Brain Cancer

NEW YORK-The cognitive and behavioral effects of brain tumors and their treatment are often invisible to patients, caregivers, and even clinicians, Robert A. Stern, PhD, said at a Cancer Care, Inc. teleconference for patients and their families. Dr. Stern is director of the Neuropsychology Program, Rhode Island Hospital, and associate professor of psychiatry and neurology, Brown University School of Medicine.

With worldwide use of cellular phones rising exponentially, a team of Swedish medical investigators is raising renewed concerns about the link between brain tumors and cell phones in a new, peer-reviewed article posted on the Medscape

MILWAUKEE-Light-emitting diodes (LEDs) developed by NASA for commercial plant growth research on the space shuttle are being used to remove brain tumors through photodynamic therapy. Harry Whelan, MD, and his colleagues have used the new LED red-light probes and the light-activated drug porfimer sodium (Photofrin) to attack difficult brain tumors in three patients. So far, all are doing extremely well, Dr. Whelan said in an interview with ONI.

Worldwide, approximately 100,000 patients have undergone stereotactic radiosurgery for a variety of intracranial lesions, of which brain metastases represent the most common treatment indication. This article summarizes the major issues surrounding the management of brain metastases, and also analyzes 21 independent reports of Gamma Knife– or linear accelerator–based radiosurgery, representing over 1,700 patients and more than 2,700 lesions. Variable reporting in the studies precludes a definitive, rigorous analysis, but the composite data reveal an average local control rate of 83% and median survival of 9.6 months, both of which are comparable to results in recent surgical reports. The most important prognostic factors for survival appear to be fewer than three lesions, controlled extracranial disease, and Karnofsky performance score (KPS). The exact impact of dose has not been clarified, but a dose-response relationship, especially for ³ 18 Gy, is emerging. The role of whole-brain radiotherapy remains unresolved. It may enhance local control but does not convincingly improve survival and, in some series, is associated with an increased risk of late complications. Chronic steroid dependence and increased intracranial edema do not appear to be common problems. This is an opportune time for the completion of ongoing randomized trials to validate these observations. [ONCOLOGY 13(10):1397-1409,1999]

Depression is the most common postoperative complication seen in patients who have undergone surgery for brain tumors, but it is seldom recognized or treated, according to preliminary findings of a study presented at the annual meeting of the

Brain metastases are the most common type of brain tumor in adults and are an increasingly important cause of morbidity and mortality in cancer patients. In recent years, important advances have been made in the diagnosis

One dose of radiation is proving to be an effective, less expensive method for treating patients with certain benign tumors at the base of the skull, a new study has found.

The Celgene Corporation is collaborating with the National Cancer Institute’s Radiation Treatment Oncology Group

Anew Radiation Therapy Oncology Group (RTOG) study will determine whether thalidomide combined with radiation therapy can lengthen survival and time to disease recurrence in adults with glioblastoma multiforme.

The patient’s medical history is remarkable only for asthma and mild emphysema. The family history included a grandmother with gastric cancer. The patient had been taking estrogen replacement therapy since menopause 3 years earlier, and she was

NEW YORK--Personality and brain function can change after brain surgery, yet patients and their families may not know what to expect or what to do about it, said Stanford University neuropsychologist Harriet Katz Zeiner, PhD, during a Cancer Care teleconference.

Radiosurgery uses stereotactic targeting methods to precisely deliver highly focused, large doses of radiation to small intracranial tumors and arteriovenous malformations (AVMs). This article reviews the most common

A potential treatment for hypothalamic obesity that often afflicts children who receive treatment for brain tumors or leukemia has been discovered by researchers at St. Jude Children’s Research Hospital. Many of these childhood cancer survivors die in

Doctors at UT Southwestern Medical Center at Dallas and Zale Lipshy University Hospital are using an experimental radiation therapy device to treat brain cancer patients for whom conventional radiation treatments have not been effective.

The University of Alabama at Birmingham (UAB) Comprehensive Cancer Center announced a new phase I clinical trial recently to investigate a genetically re-engineered herpes simplex virus as a treatment of malignant brain tumors.

Traditionally, cytotoxic drugs have played a limited role in the treatment of brain tumors, but important advances in chemotherapy have occurred during the past decade. Certain central nervous system (CNS) malignancies are

Rhone-Poulenc Rorer recently announced the start of a phase III clinical trial of its prolifeprosan with carmustine implant (Gliadel Wafer), in conjunction with surgery and radiation, in patients newly diagnosed with malignant glioma. The purpose of this study is to confirm the results of an earlier, small phase III trial showing that the carmustine wafer offers a significant survival advantage over placebo when used with initial surgery for malignant glioma.

A large number of oncogenes have been identified as aberrant in gliomas, but only the erbB oncogene (gene encoding the epidermal growth factor receptor [EGFR]) is amplified in an appreciable number. The loss or

There is certainly no good place to get a brain tumor, but one of the worst is in the lower portion of the brain along the base of the skull. Skull-base tumors are often intimately entwined with critical arteries and cranial nerves that emerge from the base of the brain, making surgical removal challenging and risky.

Neuroblastoma is the most common extracranial solid tumor of childhood, accounting for 15% of cancer-related deaths. These tumors have a predilection for young children; 60% of cases occur before age 2 years and 97%

Researchers may be close to developing an additional weapon for treating a type of rapidly growing, fatal brain tumor that

The lives of rats with an incurable, rapidly progressing form of brain tumor, similar to glioblastoma in humans, is greatly

The failure of chemotherapy to stop glioblastoma may be linked to a deficiency in DNA repair capability in the cell, according

Perhaps contrary to expectations, the presence of an oligodendroglial component in patients with anaplastic astrocytomas was associated with a significantly longer survival than were pure anaplastic tumors. This finding emerged from a randomized

A review of the English literature was undertaken to (1) determine the efficacy of radiation therapy for the treatment of brain metastases, (2) identify prognostic factors, and (3) ascertain whether there is an effect of treatment technique on outcome. Critical analysis of relevant randomized trials indicated that radiation therapy can effectively palliate the symptoms of brain metastases.

Although generally benign tumors, meningiomas can cause serious neurological injury and, at times, vexatious management difficulties. Currently, the accepted management of these tumors is attempted total surgical excision when technically possible and associated with an acceptable risk. However, even with innovations in instrumentation and refinements in surgical technique, the goal of total resection may not be achievable. For these patients, and for those with recurrent tumors, options for treatment include reoperation, radiation therapy, and chemotherapy. Recent developments in surgical technique and instrumentation, radiosurgery, and brachytherapy have increased the treatment options, while clinical trials with tamoxifen and mifepristone (RU486) are adding information on the effectiveness of these drugs as chemotherapeutic agents. While the search continues for a uniformly successful management plan, physicians must be aware of the available options and try to help the patient decide which treatment is appropriate, based on current medical knowledge. [ONCOLOGY 9(1):83-100]

Surgical resection has been the preferred treatment for meningiomas since the era of the pioneering neurosurgeon, Harvey Cushing. The great majority of these tumors are histologically benign, circumscribed lesions that grow slowly and tend to compress and displace, rather than invade, the surrounding intracranial structures. In contrast to the intrinsic brain tumors of glial origin, most meningiomas have well-defined borders, enabling the surgeon to dissect the tumor capsule from the arachnoid lining of the adjacent brain, blood vessels, and cranial nerves. Consequently, complete removal can be accomplished without needing to sacrifice functional tissue. In these cases, surgery is often curative, and associated with the preservation of, if not improvements in, the neurological condition.

Dr. DeMonte has used an interesting case report to provide an excellent summary of the state of the art in the management of meningiomas of the brain.