Radiotherapy for Primary and Metastatic Spinal Tumors O
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Vetp-42-06-Brief Communications
Veterinary Pathology Online http://vet.sagepub.com/ Primitive Neuroectodermal Tumor in the Spinal Cord of a Brahman Crossbred Calf A. Berrocal, D. L. Montgomery, J. T. Mackie and R. W. Storts Vet Pathol 2005 42: 834 DOI: 10.1354/vp.42-6-834 The online version of this article can be found at: http://vet.sagepub.com/content/42/6/834 Published by: http://www.sagepublications.com On behalf of: American College of Veterinary Pathologists, European College of Veterinary Pathologists, & the Japanese College of Veterinary Pathologists. Additional services and information for Veterinary Pathology Online can be found at: Email Alerts: http://vet.sagepub.com/cgi/alerts Subscriptions: http://vet.sagepub.com/subscriptions Reprints: http://www.sagepub.com/journalsReprints.nav Permissions: http://www.sagepub.com/journalsPermissions.nav Downloaded from vet.sagepub.com by guest on December 25, 2010 834 Brief Communications and Case Reports Vet Pathol 42:6, 2005 Vet Pathol 42:834–836 (2005) Primitive Neuroectodermal Tumor in the Spinal Cord of a Brahman Crossbred Calf A. BERROCAL,D.L.MONTGOMERY,J.T.MACKIE, AND R. W. STORTS Abstract. A variety of embryonal tumors of the central nervous system, typically malignant and occurring in young individuals, are recognized in humans and animals. This report describes an invasive subdural but predominantly extramedullary primitive neuroectodermal tumor developing at the lumbosacral junction in a 6-month-old Brahman crossbred calf. The tumor was composed of spindloid embryonal cells organized in interlacing fascicles. The cells had oval to elongate or round hyperchromic nuclei, single to double nucleoli, and scant discernible cytoplasm. Immunohistochemical staining for neuron-specific enolase, synaptophysin, and S-100 protein and formation of pseudorosettes suggested neuronal and possibly ependymal differentiation. -
Understanding the Potentiality of Accelerator
Bortolussi et al. Radiation Oncology (2017) 12:130 DOI 10.1186/s13014-017-0860-6 RESEARCH Open Access Understanding the potentiality of accelerator based-boron neutron capture therapy for osteosarcoma: dosimetry assessment based on the reported clinical experience Silva Bortolussi1,2* , Ian Postuma2, Nicoletta Protti2, Lucas Provenzano3,4, Cinzia Ferrari5,2, Laura Cansolino5,6, Paolo Dionigi5,6, Olimpio Galasso7, Giorgio Gasparini7, Saverio Altieri1,2, Shin-Ichi Miyatake8 and Sara J. González3,4 Abstract Background: Osteosarcoma is the most frequent primary malignant bone tumour, and its incidence is higher in children and adolescents, for whom it represents more than 10% of solid cancers. Despite the introduction of adjuvant and neo-adjuvant chemotherapy that markedly increased the success rate in the treatment, aggressive surgery is still needed and a considerable percentage of patients do not survive due to recurrences or early metastases. Boron Neutron Capture Therapy (BNCT), an experimental radiotherapy, was investigated as a treatment that could allow a less aggressive surgery by killing infiltrated tumour cells in the surrounding healthy tissues. BNCT requires an intense neutron beam to ensure irradiation times of the order of 1 h. In Italy, a Radio Frequency Quadrupole (RFQ) proton accelerator has been designed and constructed for BNCT, and a suitable neutron spectrum was tailored by means of Monte Carlo calculations. This paper explores the feasibility of BNCT to treat osteosarcoma using this neutron source based on accelerator. Methods: The therapeutic efficacy of BNCT was analysed evaluating the dose distribution obtained in a clinical case of femur osteosarcoma. Mixed field dosimetry was assessed with two different formalisms whose parameters were specifically derived from radiobiological experiments involving in vitro UMR-106 osteosarcoma cell survival assays and boron concentration assessments in an animal model of osteosarcoma. -
Radiation Oncology Guidelines
National Imaging Associates, Inc.* 2021 Magellan Clinical Guidelines For Medical Necessity Review RADIATION ONCOLOGY GUIDELINES Effective January 1, 2021 – December 31, 2021 *National Imaging Associates, Inc. (NIA) is a subsidiary of Magellan Healthcare, Inc. Copyright © 2019-2020 National Imaging Associates, Inc., All Rights Reserved Guidelines for Clinical Review Determination Preamble Magellan is committed to the philosophy of supporting safe and effective treatment for patients. The medical necessity criteria that follow are guidelines for the provision of diagnostic imaging. These criteria are designed to guide both providers and reviewers to the most appropriate diagnostic tests based on a patient’s unique circumstances. In all cases, clinical judgment consistent with the standards of good medical practice will be used when applying the guidelines. Determinations are made based on both the guideline and clinical information provided at the time of the request. It is expected that medical necessity decisions may change as new evidence-based information is provided or based on unique aspects of the patient’s condition. The treating clinician has final authority and responsibility for treatment decisions regarding the care of the patient. 2021 Magellan Clinical Guidelines-Radiation Oncology 2 Guideline Development Process These medical necessity criteria were developed by Magellan Healthcare for the purpose of making clinical review determinations for requests for therapies and diagnostic procedures. The developers of the criteria sets included representatives from the disciplines of radiology, internal medicine, nursing, cardiology, and other specialty groups. Magellan’s guidelines are reviewed yearly and modified when necessary following a literature search of pertinent and established clinical guidelines and accepted diagnostic imaging practices. -
Spinal Meningiomas: a Review
nal of S ur pi o n J e Galgano et al., J Spine 2014, 3:1 Journal of Spine DOI: 10.4172/2165-7939.1000157 ISSN: 2165-7939 Review Rrticle Open Access Spinal Meningiomas: A Review Michael A Galgano, Timothy Beutler, Aaron Brooking and Eric M Deshaies* Department of Neurosurgery, SUNY Upstate Medical University, Syracuse, NY, USA Abstract Meningiomas of the spinal axis have been identified from C1 to as distal as the sacrum. Their clinical presentation varies greatly based on their location. Meningiomas situated in the atlanto-axial region may present similarly to some meningiomas of the craniocervical junction, while some of the more distal spinal axis meningiomas are discovered as a result of chronic back pain. Surgical resection remains the mainstay of treatment, although advancements in radiosurgery have led to increased utilization as a primary or adjuvant therapy. Angiography also plays a critical role in surgical planning and may be utilized for preoperative embolization of hypervascular meningiomas. Keywords: Meningioma; Neurosurgery; Radiosurgery; Angiography favorable and biological outcome [11]. They also found that either a lack of estrogen and progesterone receptors, or the presence of estrogen Introduction receptors in meningiomas, correlated with a more aggressive clinical Spinal meningiomas are tumors originating from arachnoid cap behavior, progression, and recurrence. Hsu and Hedley Whyte also cells most commonly situated in the intradural extramedullary region found that the presence of progesterone receptors, even in a small [1,2]. They represent a high proportion of all spinal cord tumors. Spinal subgroup of tumor cells, indicated a more favorable prognostic value meningiomas tend to predominate in the thoracic region, although for meningiomas [12]. -
Primary Spinal Astrocytomas: a Literature Review
Open Access Review Article DOI: 10.7759/cureus.5247 Primary Spinal Astrocytomas: A Literature Review John Ogunlade 1 , James G. Wiginton IV 1 , Christopher Elia 1 , Tiffany Odell 2 , Sanjay C. Rao 3 1. Neurosurgery, Riverside University Health System Medical Center, Moreno Valley, USA 2. Neurosurgery, Desert Regional Medical Center, Palm Springs, USA 3. Neurosurgery, Kaiser Permanente - Fontana Medical Center, Fontana, USA Corresponding author: John Ogunlade, [email protected] Abstract Primary spinal astrocytoma is a subtype of glioma, the most common spinal cord tumor found in the intradural intramedullary compartment. Spinal astrocytomas account for 6-8% of all spinal cord tumors and are primarily low grade (World Health Organization grade I (WHO I) or WHO II). They are seen in both the adult and pediatric population with the most common presenting symptoms being back pain, sensory dysfunction, or motor dysfunction. Magnetic Resonance Imaging (MRI) with and without gadolinium is the imaging of choice, which usually reveals a hypointense T1 weighted and hyperintense T2 weighted lesion with a heterogeneous pattern of contrast enhancement. Further imaging which may aid in surgical planning includes computerized tomography, diffusion tensor imaging, and tractography. Median survival in spinal cord astrocytomas ranges widely. The factors most significantly associated with poor prognosis and shorter median survival are older age at initial diagnosis, higher grade lesion based on histology, and extent of resection. The mainstay of treatment for primary spinal cord astrocytomas is surgical resection, with the goal of preservation of neurologic function, guided by intraoperative neuromonitoring. Adjunctive radiation has been shown beneficial and may increase overall survival. -
Nuclear Data for Medical Applications ° ° INM-5: Nuklearchemie,INM-5: Forschungszentrum Germjülich, Abteilung Nuklearchemie, Zu Germanuniversitätköln, ° Syed M
Mitglied der Helmholtz-Gemeinschaft derMitglied Nuclear Data for Medical Applications ° Syed M. Qaim ° INM-5: Nuklearchemie, Forschungszentrum Jülich, Germany; ° Abteilung Nuklearchemie, Universität zu Köln, Germany Plenary Lecture given at a Workshop in the 7 th Framework Programme of the European Union on “Solving Challenges in Nuclear Data for the Safety of Nuclear Facilities (CHANDA)”, Paul Scherrer Institute, Villigen, Switzerland, 23 to 25 November 2015 Outline ° Introduction - external radiation therapy - internal radionuclide applications ° Commonly used radionuclides - status of nuclear data - alternative routes for production of 99m Tc - standardisation of production data ° Research oriented radionuclides - non-standard positron emitters - novel therapeutic radionuclides ° New directions in radionuclide applications ° Future data needs ° Summary and conclusions Nuclear Data Research for Medical Use Aim ° Provide fundamental database for - external radiation therapy - internal radionuclide applications Areas of Work ° Experimental measurements ° Nuclear model calculations ° Standardisation and evaluation of existing data Considerable effort is invested worldwide in nuclear data research External Radiation Therapy • Biological changes under the impact of radiation • Of significance is linear energy transfer (LET) to tissue Types of Therapy • Photon therapy : use of 60 Co or linear accelerator (low-LET radiation ) most common • Fast neutron therapy : accelerator with E p or E d above 50 MeV (high-LET radiation ) being abandoned -
Carbon Ion Therapy for Advanced Sinonasal Malignancies: Feasibility
Jensen et al. Radiation Oncology 2011, 6:30 http://www.ro-journal.com/content/6/1/30 RESEARCH Open Access Carbon ion therapy for advanced sinonasal malignancies: feasibility and acute toxicity Alexandra D Jensen1*, Anna V Nikoghosyan1, Swantje Ecker2, Malte Ellerbrock2, Jürgen Debus1 and Marc W Münter1 Abstract Purpose: To evaluate feasibility and toxicity of carbon ion therapy for treatment of sinonasal malignancies. First site of treatment failure in malignant tumours of the paranasal sinuses and nasal cavity is mostly in-field, local control hence calls for dose escalation which has so far been hampered by accompanying acute and late toxicity. Raster-scanned carbon ion therapy offers the advantage of sharp dose gradients promising increased dose application without increase of side-effects. Methods: Twenty-nine patients with various sinonasal malignancies were treated from 11/2009 to 08/2010. Accompanying toxicity was evaluated according to CTCAE v.4.0. Tumor response was assessed according to RECIST. Results: Seventeen patients received treatment as definitive RT, 9 for local relapse, 2 for re-irradiation. All patients had T4 tumours (median CTV1 129.5 cc, CTV2 395.8 cc), mostly originating from the maxillary sinus. Median dose was 73 GyE mostly in mixed beam technique as IMRT plus carbon ion boost. Median follow- up was 5.1 months [range: 2.4 - 10.1 months]. There were 7 cases with grade 3 toxicity (mucositis, dysphagia) but no other higher grade acute reactions; 6 patients developed grade 2 conjunctivits, no case of early visual impairment. Apart from alterations of taste, all symptoms had resolved at 8 weeks post RT. -
Present Status of Fast Neutron Therapy Survey of the Clinical Data and of the Clinical Research Programmes
PRESENT STATUS OF FAST NEUTRON THERAPY SURVEY OF THE CLINICAL DATA AND OF THE CLINICAL RESEARCH PROGRAMMES Andre Wambersie and Francoise Richard Universite Catholique de Louvain, Unite de Radiotherapie, Neutron- et CurietheVapie, Cliniques Universitaires St-Luc, 1200-Brussels, Belgium. Abstract The clinical results reported from the different neutron therapy centres, in USA, Europe and Asia, are reviewed. Fast neutrons were proven to be superior to photons for locally extended inoperable salivary gland tumours. The reported overall local control rates are 67 % and 24 % respectively. Paranasal sinuses and some tumours of the head and neck area, especially extended tumours with large fixed lymph nodes, are also indications for neutrons. By contrast, the results obtained for brain tumours were, in general, disappointing. Neutrons were shown to bring a benefit in the treatment of well differentiated slowly growing soft tissue sarcomas. The reported overall local control rates are 53 % and 38 % after neutron and photon irradiation respectively. Better results, after neutron irradiation, were also reported for bone- and chondrosarcomas. The reported local control rates are 54 % for osteosarcomas and 49 % for chondrosarcomas after neutron irradiation; the corresponding values are 21 % and 33 % respectively after photon irradiation. For locally extended prostatic adenocarcinoma, the superiority of mixed schedule (neutrons + photons) was demonstrated by a RTOG randomized trial (local control rates 77% for mixed schedule compared to 31 % for photons). Neutrons were also shown to be useful for palliative treatment of melanomas. Further studies are needed in order to definitively evaluate the benefit of fast neutrons for other localisations such as uterine cervix, bladder, and rectum. -
Malignant Bone Tumors (Other Than Ewing’S): Clinical Practice Guidelines for Diagnosis, Treatment and Follow-Up by Spanish Group for Research on Sarcomas (GEIS)
Cancer Chemother Pharmacol DOI 10.1007/s00280-017-3436-0 ORIGINAL ARTICLE Malignant bone tumors (other than Ewing’s): clinical practice guidelines for diagnosis, treatment and follow-up by Spanish Group for Research on Sarcomas (GEIS) Andrés Redondo1 · Silvia Bagué2 · Daniel Bernabeu1 · Eduardo Ortiz-Cruz1 · Claudia Valverde3 · Rosa Alvarez4 · Javier Martinez-Trufero5 · Jose A. Lopez-Martin6 · Raquel Correa7 · Josefina Cruz8 · Antonio Lopez-Pousa9 · Aurelio Santos10 · Xavier García del Muro11 · Javier Martin-Broto10 Received: 7 July 2017 / Accepted: 15 September 2017 © The Author(s) 2017. This article is an open access publication Abstract Primary malignant bone tumors are uncommon of a localized bone tumor, with various techniques available and heterogeneous malignancies. This document is a guide- depending on the histologic type, grade and location of the line developed by the Spanish Group for Research on Sar- tumor. Chemotherapy plays an important role in some che- coma with the participation of different specialists involved mosensitive subtypes (such as high-grade osteosarcoma). in the diagnosis and treatment of bone sarcomas. The aim is In other subtypes, historically considered chemoresistant to provide practical recommendations with the intention of (such as chordoma or giant cell tumor of bone), new targeted helping in the clinical decision-making process. The diag- therapies have emerged recently, with a very significant effi- nosis and treatment of bone tumors requires a multidiscipli- cacy in the case of denosumab. Radiation therapy is usually nary approach, involving as a minimum pathologists, radi- necessary in the treatment of chordoma and sometimes of ologists, surgeons, and radiation and medical oncologists. other bone tumors. Early referral to a specialist center could improve patients’ survival. -
A Lumbar Disc Herniation Misdiagnosed As a Neurofibromatosis Type I -A Case Report
CASE REPORT Kor J Spine 5(3):215-218, 2008 A Lumbar Disc Herniation Misdiagnosed as A Neurofibromatosis Type I -A Case Report- Chang-hyun Oh, M.D., Hyeong-chun Park, M.D., Chong-oon Park, M.D., Seung Hwan Yoon, M.D. Department of Neurosurgery, College of Medicine, Inha University, Incheon, Korea We describe a rare case of an extradural disc herniation mimicking an extradural spinal tumor radiologically. It is often quite difficult to differentiate a sequestered disc from an extradural tumor when the discal fragments are migrated away from the origin. Distinguishable features of clinical and radiological characteristics between sequestered discs and benign intraspinal tumors were discussed. Although a well enhancing spherical mass in the spinal canal is routinely diagnosed as tumors, a free sequestered disc fragment also should be taken into consideration. This case demonstrates the role and the importance of contrast magnetic resonance imaging and of a clinical history in the diagnosis of disc herniation. Key Words: Disc herniationㆍNeurofibromatosis type IㆍMagnetic resonance imaging INTRODUCTION CASE REPORT A herniated intervertebral disc is by far the most common A 57-year-old woman was admitted to hospital having soft-tissue mass lesion within the lumbar spinal canal. In the experienced pain in the lower back and right leg for 6 absence of epidural scar, computed tomography (CT) and mag- months after the accident of slip-down from a chair. She netic resonance (MR) imaging findings of such a lesion are had MR imaging films which were taken at local hospital, typical, so that the differential diagnosis usually does not and the films showed us two mass lesions on T12 verte- exist, i.e., the disc has the same signal intensity, and the mass bral body level and L5-S1 level. -
Primitive Neuroectodermal Tumor in the Spinal Canal: a Case Report
1934 ONCOLOGY LETTERS 9: 1934-1936, 2015 Primitive neuroectodermal tumor in the spinal canal: A case report XIAO-TONG MENG and SHI‑SHENG HE Department of Orthopaedics, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai 200072, P.R. China Received May 22, 2014; Accepted January 8, 2015 DOI: 10.3892/ol.2015.2907 Abstract. Primitive neuroectodermal tumors (PNETs) are rare The present study reports the case of an otherwise healthy tumors of uncertain histogenesis that occur predominantly in 60-year-old female with extradural PNET extending into children and young adults. The current study reports a case the lumbar cavity, which caused symptoms of nerve root of PNET in a 60-year-old female, which presented clinically compression. Few such presentations have been reported as an intraspinal tumor, causing symptoms of lower back previously (6-8). Written informed consent was obtained from pain, numbness and pain in the right lower extremity. The the patient’s family. patient underwent tumorectomy. Following primary therapy, the symptoms of spinal cord compression were relieved. The Case report patient underwent several courses of radiotherapy following surgery but refused to continue with chemotherapy. After a A 60-year-old female was admitted to Shanghai Tenth further four months, the tumors recurred and the patient People's Hospital Affiliated to Tongji University (Shanghai, succumbed to the disease. China) due to a one-year history of increasing lower back pain, worsening numbness and pain on the back of the right Introduction thigh. The patient did not smoke or consume alcohol, and was suffering from diabetes, which was managed by a controlled Primitive neuroectodermal tumors (PNETs) are extremely diet. -
Sclerostin Inhibition Alleviates Breast Cancer–Induced Bone Metastases and Muscle Weakness
Sclerostin inhibition alleviates breast cancer–induced bone metastases and muscle weakness Eric Hesse, … , Hiroaki Saito, Hanna Taipaleenmäki JCI Insight. 2019. https://doi.org/10.1172/jci.insight.125543. Research In-Press Preview Bone biology Oncology Breast cancer bone metastases often cause a debilitating non-curable condition with osteolytic lesions, muscle weakness and a high mortality. Current treatment comprises chemotherapy, irradiation, surgery and anti-resorptive drugs that restrict but do not revert bone destruction. In metastatic breast cancer cells, we determined the expression of sclerostin, a soluble Wnt inhibitor that represses osteoblast differentiation and bone formation. In mice with breast cancer bone metastases, pharmacological inhibition of sclerostin using an anti-sclerostin antibody (Scl-Ab) reduced metastases without tumor cell dissemination to other distant sites. Sclerostin inhibition prevented the cancer-induced bone destruction by augmenting osteoblast-mediated bone formation and reducing osteoclast-dependent bone resorption. During advanced disease, NF-κB and p38 signaling was increased in muscles in a TGF-β1-dependent manner, causing muscle fiber atrophy, muscle weakness and tissue regeneration with an increase in Pax7-positive satellite cells. Scl-Ab treatment restored NF-κB and p38 signaling, the abundance of Pax7-positive cells and ultimately muscle function. These effects improved the overall health condition and expanded the life span of cancer-bearing mice. Together, these results demonstrate that pharmacological