Journal ArticleDOI
Concurrent stereotactic radiosurgery and bevacizumab in recurrent malignant gliomas: A prospective trial
Alvin R. Cabrera,Kyle C. Cuneo,Kyle C. Cuneo,Annick Desjardins,John H. Sampson,Frances McSherry,James E. Herndon,Katherine B. Peters,Karen Allen,Jenny K. Hoang,Zheng Chang,Oana Craciunescu,James J. Vredenburgh,Henry S. Friedman,John P. Kirkpatrick +14 more
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TLDR
Treatment of recurrent MG with concurrent SRS and BVZ was not associated with excessive toxicity in this prospective trial, and a randomized trial of concurrent S RS/BVZ versus conventional salvage therapy is needed to establish the efficacy of this approach.Abstract:
Purpose Virtually all patients with malignant glioma (MG) eventually recur. This study evaluates the safety of concurrent stereotactic radiosurgery (SRS) and bevacizumab (BVZ), an antiangiogenic agent, in treatment of recurrent MG. Methods and Materials Fifteen patients with recurrent MG, treated at initial diagnosis with surgery and adjuvant radiation therapy/temozolomide and then at least 1 salvage chemotherapy regimen, were enrolled in this prospective trial. Lesions Results One grade 3 (severe headache) and 2 grade 2 CNS toxicities were observed. No patients experienced grade 4 to 5 toxicity or intracranial hemorrhage. Neurocognition, quality of life, and Karnofsky performance status did not change significantly with treatment. DCE-MRI results suggest a significant decline in tumor perfusion and permeability 1 week after SRS and further decline by 2 months. Conclusions Treatment of recurrent MG with concurrent SRS and BVZ was not associated with excessive toxicity in this prospective trial. A randomized trial of concurrent SRS/BVZ versus conventional salvage therapy is needed to establish the efficacy of this approach.read more
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Journal ArticleDOI
Management of glioblastoma: State of the art and future directions.
Aaron C. Tan,David M. Ashley,Giselle Y. Lopez,Michael D. Malinzak,Henry S. Friedman,Mustafa Khasraw +5 more
TL;DR: Supportive and palliative care remain important considerations throughout the disease course in the multimodality approach to management, and innovative clinical trial designs with biomarker-enrichment strategies are needed to ultimately improve the outcome of patients with glioblastoma.
Book ChapterDOI
Current Standards of Care in Glioblastoma Therapy
C. Fernandes,Andreia Costa,Lígia Osório,Rita Costa Lago,Paulo Linhares,Bruno Carvalho,Cláudia Caeiro +6 more
TL;DR: In newly diagnosed GBM, methylation of the O6-methylguanine-DNA methyltransferase (MGMT) promoter has been shown to predict response to alkylating agents, as well as prognosis, and may have a crucial role in the choice of single modality treatment in fragile elderly population.
Journal ArticleDOI
Therapeutic options in recurrent glioblastoma--An update.
TL;DR: Proper patient selection, development of predictive biomarkers and randomized controlled studies are required to develop evidence-based concepts for recurrent glioblastoma.
Journal ArticleDOI
Toxicity of concurrent stereotactic radiotherapy and targeted therapy or immunotherapy: A systematic review
Stephanie G. C. Kroeze,C. Fritz,Morten Høyer,Simon S. Lo,Umberto Ricardi,Arjun Sahgal,Rolf A. Stahel,Roger Stupp,Matthias Guckenberger +8 more
TL;DR: A best-possible overview of current knowledge and its limitations is given and the need for a timely generation of stronger evidence in this rapidly expanding field of stereotactic radiotherapy is underlined.
Journal ArticleDOI
Radiation therapy for glioblastoma: Executive summary of an American Society for Radiation Oncology Evidence-Based Clinical Practice Guideline
Alvin R. Cabrera,John P. Kirkpatrick,John B. Fiveash,Helen A. Shih,Eugene J. Koay,Stephen Lutz,Joshua Petit,Samuel T. Chao,Paul D. Brown,Michael A. Vogelbaum,David A. Reardon,Arnab Chakravarti,Patrick Y. Wen,Eric L. Chang +13 more
TL;DR: In this article, the authors present evidence-based guidelines for radiation therapy in treating glioblastoma not arising from the brainstem, including the optimal dose-fractionation schedule for external beam radiation therapy after biopsy/resection and how treatment vary based on pretreatment characteristics such as age or performance status.
References
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Journal ArticleDOI
“Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician
Marshal F. Folstein,Marshal F. Folstein,Susan E B Folstein,Susan E B Folstein,Paul R. McHugh,Paul R. McHugh +5 more
TL;DR: A simplified, scored form of the cognitive mental status examination, the “Mini-Mental State” (MMS) which includes eleven questions, requires only 5-10 min to administer, and is therefore practical to use serially and routinely.
A practical method for grading the cognitive state of patients for the clinician
TL;DR: The Mini-Mental State (MMS) as mentioned in this paper is a simplified version of the standard WAIS with eleven questions and requires only 5-10 min to administer, and is therefore practical to use serially and routinely.
Journal ArticleDOI
CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2007-2011.
Quinn T. Ostrom,Haley Gittleman,Peter Liao,Chaturia Rouse,Yanwen Chen,Jacqueline Dowling,Yingli Wolinsky,Carol Kruchko,Jill S. Barnholtz-Sloan +8 more
TL;DR: The Central Brain Tumor Registry of the United States (CBTRUS), in collaboration with the Centers for Disease Control and Prevention and National Cancer Institute, is the largest population-based registry focused exclusively on primary brain and other central nervous system (CNS) tumors in the US.
Journal ArticleDOI
Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial
Roger Stupp,Monika E. Hegi,Warren P. Mason,Martin J. van den Bent,Martin J.B. Taphoorn,Robert C. Janzer,Samuel K. Ludwin,Anouk Allgeier,Barbara Fisher,Karl Belanger,Peter Hau,Alba A. Brandes,J.M.M. Gijtenbeek,Christine Marosi,Charles J. Vecht,Karima Mokhtari,Pieter Wesseling,Salvador Villà,Elizabeth Eisenhauer,Thierry Gorlia,Michael Weller,Denis Lacombe,J. Gregory Cairncross,René-Olivier Mirimanoff +23 more
TL;DR: Benefits of adjuvant temozolomide with radiotherapy lasted throughout 5 years of follow-up, and a benefit of combined therapy was recorded in all clinical prognostic subgroups, including patients aged 60-70 years.
Journal ArticleDOI
Updated Response Assessment Criteria for High-Grade Gliomas: Response Assessment in Neuro-Oncology Working Group
Patrick Y. Wen,David R. Macdonald,David A. Reardon,Timothy F. Cloughesy,A. Gregory Sorensen,Evanthia Galanis,John DeGroot,Wolfgang Wick,Mark R. Gilbert,Andrew B. Lassman,Christina Tsien,Tom Mikkelsen,Eric T. Wong,Marc C. Chamberlain,Roger Stupp,Kathleen R. Lamborn,Michael A. Vogelbaum,Martin J. van den Bent,Susan M. Chang +18 more
TL;DR: The recognition that contrast enhancement is nonspecific and may not always be a true surrogate of tumor response and the need to account for the nonenhancing component of the tumor mandate that new criteria be developed and validated to permit accurate assessment of the efficacy of novel therapies.
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