Executive summary from American Radium Society’s appropriate use criteria on neurocognition after stereotactic radiosurgery for multiple brain metastases

BackgroundThe American Radium Society (ARS) Appropriate Use Criteria brain malignancies panel systematically reviewed (PRISMA [Preferred Reporting Items for Systematic Reviews and Meta-Analyses]) published literature on neurocognitive outcomes after stereotactic radiosurgery (SRS) for patients with multiple brain metastases (BM) to generate consensus guidelines.MethodsThe panel developed 4 key questions (KQs) to guide systematic review. From 11 614 original articles, 12 were selected. The panel developed model cases addressing KQs and potentially controversial scenarios not addressed in the systematic review (which might inform future ARS projects). Based upon quality of evidence, the panel confidentially voted on treatment options using a 9-point scale of appropriateness.ResultsThe panel agreed that SRS alone is usually appropriate for those with good performance status and 2–10 asymptomatic BM, and usually not appropriate for >20 BM. For 11–15 and 16–20 BM there was (between 2 case variants) agreement that SRS alone may be appropriate or disagreement on the appropriateness of SRS alone. There was no scenario (among 6 case variants) in which conventional whole-brain radiotherapy (WBRT) was considered usually appropriate by most panelists. There were several areas of disagreement, including: hippocampal sparing WBRT for 2–4 asymptomatic BM; WBRT for resected BM amenable to SRS; fractionated versus single-fraction SRS for resected BM, larger targets, and/or brainstem metastases; optimal treatment (WBRT, hippocampal sparing WBRT, SRS alone to all or select lesions) for patients with progressive extracranial disease, poor performance status, and no systemic options.ConclusionsFor patients with 2–10 BM, SRS alone is an appropriate treatment option for well-selected patients with good performance status. Future study is needed for those scenarios in which there was disagreement among panelists.     

Sensitivity of the Montreal Cognitive Assessment in screening for cognitive impairment in patients with newly diagnosed high-grade glioma

Journal of Neuro-Oncology - Cognitive impairment is frequent in patients with high-grade glioma and requires cognitive follow-up. Cognitive screening tools such as the Montreal Cognitive Assessment...     

Cognitive functions and psychological symptoms in migraine: a study on patients with and without aura

Aim: Migraine is neurological disorder with a complex pathophysiology. We described the neuropsychological profile of 100 migraineurs (50 with visual aura and 50 without aura), in interictal phase, compared to 50 matched healthy controls.

Materials and methods: A battery of standardized neuropsychological tests was used to assess attention, memory and executive functions. Beck Depression Inventory and Hamilton Rating Scale for Anxiety were used to evaluate anxiety and depressive symptoms. Severity of disability during daily activities was assessed by Migraine Disability Assessment.

Results: Migraine without aura showed a significant difference in comparison to healthy controls in semantic verbal fluency (p?=?0.02), delayed memory (p?<?0.001) and set-shifting (p?<?0.001). Migraine with aura showed a significant difference in delayed memory (p?=?0.001) and set-shifting (p?=?0.005) if compared to healthy controls. No significant correlation between cognitive functions and mood was found (HAM-A p?=?0.67) (BDI-II p?=?0.42).

Conclusions: Our data showed isolate and specific cognitive deficit during interictal phase in migraine patients. Future studies are need to identify if specific migraine characteristics may affect cognitive functions.     

Perioperative Bevacizumab-based Triplet Chemotherapy in Patients With Potentially Resectable Colorectal Cancer Liver Metastases

Background

In colorectal cancer liver metastases (CRCLM), bevacizumab-based neoadjuvant strategies provide increased pathologic response. We aimed at assessing the activity of perioperative capecitabine, oxaliplatin, irinotecan, and bevacizumab (COI-B regimen) in patients with potentially resectable CRCLM, and investigating biomarkers for early prediction of pathologic response.

Gut vascular barrier impairment leads to intestinal bacteria dissemination and colorectal cancer metastasis to liver

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Silk Fibroin Processing from CeCl3 Aqueous Solution: Fibers Regeneration and Doping with Ce(III)

Silk fibroin (SF) obtained from Bombyx mori cocoon is a very promising biopolymer. It can be processed from aqueous solutions to obtain many versatile scaffolds useful in optoelectronics, photonics, and biomedicine. Aqueous solutions are prepared by dissolving degummed fibroin with chaotropic agents and then purifying by dialysis. This work presents, for the first time, a solubilization protocol, involving CeCl₃·7H₂O as chaotropic salt in water and ethanol, that allows to regenerate SF under a fibrous form, unlike the standard Ajisawa’s method, which uses CaCl₂ and allows to obtain aqueous gels. All the experimental analyses performed (SEM, XPS, WAXS, ATR‐FTIR, NMR) suggest that the fiber recovered preserves most of the morphological and structural features of the pristine SF and is doped with Ce(III) ions, that interact mainly with the oxygen atoms of C?O moieties and side‐chains of amino acids. Ce(III) doped SF could be the base for new luminescent materials.     

Diagnostic and prognostic value of magnetic resonance imaging in the detection of tumor depth of invasion and bone invasion in patients with oral cavity cancer

La radiologia medica - To evaluate the accuracy of preoperative contrast-enhanced magnetic resonance imaging (MRI) in the assessment of radiological depth of invasion (rDOI) and bone invasion in...