SU-FF-T-69: Determining Patient Eligibility for Prostate IMRT Dose Painting Protocols: The Role of Image Resolution, Margin Requirements, and Intraprostatic Tumor Volume

2005 ◽  
Vol 32 (6Part7) ◽  
pp. 1965-1965
Author(s):  
K Osterman ◽  
T Liu ◽  
P Zhang ◽  
E Mullokandov ◽  
R Ennis ◽  
...  
Author(s):  
Jonathan Weller ◽  
Sophie Katzendobler ◽  
Philipp Karschnia ◽  
Stefanie Lietke ◽  
Rupert Egensperger ◽  
...  

Abstract Introduction The role of chemotherapy alone in newly diagnosed WHO grade 2 oligodendroglioma after biopsy, incomplete or gross total resection remains controversial. We here analyze the clinical outcome of four patient cohorts being treated with either procarbazine, CCNU and vincristine (PCV) or temozolomide (TMZ) after biopsy, resection only, or wait-and-scan after biopsy. Methods Patients (n = 142) with molecularly defined oligodendroglioma (WHO 2016) were assigned to four cohorts: W&S, wait-and-scan after stereotactic biopsy (n = 59); RES, surgical resection only (n = 27); TMZ, temozolomide after biopsy (n = 26) or PCV (n = 30) after biopsy. Presurgical MRI T2 tumor volumes were obtained by manual segmentation. Progression-free survival (PFS), post-recurrence PFS (PR-PFS) and rate of histological progression to grade 3 were analyzed. Results PFS was longest after PCV (9.1 years), compared to 5.1 years after W&S, 4.4 years after RES and 3.6 years after TMZ. The rate of histological progression from grade 2 to 3 within 10 years was 9% for the PCV, 29% for the W&S, 67% for the RES and 75% for the TMZ group (p = 0.01). In the W&S group, patients treated with PCV at first relapse had a longer PFS from intervention than those treated with TMZ (7.2 vs 4.0 years, p = 0.04). Multivariate analysis identified smaller tumor volume prior to any intervention (p = 0.02) to be prognostic for PFS. Conclusions PCV chemotherapy alone is an effective treatment for WHO grade 2 oligodendroglioma, with long PFS and low rate of histological progression.


1995 ◽  
Vol 34 (3) ◽  
pp. 405-408 ◽  
Author(s):  
Monika Busse ◽  
Peter W. Vaupel

2020 ◽  
pp. 1-6
Author(s):  
Marco Raber ◽  
Noor Buchholz ◽  
Augusto Vercesi ◽  
Nashaat A. Hendawi ◽  
Vincenzo Inneo ◽  
...  

<b><i>Introduction:</i></b> The endoscopic resection of large and bulky bladder cancers represents a challenge. To reduce the tumor and make it more easy to resect, we used neoadjuvant short and intensive intravesical mitomycin (MMC) therapy. <b><i>Methods:</i></b> Patients with large bladder tumors were evaluated for this study. At cystoscopy, the surgeon evaluated the feasibility of complete resection. In patients where this was not possible, biopsies from the tumor, bladder mucosa, and prostatic urethra were taken. These patients then underwent a short and intensive cytoreductive schedule of intravesical MMC. This was then followed by TUR-BT. <b><i>Results:</i></b> Fifteen patients were included in our study. The mean age was 74 years (range: 56–82; SD ±6 years). Mean tumor size was 51 mm (range: 35–65; SD ±8 mm). After neoadjuvant treatment, complete resection was then feasible in all patients. The mean tumor volume after the chemo-resection had reduced to 34 mm (range: 10–50; SD ±13 mm). No adverse effects were reported. <b><i>Conclusion:</i></b> Intravesical cytoreductive neoadjuvant MMC as an initial treatment of large NMIBC can be considered safe, effective, and feasible.


2005 ◽  
Author(s):  
Michael Fehler ◽  
Lianjie Huang ◽  
Ru‐Shan Wu ◽  
Xiao‐Bi Xie

2018 ◽  
Vol 25 (5) ◽  
pp. 436-441
Author(s):  
Raj Vikesh Tiwari ◽  
Chia Ming Ho ◽  
Hong Hong Huang ◽  
Henry Sun Sien Ho ◽  
Allen Soon Phang Sim

2014 ◽  
Vol 15 (2) ◽  
pp. 103-109 ◽  
Author(s):  
Friedrich D. Knollmann ◽  
Rohan Kumthekar ◽  
David Fetzer ◽  
Mark A. Socinski

2008 ◽  
Vol 26 (8) ◽  
pp. 1338-1345 ◽  
Author(s):  
Justin S. Smith ◽  
Edward F. Chang ◽  
Kathleen R. Lamborn ◽  
Susan M. Chang ◽  
Michael D. Prados ◽  
...  

Purpose The prognostic role of extent of resection (EOR) of low-grade gliomas (LGGs) is a major controversy. We designed a retrospective study to assess the influence of EOR on long-term outcomes of LGGs. Patients and Methods The study population (N = 216) included adults undergoing initial resection of hemispheric LGG. Region-of-interest analysis was performed to measure tumor volumes based on fluid-attenuated inversion-recovery (FLAIR) imaging. Results Median preoperative and postoperative tumor volumes and EOR were 36.6 cm3 (range, 0.7 to 246.1 cm3), 3.7 cm3 (range, 0 to 197.8 cm3) and 88.0% (range, 5% to 100%), respectively. There was no operative mortality. New postoperative deficits were noted in 36 patients (17%); however, all but four had complete recovery. There were 34 deaths (16%; median follow-up, 4.4 years). Progression and malignant progression were identified in 95 (44%) and 44 (20%) cases, respectively. Patients with at least 90% EOR had 5- and 8-year overall survival (OS) rates of 97% and 91%, respectively, whereas patients with less than 90% EOR had 5- and 8-year OS rates of 76% and 60%, respectively. After adjusting each measure of tumor burden for age, Karnofsky performance score (KPS), tumor location, and tumor subtype, OS was predicted by EOR (hazard ratio [HR] = 0.972; 95% CI, 0.960 to 0.983; P < .001), log preoperative tumor volume (HR = 4.442; 95% CI, 1.601 to 12.320; P = .004), and postoperative tumor volume (HR = 1.010; 95% CI, 1.001 to 1.019; P = .03), progression-free survival was predicted by log preoperative tumor volume (HR = 2.711; 95% CI, 1.590 to 4.623; P ≤ .001) and postoperative tumor volume (HR = 1.007; 95% CI, 1.001 to 1.014; P = .035), and malignant progression-free survival was predicted by EOR (HR = 0.983; 95% CI, 0.972 to 0.995; P = .005) and log preoperative tumor volume (HR = 3.826; 95% CI, 1.632 to 8.969; P = .002). Conclusion Improved outcome among adult patients with hemispheric LGG is predicted by greater EOR.


Author(s):  
Ajay Niranjan ◽  
Timothy Witham ◽  
Douglas Kondziolka ◽  
L. Dade Lunsford

Objective:To evaluate the role of stereotactic cyst aspiration in the context of multimodality management of cystic glial and metastatic tumors, we retrospectively reviewed our experience with 38 patients during a 10-year interval.Methods:All 38 patients had one or more computed tomography or magnetic resonance imaging guided stereotactic cyst aspirations. Twenty-seven patients had glial neoplasms and 11 had metastatic brain tumors. Twenty-two patients underwent cyst aspiration as the initial treatment modality while 15 patients had cyst aspiration following previous treatments.Results:In the immediate postoperative period, 19 of the 27 (70%) patients with gliomas and nine of the 11 (82%) patients with metastatic tumors experienced symptomatic improvement. No procedure-related morbidity was encountered. Twelve patients (31.5%) eventually required a catheter-reservoir system. Thirty-seven percent of patients with cystic glial neoplasms and 18% of patients with metastatic tumors had delayed cytoreductive surgery by craniotomy subsequent to stereotactic cyst aspiration. Reduction in tumor volume following aspiration facilitated Gamma knife radiosurgery in seven patients.Conclusion:Single stereotactic aspiration is a low risk procedure that provides immediate relief of symptoms in patients with cystic brain tumors. It appears to be valuable together with the use of other therapeutic strategies.


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