Journal of neuro-oncology
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Journal of neuro-oncology · Oct 2000
ReviewAnti-angiogenic treatment strategies for malignant brain tumors.
The use of angiogenesis inhibitors may offer novel strategies in brain tumor therapy. In contrast to traditional cancer treatments that attack tumor cells directly, angiogenesis inhibitors target at the formation of tumor-feeding blood vessels that provide continuous supply of nutrients and oxygen. With respect to brain tumor therapy, inhibitors of angiogenesis display unique features that are unknown to conventional chemotherapeutic agents. ⋯ In a clinical setting, they could be applied in the treatment of multiple tumors or postsurgically as an adjuvant therapy to prevent recurrence. This article provides an overview of current anti-angiogenic treatment strategies with emphasis on substances already in clinical trials or candidate substances for clinical trials. The cellular and molecular basis of these substances is reviewed.
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Journal of neuro-oncology · Sep 2000
Craniotomy under local anesthesia and monitored conscious sedation for the resection of tumors involving eloquent cortex.
Resection or even biopsy of an intra-axial mass lesion in close relationship to eloquent cortex carries a major risk of neurological deficit. We have assessed the safety and effectiveness of craniotomy under local anesthesia and monitored conscious sedation for the resection of tumors involving eloquent cortex. ⋯ Tumor surgery with conscious sedation is a safe technique that allows maximal resection of lesions in close anatomical relationship to eloquent cortex, with a low risk of new neurological deficit. Only 7% of intrinsic cortical tumors were ineligible for partial or complete resection with this technique.
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Journal of neuro-oncology · Sep 2000
Hydroxyurea chemotherapy for unresectable or residual meningioma.
Meningiomas represent 18-20% of all intracranial tumors and have a 10-year recurrence rate of 20-50%, despite aggressive surgery and irradiation. In addition, many tumors are not amenable to surgery due to their deep location or proximity to delicate structures. Chemotherapy is being explored as another potential treatment option for unresectable or refractory meningiomas. ⋯ Toxicity was hematologic in most patients; leukopenia was most common. Nine patients (53%) required dosage reductions (250-500 mg/d) secondary to hematologic toxicity. Hydroxyurea appears to have modest activity against meningiomas and should be considered in patients with unresectable tumors or large residual tumors following surgical resection.
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We evaluated the efficacy of postoperative radiation therapy (RT), prognostic factors for local control probability, dose response relationship and treatment sequelae in 75 patients with pituitary adenoma. ⋯ Except with prolactinoma, the dose of postoperative RT for pituitary adenoma should not exceed 50 Gy. Large prolactinoma, however, was very difficult to control with the irradiation doses between 50 and 60 Gy, and would be good candidates for stereotactic radiosurgery or stereotactic radiation therapy.
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Journal of neuro-oncology · Jun 2000
Comparative StudyManagement of atypical and malignant meningiomas: role of high-dose, 3D-conformal radiation therapy.
Atypical and malignant meningiomas are at high risk for local failure. The role of radiation therapy (RT) and dose levels required to improve tumor control are poorly defined. This study reviews our experience with RT. ⋯ Conformal, high dose RT resulted in significant improvement of local control for atypical and malignant meningiomas. Increased local control resulted also in improved rates of survival for patients with malignant meningioma.