Efficacy of irradiation for incompletely excised acoustic neurilemomas

1987 ◽  
Vol 67 (6) ◽  
pp. 858-863 ◽  
Author(s):  
Kent E. Wallner ◽  
Glenn E. Sheline ◽  
Lawrence H. Pitts ◽  
William M. Wara ◽  
Richard L. Davis ◽  
...  
Keyword(s):  
Surgical Resection ◽  
San Francisco ◽  
Primary Treatment ◽  
Subtotal Resection ◽  
Preoperative Irradiation ◽  
Tumor Vascularity ◽  
Total Resection ◽  
Content Type ◽  
Postoperative Irradiation ◽  
The University

✓ The records of 124 patients treated for acoustic neurilemoma at the University of California, San Francisco, from 1945 through 1983 were reviewed. Patients were classified by the extent of surgical resection: total, nearly total (90% to 99% resection), subtotal (< 90% resection), or biopsy. Thirty-one patients received irradiation as part of their primary treatment. Total resection of tumor, without irradiation, was associated with a 3% chance of local recurrence. One of 15 patients who had nearly total resection of their tumor and did not receive postoperative irradiation suffered a recurrence, compared with neither of the two patients who received postoperative irradiation (> 45 Gy) following nearly total resection. Postoperative irradiation (> 45 Gy) decreased the recurrence rate after subtotal resection from 46% (six of 13 cases without irradiation) to 6% (one of 17 cases: p = 0.01). All three patients treated by biopsy alone received postoperative irradiation (> 45 Gy), and none had a recurrence. Six patients were treated with preoperative irradiation because of excessive tumor vascularity; four are without evidence of disease 12 to 23 years later. Only three of seven patients treated with irradiation for tumor recurrence after surgical resection survived. It is concluded that postoperative irradiation significantly decreased the chance for local tumor progression following subtotal resection of acoustic neurilemoma, and that postoperative irradiation may be effective therapy following treatment by biopsy. Patients with total or nearly total resection appeared not to benefit from postoperative irradiation.

Treatment of oligodendrogliomas with or without postoperative irradiation

1988 ◽  
Vol 68 (5) ◽  
pp. 684-688 ◽  
Author(s):  
Kent E. Wallner ◽  
Michael Gonzales ◽  
Glenn E. Sheline
Keyword(s):  
San Francisco ◽  
Tumor Recurrence ◽  
Survival Rates ◽  
Content Type ◽  
Brain Irradiation ◽  
Postoperative Irradiation ◽  
A Minor ◽  
The University ◽  
Mixed Tumors ◽  
Histological Progression

✓ The authors have reviewed the treatment results in 42 patients with intracranial oligodendroglioma treated from 1940 through 1983 at the University of California, San Francisco. Two patients who died postoperatively were excluded from analysis. Eleven patients had mixed tumors, with a minor astrocytic component. The overall survival rates for the 29 patients with pure oligodendroglioma were 61% and 33% at 5 and 10 years, respectively; these rates for the 11 patients with mixed tumors were 57% and 38% at 5 and 10 years, respectively. The 10-year survival rate for 14 patients with pure oligodendroglioma who received greater than 45 Gy irradiation was 56% versus 18% for 11 patients who did not receive postoperative irradiation (p = 0.09). Nine patients with mixed tumor who received more than 45 Gy postoperatively had survival rates similar to those for the 14 patients with pure tumors irradiated with more than 45 Gy (p = 0.89). All patients who died of their tumor had evidence of intracranial recurrence. One patient, who did not receive initial postoperative irradiation, also had clinical and myelographic evidence of spinal seeding. All five patients examined postmortem had tumor recurrence at the primary site; one patient also had intraventricular seeding. Six of the 10 patients with pure oligodendroglioma who had a repeat biopsy at the time of tumor recurrence or at postmortem examination showed histological progression to an anaplastic astrocytoma or glioblastoma multiforme. Based on this study, adult patients with pure or mixed oligodendroglioma currently are treated with partial-brain irradiation to a dose of about 60 Gy. In general, children are treated with partial-brain irradiation to about 50 Gy.

Radiation treatment for medulloblastoma

1981 ◽  
Vol 55 (1) ◽  
pp. 43-51 ◽  
Author(s):  
Martin P. Berry ◽  
R. Derek T. Jenkin ◽  
Colin W. Keen ◽  
Bhavani D. Nair ◽  
W. John Simpson
Keyword(s):  
Posterior Fossa ◽  
Radiation Treatment ◽  
Survival Rates ◽  
Current Treatment ◽  
Subtotal Resection ◽  
Total Resection ◽  
Content Type ◽  
Postoperative Irradiation ◽  
First Relapse ◽  
Systemic Relapse

✓ One hundred and twenty-two patients with medulloblastoma received postoperative irradiation at the Princess Margaret Hospital, Toronto, from 1958 to 1978, inclusive. The surgical procedure in these patients was total resection (44 patients), subtotal resection (66 patients), or biopsy alone (12 patients). Twenty-five patients received adjuvant chemotherapy. Overall 5- and 10-year survival rates were 56% and 43%, respectively. Improved survival rates were associated with an increased degree of resection and with posterior fossa radiation doses of 5200 rads or more. The posterior fossa was the common site of first relapse (in 56 patients, 46%). Systemic metastases at first relapse occurred in 18 of 52 patients (35%), and were associated with the use of ventriculosystemic shunts. Millipore filters did not prevent systemic relapse in shunted patients. A subset of 15 patients who received a posterior fossa dose of 5200 rads or more after a total resection had a 5-year survival rate of 77%, which remained constant to 10 years. This result is considered to be the upper limit that can be achieved by current treatment methods.

scholarly journals Intramedullary mature teratoma of the conus medullaris

2016 ◽  
Vol 07 (02) ◽  
pp. 305-307 ◽  
Author(s):  
Kadir Oktay ◽  
Eralp Nuri Cetinalp ◽  
Kerem Mazhar Ozsoy ◽  
Semih Kivanc Olguner ◽  
Mustafa Emre Sarac ◽  
...  
Keyword(s):  
Rare Disease ◽  
Surgical Resection ◽  
Treatment Modality ◽  
Mature Teratoma ◽  
Neural Tissue ◽  
Primary Treatment ◽  
Conus Medullaris ◽  
Subtotal Resection ◽  
Total Resection ◽  
Primary Treatment Modality

ABSTRACTTeratoma is a tumor that derivatives from all three primitive germ layers and spinal intramedullary teratomas are very rare lesions. The primary treatment modality for these tumors is surgical resection, and total resection should be the aim. However, subtotal resection is a valid alternative to prevent traumatizing adjacent functional neural tissue. In this report, we presented a case of a 12-year-old male patient with spinal teratoma of the conus medullaris. We describe the presentation, evaluation, and treatment of this rare disease.

Intraoperative angiography in the resection of arteriovenous malformations

1994 ◽  
Vol 80 (1) ◽  
pp. 73-78 ◽  
Author(s):  
Shigetaka Anegawa ◽  
Takashi Hayashi ◽  
Ryuichiro Torigoe ◽  
Katsuhiko Harada ◽  
Shun-ichi Kihara
Keyword(s):  
Surgical Resection ◽  
Arteriovenous Malformations ◽  
Three Dimensional ◽  
Initial Operation ◽  
Total Resection ◽  
Intraoperative Angiography ◽  
Content Type ◽  
Fine Print

✓ Surgical resection of 13 operatively obscure arteriovenous malformations (AVM's) was accomplished with the assistance of intraoperative angiography, which was performed stereographically to provide three-dimensional orientation and was repeated until total resection of the AVM was confirmed. All films obtained were subtracted to improve clarity. The method presented here may be useful for the resection of all types of AVM. Only two patients had residual AVM after the initial operation. No complications attributable to angiography were noted.

Radiation Therapy in the Treatment of Partially Resected Meningiomas

Neurosurgery ◽  
1987 ◽  
Vol 20 (4) ◽  
pp. 525-528 ◽  
Author(s):  
Nicholas M. Barbaro ◽  
Philip H. Gutin ◽  
Charles B. Wilson ◽  
Glenn E. Sheline ◽  
Edwin B. Boldrey ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
San Francisco ◽  
Tumor Location ◽  
Convincing Evidence ◽  
Subtotal Resection ◽  
Intracranial Meningioma ◽  
Total Resection ◽  
Female Ratio ◽  
Time To Recurrence ◽  
Male Female Ratio

Abstract To address the question of whether radiation therapy is beneficial in the management of partially resected meningiomas, we reviewed the records of all patients admitted to the University of California, San Francisco, between 1968 and 1978 who had a diagnosis of intracranial meningioma. The patients were divided into three groups: 51 patients had gross total resection and did not receive radiation therapy, 30 patients had subtotal resection and no radiation therapy, and 54 patients had subtotal resection followed by radiation therapy. The subtotal resection groups were similar in average age, male: female ratio, and tumor location, which allowed a valid comparison of the effects of irradiation. The recurrence rate in the total resection group was 4% (2 of 51 patients). Among patients in the subtotal resection groups, 60% of nonirradiated patients had a recurrence, compared with only 32% of the irradiated patients. The median time to recurrence was significantly longer in the irradiated group than in the nonirradiated group (125 vs. 66 months, P &lt; 0.05). There was no complication related to irradiation. These results provide convincing evidence that radiation therapy is beneficial in the treatment of partially resected meningiomas.

The Pransky interview: Dr Ken Goldberg, Professor, Industrial Engineering and Operations Research, UC Berkeley; Inventor and Artist

2019 ◽  
Vol 46 (2) ◽  
pp. 188-191
Author(s):  
Joanne Pransky
Keyword(s):  
Computer Science ◽  
San Francisco ◽  
Operations Research ◽  
Industrial Robot ◽  
Electrical Engineering ◽  
Medical Robotics ◽  
Industrial Engineering ◽  
Science And Engineering ◽  
Content Type ◽  
The University

Purpose The following article is a “Q&A interview” conducted by Joanne Pransky of Industrial Robot Journal as a method to impart the combined technological, business, and personal experience of a prominent, robotic industry PhD and inventor regarding his pioneering efforts and the commercialization of bringing a technological invention to market. The paper aims to discuss these issues. Design/methodology/approach The interviewee is Dr Ken Goldberg, an inventor working at the intersection of art, robotics, and social media. He joined the UC Berkeley faculty in 1995 where he is the UC Berkeley William S. Floyd Jr Distinguished Chair in Engineering and recently served as Chair of the Industrial Engineering and Operations Research Department. He has secondary appointments in UC Berkeley’s Electrical Engineering/Computer Science, Art Practice and the School of Information. Goldberg also holds an appointment at the UC San Francisco Medical School’s Department of Radiation Oncology where he pursues research in medical robotics. Goldberg is Director of the CITRIS “People and Robots” Initiative and the UC Berkeley’s Laboratory for Automation Science and Engineering (AUTOLAB) where he and his students research machine learning for robotics and automation in warehouses, homes, and operating rooms. In this interview, Goldberg shares some of his personal and business perspectives from his career-long pursuit of making robots less clumsy. Findings Goldberg earned dual BS degrees in Electrical Engineering and Economics from the University of Pennsylvania in 1984, and MS and PhD degrees in Computer Science from Carnegie Mellon University in 1990. Goldberg also studied at Edinburgh University and the Technion. From 1991-95 he taught at the University of Southern California, and in fall 2000, he was visiting faculty at the MIT Media Lab. Goldberg and his students pursue research in three primary areas: Geometric Algorithms for Automation, Cloud Robotics, and Robot Learning. Originality/value Goldberg developed the first complete algorithms for part feeding and part fixturing, and developed the first robot on the Internet. His inventions have been awarded nine US Patents. Goldberg has published over 250 peer-reviewed technical papers and edited four books. He co-founded and served as Editor-in-Chief of the IEEE Transactions on Automation Science and Engineering (T-ASE). He is also Co-Founder of the Berkeley AI Research (BAIR) Lab, the Berkeley Center for New Media (BCNM), the African Robotics Network (AFRON), the Center for Automation and Learning for Medical Robotics (CAL-MR), the CITRIS Data and Democracy Initiative (DDI), Hybrid Wisdom Labs, and Moxie Institute. He has presented over four hundred keynote and invited lectures. Goldberg's artwork, closely linked with his research, has appeared in over seventy venues. Ken was awarded the Presidential Faculty Fellowship in 1995 by Bill Clinton, the Joseph Engelberger Robotics Award in 2000, elected IEEE Fellow in 2005, and selected by the IEEE Robotics and Automation Society for the George Saridis Leadership Award in 2016.

Meningiomas: genetics, malignancy, and the role of radiation in induction and treatment

1994 ◽  
Vol 81 (5) ◽  
pp. 666-675 ◽  
Author(s):  
Charles B. Wilson
Keyword(s):  
San Francisco ◽  
Early Recognition ◽  
Neurological Injury ◽  
High Dose ◽  
Content Type ◽  
Parasellar Region ◽  
Patients At Risk ◽  
Radiation Induced ◽  
Malignant Lesions ◽  
The University

✓ The author reviews the molecular genetics, pathology, and cell kinetics of meningiomas and the role that regional multiplicity in the dura mater may play in their recurrence. Malignant and radiation-induced meningiomas are discussed, with summaries of series of 60 patients with frankly malignant lesions treated over a period of 22 years at the University of California, San Francisco, and of 10 patients with meningiomas induced by high-dose radiation therapy. Reviewing a 23-year series of 140 patients with subtotally removed meningiomas who were treated postoperatively with radiation, the author recommends that, with meticulous technique, irradiation is effective in preventing the regrowth of subtotally removed benign meningiomas and of all malignant meningiomas. Adoption of both the microscopical cytological grading system proposed by Jääskeläinen's group in Helsinki and the classification of operations proposed by Donald Simpson is also recommended. Wide removal of dura adjacent to meningioma reduces the risk of recurrence, and determination of the bromodeoxyuridine labeling index provides a valid basis for planning treatment and follow-up evaluations. Increased awareness is necessary for early recognition of radiation-induced meningiomas in patients at risk for developing such tumors. For meningiomas in such sites as the parasellar region and the posterior fossa, conservative removal of tumor followed by irradiation is advocated in preference to a radical operation that may cause neurological injury without being curative.

Medulloblastoma in children

1977 ◽  
Vol 46 (1) ◽  
pp. 56-64 ◽  
Author(s):  
John Mealey ◽  
Peter V. Hall
Keyword(s):  
Recurrent Disease ◽  
Fatal Outcome ◽  
Primary Treatment ◽  
Cerebellar Tumor ◽  
Content Type ◽  
Drug Of Choice ◽  
Spinal Axis ◽  
Postoperative Irradiation ◽  
Locally Recurrent ◽  
Higher Doses

✓ The authors review treatment and results in 45 cases of medulloblastoma arising in childhood. The surgical mortality rate observed was 11%. Of those completing postoperative cerebrospinal irradiation at this institution, 53% have survived for 3 years, 41% for 5 years, and 22% for 10 years. The extent of surgical resection of the cerebellar tumor had no significant bearing on the prognosis. Those cases remaining free of recurrent disease had received significantly higher doses of postoperative irradiation, approaching 5000 rads to the whole brain or posterior fossa and 4000 rads to the spinal axis. Repeat irradiation and chemotherapy (vincristine, the nitrosoureas, and methotrexate) provided good palliation in most cases and significantly extended the survival time. However, 28 of 29 patients who developed locally recurrent or metastatic disease have died. Vincristine was considered the chemotherapeutic drug of choice and in 14 cases its use was associated with remissions lasting 2 to 18 months. The combination of chemotherapy and repeat irradiation was followed by remissions of longer duration compared to retreatment by irradiation alone when the disease recurred within 2 years. The inherent value of ventricular shunting procedures and steroid therapy for recurrent intracranial disease could not be ascertained. The findings in this study suggest that the primary treatment of medulloblastoma should be extended to include chemotherapy and optimum radiation therapy, since once recurrent disease develops retreatment is essentially palliative and a fatal outcome is virtually certain.

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