Journal of neuro-oncology
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Journal of neuro-oncology · Jan 2011
Post mortem examinations in diffuse intrinsic pontine glioma: challenges and chances.
The concept of organ donation for research purposes has evolved to overcome limited availability of tissue and foster research, in particular in diseases for which surgery is not routinely performed. Diffuse intrinsic pontine glioma (DIPG) is an almost invariably fatal childhood tumour, not amenable to surgery because of its location and infiltrative nature. We report our institutional experience of post mortem brain or tumour donation and its impact on the families. ⋯ None of the families expressed distress from the autopsy, or regretted the choice made. Autopsy limited to the brain did not interfere with the choices related to palliation. The families derived comfort from the hope that scientific breakthroughs could be made and felt that they were helping to make a difference in the future management of DIPG.
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Journal of neuro-oncology · Jan 2011
Review Case ReportsTemozolomide for malignant primary spinal cord glioma: an experience of six cases and a literature review.
Malignant primary spinal cord gliomas (PSCGs) are rare, and the optimal treatment for these lesions remains controversial. We report herein treatment outcomes of six malignant PSCGs managed with temozolomide (TMZ)-based multidisciplinary treatment. TMZ was administered concomitantly with fractionated radiotherapy for two newly diagnosed primary spinal cord glioblastoma multiforme (GBM), followed by adjuvant chemotherapy with TMZ. ⋯ TMZ treatment may have a positive effect on control of malignant PSCGs and survival for some patients. Specifically, treatment with TMZ during and after radiation therapy might provide survival benefit to patients with primary spinal cord GBM. A multicenter cooperative investigation for a large-scale study on malignant PSCGs may be required.
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Journal of neuro-oncology · Jan 2011
Perioperative levetiracetam for prevention of seizures in supratentorial brain tumor surgery.
Efficacy and tolerability of levetiracetam (LEV) as perioperative seizure prophylaxis in supratentorial brain tumor patients were retrospectively studied. Between February 2007 and April 2009 in a single institution, 78 patients with primary or secondary supratentorial brain tumors [40 female, 38 male; mean age 57 years, from 27 to 89 years; gliomas in 42 patients (53.8%), brain metastases in 17 (21.8%), meningiomas in 16 (20.5%), 1 primary central nervous system (CNS) lymphoma patient, and 2 patients with radiation necrosis] received between 1,000 mg and 3,000 mg LEV perioperatively. Preoperatively, 30 patients had experienced seizures (38.5%), most commonly glioma patients (47.6%), but also meningioma patients (31.3%) or patients with brain metastases (23.5%). ⋯ Perioperative LEV in supratentorial brain tumor patients was well tolerated. Compared with the literature, it resulted in low (2.6%) [corrected] seizure frequency in the early postoperative period. Additionally, its advantage of lacking cytochrome P450 enzyme induction allowed early initiation of effective postoperative chemotherapy in malignant glioma patients.