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排序方式: 共有1445条查询结果,搜索用时 31 毫秒
1.
《Neuro-Chirurgie》2022,68(3):262-266
BackgroundThe prognosis for patients with recurrent glioblastoma (GBM) is dismal, and the question of repeat surgery at time of recurrence is common. Re-operation in the management of these patients remains controversial, as there is no randomized evidence of benefit. An all-inclusive pragmatic care trial is needed to evaluate the role of repeat resection.Methods3rGBM is a multicenter, pragmatic, prospective, parallel-group randomized care trial, with 1:1 allocation to repeat resection or standard care with no repeat resection. To test the hypothesis that repeat resection can improve overall survival by at least 3 months (from 6 to 9 months), 250 adult patients with prior resection of pathology-proven glioblastoma for whom the attending surgeon believes repeat resection may improve quality survival will be enrolled. A surrogate measure of quality of life, the number of days outside of hospital/nursing/palliative care facility, will also be compared. Centers are invited to participate without financial compensation and without contracts. Clinicians may apply to local authorities to approve an investigator-led in-house trial, using a common protocol, web-based randomization platform, and simple standardized case report forms.DiscussionThe 3rGBM trial is a modern transparent care research framework with no additional risks, tests, or visits other than what patients would encounter in normal care. The burden of proof remains on repeat surgical management of recurrent GBM, because this management has yet to be shown beneficial. The trial is designed to help patients and surgeons manage the uncertainty regarding optimal care.Clinical Trial Registrationhttp://www.clinicaltrials.gov. Unique identifier: NCT04838782. 相似文献
2.
ObjectivePrevious studies on glioblastomas (GBMs) have not reached a consensus on peritumoral edema (PTE)’s influence on survival. This study evaluated the PTE index’s prognostic role in newly diagnosed GBMs using a well-designed method.MethodsSelected patients were reviewed after a rigorous screening process. Their general information was obtained from electronic medical records. The imaging metrics (MTD, TTM, TTE) representing tumor diameter, laterality, and PTE extent were obtained by manual measurement in Syngo FastView software. The PTE index was a ratio of TTE to MTD. Multiple variables were evaluated using analysis of variance and Cox regression model.ResultsOf 143 patients, 62 were included in this study. MGMT promoter methylation and tumor laterality were both independent prognostic factors (p = 0.020, 0.042; HR = 0.272, 2.630). The lateral tumors’ index was higher than that of the medial tumors (57.7% vs. 42.6%, p = 0.027). Low-index tumors were located in relatively medial positions compared with high-index tumors (TTM, 4.9 vs. 12.8, p = 0.032). This finding indicated that the PTE index tended to increase with tumor laterality. Moreover, the patients with low-index tumors had a significant survival disadvantage in the univariate analysis but not in the multivariate analysis (p = 0.023, 0.220). However, further analysis found that the combination of tumor laterality and PTE statistically stratified the survival outcome. The patients with lateral high-index tumors survived significantly longer (p = 0.022, HR = 1.927).ConclusionsIn contrast with the previous studies, this study recommends combining PTE and tumor laterality for survival stratification in newly diagnosed GBMs. 相似文献
3.
BackgroundPrior reports demonstrate the expression of estrogen and progesterone receptors in high-grade gliomas (HGGs), but the relationship between hormone receptor-positive disease and risk of HHGs in patients with breast cancer (BC) remains uncharacterized.MethodsUsing the SEER 18 registries (2000–2017), we examined the temporal trend of the incidence of HGGs and BC. The standardized incidence ratio was calculated to assess the risk of subsequent HGG in BC patients.ResultsDuring the study period, the incidence of BC and HGGs remained comparable for men and women. Among 976,134 patients with BC, we found a decreased incidence of HGGs in females, but not in males. Female BC patients with hormone receptor-positive disease were at a lower risk of developing glioblastoma and anaplastic astrocytoma.ConclusionOur study findings allude to the protective role of hormone exposure in the development of HGGs, which may lead to the development of therapies targeting hormonal pathways. 相似文献
4.
miR-30c has been acknowledged as a tumor suppressor in various human cancers, such as ovarian cancer, gastric cancer, and prostate cancer. However, the role of miR-30c in glioblastoma (GBM) needs to be investigated.
In our study, we found that the expression of miR-30c was significantly downregulated in GBM tissues and
cell lines. We found that overexpression of miR-30c inhibited cellular proliferation of GBM cells in vitro and
in vivo. More GBM cells were arrested in the G0 phase after miR-30c overexpression. Moreover, we showed
that miR-30c overexpression suppressed the migration and invasion of GBM cells. Mechanistically, we found
that SOX9 was a direct target of miR-30c in GBM cells. Overexpression of miR-30c inhibited the mRNA
and protein levels of SOX9 in GBM cells. Moreover, there was a negative correlation between the expression
of miR-30c and SOX9 in GBM tissues. Finally, we showed that restoration of SOX9 in GBM cells reversed
the proliferation, migration, and invasion of GBM cells transfected with miR-30c mimic. Collectively, our
results demonstrated that miR-30c suppressed the proliferation, migration, and invasion of GBM cells via
targeting SOX9. 相似文献
5.
C. Banella M. Ginevrino G. Catalano E. Fabiani G. Falconi M. Divona P. Curzi P. Panetta M.T. Voso N.I. Noguera 《Hematology/oncology and stem cell therapy》2021,14(2):163-168
FGFR–TACC, found in different tumor types, is characterized by the fusion of a member of fibroblast grown factor receptor (FGFR) tyrosine kinase (TK) family to a member of the transforming acidic coiled-coil (TACC) proteins. Because chromosome numerical alterations, hallmarks of FGFR–TACC fusions are present in many hematological disorders and there are no data on the prevalence, we studied a series of patients with acute myeloid leukemia and myelodysplastic syndrome who presented numerical alterations using cytogenetic traditional analysis. None of the analyzed samples showed FGFR3–TACC3 gene fusion, so screening for this mutation at diagnosis is not recommended. 相似文献
6.
7.
B. Bouchez R. Assaker P. Hautefeuille G. Combelles G. Arnott 《Journal of neurology》1986,233(4):218-220
Summary A false-negative finding on initial CT is reported in a case of supratentorial glioma. This observation was peculiar because the first CT revealed a meningioma which might initially have been related to the clinical symptoms. The term false positive-false negative CT is proposed. The reasons for such CT failures are discussed. The accuracy of clues as to the localization of the glioma provided by EEG is emphasized. 相似文献
8.
M. Riva A. Salmaggi E. Marchioni A. Silvani G. Tomei L. Lorusso R. Merli F. Imbesi A. Russo 《Neurological sciences》2006,27(5):345-351
Abstract Epilepsy in high-grade glioma patients is a major concern, mainly as regards indications to treatment and best choice; toxicities,
and pharmocokinetic and pharmacodynamic interactions of drugs. All these generally unsolved problems complicate patients’
quality of life and interfere with the evaluation of response criteria in clinical trials. A prospective, multicentre data
collection on 132 adult newly diagnosed, histologically proven glioblastomas from 9 Lombardy hospitals collected in the same
database during a one-year period was recently published. From this database we report epidemiological and clinical characteristics
in epilepsy-symptomatic (31%) glioblastoma patients vs. the group with other presenting symptoms (69%). We analyse demographic
and clinico-radiological features, timing of onset and the course of seizures, and modalities of treatment in the two groups
of patients. No statistically significant differences were observed between the two groups as regards age, site of lesion(s),
extent of surgery and survival in relation to anticonvulsant treatment status or pharmacokinetic properties of drugs. 相似文献
9.
Daniel Klase Stefan Gottschalk Erich Reusche Christian Hagel Einar Goebel Volker Tronnier Alf Giese 《Child's nervous system》2007,23(8):907-912
CASE REPORT: The reported female patient underwent sub-total resection of an intra-medullary cervicothoracic astrocytoma classified as WHO grade II in 1984 at the age of 18 months and received local irradiation. In 1989, a local recurrence was diagnosed and a partial resection was performed. Sixteen years later, a small recurrent cervicothoracic tumour was found and spinal seeding to the equine nerve roots and the left cerebellar cortex was apparent on MRI. The patient was implanted with a ventriculoperitoneal shunt for a pseudo-tumour cerebri producing papilloedema, which eventually lead to amaurosis. After an extended biopsy, the invasive lumbosacral tumour was classified as glioblastoma multiforme. Two months later, the patient died after rapid progression of the caudal cranial nerve dysfunction. DISCUSSION AND CONCLUSION: Anaplastic progression and dissemination of spinal astrocytomas even two decades after initial diagnosis and treatment are rare. Therapies and diagnostic follow-up strategies are discussed. 相似文献
10.