Clinical Oncology, Journal Year: 2023, Volume and Issue: 35(12), P. 761 - 763
Published: Nov. 15, 2023
Language: Английский
Radiotherapy and Oncology, Journal Year: 2023, Volume and Issue: 186, P. 109767 - 109767
Published: June 28, 2023
Long-term potentiation (LTP) was used to gauge the impact of conventional and FLASH dose rates on synaptic transmission. Data collected from hippocampus medial prefrontal cortex confirmed significant inhibition LTP after 10 fractions 3Gy (30Gy total) radiotherapy. Remarkably, 10x3Gy radiotherapy unirradiated controls were identical exhibited normal LTP.
Language: Английский
Citations
32
Current Treatment Options in Oncology, Journal Year: 2025, Volume and Issue: unknown
Published: Jan. 3, 2025
Opinion statement Clinical management of melanoma brain metastases is complex and requires multidisciplinary approach. With close collaboration between neurosurgeons, radiation oncologists medical oncologists, patients with are offered different treatment modalities: surgery, therapy, systemic therapy or combined treatments. Radiation (whole radiotherapy- WBRT stereotactic radiosurgery- SRS) an integral part treating metastases. Use immunotherapy (checkpoint inhibitors) targeted (BRAF/MEK significantly changed the outcome in Currently, ipilimumab nivolumab (COMBO) preferred first-line for all asymptomatic metastases, regardless BRAF status (BRAF wild-type BRAF-mutated). Although at moment there no consensus on concomitant use SRS COMBO, results from clinical trials suggest that this modality should be considered standard care However, further research required to define optimal modalities routine lesions.
Language: Английский
Citations
1
Journal of Neuro-Oncology, Journal Year: 2025, Volume and Issue: unknown
Published: Feb. 19, 2025
Abstract Purpose Hippocampal injury from WBRT contributes to neurocognitive decline in brain malignancy patients. HA-WBRT may mitigate this by reducing hippocampal radiation exposure, but its feasibility PCNSL remains unassessed regarding involvement and failure rates. This study evaluates at diagnosis after treatment Materials methods We conducted a retrospective analysis of 278 immunocompetent patients diagnosed between 2000 2021. Following high-dose methotrexate-based induction chemotherapy, either received consolidation therapy, including RT, cytarabine alone, or autologous stem cell transplantation underwent observation. Hippocampus was outlined on T1 MRI images expanded 5 mm margin create the avoidance region (HAR). defined as recurrence progression HAR. The median follow-up 38.7 months (range 3.1–239.4 months). Results Of with PCNSL, 39.9% presented initial lesions After 212 evaluable treatments Intracranial failures occurred 47.6% (n = 101), 66.3% 67) occurring outside HAR 33.7% 34) inside Unifocal disease (HR 0.61, 95% CI 0.39–0.96, p 0.025) associated lower risk failures, while significantly increased 2.26, 1.18–4.47, 0.018). Patients unifocal had lowest 3-year rate (6.2%). RT that included hippocampus did not affect rates without (p 0.282), three-year 9.2 vs. 14.6% for other treatments. However, among involvement, reduced compared approaches 0.002). were comparable, conventional 19% 0.734). Conclusion routine application strategy is supported due high general requires further investigation establish safety well-defined subgroups. Our results suggest could be evaluated select those located
Language: Английский
Citations
1
TumorDiagnostik & Therapie, Journal Year: 2025, Volume and Issue: 46(02), P. 117 - 128
Published: March 1, 2025
Zusammenfassung Zerebrale Metastasen bei Patienten mit Lungenkarzinom im Stadium der Metastasierung finden sich bereits mehr als 30% zum Zeitpunkt Erstdiagnose und manifestieren Verlauf Erkrankung 2 von 3 Patienten. Die zerebrale Krankheitsmanifestation wurde lange Zeit prognostisch ungünstig eingestuft. Betroffene wurden regelhaft Therapiestudien unter Berücksichtigung ungünstigen Prognose ausgeschlossen. Im Kontext zielgerichteter molekularer Therapiestrategien etablierter immunonkologischer Systemtherapien stellt die Blut-Hirn-Schranke mittlerweile keine unüberwindbare Barriere dar. Therapie Hirnmetastasen erfordert aber stets Betreuung in einem interdisziplinären Team muss Zentrumsaufgabe angesehen werden. Unter Anzahl, Größe Lokalisation Hirnmetastasen, Neurologie Allgemeinzustand, Komorbiditäten, potenzieller Lebenserwartung Wunsch des Patienten, auch Tumorbiologie inklusive Veränderungen, extrakranieller Tumorlast Verfügbarkeit einer ZNS-wirksamen erfolgt differenzierte Therapieentscheidung. Hierbei werden häufig sowie lokale neurochirurgische strahlentherapeutische Therapiekonzepte kombiniert Sinne optimierter prognoseverbessernder Therapiestrategien.
Citations
0
Journal of Neuro-Oncology, Journal Year: 2025, Volume and Issue: unknown
Published: April 9, 2025
Language: Английский
Citations
0
International Journal of Molecular Sciences, Journal Year: 2025, Volume and Issue: 26(8), P. 3828 - 3828
Published: April 18, 2025
The therapeutic management of melanoma brain metastases has undergone a profound revolution during recent decades. Optimal integration systemic therapies with local treatments seems to represent the strategy pursue in order maximize clinical outcomes, stressing need for real multidisciplinary care this setting patients. However, current approach clinics does not necessarily reflect what guidelines state, and several pending issues are present, from ideal sequence between stereotactic radiosurgery (SRS) drug administration role surgery whole radiotherapy (WBRT), all which be addressed. This narrative review aims provide practical help navigating controversies, an eye towards possible future advancements field, could obtain comprehensive molecular characterization tumor more personalized patient-centered approach.
Language: Английский
Citations
0
Journal of Neuro-Oncology, Journal Year: 2025, Volume and Issue: unknown
Published: April 22, 2025
Language: Английский
Citations
0
Radiotherapy and Oncology, Journal Year: 2024, Volume and Issue: 197, P. 110331 - 110331
Published: May 19, 2024
Language: Английский
Citations
3
Cancers, Journal Year: 2023, Volume and Issue: 15(12), P. 3193 - 3193
Published: June 15, 2023
(1) Background: In recent decades, the use of whole-brain radiation therapy (WBRT) in treatment brain metastases has significantly decreased, with clinicians fearing adverse neurocognitive events and data showing limited efficacy regarding local tumor control overall survival. The present study thus aimed to reassess role that WBRT holds metastases. (2) Methods: This review summarizes available evidence from 1990 until today supporting WBRT, as well new developments their clinical implications. (3) Results: While one four should be exclusively treated radiosurgery, does remain an option for patients multiple particular, hippocampus-avoidance dose escalation metastases, combination have shown promising results offer valid alternatives stereotactic radiotherapy. Ongoing published prospective trials on toxicity these methods are presented. (4) Conclusions: Unlike conventional which indications, modern techniques continue a significant play situations radiosurgery or first investigated further studies. Until then, therapeutic decision must made individually depending oncological context.
Language: Английский
Citations
7
Neuro-Oncology Advances, Journal Year: 2024, Volume and Issue: 6(1)
Published: Jan. 1, 2024
Changes in the hippocampus after brain metastases radiotherapy can significantly impact neurocognitive functions. Numerous studies document hippocampal atrophy correlating with radiation dose. This study aims to elucidate volumetric changes patients undergoing whole-brain (WBRT) or targeted stereotactic (SRT) and explore individual subregions of hippocampus.
Language: Английский
Citations
2