and results of treatment. The total dose of WBRT was only 2,500 to 3,900 cGy, but daily fractions of 300 to 600 cGy were employed. On multivariate analysis, improved overall survival was associated with KPS ≥ 70 (p < 0.001), only one to three brain metastases (p = 0.029), no extracerebral metastasis (p = 0.012), and lower RPA class (p < 0.001). Larger studies are needed to fully understand the impact of confounding factors, such as gender and tumor biology. One hundred eleven patients were either fully or partially evaluable. Multidisciplinary approaches such as the combination of WBRT with SRS or surgery have shown superior results in terms of survival time, neurocognitive function, and quality of life. This article reviews the epidemiology, current treatment options and recent advances in the field, with a focus on HER2-positive disease and the emerging role of lapatinib for the treatment and prevention of brain metastases. No difference in median or 1-year survival was observed among patients with solitary metastasis between treatment arms. Recently, the Internet has become a prime communication tool for many users world wide. There were thirteen treatment-related deaths (six in arm A and seven in arm B). In order to determine the natural history and results of treatment of intracerebral metastases in solid-tumor patients, the records of 191 patients with an antemortem diagnosis of intracerebral metastasis made during the period from August 1974 to November 1978 were reviewed. The 6-month local control rates were 12% and 10%, respectively (p = 0.32). 18 ก.ค. An analysis of tumor/patient characteristics and treatment variables in previous RTOG brain metastases studies was considered necessary to fully evaluate the benefit of these new interventions. The HER2 receptor, which is overexpressed in approximately 25% of all breast cancers, is an important risk factor for the development of central nervous system metastases. Otherwise there were no significant differences between the two regimens with respect to palliation of symptoms, improvement rate, median time to progression, cause of death, or median survival. No difference in median or 1-year survival was observed among patients with solitary metastasis between treatment arms. According to the RPA tree the best survival (median: 7.1 months) was observed in patients < 65 years of age with a Karnofsky Performance Status (KPS) of at least 70, and a controlled primary tumor with the brain the only site of metastases. To compare 1-year survival and acute toxicity rates between an accelerated hyperfractionated (AH) radiotherapy (1.6 Gy b.i.d.) Results: IntroductionRationale for stereotactic radiosurgeryDoes radiosurgery improve local control?Does radiosurgery improve survival?Prognostic factors for response, local control, and survivalA comparison of radiosurgery and surgeryComplicationsConclusions. All other patients had relatively minor differences in observed survival, with a median of 4.2 months. Prim Chanikarn♡ on Instagram: “รอจนเปื่อย” 7,015 Likes, 28 Comments - Prim Chanikarn♡ (@primiily) on Instagram: “รอจนเปื่อย” Filipino Girl Filipina Beauty My Girl Asian Girl … Results The primary cancers included 35 cases of lung cancer, 19 cases of breast cancer, nine cases of renal-cell cancer, six cases of melanoma and six cases of other primary sites. On the other hand, previous studies have often reported median time intervals of 12 months or less, indirectly confirming that late dissemination is uncommon [20][21][22]. 840 talking about this. The 6-month overall survival rates were 29% after 5 × 4 Gy and 21% after 10 × 3 Gy (p = 0.020). Love for Prim Chanikarn Tangabodi. Title Author FOA Number Priority Area In vivoO MRS imaging - Quantitative assessment of regional oxygen consumption and perfusion rates in living brain. For AH, 32 Gy in 20 fractions over 10 treatment days (1.6 Gy twice daily) was delivered to the whole brain. The first trial (September 1980 to December 1984) was randomly allocated by two different time-dose radiotherapy schemes, i.e., 30 Gy/ten fractions/two weeks versus 50 Gy/20 fractions/four weeks. The incidence of symptomatic brain metastases among women with metastatic breast cancer ranges from 10% to 16%. Eine Entscheidungsgrundlage bietet hier die Leitlinie ,,Meningeosis neoplastica“ der Neuroonkologischen Arbeitsgemeinschaft (NOA) der deutschen Krebshilfe. We endeavor to be promptly responsive in correcting errors in the material published on digital platforms. patients who received WBRT alone for brain metastases were retrospectively analyzed. Cycles were repeated every four weeks. Cortical atrophy and hypodense white matter were identified by CT in all. There was no significant difference in response rate or survival between the treatment groups. ?na H, Gouva S, Dabouis G, Bennouna J, Souquet PJ, Balmes P, Thiberville L, Fournel P, Quoix E, Riou R, Rebattu P, P? Main Blog: @multilingual99 However, the two Kaplan-Meier curves were not statistically significantly different, p = 0.13. Knowledge about overall survival (OS) contributes to individualization of treatment concepts. Despite the resulting incompleteness of the data, it is desired to estimate the proportion P(t) of items in the population whose lifetimes would exceed t (in the absence of such losses), without making any assumption about the form of the function P(t). Results generated by more dose-intensive regimens were disappointing. This review analyzes prognosis and treatment of BCBM by tumor phenotype and discusses ongoing research into new therapies. Data regarding 416 patients who were treated with WBRT for multiple brain metastases were evaluated retrospectively. Cancer: principles and practice of oncology. We studied whether neural processes containing nitric oxide synthase (NOS) are associated with large cerebral arteries and/or intraparenchymal microvessels. where active brain metastases treatment is neither expected to prolong survival nor improve the patient’s quality of life. On multivariate analysis, improved survival was found to be associated with lower RPA class (P < .001), age <60 years (P = .026), KPS >or=70 (P < .001), and absence of extracranial metastases (P = .003). Patient outcomes vary depending on factors, including tumor phenotype, extent of disease within and outside the brain, as well as patient performance status. She studied at Chulalongkorn Demonstration School. The treatment of brain metastases should be individualized for each patient: in case of single brain metastasis, surgery or radiosurgery should be considered as first options of treatment; in case of multiple lesions, whole-brain radiotherapy is the standard of care in association with systemic therapy or surgery/radiosurgery. International Journal of Radiation Oncology, Biology, Physics. Brain Res 606:148-155, Radiation therapy for brain metastases from lung carcinoma. The standard WBRT regimen, 30 Gy in ten fractions (10 x 3 Gy), has generally resulted in poor outcomes. Fotemustine was administered intravenously at 100 mg m–2 on day 1, 8 and 15, followed by a 5-week rest period, then every 3 weeks in non-progressive patients. Those cases treated with surgery and radiation had a median survival time of 9.7 months versus 3.7 months for those treated with radiation alone (P < 0.02). failures might develop after initial treatment, either locally (regrowth of a previously treated lesion), regionally (elsewhere, Using a murine model, we examined the effects of whole-brain irradiation on FUS-BBBD. Prim Pankamol Phengsuriya finns på Facebook Gå med i Facebook för att komma i kontakt med Prim Pankamol Phengsuriya och andra som du känner. This study investigated whether an escalation of the WBRT dose improves these results. In particular, the implementation of boost treatment following WBRT in selected patients seems to extend survival time. Methods and materials: ... Chanikarn. Maßnahme, prophylaktisch oder in der postoperativen Situation, dar. The estimated difference in total societal costs was larger, also in favor of the single-fraction schedule, but it was not statistically significant ($4700 versus $6453, difference = $1753, 95% CI on the difference = -$99 to $3604; P =.06). in der Rezidivsituation diskutiert. One hundred thirty-two patients (63.5%) benefited from RB of 9 Gy in 3 fractions of 3 Gy at the metastatic site. Intracranial metastases: current management strategies. Cancer 48: 384-394, Nonparametric Estimation From Incomplete Observations, The palliation of brain metastases in a favorable patient population: A randomized clinical trial by the Radiation Therapy Oncology Group, Randomized trial of radiotherapy versus radiotherapy plus metronidazole for the treatment metastatic cancer to brain. The response rates (CR + PR) and survival showed no significant differences between treatments. Malignancies included lung (122 patients), breast (26), unknown primary (16), melanoma (8), colorectal (6), hypernephroma (4), and others (12). Favorable prognostic factors were assessed (age less than 60, Karnofsky of 70-100, controlled primary and brain metastasis only) in each treatment arm and no difference was found. Methods and Materials In lifetesting, medical follow-up, and other fields the observation of the time of occurrence of the event of interest (called a death) may be prevented for some of the items of the sample by the previous occurrence of some other event (called a loss). Dr. Chanikarn Changsri, the medical examiner at the Los Angeles County Coroner, conducted an autopsy on Eliza Jane on May 18, 2005 (Case No 2005-03767) and investigated this case. Fifty-four patients completed the planned treatment. Ann Med 30: 296-299, Treatment of Brain Metastases of Small-Cell Lung Cancer: Comparing Teniposide and Teniposide With Whole-Brain Radiotherapy—A Phase III Study of the European Organization for the Research and Treatment of Cancer Lung Cancer Cooperative Group, Robinet G, Thomas P, Breton JL, L? – The main objective of this prospective multicenter randomised phase III study was to compare a combined regimen of fotemustine plus whole brain irradiation versus fotemustine alone in terms of cerebral response and time to cerebral progression in patients with melanoma brain metastases.Patients and methods. Then, microbubble-assisted FUS-BBBD was performed unilaterally while the contralateral sides served as unsonicated controls. 6th ed. Brain metastases are the most common malignancy encountered in the central nervous system in adults; whole-brain radiotherapy (WBRT) has served as a component of treatment for several decades, but its role is rapidly evolving. More widespread use and improved quality of MRI may lead to early detection of brain metastases. Although the therapeutic goal in intracerebral metastases is generally palliative, it appears that there are categories of cases that may benefit from more aggressive treatment. Seventy-five patients with brain metastases from solid tumours were treated with whole-brain irradiation at our institution between 1990 and 1993. The one-year OS for patients with one metastasis was 42% versus 15% for more than one (p<0.04). They affect 20-40% of all cancer patients. Not all patients with a brain metastases undergo surgery: many are submitted to alternative or palliative treatments. FUS-BBBD, as evident by measuring the fluorescence yield of extravasated trypan blue dye, was identified at all sites with minimal or no apparent pathology. Early studies demonstrated the efficacy of WBRT in relieving neurologic symptoms related to intracranial disease and improving survival for patients with brain metastases. Treatment results showed no significant difference in neurological improvement and survival between the two arms and lactate dehydrogenase (LDH) as the most important prognostic factor. Whole-brain radiotherapy (WBRT) gives symptomatic improvement in more than 50% of these patients. Eine zeitnahe Diagnose ist häufig durch die sehr heterogene neurologische Symptomatik erschwert. Zimm S, Wampler GL, Stablein D, Hazra T, Youg HF. Fotemustine plus whole brain irradiation delayed the time to brain progression of melanoma cerebral metastases compared to fotemustine alone but without a significant improvement in terms of objective control or overall survival. This specific score can be used to estimate OS in patients receiving local therapies for single brain metastasis from gynecological malignancies and personalize their care. A short course (30 Gy/ten fractions/two weeks) is an advantageous XRT because of the short treatment time for normal LDH and neurological improvement and minor toxicity for the high LDH group, while an optional treatment may be necessary for the selected patients. Correspondingly, a large difference in actuarial median survival was observed (39.9 months [95% confidence interval, 16.8-63.0 months] versus 9.7 months (95% confidence interval, 6.1-13.3 months). The patients with the brain as the only metastatic site had significantly better survival (P = 0.019) than those with both intracranial and extracranial metastatic sites. Survival was poor in both groups and not significantly different. You can request the full-text of this article directly from the authors on ResearchGate. We compared quality-adjusted life expectancy (the overall valuation of the health of the patients) and societal costs for patients receiving either single- or multiple-fraction radiotherapy. Eighty-five percent of patients had active extracranial disease. Chanikarn Tangabodi was born on February 20, 2004 in Bangkok, Thailand. Mehta MP, Tremont-Lukats I.Radiosurgery for single and Because up to 1/3 of the patients in this study died secondary to uncontrolled brain metastasis, improvement in local control remains an important goal. Although single- and multiple-fraction radiotherapy are thought to provide equal palliation, which treatment schedule provides better value for the money is unknown. Survival at 6 and 12 months was 36% and 16% after OTT of 5 days vs. 35% and 19% after OTT of 7 days (p=0.81). By investigator, MGd improved time to neurologic progression in all patients (median, 4.3 months for MGd v 3.8 months for WBRT; P =.018) and in lung cancer patients (median, 5.5 months for MGd v 3.7 months for WBRT; P =.025). When using a proportional hazard regression analysis to adjust for the three most important prognostic factors, treatment (surgery and radiation versus radiation alone) still appeared to be important. Poor prognostic factors included advanced age (P < 0.04) and evidence of impaired consciousness, i.e., disorientation, lethargy, stupor, or coma (P < 0.007). 2020 - สำรวจบอร์ด "สาวเกาหลี" ของ นิภาพร คงมั่น บน Pinterest ดูไอเดียเพิ่มเติมเกี่ยวกับ สาวชนบท, หมวกผู้หญิง, ผู้หญิง The Although overall survival (OS) is an important endpoint in patients receiving radiotherapy, given their poor life expectancy in general, quality of life is becoming an increasingly useful endpoint. As focused ultrasound for blood–brain barrier disruption (FUS-BBBD) has progressed to human application, it has become necessary to consider the potential effects of prior irradiation treatments. Chemotherapy was associated with longer median survival. Ann Oncol 12: 59-67, Single- Versus Multiple-Fraction Radiotherapy in Patients With Painful Bone Metastases: Cost–Utility Analysis Based on a Randomized Trial, Non-parametric estimation from incomplete observation, Non‐parametric estimation from incomplete observation, Results of a phase III study of early versus delayed whole brain radiotherapy with concurrent cisplatin and vinorelbine combination in inoperable brain metastasis of non-small-cell lung cancer: Groupe Française de Pneumo-Cancerologie (GFPC) Protocol 95-1, Non Parametric Estimation From Incomplete Observation, Whole brain radiotherapy alone or in combination with temazolamide for brain metastases. Escalation of the WBRT dose beyond 30 Gy resulted in better outcomes, particularly for patients who had less radiosensitive tumors. She is an actress, known for Chiang Khan Story (2014), The Gifted: Graduation (2020), and Blacklist (2019). CNS metastasis: The role of radiotherapy for brain metastasis and metastatic spinal cord compression, Expérience de l’irradiation encéphalique totale avec escalade de dose focalisée pour le traitement des métastases cérébrales uniques d’un carcinome bronchopulmonaire. We conclude that 3000 rad in two weeks is at least as effective as 5000 rad in four weeks in the palliation of brain metastases, even in this relatively favorable patient population. Rades et al. One of the hardly known possibilities is the remote interactive real-time Theoretical study of the power distributions for interstitial microwave hyperthermia A trend was observed for number of metastases (2-3 vs >or=4; P = .07). The societal values of life expectancies were assessed with the EuroQol classification system (EQ-5D) questionnaire. In general, patients with breast cancer had better survival than patients with other primary cancers. A subgroup analysis was performed to determine whether an additional boost could potentially improve outcome in patients who presented with less than three metastases, performance status <2, and no surgical resection of their metastasis. ... Non-randomized trials have suggested that WBRT increases survival to 3-6 months in these patients [4]. The Radiation Therapy Oncology Group (RTOG) accrued 445 patients to a Phase III comparison of accelerated hyperfractionation vs. standard fractionation from 1991 through 1995. Treatment 1: CR + PR 24%, median survival 14 weeks, Treatment 2: CR + PR 27%, median survival 12 weeks. Peer Reviewed http://deepblue.lib.umich.edu/bitstream/2027.42/45380/1/11060_2004_Article_BF00178115.pdf, A controlled randomized study was carried out to evaluate the effects of chemotherapy in patients with brain metastases from lung carcinoma. in the brain parenchyma), or even in the form of leptomeningeal dissemination, the latter carrying the worst prognosis. The LC rate at 1 year was 28% after 30 Gy and 44% after 40 Gy (P = .064). Patricia Suteu, Zsolt Fekete, Nicolae Todor, Viorica Nagy Treatment assignment was not statistically significant. An icon used to represent a menu that can be toggled by interacting with this icon. And 13 % other or unknown primaries patients, the median survival time diagnosis. Regimen in most centers response outside the brain was longer in the AF arm vs. prim chanikarn facts.... Lc ) and absence of extracerebral metastases significantly decreased OS from 39 % without extracerebral metastases to 19 in... 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