Brain tumor research and treatment最新文献

{"title":"The Korean Society for Neuro-Oncology (KSNO) Guideline for the Management of Brain Tumor Patients During the Crisis Period: A Consensus Survey About Specific Clinical Scenarios (Version 2023.1).","authors":"Min-Sung Kim,&nbsp;Se-Il Go,&nbsp;Chan Woo Wee,&nbsp;Min Ho Lee,&nbsp;Seok-Gu Kang,&nbsp;Kyeong-O Go,&nbsp;Sae Min Kwon,&nbsp;Woohyun Kim,&nbsp;Yun-Sik Dho,&nbsp;Sung-Hye Park,&nbsp;Youngbeom Seo,&nbsp;Sang Woo Song,&nbsp;Stephen Ahn,&nbsp;Hyuk-Jin Oh,&nbsp;Hong In Yoon,&nbsp;Sea-Won Lee,&nbsp;Joo Ho Lee,&nbsp;Kyung Rae Cho,&nbsp;Jung Won Choi,&nbsp;Je Beom Hong,&nbsp;Kihwan Hwang,&nbsp;Chul-Kee Park,&nbsp;Do Hoon Lim","doi":"10.14791/btrt.2023.0010","DOIUrl":"https://doi.org/10.14791/btrt.2023.0010","url":null,"abstract":"<p><strong>Background: </strong>During the coronavirus disease 2019 (COVID-19) pandemic, there was a shortage of medical resources and the need for proper treatment guidelines for brain tumor patients became more pressing. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, has undertaken efforts to develop a guideline that is tailored to the domestic situation and that can be used in similar crisis situations in the future. As part II of the guideline, this consensus survey is to suggest management options in specific clinical scenarios during the crisis period.</p><p><strong>Methods: </strong>The KSNO Guideline Working Group consisted of 22 multidisciplinary experts on neuro-oncology in Korea. In order to confirm a consensus reached by the experts, opinions on 5 specific clinical scenarios about the management of brain tumor patients during the crisis period were devised and asked. To build-up the consensus process, Delphi method was employed.</p><p><strong>Results: </strong>The summary of the final consensus from each scenario are as follows. For patients with newly diagnosed astrocytoma with isocitrate dehydrogenase (<i>IDH</i>)-mutant and oligodendroglioma with <i>IDH</i>-mutant/1p19q codeleted, observation was preferred for patients with low-risk, World Health Organization (WHO) grade 2, and Karnofsky Performance Scale (KPS) ≥60, while adjuvant radiotherapy alone was preferred for patients with high-risk, WHO grade 2, and KPS ≥60. For newly diagnosed patients with glioblastoma, the most preferred adjuvant treatment strategy after surgery was radiotherapy plus temozolomide except for patients aged ≥70 years with KPS of 60 and unmethylated <i>MGMT</i> promoters. In patients with symptomatic brain metastasis, the preferred treatment differed according to the number of brain metastasis and performance status. For patients with newly diagnosed atypical meningioma, adjuvant radiation was deferred in patients with older age, poor performance status, complete resection, or low mitotic count.</p><p><strong>Conclusion: </strong>It is imperative that proper medical care for brain tumor patients be sustained and provided, even during the crisis period. The findings of this consensus survey will be a useful reference in determining appropriate treatment options for brain tumor patients in the specific clinical scenarios covered by the survey during the future crisis.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 2","pages":"133-139"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/65/38/btrt-11-133.PMC10172008.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9505099","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}

{"title":"Intracranial Metastasis of Extracranial Chondrosarcoma: Systematic Review With Illustrative Case.","authors":"Charles E Mackel,&nbsp;Harry Rosenberg,&nbsp;Hemant Varma,&nbsp;Erik J Uhlmann,&nbsp;Rafael A Vega,&nbsp;Ron L Alterman","doi":"10.14791/btrt.2023.0003","DOIUrl":"https://doi.org/10.14791/btrt.2023.0003","url":null,"abstract":"<p><strong>Background: </strong>Cerebral chondrosarcoma metastases are rare and aggressive neoplasms. The rarity of presentation has precluded rigorous analysis of diagnosis, risk factors, treatment, and survival. We analyzed every reported case through exhaustive literature review. We further present the first case with Maffucci syndrome.</p><p><strong>Methods: </strong>Three databases, PubMed, Embase, and Google Scholar, and crossed references were queried for cerebral chondrosarcoma metastases. Extracted variables included demographics, risk factors, tumor characteristics, interventions, and outcomes. Univariate and multivariate analyses were performed.</p><p><strong>Results: </strong>Fifty-six patients were included from 1,489 literature results. The average age at brain metastasis was 46.6±17.6 years and occurred at a median of 24±2.8 months from primary diagnosis. Primary tumor histology (dedifferentiated 5.0±1.5 months, mesenchymal 24±3.0 months, conventional 41±7.4 months, <i>p</i><0.05) and grade (low grade 54±16.7 months vs. high-grade 10±6.4 months, <i>p</i><0.001) correlated with time interval until brain metastasis. A multiple enchondromatosis syndrome occurred in 13.2% of cases. At time of brain metastases diagnosis, extracranial metastases were identified in 76.2% of cases. Median survival after the development of brain metastasis was 2.0±0.78 months with a 1-year survival of 10.0%. On regression analysis, surgery reduced brain metastasis mortality risk and radiation trended towards reduced mortality risk (surgery: hazard ratio [HR] 0.22, 95% confidence interval [CI] 0.064-0.763, <i>p</i>=0.017; radiation: HR 0.31, 95% CI 0.091-1.072, <i>p</i>=0.064).</p><p><strong>Conclusion: </strong>We present a systematic review of cerebral chondrosarcoma metastases. Primary tumor histology and grade correlate with time until cerebral metastasis. Following cerebral metastasis, these tumors have poor prognosis and modestly benefit from surgery.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 2","pages":"103-113"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/73/bb/btrt-11-103.PMC10172009.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9505101","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}

{"title":"Pituitary Apoplexy After Leuprolide Therapy in a Breast Cancer Patient: A Case Report.","authors":"Jungbin Lee,&nbsp;Sun-Chul Hwang,&nbsp;Sung-Tae Park","doi":"10.14791/btrt.2023.0006","DOIUrl":"https://doi.org/10.14791/btrt.2023.0006","url":null,"abstract":"<p><p>Pituitary apoplexy (PA) is a clinical syndrome resulting from sudden hemorrhage and/or infarction of the pituitary gland. Recent reports documented the development of PA secondary to treatment with gonadotropin-releasing hormone (GnRH) agonists for prostate cancer. A 52-year-old woman visited our emergency room with a severe headache, occurred 1 day prior. She underwent breast-conserving surgery for breast cancer 1 month prior. She was currently undergoing radiation and hormone therapy, consisting of leuprorelin. Brain contrast-enhanced MRI revealed a pituitary adenoma with internal hemorrhage in the sellar and suprasellar areas. Pachymeningeal enhancement was observed along the retroclival and bilateral frontal areas. The patient was diagnosed with PA and aseptic meningitis. The patient underwent total excision via transsphenoidal surgery 8 days after admission. The patient was pathologically diagnosed with a pituitary adenoma with necrosis. On immunochemical staining, the tumor was positive for follicle-stimulating hormone. The follow-up MRI revealed no evidence of residual tumor or an improved pachymeningeal enhancement. She is currently undergoing follow-up at the neurosurgery and endocrinology outpatient departments with no noted complications. In breast cancer patients receiving GnRH agonist therapy, PA may be rare complication.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 2","pages":"153-157"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d0/16/btrt-11-153.PMC10172007.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9803271","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}

{"title":"Brain Invasion and Trends in Molecular Research on Meningioma.","authors":"Kyeong-O Go,&nbsp;Young Zoon Kim","doi":"10.14791/btrt.2022.0044","DOIUrl":"https://doi.org/10.14791/btrt.2022.0044","url":null,"abstract":"<p><p>Meningiomas are the most common primary brain tumors in adults. The treatment of non-benign meningiomas remains a challenging task, and after the publication of the 2021 World Health Organization classification, the importance of molecular biological classification is emerging. In this article, we introduce the mechanisms of brain invasion in atypical meningioma and review the genetic factors involved along with epigenetic regulation. First, it is important to understand the three major steps for brain invasion of meningeal cells: 1) degradation of extracellular matrix by proteases, 2) promotion of tumor cell migration to resident cells by adhesion molecules, and 3) neovascularization and supporting cells by growth factors. Second, the genomic landscape of meningiomas should be analyzed by major categories, such as germline mutations in <i>NF2</i> and somatic mutations in non-<i>NF2</i> genes (<i>TRAF7</i>, <i>KLF4</i>, <i>AKT1</i>, <i>SMO</i>, and <i>POLR2A</i>). Finally, epigenetic alterations in meningiomas are being studied, with a focus on DNA methylation, histone modification, and RNA interference. Increasing knowledge of the molecular landscape of meningiomas has allowed the identification of prognostic and predictive markers that can guide therapeutic decision-making processes and the timing of follow-up.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 1","pages":"47-58"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6f/3d/btrt-11-47.PMC9911709.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10725979","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}

{"title":"Breast Cancer to Meningioma: A Rare Case of Tumor-to-Tumor Metastasis.","authors":"Woo Hyeong Joe,&nbsp;Chang-Young Lee,&nbsp;Chang-Hyun Kim,&nbsp;Young San Ko,&nbsp;Sang Pyo Kim,&nbsp;Sae Min Kwon","doi":"10.14791/btrt.2022.0042","DOIUrl":"https://doi.org/10.14791/btrt.2022.0042","url":null,"abstract":"<p><p>Tumor-to-tumor metastasis (TTM) is defined as the hematogenous metastasis within a primary host tumor from a donor neoplasm. Since there is insufficient evidence regarding the pathophysiology, clinical course, and management of TTM, there are no precise guidelines for its management. A 73-year-old female patient diagnosed with breast cancer was found to have convexity meningioma. Since the size of tumor and peritumoral brain edema increased during follow-up period, the meningioma was treated with surgical resection. Postoperatively, histopathologic examination confirmed metastasis of invasive ductal carcinoma within a secretory meningioma. The final diagnosis was TTM of breast cancer in meningioma. Here, we report a rare case of intra-meningioma metastasis and a review of literature to provide a better understanding of this rare phenomenon.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 1","pages":"73-78"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/86/b2/btrt-11-73.PMC9911711.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10738033","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}

{"title":"Molecular Biology of Brain Metastases.","authors":"Ho-Shin Gwak","doi":"10.14791/btrt.2022.0045","DOIUrl":"https://doi.org/10.14791/btrt.2022.0045","url":null,"abstract":"<p><p>Brain metastases (BMs) often occur in patients with lung cancer, breast cancer, and melanoma and are the leading cause of morbidity and mortality. The incidence of BM has increased with advanced neuroimaging and prolonged overall survival of cancer patients. With the advancement of local treatment modalities, including stereotactic radiosurgery and navigation-guided microsurgery, BM can be controlled long-term, even in cases with multiple lesions. However, radiation/chemotherapeutic agents are also toxic to the brain, usually irreversibly and cumulatively, and it remains difficult to completely cure BM. Thus, we must understand the molecular events that begin and sustain BM to develop effective targeted therapies and tools to prevent local and distant treatment failure. BM most often spreads hematogenously, and the blood-brain barrier (BBB) presents the first hurdle for disseminated tumor cells (DTCs) entering the brain parenchyma. Nevertheless, how the DTCs cross the BBB and settle on relatively infertile central nervous system tissue remains unknown. Even after successfully taking up residence in the brain, the unique tumor microenvironment is marked by restricted aerobic glycolysis metabolism and limited lymphocyte infiltration. Brain organotropism, certain phenotype of primary cancers that favors brain metastasis, may result from somatic mutation or epigenetic modulation. Recent studies revealed that exosome secretion from primary cancer or over-expression of proteolytic enzymes can \"pre-condition\" brain vasculoendothelial cells. The concept of the \"metastatic niche,\" where resident DTCs remain dormant and protected from systemic chemotherapy and antigen exposure before proliferation, is supported by clinical observation of BM in patients clearing systemic cancer and experimental evidence of the interaction between cancer cells and tumor-infiltrating lymphocytes. This review examines extant research on the metastatic cascade of BM through the molecular events that create and sustain BM to reveal clues that can assist the development of effective targeted therapies that treat established BMs and prevent BM recurrence.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 1","pages":"8-15"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0d/5f/btrt-11-8.PMC9911708.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10725980","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}

{"title":"Revisiting the Role of Surgical Resection for Brain Metastasis.","authors":"Joonho Byun,&nbsp;Jong Hyun Kim","doi":"10.14791/btrt.2022.0028","DOIUrl":"https://doi.org/10.14791/btrt.2022.0028","url":null,"abstract":"<p><p>Brain metastasis (BM) is the most common type of brain tumor in adults. The contemporary management of BM remains challenging. Advancements in systemic cancer treatment have increased the survival of patients with cancer. Although the treatment of BM is still complicated, advances in radiotherapy, including stereotactic radiosurgery and chemotherapy, have improved treatment outcomes. Surgical resection is the traditional treatment for BM and its role in the surgical resection of BM has been well established. However, refinement of the surgical resection technique and strategy for BM is needed. Herein, we discuss the evolving role of surgery in patients with BM and the future of BM treatment.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/30/cf/btrt-11-1.PMC9911712.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10725978","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}

{"title":"A Rare Occurrence of Primarily Extranodal Spinal Epidural Lymphoma With Spinal Cord Compression and Invasion to the Thoracic Cavity.","authors":"Min-Cheol Seok,&nbsp;Ahmad Khalid Madadi,&nbsp;Mohammad Mohsen Mosleh,&nbsp;Sun Hee Chang,&nbsp;Moon-Jun Sohn","doi":"10.14791/btrt.2022.0038","DOIUrl":"https://doi.org/10.14791/btrt.2022.0038","url":null,"abstract":"<p><p>A 41-year-old man suffered from progressive radiculomyelopathy caused by spinal epidural mass primarily encasing the spinal cord at the cervicothoracic vertebrae that extended into the thoracic cavity through the neural foramen. An urgent decompressive laminectomy and epidural tumor resection were performed to prevent neurological deterioration and effective spinal cord decompression. The histopathologic diagnosis was diffuse large B-cell lymphoma. As first-line treatment for stage II extranodal lymphoma, he received 6 cycles of R-CHOP (rituximab/cyclophosphamide, hydroxydaunorubicin, Oncovin, and prednisone) chemotherapy. Consequently, follow-up positron-emission tomography CT and MR images demonstrated a complete metabolic response (Deauville score 1). This rare occurrence of primarily extranodal spinal epidural lymphoma with limited disease will be presented in a literature review.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 1","pages":"66-72"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ad/03/btrt-11-66.PMC9911714.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10725981","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}

{"title":"The Role of Hypoxia in Brain Tumor Immune Responses.","authors":"Jang Hyun Park, Heung Kyu Lee","doi":"10.14791/btrt.2022.0043","DOIUrl":"10.14791/btrt.2022.0043","url":null,"abstract":"<p><p>Oxygen is a vital component of living cells. Low levels of oxygen in body tissues, known as hypoxia, can affect multiple cellular functions across a variety of cell types and are a hallmark of brain tumors. In the tumor microenvironment, abnormal vasculature and enhanced oxygen consumption by tumor cells induce broad hypoxia that affects not only tumor cell characteristics but also the antitumor immune system. Although some immune reactions require hypoxia, hypoxia generally negatively affects immunity. Hypoxia induces tumor cell invasion, cellular adaptations to hypoxia, and tumor cell radioresistance. In addition, hypoxia limits the efficacy of immunotherapy and hinders antitumor responses. Therefore, understanding the role of hypoxia in the brain tumor, which usually does not respond to immunotherapy alone is important for the development of effective anti-tumor therapies. In this review, we discuss recent evidence supporting the role of hypoxia in the context of brain tumors.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 1","pages":"39-46"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5e/60/btrt-11-39.PMC9911710.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10725974","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}

{"title":"Role of Radiotherapy in Patients With Relapsed Medulloblastoma.","authors":"Do Hoon Lim","doi":"10.14791/btrt.2022.0033","DOIUrl":"https://doi.org/10.14791/btrt.2022.0033","url":null,"abstract":"<p><p>During the last three decades, the management of medulloblastoma (MBL) has made enormous progress with a multidisciplinary approach, incorporating surgery, radiotherapy (RT), and chemotherapy. Despite this improvement, 20%-30% of patients with MBL remain at risk of disease recurrence, with its relapse being possibly fatal. To date, the salvage treatment for relapse remains challenging, and various approaches have been suggested for the retreatment. In this review, I have described the characteristics of patients with relapsed MBL, patterns of relapse and the most commonly prescribed treatment. Further, I have reviewed the studies on re-irradiation and its associated issues to conclusively suggest the RT recommendations for patients with relapsed MBL.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 1","pages":"22-27"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e6/a9/btrt-11-22.PMC9911706.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10738032","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}