scholarly journals MET-5 Salvage surgical resection after linac-based stereotactic radiosurgery and radiotherapy for brain metastasis

2021 ◽  
Vol 3 (Supplement_6) ◽  
pp. vi25-vi25
Author(s):  
Ryosuke Matsuda ◽  
Takayuki Morimoto ◽  
Tetsuro Tamamoto ◽  
Masashi Kotsugi ◽  
Yasuhiro Takeshima ◽  
...  
Keyword(s):  
Brain Metastasis ◽  
Brain Metastases ◽  
Survival Time ◽  
Statistical Significance ◽  
Cyst Formation ◽  
Histopathological Diagnosis ◽  
Long Term Follow Up ◽  
To Receive

Abstract Methods: Between November 2009 and December 2018, 335 consecutive patients with 1085 brain metastases were treated with SRS/fSRT for newly diagnosed brain metastasis at our hospital. Nineteen of 335 patients (5.6%) and 19 of 1044 brain metastases (1.8%) went on to receive SSR after SRS/fSRT during this study period. Two patients underwent multiple surgical resections. Nineteen consecutive patients underwent 21 SSRs. Results: The median time from initial SRS/fSRT to SSR was 14 months (range: 2–96 months). The median follow-up after SSR was 15 months (range: 2–76 months). The range of tumor volume at initial SRS/fSRT was 0.12–21.46 cm3 (median: 2.19 cm3). Histopathological diagnosis after SSR was recurrence, radiation necrosis (RN) and cyst formation in 13 and 6 cases, respectively. The time from SRS/fSRT to SSR were shorter in the recurrence than in the RNs and cyst formation, but these differences did not reach statistical significance (p = 0.07). The median survival time from SSR and from initial SRS/fSRT was 17 months and 74 months, respectively. The cases with recurrence had a significantly shorter survival time from initial SRS/fSRT than those without recurrence (p=0.045).Conclusion: The patients treated with SRS/fSRT for brain metastasis need long-term follow-up. SSR is a safe and effective treatment for the recurrence, RN, and cyst formation after SRS/fSRT for brain metastasis.

Salvage Surgical Resection After Linac-based Stereotactic Radiosurgery and Radiotherapy for Newly Diagnosed Brain Metastasis

2021 ◽  
Author(s):  
Ryosuke Matsuda ◽  
Takayuki Morimoto ◽  
Tetsuro Tamamoto ◽  
Nobuyoshi Inooka ◽  
Tomoko Ochi ◽  
...  
Keyword(s):  
Brain Metastasis ◽  
Survival Time ◽  
Stereotactic Radiosurgery ◽  
Surgical Resection ◽  
Cyst Formation ◽  
Histopathological Diagnosis ◽  
Newly Diagnosed ◽  
Long Term Follow Up

Abstract Purpose: This study aimed to assess the clinical outcomes of salvage surgical resection (SSR) after stereotactic radiosurgery and fractionated stereotactic radiotherapy (SRS/fSRT) for brain metastasis.Methods: Between November 2009 and December 2018, we treated 427 consecutive patients with 919 lesions with SRS/fSRT for newly diagnosed brain metastasis at our hospital. During the follow-up period, we treated 19 consecutive patients who underwent 21 SSRs for recurrence, radiation necrosis (RN), and cyst formation after SRS/fSRT for newly diagnosed brain metastasis. Two patients underwent multiple surgical resections. Brain metastasis originated from the lung (n=15, 78.9%), breast (n=3, 15.7%), and colon (n=1, 5.2%). Results: The median time from initial SRS/fSRT to SSR was 14 months (range: 2–96 months). The median follow-up after SSR was 15 months (range: 2–76 months). The range of tumor volume at initial SRS/SRT was 0.121–21.459 cm3 (median: 2.188 cm3). Histopathological diagnosis after SSR was recurrence, RN and cyst formation in 13 and 6 cases, respectively. The median survival time from SSR and from initial SRS/SRT was 17 months and 74 months, respectively. The cases with recurrence had a significantly shorter survival time than those without recurrence (p=0.0453).Conclusion: The patients treated with SRS/fSRT for brain metastasis need long-term follow-up. SSR is a safe and effective treatment for the recurrence, RN, and cyst formation after SRS/fSRT for brain metastasis.

scholarly journals Salvage Surgical Resection after Linac-Based Stereotactic Radiosurgery for Newly Diagnosed Brain Metastasis

2021 ◽  
Vol 28 (6) ◽  
pp. 5255-5265
Author(s):  
Ryosuke Matsuda ◽  
Takayuki Morimoto ◽  
Tetsuro Tamamoto ◽  
Nobuyoshi Inooka ◽  
Tomoko Ochi ◽  
...  
Keyword(s):  
Brain Metastasis ◽  
Brain Metastases ◽  
Survival Time ◽  
Stereotactic Radiosurgery ◽  
Surgical Resection ◽  
Statistical Significance ◽  
Cyst Formation ◽  
Histopathological Diagnosis ◽  
Newly Diagnosed

Background: This study aimed to assess the clinical outcomes of salvage surgical resection (SSR) after stereotactic radiosurgery and fractionated stereotactic radiotherapy (SRS/fSRT) for newly diagnosed brain metastasis. Methods: Between November 2009 and May 2020, 318 consecutive patients with 1114 brain metastases were treated with SRS/fSRT for newly diagnosed brain metastasis at our hospital. During this study period, 21 of 318 patients (6.6%) and 21 of 1114 brain metastases (1.9%) went on to receive SSR after SRS/fSRT. Three patients underwent multiple surgical resections. Twenty-one consecutive patients underwent twenty-four SSRs. Results: The median time from initial SRS/fSRT to SSR was 14 months (range: 2–96 months). The median follow-up after SSR was 17 months (range: 2–78 months). The range of tumor volume at initial SRS/fSRT was 0.12–21.46 cm3 (median: 1.02 cm3). Histopathological diagnosis after SSR was recurrence in 15 cases, and radiation necrosis (RN) or cyst formation in 6 cases. The time from SRS/fSRT to SSR was shorter in the recurrence than in the RNs and cyst formation, but these differences did not reach statistical significance (p = 0.067). The median survival time from SSR and from initial SRS/fSRT was 17 and 74 months, respectively. The cases with recurrence had a shorter survival time from initial SRS/fSRT than those without recurrence (p = 0.061). Conclusions: The patients treated with SRS/fSRT for brain metastasis need long-term follow-up. SSR is a safe and effective treatment for the recurrence, RN, and cyst formation after SRS/fSRT for brain metastasis.

Nivolumab (NIVO) plus ipilimumab (IPI) versus chemotherapy (chemo) as first-line (1L) treatment for advanced non-small cell lung cancer (NSCLC): 4-year update from CheckMate 227.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 9016-9016
Author(s):  
Luis G. Paz-Ares ◽  
Tudor-Eliade Ciuleanu ◽  
Jong-Seok Lee ◽  
Laszlo Urban ◽  
Reyes Bernabe Caro ◽  
...  
Keyword(s):  
Advanced Nsclc ◽  
Performance Status ◽  
Stage Iv ◽  
Ecog Performance Status ◽  
Programmed Death ◽  
Long Term Follow Up ◽  
To Receive ◽  
Clinical Trial Information

9016 Background: 1L NIVO + IPI was shown to provide durable long-term overall survival (OS) benefit vs chemo regardless of tumor programmed death ligand 1 (PD-L1) expression in patients (pts) with advanced NSCLC in CheckMate 227 Part 1 (NCT02477826); 3-year OS rates were 33% vs 22% in pts with PD-L1 ≥ 1% (HR, 0.79 [95% CI, 0.67–0.93]) and 34% vs 15% in pts with PD-L1 < 1% (HR, 0.64 [95% CI, 0.51–0.81]). Here we report updated results from the study with 4 years’ minimum follow-up. Methods: Adults with previously untreated stage IV / recurrent NSCLC, no known EGFR/ ALK alterations , and ECOG performance status ≤ 1 were enrolled; pts were stratified by squamous (SQ) and non-squamous (NSQ) histology. Pts with PD-L1 ≥ 1% (n = 1189) were randomized 1:1:1 to receive NIVO (3 mg/kg Q2W) + IPI (1 mg/kg Q6W), NIVO alone (240 mg Q2W), or chemo. Pts with PD-L1 < 1% (n = 550) were randomized 1:1:1 to receive NIVO + IPI, NIVO (360 mg Q3W) + chemo, or chemo. OS with NIVO + IPI vs chemo in pts with PD-L1 ≥ 1% was the primary endpoint. Results: With minimum follow-up of 49.4 months (database lock, Feb 18, 2021), pts were at least 2 years beyond the protocol-specified end of immunotherapy treatment. Pts with PD-L1 ≥ 1% continued to show durable benefit with NIVO + IPI vs chemo (HR, 0.76 [95% CI, 0.65–0.90]); 4-year OS rates were 29% (NIVO + IPI), 21% (NIVO), and 18% (chemo). At 4 years, 14% (NIVO + IPI), 10% (NIVO), and 4% (chemo) remained progression free. Among responders, 34%, 30%, and 7% remained in response, respectively. In an exploratory analysis in pts with PD-L1 ≥ 50%, 4-year OS rates were 37% (NIVO + IPI), 26% (NIVO), and 20% (chemo). In pts with PD-L1 < 1%, OS HR for NIVO + IPI vs chemo was 0.64 (95% CI, 0.51–0.81); 4-year OS rates were 24% (NIVO + IPI), 13% (NIVO + chemo) and 10% (chemo). At 4 years, 12% (NIVO + IPI), 7% (NIVO + chemo), and 0% (chemo) remained progression free. Among responders, 31%, 13%, and 0% remained in response, respectively. Among pts who progressed on NIVO + IPI vs chemo, 7% vs 40% (PD-L1 ≥ 1%), and 9% vs 33% (PD-L1 < 1%), received subsequent immunotherapy. Benefit with NIVO + IPI vs chemo was observed for both SQ and NSQ histology (Table). With long-term follow-up, no new safety signals were identified. Conclusions: With 4 years’ minimum follow-up, 1L NIVO + IPI continued to provide durable, long-term OS benefit vs chemo in pts with advanced NSCLC regardless of PD-L1 expression or histology. Clinical trial information: NCT02477826. [Table: see text]

Juvenile Ossifying Fibroma in a Juvenile Diabetic: A Case Report with Surgical Management

2010 ◽  
Vol 1 (1) ◽  
pp. 59-64
Author(s):  
Jagadish Hosmani ◽  
Sujata M Byahatti ◽  
Ranganath Nayak ◽  
Ramakant Nayak ◽  
Bhushan Jayade
Keyword(s):  
High Recurrence Rate ◽  
Ossifying Fibroma ◽  
Histopathological Diagnosis ◽  
Massive Growth ◽  
Juvenile Ossifying Fibroma ◽  
Histological Variants ◽  
Long Term Follow Up ◽  
Juvenile Diabetic

ABSTRACT Juvenile ossifying fibroma (JOF) is a highly aggressive uncommon fibro-osseous lesion occurring in the facial bones. Two histological variants of JOF, i.e. trabecular and psammomatoid have been reported. Here we present a case of a 20-year-old juvenile diabetic patient with massive growth on her left side of the jaw which was diagnosed as juvenile ossifying fibroma. This huge aggressive mass in the left side of the mandible had lead to complete lingual tilting of molars and premolars. After clinical and radiological examination, a biopsy led to the histopathological diagnosis of mixed variant of juvenile ossifying fibroma. The required surgical treatment (hemimandibulectomy) was undertaken under GA. The aggressive local behavior and high recurrence rate of JOF emphasizes the need for an early diagnosis, and appropriate radical treatment with long-term follow-up. One such case is reviewed and discussed in detail in the following article.

Follow-up Analysis of a Randomized Comparison of Prolonged Myelosuppressive Maintenance Therapy Versus Intensive Consolidation Therapy as Postremission Therapy in AML.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1056-1056
Author(s):  
Utz O. Krug ◽  
Maria Cristina Sauerland ◽  
Bernhard J Woermann ◽  
Wolfgang Berdel ◽  
Wolfgang Hiddemann ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Maintenance Therapy ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Postremission Therapy ◽  
To Receive

Abstract Abstract 1056 Poster Board I-78 Introduction: We previously showed that a prolonged myelosuppressive maintenance chemotherapy was superior to S-HAM as a postremission therapy in patients > 16 years of age with AML after a TAD-HAM double induction therapy and TAD consolidation chemotherapy with regard to relapse-free survival (RFS) and borderline significance of the overall survival (OS) in responding patients (Buchner et al., JCO 2003, 21:4496-4504). Here we present long-term follow-up data with a median follow-up of 7.9 years from diagnosis and 7.1 years from the date of complete remission. Patients and Methods: Eight hundred thirty-two patients (median age, 54 years; range, 16 to 82 years) with de novo AML were upfront randomized in the AMLCG1992 study of the German AML Co-operative Group to receive 6-thioguanine, cytarabine, and daunorubicin (TAD) plus cytarabine and mitoxantrone (HAM; cytarabine 3 g/m2 [age < 60 years] or 1 g/m2 [age ≥ 60 years] x 6 (HAM in patients ≥ 60 years only in case of blast persistence on day 16 of therapy) induction, TAD consolidation, and monthly maintenance with cycles of cytarabine combined with either daunorubicin (course 1), 6-thioguanine (course 2), cyclophosphamide (course 3), and again 6-thioguanine (course 4), and restarting with course 1 for 3 years, or to receive TAD-HAM-TAD and one course of intensive consolidation with sequential HAM (S-HAM) with cytarabine 1 g/m2 (age < 60 years) or 0.5 g/m2 (age ≥ 60 years) x 8 instead of maintenance. Results: A total of 576 patients (69.2%) achieved a complete remission (CR) those were 294 of 429 (68.5%) patients randomized to receive maintenance and 282 of 403 (70.0%) patients randomized to receive intensive consolidation S-HAM (p=n.s.). 190 patients received maintenance therapy as intended and 135 patients received an intensive consolidation therapy as intended. This prolonged follow-up analysis verified the superior relapse-free survival in all patients in the maintenance arm (10-year RFS 30.0 ± 5.6 versus 19.9 ± 6.1 %, p = 0.015). Stratified by age, the 10-year RFS was superior in younger patients < 60 years (36.9 ± 7.1 versus 25.2 ± 8.0 %, p = 0.038) and borderline significant in elderly patients (17.2 ± 4.5 versus 6.8 ± 6.2 %, p = 0.075). A subgroup analysis of known risk groups (lactate dehydrogenase (LDH) level < 700U/l versus ≥ 700U/l at diagnosis, cytogenetic risk profile, bone marrow blasts on day 16 after the start of the induction therapy) revealed a superior RFS in the subgroup of patients with LDH level > 700 U/l at diagnosis (33.5 ± 12.3 versus 18.2 ± 9.5 %, p = 0.043). This superior RFS also translated into a superior 10-year relapse-free interval (RFI) of all responding patients in the maintenance arm (35.7 ± 6.3 versus 27.6 ± 5.9 %, p = 0.015) with borderline significance in younger patients (42.9 ± 7.4 versus 35.0 ± 7.4 %, p = 0.053) and a significant difference in elderly patients (20.6 ± 10.0 versus 8.4 ± 7.5 %, p = 0.043). In this updated analysis, there was a trend, but no significant difference in the OS (maintenance arm: 10-year OS 24.3 ± 4.8, intensive consolidation arm: 19.7 ± 4.7 %, p = 0.148), and we verified a trend for a better OS in responding patients for the maintenance arm (10-year OS in responding patients 33.6 ± 7.5 versus 28.5 ± 6.2 %, p = 0.093). The event-free survival (EFS) also showed a trend towards better EFS in the maintenance arm (10-year EFS 20.7 ± 4.2 versus 14.8 ± 4.1 %, p = 0.082) which was significant in elderly patients (10-year EFS 10.5 ± 5.5 versus 3.9 ± 3.7 %, p = 0.044). Discussion: This updated analysis with a long-term follow-up of median 7.9 years from diagnosis and 7.1 years from CR verified the superior RFS and the trend for enhanced OS in responding patients. These results suggest the superiority of a prolonged monthly myelosuppressive maintenance therapy as compared to intensive consolidation S-HAM after TAD-HAM induction and TAD consolidation. Disclosures: No relevant conflicts of interest to declare.

Radiation ±cisplatin for bulky stage IB cervical carcinoma; Long-term follow-up of a GOG trial

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 5015-5015
Author(s):  
F. B. Stehman ◽  
S. Ali ◽  
D. G. Gallup ◽  
H. Key
Keyword(s):  
Cervical Carcinoma ◽  
Progression Free Survival ◽  
Free Survival ◽  
Stage Ib ◽  
Long Term Follow Up ◽  
Weekly Cycles ◽  
To Receive ◽  
Weekly Cisplatin

5015 Purpose: To confirm that concurrent cisplatin (CT) with radiation (RT) is associated with improved long-term progression-free survival (PFS), overall survival (OS), and decreased morbidity compared to RT stage IB bulky carcinoma of the cervix, when both groups’ therapy is followed by hysterectomy. Methods: Three hundred seventy-four patients entered this trial. There were 369 evaluable patients; 186 were randomly allocated to receive RT alone and 183 to receive CT+RT. Radiation dosage was 40 Gray (Gy) in 20 fractions followed by a single low dose-rate intracavitary application of 30 Gy to Point A. Chemotherapy consisted of cisplatin 40 mg/M2 every week for up to six weekly cycles. Total extrafascial hysterectomy followed the completion of RT by 3–6 weeks. Results: Preliminary results have been published, at which time there many censored observations and limited follow-up. Patient and tumor characteristics were well-balanced between the regimens. The median patient age was 41.5 years; 81% had squamous tumors; 59% were white. Median follow-up is 101 months. The relative risk for progression was 0.61 favoring CT+RT (95% confidence interval [CI]: 0.43–0.85, p < 0.004). At 72 months 71% of patients receiving CT+RT were predicted to be alive and disease-free when adjusting age and for tumor size compared to 60% of those receiving RT alone. The adjusted death hazard ratio was 0.63 (95% CI: 0.43–0.91, p < 0.015) favoring CT+RT. At 72 months, 78% of CT+RT patients were predicted to be alive compared to 64% of RT patients. An increased rate of early hematologic and gastrointestinal toxicity was seen with CT+RT. There was no detectable difference in the frequency of late adverse events. Conclusion: Concurrent weekly cisplatin with RT significantly improves long term PFS and OS when compared to RT alone. Serious late effects were not increased. The inclusion of hysterectomy has been discontinued on the basis of another trial. Pending further trials, weekly cisplatin with radiation is the standard against which other regimens must be compared. Key Words: Cervical carcinoma, chemoradiotherapy. No significant financial relationships to disclose.

Odontogenic Fibromyxoma in a Cat: First Confirmed Case in This Species

2017 ◽  
Vol 34 (1) ◽  
pp. 18-29
Author(s):  
Kristin I. Scott ◽  
Colin E. Harvey ◽  
James G. Anthony ◽  
Roy Pool
Keyword(s):  
Literature Review ◽  
Clinical Presentation ◽  
Case Reports ◽  
Companion Animals ◽  
Histopathological Diagnosis ◽  
Extensive Literature ◽  
En Bloc ◽  
Long Term Follow Up

An inflammatory gingival mass surrounding resorbing teeth was diagnosed via biopsy in a 9-year-old domestic shorthair cat. A dorsal rim excision was performed to remove the entire mass with associated teeth and bone. Histopathological diagnosis of the en bloc tissue revealed an odontogenic fibromyxoma. Extensive literature review revealed few case reports of companion animals with this neoplasm, and none in a feline patient. This report documents the clinical presentation, diagnostic differentials, surgical therapy, and long-term follow-up of an odontogenic fibromyxoma in a cat.

A measure of survival time for long-term follow-up studies of the elderly

1989 ◽  
Vol 42 (6) ◽  
pp. 541-549 ◽  
Author(s):  
D.J.H. Deeg ◽  
G.J. van Oortmarssen ◽  
J.D.F. Habbema ◽  
P.J. van der Maas
Keyword(s):  
Survival Time ◽  
The Elderly ◽  
Follow Up Studies ◽  
Long Term Follow Up

scholarly journals Cyst Formation Following Radiosurgery for AVMs: Report of 3 Cases

2011 ◽  
Vol 38 (5) ◽  
pp. 734-740 ◽  
Author(s):  
Q. Al Hinai ◽  
D. Tampieri ◽  
L. Souhami ◽  
A. Sadikot ◽  
D. Sinclair ◽  
...  
Keyword(s):  
Arteriovenous Malformations ◽  
Radiation Dosage ◽  
Clinical Presentation ◽  
Late Complication ◽  
Cyst Formation ◽  
The Other ◽  
Treatment Site ◽  
Long Term Follow Up

ABSTRACT:Background:Stereotactically-focused radiosurgery (SRS) for the treatment of arteriovenous malformations (AVM) has been in widespread use for over two decades. Over this timeframe the indications for treatment, standardization of radiation dosage, and the results expected from treatment have been elaborated. Less well known are the long-term complications associated with SRS. We report three patients who had SRS for the treatment of AVM who developed a cyst at the site of treatment as a late complication.Methods:From 201 patients treated by SRS for an AVM, three developed a cyst at the treatment site. Their clinical presentation, the characteristics of the AVMs and the treatment were reviewed, as well as similar cases gleaned from the literature.Results:Three women, aged 28-43 years, had an AVM treated by: craniotomy and clipping of arterial feeders followed by SRS, by craniotomy for resection followed by SRS or by endo vascular embolization and SRS. The patients did well following treatment but two of them developed a symptomatic and the other an asymptomatic cyst at the treatment site 3-19 years later. The symptomatic patients underwent marsupialization of the cyst and the other is under observation.Conclusion:Stereotactic radiosurgery is an established and safe treatment for patients with AVMs. Delayed cyst formation can occur many years after treatment and long term follow-up is indicated in patients whose AVM has been treated with SRS.

Sign in / Sign up

Export Citation Format

Share Document