Brain tumor research and treatment最新文献_第5页

Spontaneous Regression of Glioma-Mimicking Brainstem Lesion in a Child: A Case Report. 一名儿童脑胶质瘤模拟脑干病变的自发消退：病例报告。

Brain tumor research and treatment Pub Date : 2024-01-01 DOI: 10.14791/btrt.2023.0039

Sung Hyun Kang, Hyeon Jin Park, Jae-Won Hyun, Ho-Shin Gwak

{"title":"Spontaneous Regression of Glioma-Mimicking Brainstem Lesion in a Child: A Case Report.","authors":"Sung Hyun Kang, Hyeon Jin Park, Jae-Won Hyun, Ho-Shin Gwak","doi":"10.14791/btrt.2023.0039","DOIUrl":"10.14791/btrt.2023.0039","url":null,"abstract":"Differential diagnosis of focal brainstem lesions detected on MRI is challenging, especially in young children. Formerly, brainstem gliomas were classified mainly based on MRI features and location. However, since 2016, the World Health Organization's brainstem lesion classification requires tissue biopsy to reveal molecular characteristics. Although modern techniques of stereotactic or navigation-guided biopsy ensure accurate biopsy of the lesion with safety, biopsy of brainstem lesions is still generally not performed. Here, we report a focal brainstem lesion mimicking brainstem glioma in a 9-year-old girl. Initial MRI, MR spectroscopy, and 11C-methionine positron emission tomography (PET) features suggested low-grade glioma or diffuse intrinsic pontine glioma. However, repeated MR spectroscopy, perfusion MRI, and 18fluorodeoxyglucose PET findings suggested that it was more likely a non-tumorous lesion. As the patient presented not with a neurological manifestation but with precocious puberty, the attending oncologist chose to observe with regular follow-up MRI. The pontine lesion with high signal intensity on T2-weighted MRI regressed from the 6-month follow-up and became invisible on the 1.5-year follow-up MRI. We reviewed brainstem glioma-mimicking lesions in the literature and discussed the key points of differential diagnosis.","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"12 1","pages":"58-62"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10864136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Basics for Pediatric Brain Tumor Imaging: Techniques and Protocol Recommendations. 小儿脑肿瘤成像基础：技术和方案建议。

Brain tumor research and treatment Pub Date : 2024-01-01 DOI: 10.14791/btrt.2023.0037

Ah Young Jung

{"title":"Basics for Pediatric Brain Tumor Imaging: Techniques and Protocol Recommendations.","authors":"Ah Young Jung","doi":"10.14791/btrt.2023.0037","DOIUrl":"10.14791/btrt.2023.0037","url":null,"abstract":"This review provides an overview of the current state of pediatric brain tumor imaging, emphasizing the role of various imaging sequences and highlighting the advantages of standardizing protocols for pediatric brain tumor imaging in diagnosis and treatment response evaluation. Basic anatomical sequences such as pre- and post-contrast 3D T1-weighted, T2-weighted, fluid-attenuated inversion recovery, T2*-weighted, and diffusion-weighted imaging (DWI), are fundamental for assessing tumor location, extent, and characteristics. Advanced techniques like DWI, diffusion tensor imaging, perfusion imaging, magnetic resonance spectroscopy, and functional MRI offer insights into cellularity, vascularity, metabolism, and function. To enhance consistency and quality, standardized protocols for pediatric brain tumor imaging have been recommended by expert groups. Special considerations for pediatric patients, including the minimization of anesthesia exposure and gadolinium contrast agent usage, are essential to ensure patient safety and comfort. Staying up-to-date with diagnostic imaging techniques can contribute to improved communication, outcomes, and patient care in the field of pediatric neurooncology.","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"12 1","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10864130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Central Nervous System Dissemination of Solitary Sporadic Supratentorial Hemangioblastoma: A Case Report and Literature Review. 孤立性散发性幕上血管母细胞瘤的中枢神经系统扩散：病例报告和文献综述。

Brain tumor research and treatment Pub Date : 2024-01-01 DOI: 10.14791/btrt.2023.0047

Seong-Chan Jung, In-Young Kim, Shin Jung, Tae-Young Jung, Kyung-Sub Moon, Yeong-Jin Kim, Sue-Jee Park, Kyung-Hwa Lee

{"title":"Central Nervous System Dissemination of Solitary Sporadic Supratentorial Hemangioblastoma: A Case Report and Literature Review.","authors":"Seong-Chan Jung, In-Young Kim, Shin Jung, Tae-Young Jung, Kyung-Sub Moon, Yeong-Jin Kim, Sue-Jee Park, Kyung-Hwa Lee","doi":"10.14791/btrt.2023.0047","DOIUrl":"10.14791/btrt.2023.0047","url":null,"abstract":"We report a patient with whole neuroaxis dissemination of a sporadic supratentorial hemangioblastoma (HB) for more than 15 years. A 68-year-old female patient presented with severe radiating pain in the right leg. Gadolinium-enhanced lumbar spine MRI showed an intradural mass (2.5 cm in diameter) at the L4 level. The patient had been severely disabled for 22 years after a previous intraventricular brain tumor resection. At that time, the diagnosis was angioblastic meningioma, which was thought to be incorrect. At 14 years after the brain surgery, gamma knife radiosurgery was performed three times for newly developed or recurred supratentorial and infratentorial tumors in the cerebrospinal fluid pathway. The patient underwent lumbar spinal surgery, and a gross total removal of the mass was performed, which confirmed the histopathological diagnosis of HB. We reexamined the old histopathological specimen of the intraventricular tumor from 20 years ago and changed the diagnosis from angioblastic meningioma to supratentorial HB. Six months after spinal surgery, the patient underwent a second spinal surgery and brain surgery, and the histopathological diagnosis was HB following both surgeries, which was the same following the first spinal surgery. Here, we report a sporadic supratentorial HB patient who showed cranial and spinal disseminations for more than two decades along with a literature review.","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"12 1","pages":"80-86"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10864138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Value of Thallium-201 SPECT and SPECT/CT Brain Imaging in Differentiating Malignant From Nonmalignant Lesions: A Comparative Case-Series Study With Pathologic and/or Clinical Correlation. 铊-201 SPECT和SPECT/CT脑成像在鉴别恶性和非恶性病变中的价值:一项具有病理和/或临床相关性的比较病例系列研究。

Brain tumor research and treatment Pub Date : 2023-10-01 DOI: 10.14791/btrt.2023.0022

Nicole Girlyn T Pang, Julette Marie F Batara, Lara Triccia C Luistro, Christianne V Mojica, Allan Jay C Domingo

{"title":"Value of Thallium-201 SPECT and SPECT/CT Brain Imaging in Differentiating Malignant From Nonmalignant Lesions: A Comparative Case-Series Study With Pathologic and/or Clinical Correlation.","authors":"Nicole Girlyn T Pang, Julette Marie F Batara, Lara Triccia C Luistro, Christianne V Mojica, Allan Jay C Domingo","doi":"10.14791/btrt.2023.0022","DOIUrl":"10.14791/btrt.2023.0022","url":null,"abstract":"Background: Thallium-201 single-photon emission computed tomography/computed tomography (SPECT/CT) brain scan is an imaging modality which can be done to differentiate between malignant and nonmalignant lesions among patients with nonconclusive findings on conventional neuroimaging. This study describes the results of thallium-201 SPECT/CT brain imaging and relate it to histopathologic and/or clinical findings and evaluate the value of thallium-201 SPECT/CT brain imaging in differentiating malignant from nonmalignant lesions.Methods: This is a retrospective case series study of 10 patients with cerebral lesions who underwent thallium-201 SPECT/CT brain imaging in a hospital in the Philippines from 2010 to 2021.Results: A total of 10 patients underwent thallium-201 SPECT/CT brain scan. Six had negative results while 4 had positive results. All of the patients who had positive results were found to have malignancy, whether recurrent or newly diagnosed. All of the patients with negative scan were found to have either an infectious and inflammatory disease and responded to treatment albeit in different degrees. Two of the 10 patients underwent biopsy whose results were consistent with the thallium-201 SPECT/CT brain scan results.Conclusion: Thallium-201 brain scan combined with SPECT and SPECT/CT has been demonstrated to be useful in distinguishing malignant from nonmalignant lesions and is more cost-effective versus other imaging techniques. The findings in this study support the role of thallium scintigraphy in the diagnosis of patients with brain lesions most significantly when there is a need to differentiate between a malignant and benign condition.","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 4","pages":"239-245"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10641321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89720919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Awake Surgery for Lesional Epilepsy in Resource-Limited Settings: Case Report and Review of Literature. 在资源有限的情况下清醒手术治疗病变性癫痫:病例报告和文献回顾。

Brain tumor research and treatment Pub Date : 2023-10-01 DOI: 10.14791/btrt.2023.0035

Mohammad Hamza Bajwa, Syeda Amrah Hashmi, Abdullah Nisar, Muhammad Waqas Baqai, Saqib Kamran Bakhshi, Muskaan Abdul Qadir, Faraz Shafiq, Syed Ather Enam

{"title":"Awake Surgery for Lesional Epilepsy in Resource-Limited Settings: Case Report and Review of Literature.","authors":"Mohammad Hamza Bajwa, Syeda Amrah Hashmi, Abdullah Nisar, Muhammad Waqas Baqai, Saqib Kamran Bakhshi, Muskaan Abdul Qadir, Faraz Shafiq, Syed Ather Enam","doi":"10.14791/btrt.2023.0035","DOIUrl":"10.14791/btrt.2023.0035","url":null,"abstract":"Epilepsy surgery is a well-established treatment for drug-resistant epilepsy, with awake craniotomy being used in certain cases to remove epileptogenic foci while preserving crucial brain functions. We are presenting the first reported case from Pakistan of a 19-year-old woman who underwent awake epilepsy surgery to treat cortical dysplasia. She had a history of generalized tonic-clonic seizures since her childhood and was referred to our clinic due to an increase in seizure frequency. EEG and MRI identified the epileptogenic focus in the right parieto-temporal region. The patient underwent a neuro-navigation guided awake craniotomy and an excision of the epileptogenic focus in the right parieto-temporal region. The procedure was carried out using a scalp block and dexmedetomidine for conscious sedation, enabling the patient to remain awake throughout the surgery. Intraoperative mapping and electrocorticography were used for complex multidisciplinary care. Post-resection corticography showed no spikes along the resected margins. The patient was discharged without any complications and remained free of symptoms a year after the surgery. Awake epilepsy surgery is a viable option for removing epileptogenic foci while preserving vital cognitive functions. However, it is seldom used in low- and middle-income countries such as Pakistan. The successful outcome of this case underscores the need for greater awareness and availability of epilepsy surgery in resource-limited settings. Cost-effective measures, such as using small subdural strips for intraoperative localization, can be implemented.","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 4","pages":"289-294"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10641320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89720911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Survival and Malignant Transformation of Pineal Parenchymal Tumors: A 30-Year Retrospective Analysis in a Single-Institution. 松果体实质肿瘤的生存和恶性转化:一个单一机构的30年回顾性分析。

Brain tumor research and treatment Pub Date : 2023-10-01 DOI: 10.14791/btrt.2023.0033

Tae-Hwan Park, Seung-Ki Kim, Ji Hoon Phi, Chul-Kee Park, Yong Hwy Kim, Sun Ha Paek, Chang-Hyun Lee, Sung-Hye Park, Eun Jung Koh

{"title":"Survival and Malignant Transformation of Pineal Parenchymal Tumors: A 30-Year Retrospective Analysis in a Single-Institution.","authors":"Tae-Hwan Park, Seung-Ki Kim, Ji Hoon Phi, Chul-Kee Park, Yong Hwy Kim, Sun Ha Paek, Chang-Hyun Lee, Sung-Hye Park, Eun Jung Koh","doi":"10.14791/btrt.2023.0033","DOIUrl":"10.14791/btrt.2023.0033","url":null,"abstract":"Background: This study aims to elucidate clinical features, therapeutic strategies, and prognosis of pineal parenchymal tumors (PPT) by analyzing a 30-year dataset of a single institution.Methods: We reviewed data from 43 patients diagnosed with PPT at Seoul National University Hospital between 1990 and 2020. We performed survival analyses and assessed prognostic factors.Results: The cohort included 10 patients with pineocytoma (PC), 13 with pineal parenchymal tumor of intermediate differentiation (PPTID), and 20 with pineoblastoma (PB). Most patients presented with hydrocephalus at diagnosis. Most patients underwent an endoscopic third ventriculostomy and biopsy, with some undergoing additional resection after diagnosis confirmation. Radiotherapy was administered with a high prevalence of gamma knife radiosurgery for PC and PPTID, and craniospinal irradiation for PB. Chemotherapy was essential in the treatment of grade 3 PPTID and PB. The 5-year progression-free survival rates for PC, grade 2 PPTID, grade 3 PPTID, and PB were 100%, 83.3%, 0%, and 40%, respectively, and the 5-year overall survival rates were 100%, 100%, 40%, and 55%, respectively. High-grade tumor histology was associated with lower survival rates. Significant prognostic factors varied among tumor types, with World Health Organization (WHO) grade and leptomeningeal seeding (LMS) for PPTID, and the extent of resection and LMS for PB. Three patients experienced malignant transformations.Conclusion: This study underscores the prognostic significance of WHO grades in PPT. It is necessary to provide specific treatment according to tumor grade. Grade 3 PPTID showed a poor prognosis. Potential LMS and malignant transformations necessitate aggressive multimodal treatment and close-interval screening.","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 4","pages":"254-265"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10641322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89720917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Case Series of DuraMatrix-Onlay^® Plus in Cranial Surgery Is Associated With a Low Complication Profile. DuraMatrix-Onlay®Plus在颅外科中的应用与低并发症相关

Brain tumor research and treatment Pub Date : 2023-10-01 DOI: 10.14791/btrt.2023.0021

Mahlet Mekonnen, Gabrielle Hovis, Natalie Mahgerefteh, Anubhav Chandla, Yelena Malkhasyan, Ashley B Zhang, Isaac Yang

{"title":"A Case Series of DuraMatrix-Onlay® Plus in Cranial Surgery Is Associated With a Low Complication Profile.","authors":"Mahlet Mekonnen, Gabrielle Hovis, Natalie Mahgerefteh, Anubhav Chandla, Yelena Malkhasyan, Ashley B Zhang, Isaac Yang","doi":"10.14791/btrt.2023.0021","DOIUrl":"10.14791/btrt.2023.0021","url":null,"abstract":"Background: DuraMatrix-Onlay® Plus is a collagen dura membrane derived from purified bovine Achilles tendon. The matrix provides a scaffold for collagen synthesis and is intended to be used as an onlay without the need for dural sutures. The study aims to describe our experience with 33 consecutive patients who underwent a duraplasty procedure using the novel DuraMatrix-Onlay® Plus collagen dura membrane.Methods: This is a retrospective case series of 33 patients who underwent a duraplasty procedure at a single academic hospital in Los Angeles, CA, USA between May 2016 and March 2017. The primary outcome was the incidence rate of cerebrospinal fluid (CSF) leak. Secondary outcomes included rates of patient infection, dural substitute complication, and removal.Results: Thirty-three patients underwent a duraplasty procedure using the DuraMatrix-Onlay® Plus material. The average age of the patients was 41.12±7.34 years (range 2-75 years). There were 18 (54.5%) females and 15 (45.5%) males. The majority of procedures were elective operations for the resection of a lesion (n=19, 58%), and the average graft size was 17.69±4.73 cm². At an average follow-up of 3 months, there were no postoperative CSF leaks. The rates of patient infection, dural substitute complication, and removal were 6%, 6%, and 3%, respectively.Conclusion: DuraMatrix-Onlay® Plus is associated with a low rate of postoperative CSF leakage and an acceptable complication profile. This result supports the use of collagen matrices for dural closure in general neurosurgical procedures.","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 4","pages":"232-238"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10641318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89720910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Extensive Leptomeningeal Spreading of Ependymoma in an Adult: Case Report and Literature Review. 成人室管膜瘤广泛的脑膜扩散:1例报告及文献复习。

Brain tumor research and treatment Pub Date : 2023-10-01 DOI: 10.14791/btrt.2023.0029

Joonseo Kang, Kwon Woo Lee, Yeongu Chung, Yusam Won, Je Beom Hong

{"title":"Extensive Leptomeningeal Spreading of Ependymoma in an Adult: Case Report and Literature Review.","authors":"Joonseo Kang, Kwon Woo Lee, Yeongu Chung, Yusam Won, Je Beom Hong","doi":"10.14791/btrt.2023.0029","DOIUrl":"10.14791/btrt.2023.0029","url":null,"abstract":"Ependymoma is a rare adult tumor that originates from ependymal cells of the central nervous system, primarily occurring in the cerebral ventricles or the central canal of the spinal cord. In this paper, we report a case of extensive leptomeningeal seeding of ependymoma of a 39-year-old male patient, in whom the tumor was found incidentally after head trauma. The MRI exhibited diffuse leptomeningeal infiltrative lesions along with bilateral multiple cerebral sulci, basal cisterns, cerebellopontine angle, cerebellar folia. It also showed multinodular enhancing T1 low T2 high signal intensity lesions along the whole spinal cord. After the tumor biopsy at right temporal lesion, pathologic diagnosis was classic ependymoma (WHO grade 2). The patient has undergone radiation therapy and chemotherapy, and is currently maintaining a stable condition two years after surgery. This report suggests that when considering the differential diagnosis of extensive lesions both in the intracranial and intraspinal space, ependymoma should also be considered.","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 4","pages":"274-280"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10641315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89720912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Recurrence of Rathke's Cleft Cyst Following Surgery and Histopathological Considerations for Recurrence: A Case Presentation. Rathke's裂囊肿术后复发和复发的组织病理学考虑:一个病例报告。

Brain tumor research and treatment Pub Date : 2023-10-01 DOI: 10.14791/btrt.2023.0025

Dongwook Lee, Jang Hun Kim, Dong-Hyuk Park, Shin-Hyuk Kang, Kyung-Jae Park

引用次数: 0

FLASH Radiotherapy: A FLASHing Idea to Preserve Neurocognitive Function. 闪光放疗:一个闪光的想法，以保持神经认知功能。

Brain tumor research and treatment Pub Date : 2023-10-01 DOI: 10.14791/btrt.2023.0026

Hye-Ju Jo, Taerim Oh, Ye-Rim Lee, Gi-Sue Kang, Hye-Joon Park, G-One Ahn

{"title":"FLASH Radiotherapy: A FLASHing Idea to Preserve Neurocognitive Function.","authors":"Hye-Ju Jo, Taerim Oh, Ye-Rim Lee, Gi-Sue Kang, Hye-Joon Park, G-One Ahn","doi":"10.14791/btrt.2023.0026","DOIUrl":"10.14791/btrt.2023.0026","url":null,"abstract":"FLASH radiotherapy (FLASH RT) is a technique to deliver ultra-high dose rate in a fraction of a second. Evidence from experimental animal models suggest that FLASH RT spares various normal tissues including the lung, gastrointestinal track, and brain from radiation-induced toxicity (a phenomenon known as FLASH effect), which is otherwise commonly observed with conventional dose rate RT. However, it is not simply the ultra-high dose rate alone that brings the FLASH effect. Multiple parameters such as instantaneous dose rate, pulse size, pulse repetition frequency, and the total duration of exposure all need to be carefully optimized simultaneously. Furthermore it is critical to validate FLASH effects in an in vivo experimental model system. The exact molecular mechanism responsible for this FLASH effect is not yet understood although a number of hypotheses have been proposed including oxygen depletion and less reactive oxygen species (ROS) production by FLASH RT, and enhanced ability of normal tissues to handle ROS and labile iron pool compared to tumors. In this review, we briefly overview the process of ionization event and history of radiotherapy and fractionation of ionizing radiation. We also highlight some of the latest FLASH RT reviews and results with a special interest to neurocognitive protection in rodent model with whole brain irradiation. Lastly we discuss some of the issues remain to be answered with FLASH RT including undefined molecular mechanism, lack of standardized parameters, low penetration depth for electron beam, and tumor hypoxia still being a major hurdle for local control. Nevertheless, researchers are close to having all answers to the issues that we have raised, hence we believe that advancement of FLASH RT will be made more quickly than one can anticipate.","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 4","pages":"223-231"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10641319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89720913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0