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Posts Tagged ‘glioblastoma

Free CME Article: Gross Total Resection Rates in Contemporary Glioblastoma Surgery

Background: Complete resection of contrast-enhancing tumor has been recognized as an important prognostic factor in patients with glioblastoma and is a primary goal of surgery. Various intraoperative technologies have recently been introduced to improve glioma surgery.

Objective: To evaluate the impact of using 5-aminolevulinic acid and intraoperative mapping and monitoring on the rate of complete resection of enhancing tumor (CRET), gross total resection (GTR), and new neurological deficits as part of an institutional protocol.

Methods: One hundred three consecutive patients underwent resection of glioblastoma from August 2008 to November 2010. Eligibility for CRET was based on the initial magnetic resonance imaging assessed by 2 reviewers. The primary end point was the number of patients with CRET and GTR. Secondary end points were volume of residual contrast-enhancing tissue and new postoperative neurological deficits.

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Written by NEUROSURGERY® Editorial Office

November 2, 2012 at 7:39 AM

Ahead of Print: Neurosurgical Management and Prognosis of Patients with Glioblastoma that Progress During Bevacizumab Treatment

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BACKGROUND: The management and prognosis of glioblastoma patients after Stupp protocol treatment and progression during bevacizumab (BV) treatment remains undefined.

OBJECTIVE: We compared the morbidity and survival of patients whose glioblastomas progressed during bevacizumab treatment requiring craniotomy to non-bevacizumab-treated patients.

METHODS: We retrospectively reviewed patients who underwent craniotomy for recurrent glioblastoma from 2005-2009. Patients operated on for progression during bevacizumab (preoperative bevacizumab) were compared to patients receiving no bevacizumab or bevacizumab after surgery (postoperative bevacizumab). Preoperative bevacizumab patients were compared to those progressing on bevacizumab but not operated on (no surgery).

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Written by NEUROSURGERY® Editorial Office

November 1, 2011 at 2:56 PM

Ahead of Print: Regression of Recurrent Malignant Gliomas with Convection-Enhanced Delivery of Topotecan

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BACKGROUND: Convection-enhanced delivery of chemotherapeutics for the treatment of malignant glioma is a technique that delivers drugs directly into a tumor and the surrounding interstitium through chronic, low grade positive-pressure infusion. This allows for high local concentrations of drug while overcoming the limitations imposed by toxicity and the blood-brain barrier in systemic therapies that prevent the use of many potentially effective drugs.

OBJECTIVE: To examine the safety profile of a conventional chemotherapeutic agent, topotecan, via convection-enhanced delivery in the treatment of recurrent malignant gliomas and, secondarily, to assess radiographic response and survival.

METHODS: We performed a prospective, dose-escalation Phase Ib study of the topoisomerase-I inhibitor, topotecan, given by convection-enhanced delivery in patients with recurrent malignant gliomas.

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Written by NEUROSURGERY® Editorial Office

June 20, 2011 at 9:00 AM

Ahead of Print: 14-3-3zeta positive expression is associated with a poor prognosis in patients with glioblastoma

Full article access for Neurosurgery subscribers.

BACKGROUND: When identifying clinical markers predicting clinical outcome, disease recurrence and resistance to therapies often determine the diagnosis and therapy of some cancer types.

OBJECTIVE: To investigate whether 14-3-3zeta positive expression is an indicator of prognosis in patients with glioblastoma.

METHODS: Forty-seven patients treated with surgery, radiotherapy, and adjuvant chemotherapy between 2005 and 2007 were divided into two groups according to 14-3-3zeta expression in an immunohistochemical study: the 14-3-3zeta negative group (n = 12 patients) and the 14-3-3zeta positive group (n = 35 patients). The clinicopathologic features and survival data for patients in the 14-3-3zeta positive group were compared with data from the patients in the 14-3-3zeta negative group. Kaplan-Meier survival analysis and univariate and multivariate analysis were performed to determine the prognostic factors that influenced patient survival.

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Written by NEUROSURGERY® Editorial Office

January 18, 2011 at 10:16 AM

Ahead of Print: Magnetic Resonance Imaging Characteristics of Glioblastoma Multiforme: Implications for Understanding Glioma Ontogeny

Full article access for Neurosurgery subscribers.

Bohman, Leif-Erik MD; Swanson, Kristin R PhD; Moore, Julia L BS; Rockne, Russ MS; Mandigo, Christopher MD; Hankinson, Todd MD, MBA; Assanah, Marcela PhD; Canoll, Peter MD, PhD; Bruce, Jeffrey N MD

BACKGROUND: Identifying the origin of gliomas carries important implications for advancing the treatment of these recalcitrant tumors. Recent research promotes the hypothesis of a subventricular zone (SVZ) origin for the stemlike gliomagenic cells identified within human glioma specimens. However, conflicting evidence suggests that SVZ-like cells are not uniquely gliomagenic but this capacity may be shared by cycling progenitors distributed throughout the subcortical white matter (SCWM).

OBJECTIVE: To review radiological evidence in glioblastoma multiforme (GBM) patients to provide insight into the question of glioma ontogeny.

METHODS: We explored whether GBMs at first diagnosis demonstrated a pattern of anatomic distribution consistent with origin at the SVZ through retrospective analysis of preoperative contrast-enhanced T1-weighted magnetic resonance images in 63 patients. We then examined the relationship of tumor volume, point of origin, and proximity to the ventricles using a computer model of glioma growth.

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Written by NEUROSURGERY® Editorial Office

September 28, 2010 at 9:10 AM


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