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  • 1
    Electronic Resource
    Electronic Resource
    Long term prognosis of symptomatic and asymptomatic cerebral aneurysms (1991)
    Springer
    Neurosurgical review 14 (1991), S. 115-118 
    Details
    ISSN: 1437-2320
    Keywords: Asymptomatic aneurysm ; incidental aneurysm ; multiple aneurysms ; ruptured aneurysm ; unruptured aneurysm
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The authors analyze the follow-up series of 58 patients with diagnosed cerebral aneurysms who were either not treated surgically or, in surgically treated cases, in which the aneurysmal neck was not clipped. The patients are divided in three groups: untreated ruptured; ruptured treated by coating, vessel ligation or aneurysmal dome clipping; and asymptomatic cases. During the follow-up period of three to ten years, there were no bleedings from asymptomatic aneurysms and only one rebleeding from symptomatic operated aneurysms. As can be expected in the group of ruptured unoperated aneurysms, the rate of rebleeding was 40.9% with a mortality rate of 31.7%. The natural history of asymptomatic aneurysms is unclear regarding the risk of bleeding, and regardless of the obtained follow-up results in our cases, we think that all diagnosed cerebral aneurysms must be treated surgically. Certainly, individual cases must be evaluated.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00313034
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  • 2
    Electronic Resource
    Electronic Resource
    Combined Treatment Modality for Anaplastic Oligodendroglioma: A Phase II Study (1999)
    Springer
    Journal of neuro-oncology 43 (1999), S. 179-185 
    Details
    ISSN: 1573-7373
    Keywords: anaplastic oligodendroglioma ; surgery ; radiotherapy ; chemotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose: To investigate feasibility, toxicity and antitumor activity of combined surgery, postoperative radiation therapy (RT) and adjuvant chemotherapy (CHT) in adult patients with pure anaplastic oligodendroglioma (PAO) or mixed anaplastic oligoastrocytoma (MAO). Methods: Between January 1988, and June 1993, 23 patients entered into a phase II study. After surgery, post-operative RT was administered with 60 Gy in 30 daily fractions in 30 treatment days in 6 weeks. Two weeks after RT, adjuvant ‘modified’ PCV (mPCV) (Procarbazine, 60 mg/m2, days 1–14; CCNU, 100 mg/m2, day 1; and vincristine, 1.4 mg/m2 (max. 2 mg), days 1 and 8) was administered every six weeks up to six cycles or until progression occurred. Results: Median survival time is not attained yet, while 1–5 year survival rates are 100%, 100%, 78%, 61%, and 52%, respectively. Median time to tumor progression is not attained yet, while 1–5 year progression-free survival rates are 100%, 100%, 70%, 52%, and 52%, respectively. On univariate analysis of potential prognostic factors, sex, tumor location (frontal versus other), and histology (pure versus mixed anaplastic oligodendroglioma) were not found to influence survival. Age of 〈50 years carried improved prognosis as well as Karnofsky performance status (KPS) 90–100 when compared to KPS of 70–80. Patients having tumors ≤4 cm did better than those with tumors 〉4 cm as well as those with total tumor resection when compared to those with subtotal tumor resection or biopsy only. Acute high-grade (≥3) CHT-related toxicity was mainly hematological with only 3 (13%) patients experiencing acute grade 4 toxicity. Conclusions: Combined treatment modality consisting of surgery, postoperative high-dose RT and mPCV chemotherapy for patients with anaplastic oligodendroglioma was effective with acceptable toxicity. Further studies are needed with more patients and longer follow-up to verify these results in this rare disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1006206800947
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  • 3
    Electronic Resource
    Electronic Resource
    Influence of extent of surgery and tumor location on treatment outcome of patients with glioblastoma multiforme treated with combined modality approach (1994)
    Springer
    Journal of neuro-oncology 21 (1994), S. 177-185 
    Details
    ISSN: 1573-7373
    Keywords: extent of surgical resection ; tumor location ; glioblastoma multiforme ; radiation therapy ; chemotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Between 1988 and 1991, eighty-six patients with glioblastoma multiforme were evaluated in order to define the influence of extent of surgery and tumor location on treatment outcome. Patients underwent surgery followed by postoperative hyperfractionated radiotherapy and chemotherapy delivered according to one of two consecutive protocols. Surgery consisted of biopsy in 25 (29%) patients and subtotal or gross total tumor resection in 61 (71%) patients. Frontally located tumors were noted in 26 (30%) patients and other tumor locations were noted in 60 (70%) patients. Patients having more radical surgery had longer median survival time (MST) and higher 1- and 2-year survival rates than those with biopsy only (56 vs 29 weeks, respectively; 62 % and 23 % vs 16% and 0%, respectively; p=0.00000). Patients having frontally located tumors had longer MST and higher 1- and 2-year survival rates than those with other tumor locations (101 vs 47 weeks, respectively; 76% and 44% vs 37% and 2.5%, respectively; p=0.00001). Multivariate analysis confirmed that extent of surgery and tumor location were independent prognostic factors in patients with glioblastoma multiforme. Regarding progression-free survival, patients having more radical surgery had longer median time to tumor progression (MTP) than those with biopsy only (33 weeks vs 21 weeks, respectively). Also, progression-free survival at 1 year was higher in radically resected group than in biopsy only group (20% vs 0%, respectively; p=0.00000). Patients with frontally located tumors had longer MTP (42 weeks) and higher progression-free survival at 1 year (42%) than those with other tumor location (28 weeks and 1.7%, respectively; p=0.00002). Multivariate analysis confirmed that the extent of surgery and tumor location are independent prognosticators in patients with glioblastoma multiforme treated with combined modality approach using progression-free survival as an endpoint.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01052902
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  • 4
    Electronic Resource
    Electronic Resource
    Short-course Radiotherapy in Elderly and Frail Patients with Glioblastoma Multiforme. A Phase II Study (1999)
    Springer
    Journal of neuro-oncology 44 (1999), S. 85-90 
    Details
    ISSN: 1573-7373
    Keywords: elderly ; glioblastoma multiforme ; radiotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose. To evaluate efficacy of short-course radiotherapy (RT) in elderly (≥60 years) and frail [Karnofsky performance status (KPS) 50–70] patients with glioblastoma multiforme (GBM). Materials and methods. Between January 1987 and June 1993, a total of 47 elderly and frail patients with histological diagnosis of GBM entered into a phase II study. RT alone was administered with tumor dose of 45 Gy in 15 daily fractions in 15 treatment days in 3 weeks to a target volume described as tumor visible on CT scan and a 2-cm margin. Results. Forty-four patients were evaluable for this analysis. There were 15 (34%) CR and 11 (25%) PR, making the overall response rate of 60%. Median duration of response was 9 months (range, 2–36 months). Improvement in pretreatment performance status was observed in 20/44 (45%) patients, 5 of which improved their KPS for 20%. Median survival time is 9 months, and 1–4 year survival rates are 39%, 6.8%, 4.5%, and 0, respectively, while median time to tumor progression is 8 months, and 1–4 year progression-free survival rates are 30%, 4.5%, 4.5%, and 0, respectively. Females did significantly better than males, patients with KPS 60–70 did significantly better than those with KPS 50, patients having tumors 4–5 cm did significantly better than those with tumors 6–8 cm as well as did those with more radical surgery when compared to those with biopsy only. On multivariate analysis, only tumor size and extent of surgery were found to independently influence survival. Acute toxicity was generally assessed as mild. One of the 12 (8%) autopsied patients had RT-induced brain necrosis. Conclusion This shortened RT appears to be an effective tool in palliation of elderly and frail patients with GBM. Further studies with more patients are needed before testing it against more aggressive treatment approaches in this patient population.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1006356021734
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