphoma, changes in radiotherapy portals and radiotherapy doses can be predicted in patients who received high-dose methotrexate chemotherapy or not. Furthermore, it has been considered that more comprehensive studies are needed to increase the success of treatment and provide standardization in treatment, especially in patients with elderly and comorbid diseases.

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Candida central nervous system infection after neurosurgery: a single-institution case series and literature review

Annals of Palliative Medicine ◽

10.21037/apm-21-2577 ◽

2021 ◽

Vol 0 (0) ◽

pp. 0-0

Author(s):

Hongwei Chen ◽

Wenkai Cong ◽

Dongcheng Xie ◽

Shengjie Wang ◽

Jianxing Niu ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Literature Review ◽

Central Nervous System Infection ◽

Case Series ◽

Single Institution

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Efficacy of bevacizumab and temozolomide therapy in locally advanced, recurrent, and metastatic malignant solitary fibrous tumour: A population-based analysis

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155218784760 ◽

2018 ◽

Vol 25 (6) ◽

pp. 1301-1304 ◽

Cited By ~ 3

Author(s):

Mário L de Lemos ◽

Isabell Kang ◽

Kimberly Schaff

Keyword(s):

Overall Survival ◽

Overall Response Rate ◽

Response Rate ◽

Locally Advanced ◽

Case Series ◽

Progression Free Survival ◽

Population Based ◽

Solitary Fibrous Tumour ◽

Free Survival ◽

Overall Response

Background Patients with locally advanced, recurrent or metastatic solitary fibrous tumour are often treated with bevacizumab and temozolomide based on the clinical efficacy reported in a case series of 14 patients. Given the rarity of solitary fibrous tumour, large trials are not feasible. We report the efficacy of this regimen based on a population-based analysis. Methods This was a population-based retrospective, multi-centre analysis using patient data from a provincial cancer registry and treatment database. Cases from June 2006 through October 2016 were identified for patients receiving bevacizumab and temozolomide for locally advanced, recurrent or metastatic solitary fibrous tumour or hemangiopericytoma, which is sometimes used to describe tumours arising from the meninges. The primary outcome was overall response rate. Secondary outcomes included time to response, progression free survival and overall survival estimated using the Kaplan–Meier method. Results Fourteen patients were identified: median age 59 (range 44–70), male 78.6%. Diagnoses were solitary fibrous tumour in 10 (71.4%) and hemangiopericytoma in four (28.6%), with metastatic disease in 10 (72.7%) patients. The most common primary sites were meninges in four (28.6%) and pelvis in three (21.4%) patients. The median follow-up was 15.5 months, with median treatment of four months. Overall response rate was 21.4% (no complete response, 3 partial response), with median time to response of four months. Median progression free survival, six-month progression free survival and overall survival were 17 months, 65.0%, and 45 months, respectively. Conclusions Efficacy of bevacizumab and temozolomide in solitary fibrous tumour appeared to be similar to that previously reported. Our findings confirmed that bevacizumab and temozolomide is an effective and tolerated treatment for this patient population.

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