Journal of neuro-oncology
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Journal of neuro-oncology · Jul 2011
A study of patients with brain metastases as the initial manifestation of their systemic cancer in a Chinese population.
To investigate the clinical characteristics of patients with brain metastases as the initial manifestation of their systemic cancer in a Chinese population, a retrospective study of 254 such patients admitted to Huashan Hospital, Fudan University, Shanghai, China between January 1, 2003 and December 30, 2008 was performed. Data were collected to determine the features of this group (i.e., manifesting signs and symptoms, imaging studies, extracerebral metastases, primary tumor sites, initial diagnosis, and survival data). Common symptoms included headache and motor impairment. ⋯ Adenocarcinoma was the most common histologic type. Given the high frequency of primary lung tumors and the sensitivity of chest CT, chest CT should be a part of the initial screen of primary site with brain metastases as the initial manifestation. Metastatic dissemination of malignancy to the brain as the initial manifestation is generally associated with dismal prognosis, with the exception of a minority who experience long survival.
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Journal of neuro-oncology · Jul 2011
Dexamethasone differentially regulates functional membrane properties in glioma cell lines and primary astrocytes in vitro.
Similar to astrocytes, glioma cells form a well-coupled syncytium via gap junctions. This can be influenced, for example, by activated microglia, the main inflammatory cell population within the central nervous system (CNS). Under pathological conditions such as neoplastic cell growth, microglia number and activation state are enhanced. ⋯ Furthermore, DEX reduced the amount of activated microglia in M30 cocultures. DEX had no significant effects on the tested variables in the M5 coculture. DEX differentially regulates functional membrane properties of glioma cells and astrocytes in primary glial cocultures, which might resemble steroid effects in glioma cells and adjacent glial components in vivo.
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Journal of neuro-oncology · Jul 2011
Prediction of malignancy grading using computed tomography perfusion imaging in nonenhancing supratentorial gliomas.
Tumor grade differentiation is often difficult using routine neuroimaging alone. Computed tomography perfusion imaging (CTP) provides quantitative information on tumor vasculature that closely parallels the degree of tumor malignancy. This study examined whether CTP is useful for preoperatively predicting the grade of malignancy in glioma showing no enhancement on contrast-enhanced magnetic resonance imaging (MRI). ⋯ Using nCBV of 1.6 as a cutoff, specificity and sensitivity for distinguishing G3 were 83.3% and 90.9%, respectively. No significant difference in nCBV was seen between diffuse astrocytoma and G2 OT, whereas differences were noted between G2 and G3 OTs, and between diffuse astrocytoma and G3 OT. CTP offers a useful method for differentiating between G3 and G2 in nonenhancing gliomas.
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Journal of neuro-oncology · Jul 2011
Cognitive effects of tumour and surgical treatment in glioma patients.
Quality of life in brain tumour patients is an emerging issue and has prompted neurosurgeons to reconsider the need for cognitive assessment in the course of treatment. In particular, to date there has been a lack of comprehensive neuropsychological assessment performed preoperatively and in the acute postoperative period. We examined 29 patients with glioma, analysing several functional domains-intelligence, executive functions, memory, language, praxis, gnosis and mood state-in order to establish the effect of tumour and surgery on cognition. ⋯ Worsening regarded executive functions was related to tumour size and was partly explained by radiological findings on postoperative magnetic resonance imaging (MRI). This preliminary study, focussing on the effects of tumour and surgery, showed that tumour significantly affects cognitive functions, mainly due to the mass effect and higher grading. Surgical treatment improved the functions most frequently affected preoperatively and caused worsening of executive functions soon after operation, leaving the overall cognitive burden unchanged and capable of improvement prospectively.