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1.
Pin-I Huang Yi-Wei Chen Tai-Tong Wong Yi-Yen Lee Kai-Ping Chang Wan-Yuo Guo Feng-Chi Chang Muh-Lii Liang Hsin-Hung Chen Shi-Hwa Chiou Sang-Hue Yen 《Child's nervous system》2008,24(11):1315-1321
Objects To evaluate the disease characteristics and treatment outcomes for patients with intracranial synchronous bifocal germinomas
treated with extended focal irradiation alone.
Methods Between January 1996 and March 2007, seven patients (three males and four females) with intracranial synchronous bifocal germinomas
treated at Taipei Veterans General Hospital were reviewed. The median age at diagnosis was 14 years (range, 11–28 years).
Four patients had surgery before radiotherapy. All patients underwent extended focal irradiation encompassing the whole ventricle
system with a total radiation dose of 30 Gy (2 Gy daily). No patient received scheduled systemic chemotherapy before or after
radiotherapy. Disease characteristics, treatment outcomes, and the impact of lesion numbers (single vs. bifocal) on survivals
were investigated.
Results With a median follow-up time of 49 months (range, 20–66 months), the 2- and 5-year survival rates were both 100%. After treatment,
all patients had good performance without recurrence. No severe complication was observed. In comparison, the overall survival
(OS, p = 0.475) and the disease-free survival (DFS, p = 0.537) rates were not significantly different between bifocal- and single-lesion groups. Lesion numbers did not affect
both OS and DFS. In addition, the incidence of neuraxial seeding was not higher in patients with bifocal germinomas as compared
to those with single lesion.
Conclusions Intracranial germinomas are extremely radiosensitive. Young patients with synchronous bifocal germinomas could be successfully
treated with extended focal 30-Gy radiotherapy alone. The therapeutic advantage using this regimen needs to be further evaluated
with larger sample size and longer follow-up time.
Pin-I Huang, Yi-Wei Chen, and Tai-Tong Wong contributed equally to this work. 相似文献
2.
Intracranial germ cell tumors (ICGCT) occur in 2-11% of children with brain tumors between 0-19 years of age. For treatment of germinoma, relatively low radiation doses with or without chemotherapy show excellent 10 year survival rate of 80-100%. Past studies showed that neoadjuvant chemotherapy combined with focal radiotherapy resulted in unacceptably high rates of periventricular tumor recurrence. The use of generous radiation volume which covers the whole ventricular space with later boost treatment to primary site is considered as standard treatment of intracranial germinomas. For non-germinomatous germ cell tumors (NGGCT), 10-year overall survival rate is still much inferior than that of intracranial germinoma despite intensive chemotherapy and high-dose radiotherapy. Craniospinal radiotherapy combined with cisplatin-based chemotherapy provides the best treatment outcome for NGGCT; 60-70% of overall survival rate. There is a debate on the surgical role whether surgery can contribute to improved treatment outcome of NGGCT when added to combined chemoradiotherapy. Because higher dose of radiotherapy is required for treatment of NGGCT than for germinoma, it is tested whether whole ventricular irradiation can replace craniospinal irradiation in intermediate risk group of NGGCT to minimize radiation-related late toxicity in the recent studies. To minimize the treatment-related neural deficit and late sequelae while maintaining long-term survival rate of ICGCT patients, optimized administration of chemotherapy and radiotherapy should be selected. Use of technically upgraded radiotherapy modalities such as intensity-modulated radiotherapy or proton beam therapy is expected to bring an improved neurocognitive outcome with longitudinal assessment of the patients. 相似文献
3.
Jeffrey K. H. Vallance Kerry S. Courneya Ronald C. Plotnikoff John R. Mackey 《Annals of behavioral medicine》2008,35(2):150-158
Background We previously reported that a physical activity (PA) behavior change intervention based on the theory of planned behavior
(TPB) increased PA and quality of life in breast cancer survivors.
Purpose To examine the effects of our interventions on TPB variables and to determine if PA at 12 weeks follow-up was mediated by
TPB variables at 4 weeks.
Methods Breast cancer survivors (N = 377) were randomly assigned to receive either a standard public health recommendation for PA (SR group), a step pedometer
alone, or one of two TPB-based behavior change interventions consisting of print materials (alone or combined with a step
pedometer). For the purpose of this study, we compared the two TPB-based intervention groups (INT group) to the SR group.
Results Compared to the SR group, the INT group reported more favorable changes in instrumental attitude (mean difference = 0.13;
95% CI = −0.01 to 0.23; d = 0.19; p = 0.077), intention (mean difference = 0.33; 95% CI = 0.10 to 0.56; d = 0.33; p = 0.006), and planning (mean difference = 0.39; 95% CI = 0.04 to 0.73; d = 0.26; p = 0.027). Mediation analyses indicated that both planning and intention partially mediated the effects of the intervention
on PA at 12 weeks.
Conclusions Our TPB-based behavior change intervention resulted in small improvements in the TPB constructs that partially mediated the
effects of our intervention on PA behavior. Additional research with the TPB is warranted. 相似文献
4.
Raj Kumar V. Kumar N. K. Das S. Behari A. K. Mahapatra 《Child's nervous system》2007,23(11):1295-1299
Background Lumbar disc herniation is mainly a disease of elderly people as degenerative changes progress with age.
Results and discussion Present retrospective analysis was performed on 742 patients of lumbar disc disease operated over 11 years. Of 742 cases aged
20 years or less, 25 has been evaluated to see the clinical features, radiological features, operative findings, and outcome
of lumbar disc surgery. The incidence of lumbar disc herniation in pediatric and adolescent populations was 3.5% (aged 20 years
or less). All patients presented with low back pain with or without radiculopathy (n = 25). Diagnosis was easily made on magnetic resonance imaging. Gross degenerative changes in disc and end plates were uncommon
(16%) in this population. The trauma may not be a predisposing factor in most of them. In 88% (n = 22) of the cases, only 1 level was affected; the commonest was L4–5 (n = 13). Disc herniation was centrolateral in 72% (n = 18) and central in 28% (n = 7). Disc was mostly soft, hydrated, and rubbery in 92% (n = 23). Disc herniation were subligamentous in 80% (n = 20) and extruded in 4% (n = 1). Sixteen percent (n = 4) of the patients had disc bulge with intact annulus.
Conclusions Operative intervention in the form of simple discectomy offers good result in 92% (n = 23) cases irrespective of approach and method. Longer follow-up is mandatory because the chances of recurrence or another
level involvement cannot be denied. 相似文献
5.
Kerry S. Courneya PhD Donald C. McKenzie MD PhD Robert D. Reid PhD John R. Mackey MD Karen Gelmon MD Christine M. Friedenreich PhD Aliya B. Ladha MS Caroline Proulx MS Kirstin Lane PhD Jeffrey K. Vallance PhD Roanne J. Segal MD 《Annals of behavioral medicine》2008,35(1):116-122
Background
Exercise adherence is a challenge for breast cancer patients receiving chemotherapy but few studies have identified the key
barriers.
Purpose
In this paper, we report the barriers to supervised exercise in breast cancer patients participating in a randomized controlled
trial.
Methods
Breast cancer patients initiating adjuvant chemotherapy (N = 242) were randomly assigned to usual care (n = 82) or supervised resistance (n = 82) or aerobic (n = 78) exercise. Participants randomized to the two exercise groups (n = 160) were asked to provide a reason for each missed exercise session.
Results
The two exercise groups attended 70.2% (5,495/7,829) of their supervised exercise sessions and provided a reason for missing
89.5% (2,090/2,334) of their unattended sessions. The 2,090 reasons represented 36 different barriers. Feeling sick (12%),
fatigue (11%), loss of interest (9%), vacation (7%), and nausea/vomiting (5%) accounted for the most missed exercise sessions.
Disease/treatment-related barriers (19 of the 36 barriers) accounted for 53% (1,102/2,090) of all missed exercise sessions.
Demographic and medical variables did not predict the types of exercise barriers reported.
Conclusions
Barriers to supervised exercise in breast cancer patients receiving chemotherapy are varied but over half can be directly
attributed to the disease and its treatments. Behavioral support programs need to focus on strategies to maintain exercise
in the face of difficult treatment side effects.
Rapid Communication Accepted by Annals of Behavioral Medicine (October 8, 2007). 相似文献
6.
Maryam Fouladi R. Grant Sylvain Baruchel Helen Chan David Malkin Sheila Weitzman Mark L. Greenberg 《Child's nervous system》1998,14(10):596-601
Concern about long-term sequelae of irradiation has led to the use of adjuvant chemotherapy with lower dose irradiation in
the treatment of intracranial germinomas. To assess the feasibility of this approach versus radiation only, the survival of
16 evaluable patients (13 boys, 3 girls) with biopsy-proven intracranial germinomas treated at the Hospital for Sick Children
was assessed. Between 1977 and 1988, 8 patients were treated with radiation only: 7 received tumour doses between 4000 and
5100 cGy and spinal prophylaxis; 1 received 3060 cGy to the tumour with no prophylaxis. After a median follow-up of 84 months,
7 are in continuous first CR and 1 is in second CR. Between 1988 and 1996, 8 patients received adjuvant platinum- and etoposide-based
chemotherapy for two or three cycles followed by local irradiation to the tumour (2500–3500 cGy). After a median follow-up
of 40 months, 6 are in continuous first CR and 1 in second CR; 1 has died of progression. Survival outcomes in the two groups
are similar. Prospective trials to assess event-free survivals, neurocognitive and neuroendocrine outcomes are needed before
definitive treatment recommendations can be made.
Received: 24 July 1998 相似文献
7.
Background: We wished to examine the impact of the duration and intensity of physical activity on common anxiety and depressive states.
Method: A nested case-control design was applied to data from the Health and Lifestyle Survey. Anxiety and depressive states were
measured by caseness on the General Health Questionnaire. Physical activity variables were defined from a detailed activity
schedule. Results: After adjustment for potential confounders, the findings suggest that compared to men who reported 0–44 min of daily physical
activity, there is benefit to men who exercise for at least 92 min a day (92–161 min a day: OR = 0.57, 95% CI = 0.37–0.87,
P < 0.01; 162–554 min a day: OR = 0.65, 95% CI = 0.43–0.97, P < 0.05), but not to women. The protective effect does not appear to vary according to the intensity of activity in men or
women. Conclusions: Physical activity of long duration amongst men confers protection against common mood and anxiety states. This study found
no such protection for women.
Accepted: 21 October 1999 相似文献
8.
目的:探讨颅内生殖细胞瘤的综合治疗方法。方法临床诊断颅内生殖细胞瘤13例,其中孤立型8例,侵袭型4例,播散型1例;治疗上对孤立型采取局灶放疗同时联合顺铂、足叶乙甙化疗,侵袭型与播散型加用氨甲喋呤脑或鞘注给药化疗。结果肿瘤完全消失11例,瘤体缩小90%以上2例,随访0.3-4.5年(平均2.7年),无1例复发,全部病例生存状况良好。结论治疗上针对肿瘤的临床分型,采取局灶放疗与不同的化疗方案联合能有效 相似文献
9.
K.H. Carlos Chung Brian K. Owler Mark Dexter Ray Chaseling 《Journal of clinical neuroscience》2013,20(4):514-519
A retrospective analysis was conducted on consecutive patients with intracranial germ cell tumours diagnosed and treated from 1 January 1997 to 31 December 2007 to assess and determine demographic factors and treatment outcomes of children with these tumours treated in a major paediatric referral hospital in Australia. In this study, intracranial germ cell tumours represented 4.8% of paediatric brain tumours seen. Of the 21 patients identified, 15 (71.4%) were diagnosed with pure germinoma and six (28.6%) with non-germinomatous germ cell tumours (NGGCT) or mixed tumours. One patient received chemotherapy alone, two patients were treated with radiation alone and the remaining 18 received a combination of chemotherapy and radiotherapy. A total of 33 neurosurgical operations were performed with 15 biopsies via open, endoscopic or transphenoidal means; nine open resections; and nine procedures for hydrocephalus comprising seven third ventriculostomies and two ventriculoperitoneal shunts. For patients with pure germinomas, the 5-year disease-free rate (DFS) was 93.3%, and overall survival (OS) rate was 100% compared to NGGCT or mixed tumours (DFS 50%; OS 50%) (DFS p = 0.019, OS p = 0.004). The data presented show that pure germinomas carry a favourable prognosis. The data also support that treatment with induction chemotherapy followed by dose-attenuated radiotherapy is an effective alternative with results comparable to historical controls treated with craniospinal irradiation. Although chemoradiotherapy has become the mainstay of treatment in intracranial germ cell tumours, surgery remains integral to the management of this condition. Surgery remains important in establishing the histological diagnosis, as well as in the treatment of hydrocephalus. Furthermore, debulking procedures may be advocated in NGGCT as they are often resistant to chemotherapy. 相似文献
10.
11.
Summary. We investigated the effects of exogenous melatonin on the thyrocytes morphology in gamma-irradiated rats under condition where
the pineal gland, as a main physiological source of endogenous melatonin, was removed. Three months after pinealectomy animals
were divided into two groups: one group of animals was treated with 0.5 ml of vehicle (ethanol diluted in water) and other
group was injected intraperitoneally 2 mg/kg of melatonin dissolved in 0.5 ml of vehicle daily during the period of fourteen
days. After this treatment all the animals were irradiated with a single dose of 8 Gy gamma rays. Ionising radiation induced
apoptosis, hydropic swelling or/and necrosis in both groups of animals, however these changes were less discerned in the thyrocytes
of melatonin-treated animals. Our findings demonstrate that administration of exogenous melatonin prior to irradiation reduces
radiation-induced thyrocytes damage. 相似文献
12.
G��lin ?z Isabelle Iltis Diane Hutter William Thomas Khalaf O. Bushara Christopher M. Gomez 《Cerebellum (London, England)》2011,10(2):208-217
Hereditary and sporadic neurodegenerative ataxias are movement disorders that affect the cerebellum. Robust and objective
biomarkers are critical for treatment trials of ataxias. In addition, such biomarkers may help discriminate between ataxia
subtypes because these diseases display substantial overlap in clinical presentation and conventional MRI. Profiles of 10–13
neurochemical concentrations obtained in vivo by high field proton magnetic resonance spectroscopy (1H MRS) can potentially provide ataxia-type specific biomarkers. We compared cerebellar and brainstem neurochemical profiles
measured at 4 T from 26 patients with spinocerebellar ataxias (SCA1, N = 9; SCA2, N = 7; SCA6, N = 5) or cerebellar multiple system atrophy (MSA-C, N = 5) and 15 age-matched healthy controls. The Scale for the Assessment and Rating of Ataxia (SARA) was used to assess disease
severity. The patterns of neurochemical alterations relative to controls differed between ataxia types. Myo-inositol levels in the vermis, myo-inositol, total N-acetylaspartate, total creatine, glutamate, glutamine in the cerebellar hemispheres and myo-inositol, total N-acetylaspartate, glutamate in the pons were significantly different between patient groups (Bonferroni corrected p < 0.05). The best MRS predictors were selected by a tree classification procedure and lead to 89% accurate classification
of all subjects while the SARA scores overlapped considerably between patient groups. Therefore, this study demonstrated multiple
neurochemical alterations in SCAs and MSA-C relative to controls and the potential for these neurochemical levels to differentiate
ataxia types. Studies with higher numbers of patients and other ataxias are warranted to further investigate the clinical
utility of neurochemical levels as measured by high-field MRS as ataxia biomarkers. 相似文献
13.
Koot RW Stalpers LJ Aronica E Andries Bosch D 《Clinical neurology and neurosurgery》2007,109(7):607-612
The development of brain necrosis is life-long risk of repeat radiation therapy, even after a long time interval and a moderate radiation dose. We report on a 34-year-old patient who had prophylactic cranial irradiation with 25Gy and adjuvant chemotherapy in childhood for leukaemia and in adulthood, 28 years later, therapeutic radiotherapy with 54Gy for an atypical (WHO grade II) meningioma. About 2 years later he developed a contrast-enhancing lesion on MRI-scan that was indicative of a tumor according to a thallium-201 ((201)Tl) SPECT scan. Histopathology of the operated contrast-enhancing lesion showed extensive radionecrosis. Radiation necrosis is a small but serious risk after repeat radiation therapy, even after a very long-term interval, the delivery of small fractions and an average cumulative total dose. Patients undergoing repeat radiotherapy therefore need to be followed life-long for potential late radiation toxicity. 相似文献
14.
Ana Luísa Vital Maria Dolores Tabernero Inês Crespo Olinda Rebelo Hermínio Tão Fernando Gomes Maria Celeste Lopes Alberto Orfao 《Neurogenetics》2010,11(2):227-239
Few studies have explored the patterns of clonal evolution in gliomas. Here, we investigate the cytogenetic patterns of intratumoral
clonal evolution of gliomas and their impact on tumor histopathology and patient survival. Cytogenetic analysis of 90 gliomas
was performed in individual tumor cells (>200 cells/tumor) using multicolor (N = 16 probes) interphase—FISH. Overall, chromosome gains were more frequent than chromosome losses. Gains of chromosome 7
and/or EGFR amplification were detected in 91% of the cases, whereas del(9p21) (77%) and del(10q23) (78%) were the most frequent chromosome
losses. Virtually, all cases (99%) showed ≥2 tumor cell clones, with higher numbers among high- versus low-grade gliomas (p = 0.001). Nine different cytogenetic patterns were found in the ancestral tumor clones. In most gliomas, ancestral clones
showed abnormalities of chromosome 7, 9p, and/or 10q and cytogenetic evolution consisted of acquisition of additional abnormalities
followed by tetraploidization. Conversely, early tetraploidization was associated with low-grade astrocytomas—2/3 pilocytic
and 3/6 grade II diffuse astrocytomas—and combined loss of 1p36/19q13 with oligodendrogliomas, respectively; both aberrations
were associated with a better patient outcome (p = 0.03). Overall, our results support the existence of different pathways of intratumoral evolution in gliomas 相似文献
15.
Sue Jee Park Sa-Hoe Lim Young-Jin Kim Kyung-Sub Moon In-Young Kim Shin Jung Seul-Kee Kim In-Jae Oh Jong-Hwan Hong Tae-Young Jung 《Journal of Korean Neurosurgical Society》2021,64(6):983
ObjectiveThe effectiveness of gamma knife radiosurgery (GKR) in the treatment of brain metastases is well established. The aim of this study was to evaluate the efficacy and safety of maximizing the radiation dose in GKR and the factors influencing tumor control in cases of small and medium-sized brain metastases from non-small cell lung cancer (NSCLC). MethodsWe analyzed 230 metastatic brain tumors less than 5 mL in volume in 146 patients with NSCLC who underwent GKR. The patients had no previous radiation therapy for brain metastases. The pathologies of the tumors were adenocarcinoma (n=207), squamous cell carcinoma (n=18), and others (n=5). The radiation doses were classified as 18, 20, 22, and 24 Gy, and based on the tumor volume, the tumors were categorized as follows : small-sized (less than 1 mL) and medium-sized (1–3 and 3–5 mL). The progression-free survival (PFS) of the individual 230 tumors and 146 brain metastases was evaluated after GKR depending on the pathology, Eastern Cooperative Oncology Group (ECOG) performance score (PS), tumor volume, radiation dose, and anti-cancer regimens. The radiotoxicity after GKR was also evaluated. ResultsAfter GKR, the restricted mean PFS of individual 230 tumors at 24 months was 15.6 months (14.0–17.1). In small-sized tumors, as the dose of radiation increased, the tumor control rates tended to increase (p=0.072). In medium-sized tumors, there was no statistically difference in PFS with an increase of radiation dose (p=0.783). On univariate analyses, a statistically significant increase in PFS was associated with adenocarcinomas (p=0.001), tumors with ECOG PS 0 (p=0.005), small-sized tumors (p=0.003), radiation dose of 24 Gy (p=0.014), synchronous lesions (p=0.002), and targeted therapy (p=0.004). On multivariate analyses, an improved PFS was seen with targeted therapy (hazard ratio, 0.356; 95% confidence interval, 0.150–0.842; p=0.019). After GKR, the restricted mean PFS of brain at 24 months was 9.8 months (8.5–11.1) in 146 patients, and the pattern of recurrence was mostly distant within the brain (66.4%). The small and medium-sized tumors treated with GKR showed radiotoxicitiy in five out of 230 tumors (2.2%), which were controlled with medical treatment. ConclusionThe small-sized tumors were effectively controlled without symptomatic radiation necrosis as the radiation dose was increased up to 24 Gy. The medium-sized tumors showed potential for symptomatic radiation necrosis without signifcant tumor control rate, when greater than 18 Gy. GKR combined targeted therapy improved the tumor control of GKR-treated tumors. 相似文献
16.
Shawna L. Palmer Wilburn E. Reddick John O. Glass Robert Ogg Zoltan Patay Dana Wallace Amar Gajjar 《Brain imaging and behavior》2010,4(2):132-140
Children treated with cranial irradiation for brain tumors have reduced white matter volume and deficits in reading ability.
This study prospectively examined the relationship between reading and white matter integrity within this patient group. Patients
(n = 54) were treated with post-surgical radiation followed by 4 cycles of high-dose chemotherapy with stem cell support. At
12 months post-diagnosis, all patients completed a neuropsychology evaluation and a diffusion tensor imaging (DTI) exam. White
matter integrity was determined through measures of fractional anisotropy (FA). Significant group differences in FA were found
between above average readers and below average readers within the left and right posterior limb of the internal capsule,
and right knee of the internal capsule with a trend within the left temporaloccipital region. The integrity of the white matter
in these regions may affect communication among visual, auditory, and language cortical areas that are engaged during reading. 相似文献
17.
Sassan Keshavarzi Hal Meltzer Sharona Ben-Haim Charles Benjamin Newman Joshua D Lawson Michael L. Levy Kevin Murphy 《Child's nervous system》2009,25(7):837-844
Objective The objective of this study is to report our initial experience treating pediatric patients with central nervous system tumors
using a frameless, optically guided linear accelerator.
Materials and methods Pediatric patients were selected for treatment after evaluation by a multidisciplinary neuro-oncology team including neurosurgery,
neurology, pathology, oncology, and radiation oncology. Prior to treatment, all patients underwent treatment planning using
magnetic resonance imaging (MRI) and treatment simulation on a standard computed tomography scanner (CT). For CT simulation,
patients were fitted with a customized plastic face mask with a bite block attached to an optical array with four reflective
markers. After ensuring adequate reproducibility, these markers were tracked during treatment by an infra-red camera. All
treatments were delivered on a Varian Trilogy linear accelerator. The follow-up period ranges from 1–18 months, with a median
follow-up of 6 months.
Results Nine patients, ages ranging from 12 to 19 years old (median age 15 years old), with a variety of tumors have been treated.
Patients were treated for juvenile pilocytic astrocytoma (JPA; n = 2), pontine low-grade astrocytoma (n = 1), pituitary adenoma (n = 3), metastatic medulloblastoma (n = 1), acoustic neuroma (n = 1), and pineocytoma (n = 1). We followed patients for a median of 12 months (range 3–18 months) with no in-field failures and were able to obtain
encouraging toxicity profiles.
Conclusion Frameless stereotactic optically guided radiosurgery and radiotherapy provides a feasible and accurate tool to treat a number
of benign and malignant tumors in children with minimal treatment-related morbidity. 相似文献
18.
John Jamieson Dwight Mazmanian Alexander Penney Nancy Black An Nguyen 《International journal of mental health and addiction》2011,9(2):180-192
An existing database was used to compare problem gamblers (N = 138) who presented for treatment of their gambling problem to two other groups: alcohol and/or drug addiction clients who
also had a gambling problem (N = 280) or who did not have a gambling problem (N = 2178). Clients with gambling as their primary problem were more likely to be female; employed or retired; more highly educated;
married, divorced, or widowed; without legal problems; and older than the other groups. They also had different patterns of
recent mental health diagnoses and problematic substance use. The other problem gambling clients were more similar to the
substance only clients. These findings indicate that those who present for treatment of problem gambling are a distinct subset
of addiction clients who have gambling problems, and emphasize the importance of considering the reasons for seeking treatment,
not just the presence of a gambling problem. 相似文献
19.
U. W. Thomale B. Tyler V. Renard B. Dorfman V. P. Chacko B. S. Carson E. J. Haberl G. I. Jallo 《Child's nervous system》2009,25(4):433-441
Objective Convection-enhanced delivery using carboplatin in brainstem glioma models was reported to prolong survival. Functional impairment
is of additional importance to evaluate the value of local chemotherapy. We established a neurological scoring system for
the rat brainstem glioma model.
Material and methods In 46 male Fisher rats stereotactically 105 F-98 cells were implanted at 1.4-mm lateral to midline and at the lambdoid suture using guided screws. Following 4 days local
delivery was performed using AlzetTM pumps (1 μl/h over 7 days) with either vehicle (5% dextrose) or carboplatin via one or two cannulas, respectively. All rats
were subsequently tested neurologically using a specified neurological score. In 38 animals survival time was recorded. Representative
MR imaging were acquired in eight rats, respectively, at day 12 after implantation. HE staining was used to evaluate tumor
extension.
Results Neurological scoring showed significantly higher impairment in the high dose carboplatin group during the treatment period.
Survival was significantly prolonged compared to control animals in the high dose carboplatin-one cannula group as well as
in both low dose carboplatin groups (18.6 ± 3 versus 26.3 ± 9, 22.8 ± 2, 23.6 ± 2 days; p < 0.05). Overall neurological grading correlated with survival time. MR imaging showed a focal contrast enhancing mass in
the pontine brainstem, which was less exaggerated after local chemotherapy. Histological slices visualized decreased cellular
density in treatment animals versus controls.
Conclusion Local chemotherapy in the brainstem glioma model showed significant efficacy for histological changes and survival. Our neurological
grading enables quantification of drug and tumor-related morbidity as an important factor for functional performance during
therapy. 相似文献
20.
Lucas Moreno Francisco Jose Bautista Stergios Zacharoulis 《Child's nervous system》2009,25(9):1047-1052
Background The outcome and clinical characteristics of teenagers and young adults (TYA) with ependymoma have not been well documented.
We report the Royal Marsden Hospital experience treating TYA with ependymoma.
Materials and methods Sixteen TYA were treated for ependymoma from 1971 to 2004 and are compared to 24 children (not infants) treated in the same
period.
Results Twelve TYA (75%) received treatment in a neuro-oncology unit. Average time from symptoms to diagnosis was 183 days for TYA
vs. 61.2 for children (p = 0.005). Two TYA (12.5% vs. 41.6% for children, p = 0.08) were enrolled in a clinical trial. Only 25% of TYA achieved gross total resection, all of them received radiotherapy
and five of them received chemotherapy. There were five relapses; all of them were local. Five-year overall survival was 84.6% ± 10
for TYA vs. 78.1% ± 8.7 for children (p = 0.15), and 5-year progression-free survival was 66.6% ± 12.3 for TYA vs. 44.4% ± 10.3 for children (p = 0.08). Up to 56% of patients treated in the paediatric unit received psychosocial support vs. 42.9% of patients treated
in the adult unit.
Discussion Ependymoma in adolescents and young adults is an infrequent entity, with perhaps better outcome compared to children. The
extent of surgical resection as seen in children is an important prognostic factor. Providing adolescents with ependymoma
the appropriate neuro-oncologic care, including access to multidisciplinary teams, full access to clinical trials and age-appropriate
neuro-oncologic ancillary support services, remains a challenge. 相似文献