Long-term survival of patients treated with BCNU for brain tumors

1975 ◽  
Vol 43 (2) ◽  
pp. 191-196 ◽  
Author(s):  
John Calogero ◽  
David C. Crafts ◽  
Charles B. Wilson ◽  
Edwin B. Boldrey ◽  
Alan Rosenberg ◽  
...  

✓The authors present three patients who, after excision and irradiation of their brain tumors, were treated with BCNU for recurrence. All three patients responded well and now are without evidence of tumor, 37, 30, and 36 months after BCNU was stopped. Although these patients represent only a small fraction of those treated with BCNU, they indicate the potential role of chemotherapy in the management of glial tumors.

2004 ◽  
Vol 101 (2) ◽  
pp. 219-226 ◽  
Author(s):  
Naoki Shinojima ◽  
Masato Kochi ◽  
Jun-Ichiro Hamada ◽  
Hideo Nakamura ◽  
Shigetoshi Yano ◽  
...  

Object. Glioblastoma multiforme (GBM) remains incurable by conventional treatments, although some patients experience long-term survival. A younger age, a higher Karnofsky Performance Scale (KPS) score, more aggressive treatment, and long progression-free intervals have been reported to be positively associated with long-term postoperative patient survival. The aim of this retrospective study was the identification of additional favorable prognostic factors affecting long-term survival in surgically treated adult patients with supratentorial GBM. Methods. Of 113 adult patients newly diagnosed with histologically verified supratentorial GBM who were enrolled in Phase III trials during the period between 1987 and 1998, six (5.3%) who survived for longer than 5 years were defined as long-term survivors, whereas the remaining 107 patients served as controls. All six were women and were compared with the controls; they were younger (mean age 44.2 years, range 31–60 years), and their preoperative KPS scores were higher (mean 85, range 60–100). Four of the six patients underwent gross-total resection. In five patients (83.3%) the progression-free interval was longer than 5 years and in three a histopathological diagnosis of giant cell GBM was made. This diagnosis was not made in the other 107 patients. Conclusions. Among adult patients with supratentorial GBM, female sex and histopathological characteristics consistent with giant cell GBM may be predictive of a better survival rate, as may traditional factors (that is, younger age, good KPS score, more aggressive resection, and a long progression-free interval).


2003 ◽  
Vol 99 (4) ◽  
pp. 728-737 ◽  
Author(s):  
Astrid Weyerbrock ◽  
Stuart Walbridge ◽  
Ryszard M. Pluta ◽  
Joseph E. Saavedra ◽  
Larry K. Keefer ◽  
...  

Object. The response of brain tumors to systemic chemotherapy is limited by the blood—tumor barrier (BTB). Nitric oxide (NO) has been implicated in the regulation of vascular permeability and blood flow. The authors evaluated the effects of exogenous NO, which was released from a short-acting NO donor (Proli/NO), and those of NO metabolites on the capillary permeability of tumors and normal brain tissue by using quantitative autoradiography in a C6 glioma model in rats. Methods. The Proli/NO was infused at a wide dose range (10−2 to 10−12 M) either intravenously or into the internal carotid artery (ICA) and demonstrated substantial tumor-selective increases in blood-brain barrier (BBB) permeability in response to various-sized tracers ([14C]aminoisobutyric acid, [14C]sucrose, [14C]dextran). Internal carotid artery or intravenous administration of sodium nitrite had a comparable effect on BTB permeability. The NO effect on microvascular permeability could be obtained without causing hemodynamic side effects. The effect of NO on the efficacy of carboplatin chemotherapy was investigated in intracerebral C6 gliomas. Simultaneous intravenous infusions of Proli/NO (10−6 M) and carboplatin (20 mg/kg) led to long-term survival in 40% of rats harboring intracerebral C6 gliomas compared with control animals receiving ICA or intravenous infusions of carboplatin, Proli/NO, or vehicle alone. No residual tumor was demonstrated on histological or magnetic resonance imaging studies performed in rats treated with Proli/NO and carboplatin, and no toxicity was observed. Conclusions. This new approach demonstrated the in vivo efficacy and safety of NO and nitrite in enhancing the delivery of systemically delivered radiolabeled tracers and carboplatin into rat gliomas. The NO-induced tumor-selective BBB disruption and intravenous carboplatin chemotherapy may be more efficacious than current chemotherapy strategies against brain tumors.


1984 ◽  
Vol 60 (3) ◽  
pp. 621-624 ◽  
Author(s):  
Eduardo Fernandez ◽  
Giulio Maira ◽  
Alfredo Puca ◽  
Andrea Vignati

✓ The authors present a case of multiple brain metastases and an extracranial secondary localization from malignant melanoma. The patient was operated on three times for the intracranial masses and had a 49-month survival with a good quality of life after the first of the three operations. She lived a total of 80 months from the time of diffusion of the primary tumor. The course of malignant melanoma is unpredictable, and long-term survival can be achieved in some cases, even in the presence of multiple brain metastases.


1998 ◽  
Vol 88 (2) ◽  
pp. 324-327 ◽  
Author(s):  
Abhaya V. Kulkarni ◽  
Juan M. Bilbao ◽  
Michael D. Cusimano ◽  
Paul J. Muller

✓ Ganglioneuroma is generally considered to be a benign tumor and potentially surgically curable. The authors present a case of a 21-year-old woman who underwent resection of a retroperitoneal ganglioneuroma and developed spinal neuroblastoma 11 years later. She has survived 10 more years with only recent development of metastases. To the authors' knowledge, this is the first report of malignant transformation of a ganglioneuroma into a neuroblastoma. Also, such long-term survival in an adult with spinal neuroblastoma has not been reported previously. This case raises the possibility of a dedifferentiating potential for ganglion cells in a ganglioneuroma or the presence of a long-term, quiescent form of neuroblastoma.


1982 ◽  
Vol 57 (4) ◽  
pp. 452-458 ◽  
Author(s):  
Robert T. Tenny ◽  
Edward R. Laws ◽  
Brian R. Younge ◽  
James A. Rush

✓ A series of 104 patients with surgically verified optic nerve gliomas is presented. Anterior lesions primarily affecting the optic nerve were present in 42 patients, who have a long-term survival rate of 85.5%. Posterior lesions primarily affecting the optic chiasm were present in 62 patients, most of whom underwent radiation therapy postoperatively, and they have a long-term survival rate of 50%. Unequivocal signs of neurofibromatosis were present in 14%. On the basis of these findings and a review of the literature, recommendations are made for the surgical management of these tumors.


1980 ◽  
Vol 52 (2) ◽  
pp. 229-233 ◽  
Author(s):  
Toru Hayakawa ◽  
Kazuyoshi Morimoto ◽  
Yukitaka Ushio ◽  
Takesada Mori ◽  
Toshiki Yoshimine ◽  
...  

✓ Levels of astroprotein (an astrocyte-specific protein found in the cerebrum) were measured by radioimmunoassay in the cerebrospinal fluid (CSF) of 120 patients with intracranial diseases and eight control subjects. The astroprotein level was elevated (above 25 ng/ml) in 13 of 30 cases (43.3%) of glial tumors, nine of 57 cases (15.8%) of nongliomatous intracranial tumors, seven of 33 cases (21.2%) of non-neoplastic intracranial diseases, but in none of the eight control cases. In glioblastoma patients, CSF astroprotein was elevated in eight of 12 cases (66.7%), in three of them to a remarkable degree (above 500 ng/ml). The possible role of this test is briefly discussed, and the mechanism of increase of the astroprotein levels in the CSF considered.


1991 ◽  
Vol 75 (1) ◽  
pp. 126-130 ◽  
Author(s):  
John J. Gartman ◽  
Thomas E. Melin ◽  
W. Thomas Lawrence ◽  
Stephen K. Powers

✓ The authors describe the case of a male infant who was diagnosed prenatally as having iniencephaly. Since birth, the child has grown, thrived, and undergone two successful operations to correct his cervical deformity. This case demonstrates that the iniencephaly defect is not uniformly fatal and that neurosurgical intervention may offer significant improvement in the cervical deformity.


2008 ◽  
Vol 56 (S 1) ◽  
Author(s):  
P Brenner ◽  
M Kraft ◽  
K Jaros ◽  
F Kur ◽  
J Behr ◽  
...  

1998 ◽  
Vol 89 (1) ◽  
pp. 60-68 ◽  
Author(s):  
Richard B. Schwartz ◽  
B. Leonard Holman ◽  
Joseph F. Polak ◽  
Basem M. Garada ◽  
Marc S. Schwartz ◽  
...  

Object. The study was conducted to determine the association between dual-isotope single-photon emission computerized tomography (SPECT) scanning and histopathological findings of tumor recurrence and survival in patients treated with high-dose radiotherapy for glioblastoma multiforme. Methods. Studies in which SPECT with 201Tl and 99mTc-hexamethypropyleneamine oxime (HMPAO) were used were performed 1 day before reoperation in 47 patients with glioblastoma multiforme who had previously been treated by surgery and high-dose radiotherapy. Maximum uptake of 201Tl in the lesion was expressed as a ratio to that in the contralateral scalp, and uptake of 99mTc-HMPAO was expressed as a ratio to that in the cerebellar cortex. Patients were stratified into groups based on the maximum radioisotope uptake values in their tumor beds. The significance of differences in patient gender, histological characteristics of tissue at reoperation, and SPECT uptake group with respect to 1-year survival was elucidated by using the chi-square statistic. Comparisons of patient ages and time to tumor recurrence as functions of 1-year survival were made using the t-test. Survival data at 1 year were presented according to the Kaplan—Meier method, and the significance of potential differences was evaluated using the log-rank method. The effects of different variables (tumor type, time to recurrence, and SPECT grouping) on long-term survival were evaluated using Cox proportional models that controlled for age and gender. All patients in Group I (201Tl ratio < 2 and 99mTc-HMPAO ratio < 0.5) showed radiation changes in their biopsy specimens: they had an 83.3% 1-year survival rate. Group II patients (201T1 ratio < 2 and 99mTc-HMPAO ratio of ≥ 0.5 or 201Tl ratio between 2 and 3.5 regardless of 99mTc-HMPAO ratio) had predominantly infiltrating tumor (66.6%); they had a 29.2% 1-year survival rate. Almost all of the patients in Group III (201Tl ratio > 3.5 and 99mTc-HMPAO ratio ≥ 0.5) had solid tumor (88.2%) and they had a 6.7% 1-year survival rate. Histological data were associated with 1-year survival (p < 0.01); however, SPECT grouping was more closely associated with 1-year survival (p < 0.001) and was the only variable significantly associated with long-term survival (p < 0.005). Conclusions. Dual-isotope SPECT data correlate with histopathological findings made at reoperation and with survival in patients with malignant gliomas after surgical and high-dose radiation therapy.


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