Brain tumor research and treatment最新文献

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MRI-Based Classification of Rathke's Cleft Cyst and Its Clinical Implication. Rathke裂隙囊肿的mri分型及其临床意义。
Brain tumor research and treatment Pub Date : 2023-01-01 DOI: 10.14791/btrt.2022.0036
Ginam Kim, Ju Hyung Moon, Sun Ho Kim, Eui Hyun Kim
{"title":"MRI-Based Classification of Rathke's Cleft Cyst and Its Clinical Implication.","authors":"Ginam Kim,&nbsp;Ju Hyung Moon,&nbsp;Sun Ho Kim,&nbsp;Eui Hyun Kim","doi":"10.14791/btrt.2022.0036","DOIUrl":"https://doi.org/10.14791/btrt.2022.0036","url":null,"abstract":"<p><strong>Background: </strong>Rathke's cleft cysts (RCCs) are benign tumors of the pituitary gland. Small, asymptomatic RCCs do not require surgical treatment, whereas surgical treatment is required for symptomatic RCCs.</p><p><strong>Methods: </strong>We retrospectively reviewed medical records of patients with an RCC who were diagnosed and managed in our institution between April 2004 and April 2020 and generated two different cohorts: the observation (n=114) and the surgical group (n=99). Their initial MRI signal characteristics were analyzed. The natural course focusing on cyst size was observed in the observation group and postoperative visual and endocrine outcomes were evaluated in the surgical group.</p><p><strong>Results: </strong>The characterization of MRI signals of cyst contents in both T1-weighted (T1W) and T2-weighted (T2W) images revealed nine combinations for our 213 patients. Among 115 patients with a high T2W signal, the cysts showed hypo-, iso-, and hyper-intensity on T1W images in 72, 39, and 44 patients, respectively; Type S-low, Type S-iso, and Type S-high. One more major group of 35 patients showed RCCs with hyperintensity on the T1W images and hypointensity on the T2W images named as Type M. In the comparison between observation and surgical groups, we identified only two major groups in which the number of patients in the surgical and observation groups was statistically different: more Type S-low in a surgical group (<i>p</i><0.001) and more Type M in an observation group (<i>p</i>=0.007). In subgroup analysis, the range of change in the cyst size was the highest in Type S-high in the observation group (<i>p</i>=0.028), and intergroup differences in visual and endocrine outcomes were not evident in the surgical group.</p><p><strong>Conclusion: </strong>MRI characteristics help to predict the natural course of RCCs. We identified subgroups of RCCs which are more or less likely to require surgical intervention.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 1","pages":"59-65"},"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/05/5e/btrt-11-59.PMC9911707.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10725975","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
Advances in Brain Metastasis Models. 脑转移模型的研究进展
Brain tumor research and treatment Pub Date : 2023-01-01 DOI: 10.14791/btrt.2022.0037
Jung Eun Lee, Seung Ho Yang
{"title":"Advances in Brain Metastasis Models.","authors":"Jung Eun Lee,&nbsp;Seung Ho Yang","doi":"10.14791/btrt.2022.0037","DOIUrl":"https://doi.org/10.14791/btrt.2022.0037","url":null,"abstract":"<p><p>To obtain achievements in addressing the clinical challenges of brain metastasis, we need a clear understanding of its biological mechanisms. Brain metastasis research is challenged by many practical scientific barriers. Depending on the purpose of the study, experimental brain metastasis models <i>in vivo</i> can be used. It is now possible to re-create the architecture and physiology of human organs. Human organoids provide unique opportunities for the study of human disease and complement animal models. The translation of experimental findings to clinical application has several barriers in the development of treatment for brain metastasis. A variety of models have provided significant contributions to the knowledge of brain metastasis pathology and remain pivotal tools for examining novel therapeutic strategies.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 1","pages":"16-21"},"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/aa/05/btrt-11-16.PMC9911715.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10725976","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
Medulloblastoma: Current Perspectives and Recent Advances. 髓母细胞瘤:目前的观点和最新进展。
Brain tumor research and treatment Pub Date : 2023-01-01 DOI: 10.14791/btrt.2022.0046
Jung Yoon Choi
{"title":"Medulloblastoma: Current Perspectives and Recent Advances.","authors":"Jung Yoon Choi","doi":"10.14791/btrt.2022.0046","DOIUrl":"https://doi.org/10.14791/btrt.2022.0046","url":null,"abstract":"<p><p>Medulloblastoma is the most common embryonal tumor of the central nervous system in childhood. Combined multimodality approaches, including surgery, radiation, and chemotherapy, have improved the outcome of medulloblastoma. Advances in genomic research have shown that medulloblastoma is not a biologically or clinically discrete entity. Previously, the risk was divided according to histology, presence of metastasis, degree of resection, and age at diagnosis. Through the development of integrated genomics, new biology-based risk stratification methods have recently been proposed. It is also important to understand the genetic predisposition of patients with medulloblastoma. Therefore, treatment goal aimed to improve the survival rate with minimal additional adverse effects and reduced long-term sequelae. It is necessary to incorporate genetic findings into the standard of care, and clinical trials that reflect this need to be conducted.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 1","pages":"28-38"},"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/02/c0/btrt-11-28.PMC9911713.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10725977","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
Engineered Aurotherapy for the Multimodal Treatment of Glioblastoma. 工程光疗法用于胶质母细胞瘤的多模式治疗。
Brain tumor research and treatment Pub Date : 2022-10-01 DOI: 10.14791/btrt.2022.0032
Hyung Shik Kim, Dong Yun Lee
{"title":"Engineered Aurotherapy for the Multimodal Treatment of Glioblastoma.","authors":"Hyung Shik Kim,&nbsp;Dong Yun Lee","doi":"10.14791/btrt.2022.0032","DOIUrl":"https://doi.org/10.14791/btrt.2022.0032","url":null,"abstract":"<p><p>Glioblastoma multiforme (GBM) is the most aggressive brain tumor, characterized by fatal prognosis and high rates of recurrence. Although there are various treatment strategies such as surgical resection, radiotherapy, and chemotherapy, these traditional approaches still have not improved the survival rates and prolongation. Therefore, there is a pressing requirement for developing novel technologies to combat GBM. Nanoparticle-based GBM therapy can be considered a promising approach to precisely treat tumors with minimal side effects. Among various nanoparticles, gold nanoparticle (AuNP) has been demonstrated to be effective in treating GBM because of its advantages such as easy functionalization due to self-assembled monolayers of thiols, surface plasmon resonance effect on its surface, and relatively low toxicity issues. By using nanoscale (5-100 nm) and facile functionalization with a targeting ligand, AuNP can overcome the obstacles caused by blood-brain barrier, which selectively inhibits AuNP penetration into the brain tumor mass. AuNPs delivered into brain tissue and targeted with GBM have been mostly explored for photothermal therapy and photodynamic therapy, but also investigated in the development of complex therapies including radiotherapy, chemotherapy, and immunotherapy using AuNP-based nanoplatforms. Therefore, the aim of this mini review is to summarize recent works on the AuNPs-based nanoplatforms for treating GBM with a multimodal approach.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"10 4","pages":"215-220"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/18/fc/btrt-10-215.PMC9650121.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40671650","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
Spheno-Orbital Plasmacytoma as an Initial Presentation of Multiple Myeloma. 眼眶浆细胞瘤是多发性骨髓瘤的初始表现。
Brain tumor research and treatment Pub Date : 2022-10-01 DOI: 10.14791/btrt.2022.0026
Sangjun Ahn, Seung Heon Cha, Won Ho Cho
{"title":"Spheno-Orbital Plasmacytoma as an Initial Presentation of Multiple Myeloma.","authors":"Sangjun Ahn,&nbsp;Seung Heon Cha,&nbsp;Won Ho Cho","doi":"10.14791/btrt.2022.0026","DOIUrl":"https://doi.org/10.14791/btrt.2022.0026","url":null,"abstract":"<p><p>Intracranial plasmacytoma is a rare neoplasm and a subtype of malignant plasma cell tumor. Most patients with plasma cell tumors are diagnosed with multiple myeloma, but 5%-10% of patients are not. This report includes descriptions of radiologic and clinical findings in a patient with intracranial plasmacytoma. Intracranial extra-axial plasmacytomas can be easily misdiagnosed as meningioma in radiologic and clinical findings. A 69-year-old woman presented with exophthalmos and diplopia, and MRI indicated meningioma. Thus, she underwent gross total resection, and her pathologic diagnosis was plasmacytoma. Exophthalmos and diplopia were fully recovered. She was finally diagnosed with multiple myeloma based on systemic evaluation and treated with targeted chemotherapy. MRI conducted at 3 months after surgery showed no local recurrence or remnant tumor. Although intracranial plasmacytomas are difficult to distinguish from meningiomas in preoperative evaluation, gross total resection is recommended for the same purposes as meningiomas. If the pathologic diagnosis is a plasmacytoma, it is essential to have a systemic evaluation for multiple myeloma.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"10 4","pages":"270-274"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/97/b4/btrt-10-270.PMC9650124.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40673060","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
Proteomics of Extracellular Vesicle in Glioblastoma. 胶质母细胞瘤细胞外囊泡的蛋白质组学研究。
Brain tumor research and treatment Pub Date : 2022-10-01 DOI: 10.14791/btrt.2022.0031
Yoon-Jin Lee, Chul Won Seo, Donghyeong Lee, Dongsic Choi
{"title":"Proteomics of Extracellular Vesicle in Glioblastoma.","authors":"Yoon-Jin Lee,&nbsp;Chul Won Seo,&nbsp;Donghyeong Lee,&nbsp;Dongsic Choi","doi":"10.14791/btrt.2022.0031","DOIUrl":"https://doi.org/10.14791/btrt.2022.0031","url":null,"abstract":"<p><p>Glioblastoma multiforme (GBM), a high-grade astrocytic brain tumor, has highly aggressive and heterogeneous phenotypes with active cellular invasion, angiogenesis, and immune system modulation in the tumor microenvironment driven by complex oncogenic mutations. This abnormal disease progression could be attributed to extracellular vesicles (EVs) containing diverse bioactive molecules, including proteins, genetic materials, lipids, and metabolites. Importantly, GBM-related EVs have emerged as key mediators in cancer progression, acting as carriers for the transfer of oncogenic proteins such as epidermal growth factor receptor variant III (EGFRvIII) and genetic materials (DNA and RNA). Remarkably, recent progress in EV analysis has enabled its purification with high confidence by estimating the purity level of isolated EVs. Thus, mass spectrometry-based proteomic analysis could generate highly reliable vesicular proteomes. Glioblastoma EV proteome studies have revealed the specific increase in vesicular protein cargo due to their oncogenic transformation, and these EV proteins are closely associated with cancer invasion. Moreover, their proteomic data reflects the molecular alterations that occur in parental GBM and provides potent diagnostic information in a minimally invasive manner in liquid biopsy. Thus, proteomic analysis of GBM EVs could provide an increased understanding of their biological properties and activity in the GBM microenvironment, and provide significant implications for advanced approaches in the diagnosis of these intractable tumors.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"10 4","pages":"207-214"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c5/78/btrt-10-207.PMC9650117.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40671649","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
Clinical Features and Prognosis of Diffuse Midline Glioma: A Series of 24 Cases. 24例弥漫性中线胶质瘤的临床特点及预后分析
Brain tumor research and treatment Pub Date : 2022-10-01 DOI: 10.14791/btrt.2022.0035
Sun Woo Jang, Sang Woo Song, Young-Hoon Kim, Young Hyun Cho, Seok Ho Hong, Jeong Hoon Kim, Young-Shin Ra, Sangjoon Chong
{"title":"Clinical Features and Prognosis of Diffuse Midline Glioma: A Series of 24 Cases.","authors":"Sun Woo Jang,&nbsp;Sang Woo Song,&nbsp;Young-Hoon Kim,&nbsp;Young Hyun Cho,&nbsp;Seok Ho Hong,&nbsp;Jeong Hoon Kim,&nbsp;Young-Shin Ra,&nbsp;Sangjoon Chong","doi":"10.14791/btrt.2022.0035","DOIUrl":"https://doi.org/10.14791/btrt.2022.0035","url":null,"abstract":"<p><strong>Background: </strong>Diffuse midline glioma (DMG) which occurs in midline structures and characterized by harboring K27M mutation in genes encoding the histone 3 protein is classified as World Health Organization (WHO) grade IV regardless of histological findings and has a poor prognosis. Nevertheless, because of its relatively rare incidence compared with other high-grade gliomas, a comprehensive description encompassing clinical features and genomic profiles of DMG is still lacking.</p><p><strong>Methods: </strong>In this study, we analyzed data of 24 patients who were diagnosed as DMG which was confirmed by surgical specimens in both pediatric and adult patients. We described the clinical outcomes of patients with DMG and their genomic profiles through a retrospective analysis of 24 patients with DMG.</p><p><strong>Results: </strong>The clinical characteristics of the 24 patients with DMG were analyzed. Ten patients (41%) underwent tumor resection and 14 patients (59%) underwent tumor biopsy. The median overall survival was 10.4 months (95% confidence interval [CI], 8.4 to 12.5) and progression free survival was 3.9 months (95% CI, 2.6 to 5.2). Fifteen patients (62%) were accompanied by hydrocephalus. None of the patient, tumor, or treatment factors had any significant associated with survival. In both immunohistochemistry staining (n=24) and targeted next generation sequencing (n=15), TP53 mutation was the most common genetic mutation (25% and 46%, respectively) found in the patients except alterations in histone 3 protein.</p><p><strong>Conclusion: </strong>Although surgical treatment of patient with DMG does not affect the overall survival prognosis, it can help improve the patient's accompanying neurological symptoms in some limited cases. Hydrocephalus is often accompanied with DMG and treatment for hydrocephalus is often also required. Multidisciplinary therapeutic approach is needed.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"10 4","pages":"255-264"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2b/68/btrt-10-255.PMC9650120.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40672629","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: 5
Meningioma Originating From Choroid Plexus of Foramen of Luschka: A Rare Case Report and Tip of Differential Diagnosis. 起源于吕施卡孔脉络膜丛的脑膜瘤:一例罕见病例报告及鉴别诊断提示。
Brain tumor research and treatment Pub Date : 2022-10-01 DOI: 10.14791/btrt.2022.0025
Yong-Jun Lee, Bo-Seob Kim, Yeong Jin Kim, Kyung-Hwa Lee, Shin Jung
{"title":"Meningioma Originating From Choroid Plexus of Foramen of Luschka: A Rare Case Report and Tip of Differential Diagnosis.","authors":"Yong-Jun Lee,&nbsp;Bo-Seob Kim,&nbsp;Yeong Jin Kim,&nbsp;Kyung-Hwa Lee,&nbsp;Shin Jung","doi":"10.14791/btrt.2022.0025","DOIUrl":"https://doi.org/10.14791/btrt.2022.0025","url":null,"abstract":"<p><p>Meningiomas are the most common benign brain tumors, and most of them originate from the dura mater. However, in some cases, they can originate from the choroid plexus, and they are rarely found in the posterior cranial fossa. A 63-year-old female patient presented with dizziness and swallowing difficulty and was found to have a homogeneously enhancing mass in the right posterior cranial fossa. Mass removal was performed through retrosigmoid suboccipital craniotomy, and the mass was confirmed to originate from the choroid plexus. The pathological diagnosis was meningothelial meningioma. The patient had temporary swallowing difficulty but recovered without any neurological sequelae. We report a rare case of a lower cerebellopontine angle meningioma without dural attachment originating from the choroid plexus of the foramen of Luschka.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"10 4","pages":"265-269"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e2/1f/btrt-10-265.PMC9650122.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40672630","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
Medical Treatment of Pediatric Low-Grade Glioma. 小儿低级别胶质瘤的医学治疗。
Brain tumor research and treatment Pub Date : 2022-10-01 DOI: 10.14791/btrt.2022.0039
Yeon Jung Lim
{"title":"Medical Treatment of Pediatric Low-Grade Glioma.","authors":"Yeon Jung Lim","doi":"10.14791/btrt.2022.0039","DOIUrl":"https://doi.org/10.14791/btrt.2022.0039","url":null,"abstract":"<p><p>Low-grade glioma (LGG) is the most common brain tumor in children and has excellent long-term survival. With an excellent survival rate, the choice of treatment involves careful consideration of minimizing late toxicity from surgery, radiation, and chemotherapy. Surgery, radiation therapy, and chemotherapy can be used as monotherapy or in combination, providing different therapeutic ratios and complications. As a result, establishing the selection of ideal therapies has been a controversial area, presenting challenges. Recent advances in understanding molecular characteristics of pediatric LGG affect classification and treatment approaches. This review aims to overview recent developments in medical treatment in pediatric LGG.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"10 4","pages":"221-225"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d2/97/btrt-10-221.PMC9650116.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40671651","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: 2
Lumboperitoneal Shunt Combined With Ommaya Reservoir Enables Continued Intraventricular Chemotherapy for Leptomeningeal Metastasis With Increased Intracranial Pressure. 腰腹膜分流联合Ommaya储液器使脑室内化疗在颅内压升高的情况下持续治疗脑膜轻脑膜转移。
Brain tumor research and treatment Pub Date : 2022-10-01 DOI: 10.14791/btrt.2022.0022
Byungjun Woo, Ho-Shin Gwak, Ji-Woong Kwon, Sang-Hoon Shin, Heon Yoo
{"title":"Lumboperitoneal Shunt Combined With Ommaya Reservoir Enables Continued Intraventricular Chemotherapy for Leptomeningeal Metastasis With Increased Intracranial Pressure.","authors":"Byungjun Woo,&nbsp;Ho-Shin Gwak,&nbsp;Ji-Woong Kwon,&nbsp;Sang-Hoon Shin,&nbsp;Heon Yoo","doi":"10.14791/btrt.2022.0022","DOIUrl":"https://doi.org/10.14791/btrt.2022.0022","url":null,"abstract":"<p><strong>Background: </strong>Intra-cerebrospinal fluid (CSF) chemotherapy for leptomeningeal metastasis (LM) can be delivered intraventricularly via an Ommaya reservoir. However, hydrocephalus associated with LM can interfere with chemotherapeutic drug distribution, and ventriculoperitoneal shunts can prevent drug distribution to the extra-ventricular CSF space. This study examined the feasibility of combining a lumboperitoneal (LP) shunt with an Ommaya reservoir to both control intracranial pressure and allow for intraventricular chemotherapy.</p><p><strong>Methods: </strong>We identified 16 patients with LM who received both an Ommaya reservoir and an LP shunt, either concurrently or sequentially, and subsequently received intraventricular chemotherapy. The feasibility of this combination for intraventricular chemotherapy was evaluated by assessing 1) the distribution of intraventricularly injected drugs in CSF samples collected 0, 6, and 12 h post-injection and 2) adverse events associated with the procedure and drug administration.</p><p><strong>Results: </strong>Patients received a median of seven rounds (range 1-37) of intraventricular chemotherapy during a median follow-up period of 5.2 months after LP shunt insertion. Pharmacokinetic data were obtained from six patients. Baseline methotrexate (MTX) levels from Ommaya reservoirs varied from 339.9 µM to 1,523.5 µM. CSF sampled from LP shunt reservoirs revealed an elimination half-life (t<sub>1/2</sub>) of 2.63 h, and the mean ratio of MTX concentration at 12 h to that at baseline was 0.05±0.05, ensuring drug distribution from the ventricle to the spinal canal. Nine patients (56%) underwent revision surgery due to catheter migration, malfunction, or infection. Among these patients, CSF infections attributable to intraventricular chemotherapy (n=3) occurred, but no infections occurred in later cases after we began to employ a complete aseptic technique.</p><p><strong>Conclusion: </strong>LP shunt combined with Ommaya reservoir insertion is a feasible option for achieving both intracranial pressure control and the continuation of intraventricular chemotherapy in patients with LM.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"10 4","pages":"237-243"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8c/51/btrt-10-237.PMC9650125.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40672627","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
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