Can Memantine Treat Autism? Answers from Preclinical and Clinical Studies

Neuroscience & Biobehavioral Reviews, Journal Year: 2025, Volume and Issue: 169, P. 106019 - 106019

Published: Jan. 16, 2025

Language: Английский

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Deep Learning for Detecting Brain Metastases on MRI: A Systematic Review and Meta-Analysis

Cancers, Journal Year: 2023, Volume and Issue: 15(2), P. 334 - 334

Published: Jan. 4, 2023

Since manual detection of brain metastases (BMs) is time consuming, studies have been conducted to automate this process using deep learning. The purpose study was conduct a systematic review and meta-analysis the performance learning models that use magnetic resonance imaging (MRI) detect BMs in cancer patients. A search MEDLINE, EMBASE, Web Science until 30 September 2022. Inclusion criteria were: patients with BMs; MRI images applied sufficient data were present terms detective performance; original research articles. Exclusion reviews, letters, guidelines, editorials, or errata; case reports series less than 20 patients; overlapping cohorts; insufficient machine used articles not written English. Quality Assessment Diagnostic Accuracy Studies-2 Checklist for Artificial Intelligence Medical Imaging assess quality. Finally, 24 eligible identified quantitative analysis. pooled proportion patient-wise lesion-wise detectability 89%. Articles should adhere checklists more strictly. Deep algorithms effectively BMs. Pooled analysis false positive rates could be estimated due reporting differences.

Language: Английский

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Response of treatment-naive brain metastases to stereotactic radiosurgery

Nature Communications, Journal Year: 2024, Volume and Issue: 15(1)

Published: May 2, 2024

With improvements in survival for patients with metastatic cancer, long-term local control of brain metastases has become an increasingly important clinical priority. While consensus guidelines recommend surgery followed by stereotactic radiosurgery (SRS) lesions >3 cm, smaller (≤3 cm) treated SRS alone elicit variable responses. To determine factors influencing this response to SRS, we analyzed outcomes ≤3 cm diameter no prior systemic therapy frame-based single-fraction SRS. Following 259 out 1733 (15%) demonstrated MRI findings concerning treatment failure (LTF), which 202 /1733 (12%) LTF and 54/1733 (3%) had adverse radiation effect. Multivariate analysis tumor size (>1.5 melanoma histology were associated higher rates. Our results demonstrate that are not uniformly responsive suggest prospective studies evaluate the effect or combination on matched warranted. These will help establish multi-disciplinary improve while minimizing necrosis during metastasis cm.

Language: Английский

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Local hero: A phase II study of local therapy only (stereotactic radiosurgery and / or surgery) for treatment of up to five brain metastases from HER2+ breast cancer. (TROG study 16.02)

The Breast, Journal Year: 2024, Volume and Issue: 74, P. 103675 - 103675

Published: Feb. 5, 2024

Introduction, A decade ago, stereotactic radiosurgery (SRS) without whole brain radiotherapy (WBRT) was emerging as preferred treatment for oligometastatic metastases. Studies of cavity SRS after neurosurgery were underway. Data specific to metastatic HER2 breast cancer (MHBC), describing intracranial, systemic and survival outcomes WBRT, lacking. Phase II study designed address this gap.Method, Adults with MHBC, performance status 0–2, ≤ five BrM, receiving/planned receive HER2-targeted therapy eligible. Exclusions included leptomeningeal disease prior WBRT. Neurosurgery allowed ≤6 weeks before registration required BrM >4 cm. Primary endpoint 12-month requirement Secondary endpoints; freedom from (FF-) local failure (LF), distant (DBF), extracranial (ECDF), overall (OS), cause death, mini-mental state examination (MMSE), adverse events (AE).Results, Twenty-five patients accrued Decembers 2016–2020. The closed early slow accrual. Thirty-seven four cavities received SRS. Four observed. At 12 months: one patient WBRT (FF-WBRT 95 %, % CI 72–99), FFLF 91 (95 69–98), FFDBF 57 34–74), FFECDF 64 45–84), OS 96 74–99). Two grade 3 AE occurred. MMSE abnormal 3/24 at baseline 1/17 months.Conclusion, months, and/or provided good control low toxicity. not in cases. This small supports the practice change therapies MHBC BrM.

Language: Английский

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Adverse radiation effect versus tumor progression following stereotactic radiosurgery for brain metastases: Implications of radiologic uncertainty

Journal of Neuro-Oncology, Journal Year: 2024, Volume and Issue: 166(3), P. 535 - 546

Published: Feb. 1, 2024

Abstract Background Adverse radiation effect (ARE) following stereotactic radiosurgery (SRS) for brain metastases is challenging to distinguish from tumor progression. This study characterizes the clinical implications of radiologic uncertainty (RU). Methods Cases reviewed retrospectively at a single-institutional, multi-disciplinary SRS Tumor Board between 2015–2022 RU were identified. Treatment history, diagnostic or therapeutic interventions performed upon resolution, and development neurologic deficits surrounding intervention obtained medical record. Differences in lesion volume maximum diameter onset versus resolution compared with paired t-tests. Median time was estimated using Kaplan–Meier method. Univariate multivariate associations characteristics assessed Cox proportional-hazards regression. Results Among 128 lesions RU, 23.5% had undergone ≥ 2 courses radiation. (20 vs. 16 mm, p < 0.001) (2.7 1.5 cc, larger onset. took > 6 12 months 25% 7% cases, respectively. Higher total EQD2 prior (HR = 0.45, 0.03) use MR perfusion 0.56, correlated shorter resolution; 1.05, 0.006) portended longer resolution. Most (57%) diagnosed as ARE. patients (58%) underwent an these, 38% developed deficit intervention. Conclusions cases. may lead suboptimal outcomes symptom burden. Improved characterization post-SRS needed.

Language: Английский

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DEGRO guideline for personalized radiotherapy of brain metastases and leptomeningeal carcinomatosis in patients with breast cancer

Strahlentherapie und Onkologie, Journal Year: 2024, Volume and Issue: 200(4), P. 259 - 275

Published: March 15, 2024

The aim of this review was to evaluate the existing evidence for radiotherapy brain metastases in breast cancer patients and provide recommendations use leptomeningeal carcinomatosis.

Language: Английский

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Navigating the Complexities of Brain Metastases Management

American Society of Clinical Oncology Educational Book, Journal Year: 2024, Volume and Issue: 44(3)

Published: May 23, 2024

The management of brain metastases, a potentially devastating complication advanced cancers, has become increasingly complex with advancements in local and systemic therapies. Improved outcomes extended survival for patients metastatic solid tumors have led to surge the prevalence possibly incidence affecting up 40% individuals tumors. Enhanced imaging technologies contribute more accurate early detection, shaping understanding intricate landscape this condition. Traditionally, surgery radiation stood as mainstays treatment because limited efficacy therapies within brain. However, emerging clinical data, particularly melanoma, lung, breast reveal promising results novel treatments such immunotherapy targeted Despite historical exclusion active metastases from trials, shift is occurring toward inclusive approach. This chapter delves into multifaceted challenges associated managing focus on evolving approaches well intricacies shared decision making, providing comprehensive overview current state future directions navigating complexities management.

Language: Английский

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Focused ultrasound combined with radiotherapy for malignant brain tumor: a preclinical and clinical study

Journal of Neuro-Oncology, Journal Year: 2023, Volume and Issue: 165(3), P. 535 - 545

Published: Dec. 1, 2023

Language: Английский

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Hypofractionated stereotactic radiosurgery (HSRS) as a salvage treatment for brain metastases failing prior stereotactic radiosurgery (SRS)

Journal of Neuro-Oncology, Journal Year: 2023, Volume and Issue: 162(1), P. 119 - 128

Published: March 1, 2023

Language: Английский

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The Relationship between Cancer and Dementia: An Updated Review

Cancers, Journal Year: 2023, Volume and Issue: 15(3), P. 640 - 640

Published: Jan. 19, 2023

The risk of cancer and dementia increases with age, raising complex questions about whether it is appropriate to continue treatment in older patients. There emerging research suggesting the association between dementia. However, mechanistic underpinnings are still under investigation. Progress has already been made toward understanding cognitive effects associated therapy. Such associations raise awareness need establish better prevention methods early screening clinical practice. Additionally, recent studies have suggested possible therapeutic strategies for preserving function reducing before patients start treatment. We review current literature summarize incidence mechanisms impairment lung cancer, breast head neck gastric prostate colorectal brain tumor/brain metastasis following different kinds therapies. Possible factors identify onset changes provide more insight into pathophysiological process

Language: Английский

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