Clinical outcomes of a cohort of patients with central nervous system metastases from thyroid cancer

Introduction Metastases to central nervous system (M1-CNS) are rarely reported in thyroid cancer (TC) patients. We aimed to characterize patients with M1-CNS from TC followed in our department. Methods Review of the medical records of 27 patients with TC-related M1-CNS. Results Mean age at TC diagnosis was 56.9 ± 19.1 years. Papillary TC (55.6%) was the commonest histological type, followed by poorly differentiated (18.5%), medullary (11.1%), follicular (7.4%) and Hürthle cell (7.4%) carcinomas. Angioinvasion and extrathyroidal extension were observed in a high number of patients. At M1-CNS diagnosis, other distant metastases were already present in 77.8% of the patients. Treatment directed to M1-CNS was offered to 20 (74%) patients: 1 was submitted to surgery, 18 to radiotherapy (either whole-brain radiotherapy or stereotaxic radiosurgery or both) and 4 to surgery and radiotherapy. Four patients received cytotoxic chemotherapy and one was submitted to 131I. Median survival since M1-CNS detection was 5.0 months. The only factor associated with better survival was surgery to brain metastases (P = 0.012). Conclusions The management of these patients is very challenging given the inexistence of effective treatments, except for brain surgery in selected cases.

Download Full-text

O2.05 * MAY WE ROUTINELY SPARE HIPPOCAMPAL REGION IN PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA DURING WHOLE BRAIN RADIOTHERAPY?

Neuro-Oncology ◽

10.1093/neuonc/nou174.12 ◽

2014 ◽

Vol 16 (suppl 2) ◽

pp. ii4-ii4 ◽

Cited By ~ 1

Author(s):

B. Diletto ◽

D. Marchesano ◽

S. Chiesa ◽

A. Alitto ◽

S. Gaudino ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Central Nervous System Lymphoma ◽

Whole Brain Radiotherapy ◽

Hippocampal Region ◽

Whole Brain ◽

Brain Radiotherapy

Download Full-text

Current management of brain metastases

Arquivos Brasileiros de Neurocirurgia Brazilian Neurosurgery ◽

10.1055/s-0038-1626238 ◽

2014 ◽

Vol 33 (04) ◽

pp. 347-351

Author(s):

Pedro Tadao Hamamoto Filho ◽

Vitor César Machado ◽

Flávio Ramalho Romero ◽

Luis Gustavo Ducati ◽

Marco Antônio Zanini ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Brain Metastases ◽

Whole Brain Radiotherapy ◽

Treatment Modalities ◽

Current Management ◽

Brain Radiotherapy ◽

Recent Advances ◽

The Central Nervous System ◽

Treatment Surgery

AbstractBrain metastases are the most common tumors within the central nervous system. Recent advances on diagnosis and treatment modalities have allowed for longer survival. In this paper we review the indication of each modality of treatment: surgery, whole brain radiotherapy and stereotactic radiosurgery, as also recent advances on the knowledge of brain metastases biology that may improve the use of medical treatment and chemotherapy.

Download Full-text

RADT-24. SYNTHETIC TREATMENT OF CENTRAL NERVOUS SYSTEM EWING/PRIMITIVE NEUROECTODERMAL TUMOR (EWING/PNET): A CASE REPORT

Neuro-Oncology ◽

10.1093/neuonc/noab196.182 ◽

2021 ◽

Vol 23 (Supplement_6) ◽

pp. vi46-vi46

Author(s):

yanying Yang ◽

Changguo Shan ◽

Weiping Hong ◽

Linbo Cai

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Standard Treatment ◽

Whole Brain Radiotherapy ◽

Good Survival ◽

Tumor Bed ◽

Brain Radiotherapy ◽

Anterior Cranial Base ◽

Second Resection ◽

The Central Nervous System

Abstract Ewing/PNET is a rare tumor of the central nervous system. After the standard treatment, there’re still 86.7% of patients had recurrence and no standard treatment after recurrence. Here we report a case of Ewing/PNET with a good survival after synthetic treatment to provide evidence for future clinical strategies. A 23-year-old male underwent resection of the left frontal tumor on April 28, 2017, the pathological diagnosis was Ewing/PNET. He received whole brain radiotherapy 36Gy in 18 fractions, and tumor bed boost to 56Gy in 28 fractions, with 3 courses of Nedaplatin adjuvant chemotherapy. The tumor recured 23 months after the surgery. The patient underwent the second resection, followed by 4 courses of ADM+VCR+CTX/IE chemotherapy. However, 27 months after the first surgery, the tumor evaluation progressive resection of recurrent tumors in the anterior cranial base-ethmoid sinus. During the chemotherapy, MRI showed that tumor still increased. There was a mass in the root of the forehead and nose. After the third recurrence, the patient received re-radiotherapy (50Gy in 25 fractions) 29 months later after the first RT. The tumor was significantly reduced after radiotherapy. Physical examination showed that the sense of smell continued to weaken, the visual acuity was the same as before. 8 courses of VIT (Irinotecan, vincristine, temozolomide) were followed by second RT, tumor was assessed every 2 courses. 44 months after the first surgery, he suffered a third recurrence in spina cord. And then he received rescue RT (20Gy in 10 fractions) in the recurrent tumor. The tumor was reduced after local radiotherapy. He was undergoing follow-up till May 2021, And the OS is 49 months. In conclusion, the incidence of this disease is low, especially in adults. However, the prognosis is poor. Early detection, early operation, combined with radiotherapy and chemotherapy are promising to improve the efficacy of Ewing/PNET.

Download Full-text