Recurrent malignant gliomas: survival following interstitial brachytherapy with high-activity iodine-125 sources

✓ The authors report survival data for the first 41 patients treated for recurrent malignant gliomas with interstitial brachytherapy at the University of California, San Francisco (1980–1984). Iodine-125 (125I) sources were temporarily implanted using stereotaxic techniques. The median survival period for 18 patients with recurrent glioblastomas was 52 weeks after brachytherapy; two patients are alive more than 5 years after brachytherapy. The median survival period for 23 patients with recurrent anaplastic astrocytomas is 153 weeks after brachytherapy, with 10 patients alive more than 3 years and four patients alive more than 4 years after brachytherapy. Both groups did significantly better (p < 0.01) than groups of patients with the same diagnoses and similar general characteristics who were treated at recurrence with chemotherapy alone. Because of deterioration of their clinical condition and evidence of recurrence from computerized tomographic scans, 17 (41%) of 41 patients required reoperation 20 to 72 weeks after brachytherapy. Despite the invariable presence of apparently viable tumor cells mixed with necrotic tissue in the resected specimen, nine patients have survived more than 2 years after reoperation and two of the nine are still alive 4 years after reoperation. The authors conclude that brachytherapy with temporarily implanted 125I sources for well-circumscribed, hemispheric, recurrent malignant gliomas is effective and offers a chance for long-term survival even though focal radiation necrosis can seriously degrade the quality of survival in a minority of patients.

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Widened difference of incidence and survival between different races in epithelial ovarian cancer: a period analysis.

10.21203/rs.3.rs-20560/v1 ◽

2020 ◽

Author(s):

Li Li ◽

Lili Han ◽

Sulaiya Husaiyin ◽

Miherinisha Maimaiti ◽

Mayinuer Niyazi

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Median Survival ◽

Survival Data ◽

Relative Survival ◽

Population Based ◽

Limited Information ◽

Term Survival ◽

The Past ◽

Survival Differences

Abstract Introduction To describe the incidence and relative survival in women with epithelial ovarian cancer (EOC) in a population-based cohort in the four decades after diagnosis. EOC is the major pathological type of all ovarian cancers, however, there is limited information on changes of long-term survival in EOC in the four decades. Methods We extracted the incidence and relative survival data from Surveillance, Epidemiology, and End Results (SEER) registries to assess epidemiological changes of patients with EOC from 1974 to 2013. The survival disparities of patients with EOC among four decades, age, race, and socioeconomic status (SES) were performed by Kaplan-Meier curves. Results The overall incidence of EOC gradually declined from 11.4 to 9.0 per 100,000 in the past four decades. The median survival increased from 27 months in the first decades to 48 months in the fourth decade, with 5-year relative survival rate (RSR) improving from 32.3% to 44.3% in the same period. However, the median survival differences increased from 11 months to 18 months between Whites and Blacks and increased from 7 months to 12 months between low-poverty group and high-poverty group respectively over the past four decades. Discussion This study indicated that the incidence and RSR of EOC patients had improved in the past four decades. But the survival gap between different races and SES gradually widened. More importantly, this study will promote the improvement of health care system and clinical management to erase the survival differences in SES groups and races identified in this study, thereby optimize the clinical outcome.

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Clinical factors affecting the rate of exodrift after surgery in patients with basic intermittent exotropia

Scientific Reports ◽

10.1038/s41598-021-86004-9 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Seungheon Kim ◽

Suk-Gyu Ha ◽

Young-Woo Suh ◽

Seung-Hyun Kim

Keyword(s):

Regression Analysis ◽

Median Survival ◽

Proportional Hazards ◽

Survival Period ◽

Clinical Factors ◽

Intermittent Exotropia ◽

Median Survival Period ◽

Median Period ◽

Angle Of Deviation ◽

Late Group

AbstractWe investigated the period of postoperative exodrift during follow-up and clinical factors that affect the rate of exodrift after surgery in the patients with intermittent exotropia (IXT). A retrospective review of medical records of patients with exodrift who underwent bilateral rectus recession for IXT was performed. Exodrift was defined as angle of deviation greater than 10 prism diopters (PD) at distance and near. The median survival period of postoperative exodrift was analyzed using Kaplan Meier survival analysis. The patients were divided into two groups according to the median period of postoperative exodrift (early and late group). The weighted Cox’s proportional hazards regression analysis to investigate the risk factors that affect rate of postoperative exodrift was performed. A total of 108 patients was included. The preoperative angle of deviation at distance and near were 30.3 ± 7.2 PD and 29.5 ± 8.6 PD, respectively. The median survival period of postoperative exodrift was 24 months (range, 6–48 months).The angle of deviation at postoperative day 1 in early and late group were − 3.8 ± 5.5 PD (range, − 16–8 PD) and − 7.7 ± 4.6 PD (range, − 16–4 PD) (p < 0.01). Minus value means esodeviation. In regression analysis, the angle of deviation at postoperative day 1 was the significantly related with rate of exodrift (p < 0.01). The median period of exodrift after surgery was 24 months, angle of deviation at postoperative day 1 could affect the rate of exodrift in patients with IXT.

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Survival after Stereotactic Biopsy of Malignant Gliomas

Neurosurgery ◽

10.1227/00006123-198803000-00003 ◽

1988 ◽

Vol 22 (3) ◽

pp. 465-473 ◽

Cited By ~ 99

Author(s):

Robert J. Coffey ◽

L. Dade Lunsford ◽

Floyd H. Taylor

Keyword(s):

Median Survival ◽

Stereotactic Biopsy ◽

Patient Survival ◽

Malignant Gliomas ◽

Tumor Resection ◽

Tumor Location ◽

Clinical Factors ◽

Term Survival ◽

Critical Areas

Abstract For many patients with malignant gliomas in inaccessible or functionally important locations, stereotactic biopsy followed by radiation therapy (RT) may be a more appropriate initial treatment than craniotomy and tumor resection. We studied the long term survival in 91 consecutive patients with malignant gliomas diagnosed by stereotactic biopsy: 64 had glioblastoma multiforme (GBM) and 27 had anaplastic astrocytoma (AA). Sixty-four per cent of the GBMs and 33% of the AAs involved deep or midline cerebral structures. The treatment prescribed after biopsy, the tumor location, the histological findings, and the patient's age at presentation (for AAs) were statistically important factors determining patient survival. If adequate RT (tumor dose of 5000 to 6000 cGy) was not prescribed, the median survival was <11 weeks regardless of tumor histology or location. The median survival for patients with deep or midline tumors who completed RT was similar in AA (19.4 weeks) and GBM (27 weeks) cases. Histology was an important predictor of survival only for patients with adequately treated lobar tumors. The median survival in lobar GBM patients who completed RT was 46.9 weeks, and that in lobar AA patients who completed RT was 129 weeks. Cytoreductive surgery had no statistically significant effect on survival. Among the clinical factors examined, age of less than 40 years at presentation was associated with prolonged survival only in AA patients. Constellations of clinical features, tumor location, histological diagnosis, and treatment prescribed were related to survival time. For patients with deep or midline malignant gliomas and for selected patients with lobar tumors in critical areas, stereotactic biopsy followed by RT and nonoperative adjuvant therapy is a rational treatment strategy to prolong survival and preserve neurological function. (Neurosurgery 22:465-473, 1988)

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Long-term follow-up of patients with low-grade malignant lymphomas treated with doxorubicin-based chemotherapy or chemoimmunotherapy.

Journal of Clinical Oncology ◽

10.1200/jco.1993.11.4.644 ◽

1993 ◽

Vol 11 (4) ◽

pp. 644-651 ◽

Cited By ~ 149

Author(s):

B W Dana ◽

S Dahlberg ◽

B N Nathwani ◽

E Chase ◽

C Coltman ◽

...

Keyword(s):

Median Survival ◽

Survival Data ◽

Survival Curve ◽

Performance Status ◽

Survival Duration ◽

Low Grade ◽

Term Survival ◽

Symptom Status

PURPOSE We reviewed survival data of patients with low-grade lymphoma entered on Southwest Oncology Group (SWOG) lymphoma trials in 1972 to 1983 to determine the utility of doxorubicin-containing therapy (cyclophosphamide, doxorubicin, vincristine, and prednisone [CHOP]) in such patients. PATIENTS AND METHODS We identified all patients with low-grade lymphoma, no prior therapy, and stage III or IV disease who were treated with full-dose CHOP induction therapy on any arm of SWOG studies 7204, 7426, or 7713. Survival data for this group of patients were correlated with pretreatment prognostic factors, including histology, patient age, sex, symptom status, performance status, bone marrow or extranodal involvement, and the number of disease sites. The effect of maintenance treatment was also assessed. RESULTS Four hundred fifteen patients met criteria for inclusion in the study group. With median follow-up periods of 12.8 years (maximum, 19.8 years), the median survival duration was 6.9 years. Survival was significantly shorter in patients with follicular mixed or small lymphocytic histology, age greater than 40 years, male sex, B-symptom status, and SWOG performance status greater than 1. Multivariate regression analysis showed histology, age, and sex to be independent predictors of survival. There was no definite survival plateau of cured patients in any subgroup, although the survival curve for follicular mixed histology patients showed long-term survival of approximately 25%. Maintenance therapy did not prolong survival. CONCLUSION Doxorubicin-containing treatment did not prolong the overall median survival of low-grade lymphoma patients compared with results with less-aggressive programs.

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Is It Definitely Clear That Long-Term Survival after Breast Cancer Surgery Is Not Affected by Anaesthetics?

Cancers ◽

10.3390/cancers13143390 ◽

2021 ◽

Vol 13 (14) ◽

pp. 3390

Author(s):

Mats Enlund

Keyword(s):

Breast Cancer ◽

Survival Data ◽

Retrospective Studies ◽

Breast Cancer Surgery ◽

Breast Cancer Patients ◽

Term Survival ◽

Long Term Survival ◽

Significant Difference ◽

One Year

Retrospective studies indicate that cancer survival may be affected by the anaesthetic technique. Propofol seems to be a better choice than volatile anaesthetics, such as sevoflurane. The first two retrospective studies suggested better long-term survival with propofol, but not for breast cancer. Subsequent retrospective studies from Asia indicated the same. When data from seven Swedish hospitals were analysed, including 6305 breast cancer patients, different analyses gave different results, from a non-significant difference in survival to a remarkably large difference in favour of propofol, an illustration of the innate weakness in the retrospective design. The largest randomised clinical trial, registered on clinicaltrial.gov, with survival as an outcome is the Cancer and Anesthesia study. Patients are here randomised to propofol or sevoflurane. The inclusion of patients with breast cancer was completed in autumn 2017. Delayed by the pandemic, one-year survival data for the cohort were presented in November 2020. Due to the extremely good short-term survival for breast cancer, one-year survival is of less interest for this disease. As the inclusions took almost five years, there was also a trend to observe. Unsurprisingly, no difference was found in one-year survival between the two groups, and the trend indicated no difference either.

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RARE-55. CHALLENGES AND SPECIFIC STRATEGIES FOR CONSTITUTIONAL MISMATCH REPAIR DEFICIENCY SYNDROME IN LOW RESOURCE SETTINGS. ON BEHALF OF THE INTERNATIONAL RRD CONSORTIUM IN LOW RESOURCE SETTINGS PANEL

Neuro-Oncology ◽

10.1093/neuonc/noaa222.765 ◽

2020 ◽

Vol 22 (Supplement_3) ◽

pp. iii454-iii454

Author(s):

Rejin Kebudi ◽

Nisreen Amayiri N ◽

Malak Abedalthagafi ◽

Asim Noor Rana ◽

Slman Kirmani ◽

...

Keyword(s):

Mismatch Repair ◽

Checkpoint Inhibitors ◽

Immune Therapy ◽

Malignant Gliomas ◽

Mismatch Repair Deficiency ◽

Term Survival ◽

Low Resource Settings ◽

Low Resource ◽

Repair Deficiency ◽

Constitutional Mismatch Repair Deficiency

Abstract Germline biallelic mutations in one of the mismatch repair genes (MSH2/MSH6/MLH1/PMS2 results in constitutional mismatch repair deficiency (CMMRD), a condition associated with multiple tumors arising from multiple organs during childhood, and these individuals rarely reach adulthood. The paucity of information with respect to these conditions leads to mismanagement and may be a factor in the high mortality of patients with CMMRD. Two international consortia, the European CARE4CMMRD, and the international replication repair deficiency (RRD) consortium, are addressing the many challenges associated with this condition. To address specific issues surrounding the management of CMMRD in low and middle income countries (LMIC), a multidisciplinary taskforce of 11 specialists from nine countries was formed. Preliminary conclusions are: 1) Immunohistochemistry for CMMRD should be considered for all patients with suggestive clinical features. In countries where CMMRD is common, malignant gliomas, colon cancers and T cell lymphomas should be stained routinely as the prevalence of CMMRD in these tumors can exceed 40%. 2) Temozolomide should not be used in the management of malignant glioma. By contrast, preclinical studies have suggested increased sensitivity to nitrosoureas. For the management of CMMRD related lymphoma and leukemia, mercaptopurines should not be avoided or discontinued as a part of the standard of care before more data are collected. 3) Management with checkpoint inhibitors should be limited to centers with intensive care units and expertise in complex supportive care to manage side effects of immune therapy. 4) Surveillance protocols have demonstrated long term survival benefits and should be implemented in LMIC.

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Aggressive Treatment in Glioblastoma: What Determines the Survival of Patients?

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0040-1713172 ◽

2020 ◽

Author(s):

Lei Yu ◽

Guozhong Zhang ◽

Songtao Qi

Keyword(s):

Overall Survival ◽

Malignant Gliomas ◽

Epidemiological Studies ◽

Control Cohort ◽

Poor Overall Survival ◽

Term Survival ◽

Significant Difference ◽

Positive Rate ◽

Long Term Survivors

Abstract Background and Study Aims The exact reason of long-term survival in glioblastoma (GBM) patients has remained uncertain. Molecular parameters in addition to histology to define malignant gliomas are hoped to facilitate clinical, experimental, and epidemiological studies. Material and Methods A population of GBM patients with similar clinical characteristics (especially similar resectability) was reviewed to compare the molecular variables between poor (overall survival [OS] < 18 months, control cohort) and long-term survivors (overall survival > 36 months, OS-36 cohort). Results Long-term GBM survivors were younger. In the OS-36 cohort, the positive rate of isocitrate dehydrogenase (IDH) mutation was very low (7.69%, 3/39) and there was no statistical difference in OS between IDH mutant and wild-type patients. The results of 1p/19q codeletions are similar. Besides, there were no significant difference in MGMT promoter methylation, telomerase reverse transcriptase (TERT) promoter mutation, and TP53 mutations between OS-36 cohort and control cohort. Conclusions No distinct markers consistently have been identified in long-term survivors of GBM patients, and great importance should be attached to further understand the biological characteristics of the invasive glioma cells because of the nature of diffuse tumor permeation.

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