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81.
Yun-Sik Dho Yong Hwy Kim Jin Wook Kim Chul-Kee Park Hyun-Tai Chung Seung-Ki Kim Sun Ha Paek Kyu-Chang Wang Dong Gyu Kim 《Journal of neuro-oncology》2018,136(1):135-145
Venous thromboembolism (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE), frequently complicates the postoperative course of primary malignant brain tumor patients. Thromboprophylactic anticoagulation is commonly used to prevent VTE at the risk of intracranial hemorrhage (ICH). We extracted all patients who underwent craniotomy for a primary malignant brain tumor from the National Surgical Quality Improvement Program (NSQIP) registry (2005–2015) to perform a time-to-event analysis and identify relevant predictors of DVT, PE, and ICH within 30 days after surgery. Among the 7376 identified patients, the complication rates were 2.6, 1.5, and 1.3% for DVT, PE, and ICH, respectively. VTE was the second-most common major complication and third-most common reason for readmission. ICH was the most common reason for reoperation. The increased risk of VTE extends beyond the period of hospitalization, especially for PE, whereas ICH occurred predominantly within the first days after surgery. Older age and higher BMI were overall predictors of VTE. Dependent functional status and longer operative times were predictive for VTE during hospitalization, but not for post-discharge events. Admission two or more days before surgery was predictive for DVT, but not for PE. Preoperative steroid usage and male gender were predictive for post-discharge DVT and PE, respectively. ICH was associated with various comorbidities and longer operative times. This multicenter study demonstrates distinct critical time periods for the development of thrombotic and hemorrhagic events after craniotomy. Furthermore, the VTE risk profile depends on the type of VTE (DVT vs. PE) and clinical setting (hospitalized vs. post-discharge patients). 相似文献
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83.
Hae Jin Park Hyun-Cheol Kang Il Han Kim Sung-Hye Park Dong Gyu Kim Chul-Kee Park Sun Ha Paek Hee-Won Jung 《Journal of neuro-oncology》2013,115(2):241-247
The object of this study was to analyze treatment outcomes and to identify the prognostic factors, with a focus on the role of adjuvant radiotherapy (ART), predicting disease progression in atypical meningiomas. From 1997 to 2011, 83 patients with meningioma were included in this study. All patients were histologically confirmed as atypical meningioma and were treated with surgical resection with or without ART. As primary therapy, 27 patients received surgical resection followed by ART, and 56 received no adjuvant therapy. Of 83 evaluable patients, 55 (66.3 %) patients underwent complete resection. The median ART dose was 61.2 Gy and their median age was 52 years. The 5- and 10-year actuarial overall survival rates were 90.2 and 62.0 %, and the 5- and 10-year progression-free survival (PFS) rates were both 48.0 %, with a median follow-up of 43.0 months. Addition of ART (p = 0.016) and complete tumor resection (p = 0.002) were associated with superior PFS. When stratified to four groups according to resection status and ART, the groups of patient with incomplete resection without ART showed significantly worse PFS compared to other three groups (p < 0.001). In conclusion, surgical resection followed by ART led to lower local tumor progression in patients with atypical meningioma defined by the updated 2000/2007 WHO classification. Our results may contribute to the routine use of ART, especially after incomplete resection, until the outcomes of ongoing prospective trials are available. 相似文献
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Ho-Shin Gwak Gi Taek Yee Chul-Kee Park Jin Wook Kim Yong-Kil Hong Seok-Gu Kang Jeong Hoon Kim Ho Jun Seol Tae-Young Jung Jong Hee Chang Heon Yoo Jeong-Hyun Hwang Se-Hyuk Kim Bong Jin Park Sun-Chul Hwang Min Su Kim Seon-Hwan Kim Eun-Young Kim Ealmaan Kim Hae Yu Kim Young-Cho Ko Hwan Jung Yun Ji Hye Youn Juyoung Kim Byeongil Lee Seung Hoon Lee 《Journal of Korean Neurosurgical Society》2013,54(6):489-495
Objective
To evaluate the efficacy of temozolomide (TMZ) chemotherapy for recurrent anaplastic oligodendroglioma (AO) and anaplastic oligoastrocytoma (AOA).Methods
A multi-center retrospective trial enrolled seventy-two patients with histologically proven AO/AOA who underwent TMZ chemotherapy for their recurrent tumors from 2006 to 2010. TMZ was administered orally (150 to 200 mg/m2/day) for 5 days per 28 days until unacceptable toxicity occurred or tumor progression was observed.Results
TMZ chemotherapy cycles administered was median 5.3 (range, 1-41). The objective response rate was 24% including 8 cases (11%) of complete response and another 23 patients (32%) were remained as stable disease. Severe side effects (≥grade 3) occurred only in 9 patients (13%). Progression-free survival (PFS) of all patients was a median 8.0 months (95% confidence interval, 6.0-10.0). The time to recurrence of a year or after was a favorable prognostic factor for PFS (p<0.05). Overall survival (OS) was apparently differed by the patient''s histology, as AOA patients survived a median OS of 18.0 months while AO patients did not reach median OS at median follow-up of 11.5 months (range 2.7-65 months). Good performance status of Eastern Cooperative Oncology Group 0 and 1 showed prolonged OS (p<0.01).Conclusion
For recurrent AO/AOA after surgery followed by radiation therapy, TMZ could be recommended as a salvage therapy at the estimated efficacy equal to procarbazine, lomustine, and vincristine (PCV) chemotherapy at first relapse. For patients previously treated with PCV, TMZ is a favorable therapeutic option as 2nd line salvage chemotherapy with an acceptable toxicity rate. 相似文献86.
Dimitrios Mathios Taeyoung Hwang Yuanxuan Xia Jillian Phallen Yuan Rui Alfred P. See Russell Maxwell Zineb Belcaid Joshua Casaos Peter C. Burger Kerrie L. McDonald Gary L. Gallia Leslie Cope Mihoko Kai Henry Brem Drew M. Pardoll Patrick Ha Jordan J. Green Victor E. Velculescu Chetan Bettegowda Chul-Kee Park Michael Lim 《International journal of cancer. Journal international du cancer》2019,145(12):3425-3435
87.
Paek SH Han JH Kim JW Park CK Jung HW Park SH Kim IH Kim DG 《Journal of neuro-oncology》2008,90(1):25-30
The authors report the long-term outcome of conventional radiation therapy (RT) in six cases of central neurocytoma (CN). Between 1985 and 1992, six patients were treated with RT for residual tumors or for prevention of recurrence after surgery. The median follow-up period of radiological and clinical status were 171 (range: 128-229) and 202 months (range: 165-227), respectively. Tumors disappeared in three and reduced in three patients at the last follow-up. One-mortality case due to radiation necrosis and one radiation-induced malignancy occurred. White matter degeneration and cortical atrophy were noticed with slow progression of performance deterioration in two patients. Conventional RT seemed to effectively control residual CN after surgery. However, more sophisticated radiation techniques should be applied to minimize the late sequela. 相似文献
88.
Jin Wook Kim Dong Gyu Kim Hyun-Tai Chung Seung Hong Choi Jung Ho Han Chul-Kee Park Chae-Yong Kim Sun Ha Paek Hee-Won Jung 《Journal of neuro-oncology》2013,115(3):505-511
Despite the favorable outcomes of radiosurgery for central neurocytoma (CN), these results are based on case series that included a limited number of patients and short follow-up periods because of the scarcity of CN. Because CN is a benign tumor with an indolent clinical course, long-term follow-up and analysis of failure pattern are required for the establishment of the role of radiosurgery in the management of CN. Twenty consecutive patients (10 patients who received Gamma Knife radiosurgery (GKRS) as a primary treatment and 10 patients who received GKRS as a secondary treatment) with a radiological follow-up period ≥36 months were included in this study. The mean radiological follow-up duration was 100 months (range 43–149 months). The mean tumor volume was 10.4 cm3 (range 0.4–36.4 cm3) and the mean marginal dose was 15.4 Gy (range 9–20 Gy). Local control failure was found in six patients at the last radiological follow-up. Overall actuarial local control rates were 89.5 % at 5 years and 83.1 % at 10 years. The primary GKRS group included two cases with local failure, with cyst formation or local recurrence. In contrast, in the secondary GKRS group, local control failure was found in four cases (including three cases with an “out-of-field recurrence” pattern) and occurred earlier compared with the primary GKRS group. Our study suggests that GKRS could be a primary or secondary treatment option for CN. However, long-term radiological follow-up is mandatory. In particular, more careful consideration during margin delineation and planning procedure is required in the secondary GKRS group. 相似文献
89.
Seung Hyuck Jeon Sung-Hye Park Jin Wook Kim Chul-Kee Park Sun Ha Paek Il Han Kim 《Journal of neuro-oncology》2018,137(3):567-573
We retrospectively evaluated an efficacy of adjuvant radiotherapy (RT) in the intracranial hemangiopericytoma (HPC) and analyzed prognostic factors influencing treatment outcomes. Among 49 patients diagnosed as localized intracranial HPC between 1995 and 2016, 31 patients received adjuvant RT after surgery; 26 with fractionated RT and 5 with stereotactic radiosurgery using Gamma Knife. After gross total resection (GTR) (n?=?32) and subtotal resection (STR) (n?=?17), histopathological grade was confirmed to be grade II (n?=?9) or grade III (n?=?40). The median follow-up period was 50 months (range 3–216 months). The local recurrence was defined as intracranial relapse within 15 mm and regional recurrence as beyond 15 mm from the margin of surgical bed. The 10-year overall survival (OS) and progression-free survival (PFS) were 69.9 and 34.4%, respectively. The 10-year local, regional, and distant failure-free rates were 56.6, 88.2, and 73.3%, respectively. Local tumor control was better with GTR followed by RT than GTR alone (p?=?0.056), while there was no difference in OS. Local tumor control and OS after STR plus RT were equivalent to those after GTR alone. There were no differences in distant metastasis-free survival (DMFS) among GTR plus RT, GTR alone, and STR plus RT. Tumor volume >?40 cm3 was associated with poor PFS (p?=?0.024). The local tumor recurrence was reduced by adjuvant RT after surgery. But OS or DMFS was not improved with adjuvant RT. PFS was better in the tumor with small volume at diagnosis. 相似文献
90.