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1. Blakeley J, Grossman S: Anaplastic oligodendroglioma. Curr Treat Options Neurol; 2008 Jul;10(4):295-307
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  • Patients with new seizures or new focal neurologic deficits should be referred for brain MRI with contrast.
  • If the MRI suggests a malignant glioma, maximal feasible tumor resection is advised for accurate diagnosis and for relief of tumor-related neurologic symptoms.
  • Radiation therapy (XRT) is the most commonly prescribed postsurgical therapy for patients with AODs.
  • The role and timing of adjuvant chemotherapy are less clear.
  • Tumors with intermediate oligodendroglial features or mixed astrocytic features should be referred for 1p19q assessment.
  • Identification of 1p19q status is also required in clinical trials for patients with AOD, given the association of 1p19q codeletion with improved response to therapies and overall prognosis.
  • There are not yet sufficient data to guide individual treatment planning based on 1p19q status, but several planned and ongoing trials will address this issue.
  • Unfortunately, AOD remains a terminal brain cancer even with maximal therapies.
  • As more therapeutic options become available and the full significance of molecular markers is understood, 1p19q and other markers are expected to help guide optimal antitumor therapies, and it is hoped that survival and function will improve for all patients with AOD.

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  • (PMID = 18579016.001).
  • [ISSN] 1092-8480
  • [Journal-full-title] Current treatment options in neurology
  • [ISO-abbreviation] Curr Treat Options Neurol
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / P30 CA006973
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Other-IDs] NLM/ NIHMS567597; NLM/ PMC3994534
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2. Schomas DA, Laack NN, Brown PD: Low-grade gliomas in older patients: long-term follow-up from Mayo Clinic. Cancer; 2009 Sep 1;115(17):3969-78
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  • RESULTS: Of 314 patients initially identified, 32 were aged at least 55 years, with a median age at diagnosis of 61 years (range, 55-74 years).
  • Operative pathologic diagnoses comprised astrocytoma (n = 22, 69%), mixed oligoastrocytoma (n = 7, 22%), and oligodendroglioma (n = 3, 9%).
  • Postoperative radiotherapy or chemotherapy was given to 23 (72%) patients and 1 (3%) patient, respectively.
  • Factors adversely affecting OS on univariate analysis were enhancement on computed tomography (P < .001) and supratentorial location (P = .03).
  • Aggressive management with maximally safe resection followed by adjuvant therapy should be strongly considered.

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  • (PMID = 19536875.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] ENG
  • [Grant] United States / NCRR NIH HHS / RR / UL1 RR024150; None / None / / UL1 RR024150-01; United States / NCRR NIH HHS / RR / 1 UL1 RR024150-01; United States / NCRR NIH HHS / RR / UL1 RR024150-01
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Other-IDs] NLM/ NIHMS140676; NLM/ PMC2789453
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3. Hukin J, Siffert J, Velasquez L, Zagzag D, Allen J: Leptomeningeal dissemination in children with progressive low-grade neuroepithelial tumors. Neuro Oncol; 2002 10;4(4):253-60
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  • Satisfactorily followed data were obtained on 427 of the 588 patients with localized LGN at diagnosis between 1986 and 1998, 177 (42%) of whom developed progressive or recurrent disease.
  • The median age at initial diagnosis was 5 years and at LM diagnosis was 8.5 years.
  • The histologies were pilocytic astrocytoma (4), ganglioglioma (4), fibrillary astrocytoma (3), mixed glioma (1), and glioneurofibroma (1).
  • Management included chemotherapy (2) or radiotherapy (3) or both (7); 1 patient received only radical resections of symptomatic lesions.
  • We strongly urge that for optimum treatment planning all patients with recurrent LGN be staged with an enhanced spine and brain MRI before adjuvant therapy is initiated.
  • [MeSH-minor] Adolescent. Adult. Child. Child, Preschool. Combined Modality Therapy. Disease Progression. Female. Humans. Infant. Magnetic Resonance Imaging. Male. Neoplasm Recurrence, Local / epidemiology. Neoplasm Recurrence, Local / therapy. Survival Analysis. Treatment Outcome

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  • (PMID = 12356355.001).
  • [ISSN] 1522-8517
  • [Journal-full-title] Neuro-oncology
  • [ISO-abbreviation] Neuro-oncology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC1920666
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4. Olson JD, Riedel E, DeAngelis LM: Long-term outcome of low-grade oligodendroglioma and mixed glioma. Neurology; 2000 Apr 11;54(7):1442-8
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  • [Title] Long-term outcome of low-grade oligodendroglioma and mixed glioma.
  • BACKGROUND: Low-grade oligodendrogliomas and mixed gliomas can be indolent and remain unchanged for years.
  • Optimal timing and effectiveness of initial treatment is uncertain and therapy can be associated with toxicity.
  • METHODS: Retrospective review of patients diagnosed between 1979 and 1997 with low-grade oligodendroglioma or mixed glioma.
  • Time to progression, survival, prognostic factors, and treatment toxicities were evaluated.
  • RESULTS: A total of 106 patients (77 oligodendroglioma, 29 mixed glioma) were identified; median age was 36.7 years.
  • Overall median time to progression (MTTP) was 5.0 years (range 0.5 to 14.2).
  • MTTP and OS were not significantly affected by treatment.
  • Of 62 patients who received radiation therapy, 9 (15%) developed radiation necrosis and 13 developed radiation therapy-related cognitive changes, requiring ventriculoperitoneal shunting in six.
  • Significant myelosuppression was seen in 35 of 76 (46%) patients treated with chemotherapy.
  • CONCLUSIONS: Low-grade oligodendroglioma and mixed glioma have a long median overall survival.
  • There were no apparent differences in either immediate versus deferred treatment or choice of initial therapy on disease-free or overall survival.
  • Chemotherapy was associated with significant acute toxicity in almost one half of patients; radiation therapy produced late neurotoxicity in one third, justifying deferred treatment until clinically necessary.
  • [MeSH-major] Brain Neoplasms / therapy. Glioma / therapy. Neoplasm Recurrence, Local / diagnosis. Oligodendroglioma / therapy
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / adverse effects. Cisplatin / therapeutic use. Cyclophosphamide / adverse effects. Cyclophosphamide / therapeutic use. Disease-Free Survival. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasms, Second Primary / diagnosis. Neoplasms, Second Primary / therapy. Postoperative Complications. Radiotherapy, Adjuvant / adverse effects. Retrospective Studies. Survival Rate. Treatment Outcome. Vindesine / adverse effects. Vindesine / therapeutic use


5. Brada M, Viviers L, Abson C, Hines F, Britton J, Ashley S, Sardell S, Traish D, Gonsalves A, Wilkins P, Westbury C: Phase II study of primary temozolomide chemotherapy in patients with WHO grade II gliomas. Ann Oncol; 2003 Dec;14(12):1715-21
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  • [Title] Phase II study of primary temozolomide chemotherapy in patients with WHO grade II gliomas.
  • PATIENTS AND METHODS: Thirty patients with histologically verified WHO grade II gliomas (17 astrocytoma, 11 oligodendroglioma, two mixed oligoastrocytoma) following surgery 2-104 months (median 23 months) after initial diagnosis received temozolomide 200 mg/m(2)/day for 5 days, on a 28-day cycle, for a maximum of 12 cycles or until tumour progression.
  • Twenty-four patients received 12 cycles of chemotherapy.
  • Nine patients progressed (three during chemotherapy-one PD and two initial SD-and six after completion of chemotherapy); five had evidence of transformation.
  • CONCLUSIONS: Temozolomide has single-agent activity in patients with WHO grade II cerebral glioma, with modest improvement in quality of life and improvement in epilepsy control.
  • On present evidence, temozolomide cannot be considered as primary therapy without formal comparison with other treatment modalities.

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  • [CommentIn] Ann Oncol. 2003 Dec;14(12):1695-6 [14630671.001]
  • (PMID = 14630674.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 7GR28W0FJI / Dacarbazine; 85622-93-1 / temozolomide
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6. Sipos L, Vitanovics D, Afra D: Temozolomide chemotherapy of patients with recurrent anaplastic astrocytomas and glioblastomas. Ideggyogy Sz; 2004 Nov 20;57(11-12):394-9
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  • [Title] Temozolomide chemotherapy of patients with recurrent anaplastic astrocytomas and glioblastomas.
  • In most of the cases of recurrent gliomas chemotherapy is the last choice.
  • The patients received two to 16 courses of chemotherapy.
  • The toxicity, quality of life, response to chemotherapy and survival data were analysed.
  • RESULTS: Out of 75 patients four were excluded following the first treatment due to myelotoxicity, and allergic reactions.
  • The time to progression was 6.8 months and the median survival time 8.75 months for patients with glioblastoma and with malignant astrocytoma or malignant mixed oligoastrocytoma 9.45 and 11.15 months, respectively.
  • The overall survival for patients with originally lower grade glioma was 70.32 and for patients with glioblastoma multiforme 17.43 months.
  • CONCLUSIONS: Temozolomide chemotherapy in patients with recurrent malignant astrocytoma and glioblastoma proved to be efficacious and similar good results were achieved as with a nitrosourea based combined chemotherapy.
  • Even in those patients who received previous chemotherapy temozolomide is well tolerated and a relatively long time to progression was achieved in cases of recurrent malignant gliomas.
  • Temozolomide seems to be a promising drug in the chemotherapy of malignant gliomas and can be applied as a second line chemotherapy, as well.
  • [MeSH-major] Antineoplastic Agents, Alkylating / therapeutic use. Astrocytoma / drug therapy. Brain Neoplasms / diagnosis. Dacarbazine / analogs & derivatives. Dacarbazine / therapeutic use. Neoplasm Recurrence, Local / drug therapy
  • [MeSH-minor] Adult. Aged. Disease Progression. Disease-Free Survival. Drug Administration Schedule. Female. Glioblastoma / drug therapy. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Survival Analysis. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 15662767.001).
  • [ISSN] 0019-1442
  • [Journal-full-title] Ideggyógyászati szemle
  • [ISO-abbreviation] Ideggyogy Sz
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Hungary
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; 7GR28W0FJI / Dacarbazine; 85622-93-1 / temozolomide
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7. Kish PE, Blaivas M, Strawderman M, Muraszko KM, Ross DA, Ross BD, McMahon G: Magnetic resonance imaging of ethyl-nitrosourea-induced rat gliomas: a model for experimental therapeutics of low-grade gliomas. J Neurooncol; 2001 Jul;53(3):243-57
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  • [Title] Magnetic resonance imaging of ethyl-nitrosourea-induced rat gliomas: a model for experimental therapeutics of low-grade gliomas.
  • Human low-grade gliomas represent a population of brain tumors that remain a therapeutic challenge.
  • Preclinical evaluation of agents, to test their preventive or therapeutic efficacy in these tumors, requires the use of animal models.
  • In this study Fisher-334 rats, treated transplacentally with ENU, underwent magnetic resonance imaging (MRI) examination in order to evaluate this approach for detection of tumor formation and growth.
  • ENU-induced intracranial cerebral tumors were first observable in T2-weighted images beginning at 4 months of age and grew with a mean doubling time of 0.487 +/- 0.112 months.
  • These tumors were found histologically to be predominately mixed gliomas.
  • Two therapeutic interventions were evaluated using MRI, vitamin A (all-trans retinol palmitate, RP), as a chemopreventative agent and the anti-angiogenic drug SU-5416.
  • RP was found to significantly delay the time to first tumor observation by one month (P = 0.05).
  • These results show that MRI can be used to provide novel information relating to the therapeutic efficacy of agents against the ENU-induced tumor model.
  • [MeSH-major] Brain Neoplasms / chemically induced. Brain Neoplasms / diagnosis. Carcinogens. Ethylnitrosourea. Glioma / chemically induced. Glioma / diagnosis. Magnetic Resonance Imaging. Vitamin A / analogs & derivatives
  • [MeSH-minor] Angiogenesis Inhibitors / therapeutic use. Animals. Diet. Disease Models, Animal. Indoles / therapeutic use. Neoplasms, Multiple Primary. Neoplasms, Second Primary / chemically induced. Neoplasms, Second Primary / diagnosis. Neoplasms, Second Primary / drug therapy. Pyrroles / therapeutic use. Rats. Rats, Inbred F344. Receptor Protein-Tyrosine Kinases / antagonists & inhibitors. Receptors, Growth Factor / antagonists & inhibitors. Receptors, Vascular Endothelial Growth Factor. Survival Analysis. Time Factors

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  • (PMID = 11718257.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Angiogenesis Inhibitors; 0 / Carcinogens; 0 / Indoles; 0 / Pyrroles; 0 / Receptors, Growth Factor; 11103-57-4 / Vitamin A; 1D1K0N0VVC / retinol palmitate; 71IA9S35AJ / Semaxinib; EC 2.7.10.1 / Receptor Protein-Tyrosine Kinases; EC 2.7.10.1 / Receptors, Vascular Endothelial Growth Factor; P8M1T4190R / Ethylnitrosourea
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8. Sanson M, Cartalat-Carel S, Taillibert S, Napolitano M, Djafari L, Cougnard J, Gervais H, Laigle F, Carpentier A, Mokhtari K, Taillandier L, Chinot O, Duffau H, Honnorat J, Hoang-Xuan K, Delattre JY, ANOCEF group: Initial chemotherapy in gliomatosis cerebri. Neurology; 2004 Jul 27;63(2):270-5
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  • [Title] Initial chemotherapy in gliomatosis cerebri.
  • In this setting, initial chemotherapy warrants further investigation.
  • METHODS: The authors treated 63 consecutive patients with GC with initial chemotherapy consisting of either PCV (procarbazine, 60 mg/m2 on days 8 to 21; CCNU, 110 mg/m2 on day 1; and vincristine, 1.4 mg/m2 on days 8 and 29) or temozolomide (TMZ; 150 to 200 mg/m2 for 5 days every 4 weeks).
  • GC was initially present at diagnosis in 49 patients (primary GC), whereas 14 patients with a circumscribed glioma at onset developed secondary GC after a median follow-up period of 5.11 years.
  • GC was classified based on the predominant tumor cells as astrocytic, oligodendroglial, or mixed GC.
  • CONCLUSION: Initial chemotherapy is useful for some patients with gliomatosis cerebri.
  • [MeSH-major] Antineoplastic Agents, Alkylating / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms / drug therapy. Dacarbazine / analogs & derivatives. Dacarbazine / therapeutic use. Neoplasms, Neuroepithelial / drug therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Astrocytoma / drug therapy. Astrocytoma / radiotherapy. Combined Modality Therapy. Cranial Irradiation. Disease Progression. Disease-Free Survival. Drug Administration Schedule. Female. Hematologic Diseases / chemically induced. Humans. Karnofsky Performance Status. Lomustine / administration & dosage. Lomustine / adverse effects. Magnetic Resonance Imaging. Male. Middle Aged. Oligodendroglioma / drug therapy. Oligodendroglioma / radiotherapy. Procarbazine / administration & dosage. Procarbazine / adverse effects. Survival Analysis. Treatment Outcome. Vincristine / administration & dosage. Vincristine / adverse effects

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  • [CommentIn] Neurology. 2004 Jul 27;63(2):204-5 [15277608.001]
  • (PMID = 15277619.001).
  • [ISSN] 1526-632X
  • [Journal-full-title] Neurology
  • [ISO-abbreviation] Neurology
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; 35S93Y190K / Procarbazine; 5J49Q6B70F / Vincristine; 7BRF0Z81KG / Lomustine; 7GR28W0FJI / Dacarbazine; 85622-93-1 / temozolomide; PCV protocol
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9. Chansriwong P, Sirisinha T: Clinical features, management and outcomes of high-grade glioma patients in Ramathibodi Hospital. J Med Assoc Thai; 2010 Feb;93 Suppl 2:S68-73
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  • [Title] Clinical features, management and outcomes of high-grade glioma patients in Ramathibodi Hospital.
  • OBJECTIVE: To identify prognostic factors for survival and evaluate the effect of treatment on survival of patients with high-grade glioma treated at Ramathibodi Hospital.
  • MATERIAL AND METHOD: Medical records of patients with diagnosis of high-grade glioma registered in Ramathibodi cancer registry were reviewed.
  • Mean age of diagnosis was 41.86 years (range 18-71 years).
  • Histological findings were anaplastic glioma (22.20%), glioblastoma multiforme (63.90%) and mixed glioma (13.90%).
  • Nine patients also received chemotherapy (6 temozolomide and 3 BCNU).
  • Median follow-up time was 413.2 days.
  • An overall survival time was 604.04 days and median disease free survival time was 402.45 days.
  • In univariated analysis, the following favorable prognostic factors were identified: histological findings of glioblastoma multiforme (GBM) and mixed glioma, received radiotherapy.
  • CONCLUSION: Adult high-grade glioma had poor prognosis despite aggressive treatment.
  • Radiotherapy significantly improved survival while surgical tumor removal and chemotherapy did not.
  • [MeSH-major] Antineoplastic Agents, Alkylating / therapeutic use. Brain Neoplasms / therapy. Carmustine / therapeutic use. Dacarbazine / analogs & derivatives. Glioma / therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Combined Modality Therapy. Disease-Free Survival. Female. Follow-Up Studies. Hospitals. Humans. Incidence. Male. Middle Aged. Prognosis. Proportional Hazards Models. Retrospective Studies. Survival Analysis. Treatment Outcome. Young Adult

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  • (PMID = 21299082.001).
  • [ISSN] 0125-2208
  • [Journal-full-title] Journal of the Medical Association of Thailand = Chotmaihet thangphaet
  • [ISO-abbreviation] J Med Assoc Thai
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] Thailand
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; 7GR28W0FJI / Dacarbazine; 85622-93-1 / temozolomide; U68WG3173Y / Carmustine
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10. Hyder DJ, Sung L, Pollack IF, Gilles FH, Yates AJ, Davis RL, Boyett JM, Finlay JL: Anaplastic mixed gliomas and anaplastic oligodendroglioma in children: results from the CCG 945 experience. J Neurooncol; 2007 May;83(1):1-8
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  • [Title] Anaplastic mixed gliomas and anaplastic oligodendroglioma in children: results from the CCG 945 experience.
  • PURPOSE: To review interpathologist diagnosis variability and survival of children treated for either anaplastic mixed glioma (AMG) or anaplastic oligodendroglioma (AO) with surgery, irradiation and chemotherapy.
  • PATIENTS AND METHODS: Two hundred and fifty patients with an institutional diagnosis of malignant glioma were enrolled on Children's Cancer Group CCG-945 between 1985 and 1991, and administered vincristine during involved field radiotherapy, then six cycles of prednisone, lomustine and, vincristine; or two cycles of "eight-drugs-in-one-day" (8-in-1) chemotherapy then involved-field radiotherapy followed by six cycles of 8-in-1 chemotherapy.
  • However, central review established that only nine of 26 children had AMG: either mixed oligoastrocytoma (MOA) or anaplastic mixed oligoastrocytoma (AOA) and only one had AO.
  • CONCLUSION: Diagnosis of these tumors is challenging, with only 35% of institutional diagnoses confirmed for AMG and 25% for AO, and survival among children with these tumors is poor, despite intensive therapy.
  • This suggests reliable diagnostic markers and new therapeutic approaches are needed.
  • [MeSH-major] Central Nervous System Neoplasms / diagnosis. Central Nervous System Neoplasms / therapy. Glioma / diagnosis. Glioma / therapy. Oligodendroglioma / diagnosis. Oligodendroglioma / therapy
  • [MeSH-minor] Adolescent. Astrocytoma / diagnosis. Astrocytoma / therapy. Brain Neoplasms / diagnosis. Brain Neoplasms / therapy. Child. Child, Preschool. Cohort Studies. Drug Therapy. Female. Humans. Infant. Male. Neurosurgical Procedures. Radiotherapy. Spinal Cord Neoplasms / diagnosis. Spinal Cord Neoplasms / therapy. Survival Analysis

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  • (PMID = 17252186.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Journal Article; Randomized Controlled Trial
  • [Publication-country] United States
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11. Bauman GS, Cairncross JG: Multidisciplinary management of adult anaplastic oligodendrogliomas and anaplastic mixed oligo-astrocytomas. Semin Radiat Oncol; 2001 Apr;11(2):170-80
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  • [Title] Multidisciplinary management of adult anaplastic oligodendrogliomas and anaplastic mixed oligo-astrocytomas.
  • In recent years, the histologic criteria for the diagnosis of oligodendroglioma have been broadened to include most small cell, monomorphic glial neoplasms.
  • These refinements have led to an increased recognition of oligodendroglial neoplasms, but uniform definitions of pure versus mixed oligodendroglioma as well as the criteria for high-grade (anaplastic) versus low-grade tumors remain elusive.
  • From a prognostic standpoint, the presence of an oligodendroglial component in a malignant glioma predicts longer survivals times for patients treated with surgery, and radiation therapy with or without chemotherapy.
  • High rates of response to PCV (procarbazine, CCNU and Vincristine) chemotherapy also have been noted among patients with anaplastic oligodendroglial neoplasms.
  • Ongoing prospective trials seek to clarify the role of PCV chemotherapy when added to radiation therapy and surgery.
  • In addition, the role of molecular markers as diagnostic aides and guides to therapy and prognosis are being explored for patients with pure and mixed anaplastic oligodendroglial tumors.
  • [MeSH-major] Brain Neoplasms / therapy. Glioma / therapy. Oligodendroglioma / therapy
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols. Combined Modality Therapy. Humans. Lomustine. Neoplasm Staging. Procarbazine. Prognosis. Treatment Outcome. Vincristine

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  • [Copyright] Copyright 2001 by W.B. Saunders Company
  • (PMID = 11285555.001).
  • [ISSN] 1053-4296
  • [Journal-full-title] Seminars in radiation oncology
  • [ISO-abbreviation] Semin Radiat Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 35S93Y190K / Procarbazine; 5J49Q6B70F / Vincristine; 7BRF0Z81KG / Lomustine; PCV protocol
  • [Number-of-references] 56
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12. Chang HT, Cuison RV, Gera R, Saah E, Scott-Emuakpor A, Abood C: 6-year-old girl with hydrocephalus. Brain Pathol; 2009 Oct;19(4):725-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • We report a case of a tectal glioma in a 6-years-old girl with histological features of anaplastic mixed oligoastrocytoma that continues to progress despite chemotherapy and radiation therapy.
  • [MeSH-major] Brain Stem Neoplasms / diagnosis. Glioma / diagnosis. Hydrocephalus / etiology

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  • (PMID = 19744043.001).
  • [ISSN] 1750-3639
  • [Journal-full-title] Brain pathology (Zurich, Switzerland)
  • [ISO-abbreviation] Brain Pathol.
  • [Language] eng
  • [Publication-type] Case Reports; Letter
  • [Publication-country] Switzerland
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13. Burton EC, Prados MD: Malignant gliomas. Curr Treat Options Oncol; 2000 Dec;1(5):459-68
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  • Tumors of mixed lineage are also seen, the most common of which is designated anaplastic oligoastrocytoma (AOA).
  • Standard treatment for these tumors is typically surgery, followed by radiation then chemotherapy.
  • Surgery is required for a definitive histopathologic diagnosis, which in turn will dictate subsequent therapy options.
  • In almost all cases, surgery is followed by radiation therapy.
  • Postsurgical irradiation is the most effective treatment currently available for improving survival.
  • There is also mounting evidence to suggest that additional radiation, given in the form of brachytherapy or radiosurgery, at initial diagnosis as a "boost" to standard radiation or at tumor recurrence, may provide added improvement in survival outcome.
  • Radiosurgery and brachytherapy are therapies often used to treat eligible patients at this institution.
  • Adjuvant chemotherapy, conventionally given after radiation, may offer a modest survival benefit in some patients with GBM.
  • Bischloroethylnitrosourea (BCNU) is the typical first-line agent used, but chemotherapy seems to be most beneficial in young patients, with little if any impact on survival for patients over 60 years old.
  • At this institution, we often defer treatment with adjuvant chemotherapy for elderly patients with GBM due to lack of efficacy and the attendant risk with chemotherapy.
  • For anaplastic astrocytomas, oligodendrogliomas, and oligoastrocytomas, a commonly accepted standard is adjuvant chemotherapy following irradiation with the three-drug regimen--procarbazine, CCNU, and vincristine (PCV).
  • However, recent data suggest that treatment with either PCV or BCNU may be appropriate.
  • Patients with this molecular pattern have an exceptional responsiveness to PCV chemotherapy and have prolonged survival.
  • Currently, trials are being conducted to confirm this finding and to determine the best treatment regimen for these patients, with particular regard to the timing of radiation and chemotherapy.
  • [MeSH-major] Brain Neoplasms / therapy. Glioma / therapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Clinical Trials as Topic. Female. Humans. Radiotherapy. Survival Rate

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  • (PMID = 12057153.001).
  • [ISSN] 1527-2729
  • [Journal-full-title] Current treatment options in oncology
  • [ISO-abbreviation] Curr Treat Options Oncol
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA09291; United States / NCI NIH HHS / CA / CA13525
  • [Publication-type] Journal Article; Research Support, U.S. Gov't, P.H.S.; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 31
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14. Dumont AS, Farace E, Schiff D, Shaffrey ME: Intraventricular gliomas. Neurosurg Clin N Am; 2003 Oct;14(4):571-91
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  • Gliomas are the most common primary brain tumor in adults, and those within or relating to the ventricular surface represent a less common but important subcategory.
  • Other less common varieties have been reported, including chordoid gliomas, glioblastoma multiforme, and mixed glial-neuronal tumors.
  • Each type of intraventricular glioma is associated with its own unique constellation of epidemiologic, clinical, radiologic, and pathologic defining characteristics.
  • Each tumor type has its own management considerations and nuances with unique prognostic indicators and outcomes.
  • Translational research aiming to advance the knowledge of tumor biology into new targeted cellular and molecular therapies holds tremendous promise to improve the overall outcome.
  • Additionally, more thorough delineation of prognostic factors as well as modifications and refinements to radiation and chemotherapy may help to improve the still significantly poor outcomes for patients harboring these lesions.
  • [MeSH-major] Cerebral Ventricle Neoplasms / pathology. Glioma / pathology. Neurosurgical Procedures / methods
  • [MeSH-minor] Age Factors. Combined Modality Therapy. Diagnosis, Differential. Humans. Incidence. Magnetic Resonance Imaging. Prevalence

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  • (PMID = 15024802.001).
  • [ISSN] 1042-3680
  • [Journal-full-title] Neurosurgery clinics of North America
  • [ISO-abbreviation] Neurosurg. Clin. N. Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 159
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15. Mason WP: Progress in clinical neurosciences: Advances in the management of low-grade gliomas. Can J Neurol Sci; 2005 Feb;32(1):18-26
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  • Many aspects of the treatment of low-grade gliomas are debated, including the optimal timing of surgery and radiotherapy, the benefit of extensive surgery, and the impact of these variables on the natural history of these indolent and generally incurable tumours.
  • The recognition that as many as two thirds of low-grade gliomas have oligodendroglial features, advances in molecular diagnostics making accurate pathologic diagnosis of oligodendroglial tumours possible, and the established chemosensitivity of malignant oligodendrogliomas, have raised new issues surrounding the potential value of chemotherapy for low-grade gliomas.
  • This review will be restricted to low-grade diffuse astrocytomas, oligodendrogliomas, and low-grade mixed oligoastrocytomas in adults, and provide evidence-based guidelines for the management of these tumours, including the emerging role of chemotherapy as initial treatment.
  • [MeSH-major] Brain Neoplasms. Glioma

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  • (PMID = 15825542.001).
  • [ISSN] 0317-1671
  • [Journal-full-title] The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques
  • [ISO-abbreviation] Can J Neurol Sci
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Canada
  • [Number-of-references] 74
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16. Stupp R, Janzer RC, Hegi ME, Villemure JG, Mirimanoff RO: Prognostic factors for low-grade gliomas. Semin Oncol; 2003 Dec;30(6 Suppl 19):23-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Low-grade gliomas are a heterogenous group of diseases characterized by relatively slow-growing primary brain tumors of astrocytic and/or oligodendroglial origin.
  • Several studies have retrospectively investigated tumor-, patient-, and treatment-related prognostic factors in this patient population.
  • However, although patients who undergo surgical resection and receive adjuvant radiotherapy tend to have improved survival, treatment-dependent prognostic factors have yet to be definitively identified.
  • Younger patients with good performance status, non-contrast-enhancing tumors (<5 cm), and tumors of oligodendroglial or mixed-oligoastrocytic subtype have improved survival.
  • The European Organisation for Research and Treatment of Cancer has recently developed a prognostic score based on identified prognostic factors to assist in the management of low-grade gliomas.
  • For patients with a favorable (low-risk) score, treatment with radiotherapy or chemotherapy treatment should be withheld until tumor progression.
  • For patients with a high-risk score, treatment at diagnosis may be indicated.
  • However, other than surgery, the optimal types and sequence of therapies are not yet established.
  • Improvements in defining prognostic factors will assist in low-grade glioma management.
  • [MeSH-major] Brain Neoplasms / mortality. Glioma / mortality

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  • (PMID = 14765381.001).
  • [ISSN] 0093-7754
  • [Journal-full-title] Seminars in oncology
  • [ISO-abbreviation] Semin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
  • [Number-of-references] 21
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17. Stieber VW: Low-grade gliomas. Curr Treat Options Oncol; 2001 Dec;2(6):495-506
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  • Low-grade gliomas are uncommon primary brain tumors classified as histologic grades I or II in the World Health Organization (WHO) classification.
  • The most common variants are pilocytic and low-grade astrocytomas, oligodendrogliomas, and mixed oligo-astrocytomas located in the cerebral hemispheres.
  • Dexamethasone is given at an initial dosage of 4 mg given four times daily.
  • Depending upon the proximity of the tumor to eloquent brain, gross total resection may or may not be possible.
  • In these cases a stereotactic biopsy is required to provide the histologic diagnosis.
  • Based on prospective randomized phase III trials, 50.4 Gy to 54 Gy of conventionally fractionated radiotherapy appears to be a safe and effective regimen with minimal neurotoxicity; 45 Gy may be adequate for biopsied pilocytic astrocytomas.
  • Currently, RTOG trial 98-02 is investigating the efficacy of postradiation PCV chemotherapy (procarbazine, CCNU, and vincristine) in the treatment of newly diagnosed unfavorable low-grade gliomas.
  • Other areas of investigation include Temozolomide chemotherapy and the association of 1p and 19q chromosomal deletions with prolonged survival in oligodendrogliomas and sensitivity to PCV chemotherapy.
  • Radiosurgery and/or experimental chemotherapy may provide some measure of local control in the recurrent disease setting.
  • [MeSH-major] Brain Neoplasms / pathology. Glioma / pathology
  • [MeSH-minor] Adolescent. Adult. Anti-Inflammatory Agents / therapeutic use. Anticonvulsants / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Edema / drug therapy. Brain Edema / etiology. Chemotherapy, Adjuvant. Combined Modality Therapy. Cranial Irradiation. Craniotomy. Dexamethasone / therapeutic use. Epidemiologic Methods. Forecasting. Humans. Prognosis. Radiosurgery. Radiotherapy Dosage. Radiotherapy, Adjuvant / adverse effects. Seizures / drug therapy. Seizures / etiology. Survival Analysis. Survival Rate. Treatment Outcome

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  • (PMID = 12057095.001).
  • [ISSN] 1527-2729
  • [Journal-full-title] Current treatment options in oncology
  • [ISO-abbreviation] Curr Treat Options Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Anti-Inflammatory Agents; 0 / Anticonvulsants; 7S5I7G3JQL / Dexamethasone
  • [Number-of-references] 57
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18. Rock JP, Hearshen D, Scarpace L, Croteau D, Gutierrez J, Fisher JL, Rosenblum ML, Mikkelsen T: Correlations between magnetic resonance spectroscopy and image-guided histopathology, with special attention to radiation necrosis. Neurosurgery; 2002 Oct;51(4):912-9; discussion 919-20
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Magnetic resonance imaging, single-photon emission computed tomography, and positron emission tomography cannot provide definitive histopathological insight.
  • METHODS: Twenty-seven patients who had been treated previously with surgery, radiotherapy, and chemotherapy and reoperated for clinical and/or radiographic signs that caused suspicion for recurrent disease were studied.
  • Tissues were categorized into four groups: spectroscopically normal, pure tumor, mixed tumor and radiation necrosis, and pure radiation necrosis.
  • Logistic regression analysis was performed on the basis of data obtained from 99 (1)H MRSI observations to determine whether the (1)H MRSI ratios varied according to tissue category.
  • The odds of a biopsy's being pure tumor and having either a Cho/nCr value greater than 1.79 or a Lip-Lac/Cho value less than 0.75 are seven times the odds of that biopsy's being pure necrosis (odds ratio, 7.00; P = 0.0136).
  • The odds of a biopsy's being pure necrosis and having either a Cho/nCr value less than 0.89 or a Cho/nCho value less than 0.66 are six times the odds of that biopsy's being pure tumor (odds ratio, 5.71; P = 0.0329).
  • The odds of a biopsy's being pure necrosis and having either a Lip-Lac/Cho value greater than 1.36 or a Lip-Lac/nCr value greater than 2.84 are more than five times the odds of the biopsy's being pure tumor (odds ratio, 5.25; P = 0.0322).
  • No values suggested that mixed specimens could be distinguished in a statistically significant way from either pure tumor or pure necrosis.
  • CONCLUSION: The data that we gathered suggest that metabolite ratios derived on the basis of (1)H MRSI spectral patterns do allow reliable differential diagnostic statements to be made when the tissues are composed of either pure tumor or pure necrosis, but the spectral patterns are less definitive when tissues composed of varying degrees of mixed tumor and necrosis are examined.
  • [MeSH-major] Brain Neoplasms / pathology. Brain Neoplasms / radiotherapy. Glioma / pathology. Glioma / radiotherapy. Magnetic Resonance Spectroscopy. Radiation Injuries / diagnosis
  • [MeSH-minor] Adult. Choline / metabolism. Creatine / metabolism. Diagnosis, Differential. Humans. Lactic Acid / metabolism. Lipid Metabolism. Necrosis. Neoplasm Recurrence, Local / diagnosis

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  • (PMID = 12234397.001).
  • [ISSN] 0148-396X
  • [Journal-full-title] Neurosurgery
  • [ISO-abbreviation] Neurosurgery
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 33X04XA5AT / Lactic Acid; MU72812GK0 / Creatine; N91BDP6H0X / Choline
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19. Xie J, Luo SQ, Ma ZY, Zhang YQ, Zeng HY, Qiu XG: [The clinical features and treatment of intracranial tumors in infants]. Zhonghua Yi Xue Za Zhi; 2004 Aug 2;84(15):1270-5
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  • [Title] [The clinical features and treatment of intracranial tumors in infants].
  • OBJECTIVE: To explore the treatment plan of intracranial tumors in infants.
  • But 6 patients developed worse than the children of the same age.
  • It is a trend towards performing chemotherapy after operation.
  • It is not necessary to perform auxiliary therapy for astrocytoma, oligodendroglioma, and mixed glioma, because the prognosis is good after total removal of the tumor.
  • [MeSH-major] Brain Neoplasms / diagnosis. Brain Neoplasms / surgery. Microsurgery
  • [MeSH-minor] Astrocytoma / diagnosis. Astrocytoma / surgery. Cerebellar Neoplasms / diagnosis. Cerebellar Neoplasms / surgery. Child, Preschool. Cranial Fossa, Posterior. Female. Follow-Up Studies. Humans. Infant. Male. Medulloblastoma / diagnosis. Medulloblastoma / surgery. Retrospective Studies. Sella Turcica

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  • (PMID = 15387964.001).
  • [ISSN] 0376-2491
  • [Journal-full-title] Zhonghua yi xue za zhi
  • [ISO-abbreviation] Zhonghua Yi Xue Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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20. Marti A, Almostarchid B, Maher M, Saidi A: Desmoplastic non-infantile ganglioglioma. Case report. J Neurosurg Sci; 2000 Sep;44(3):150-4
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  • Desmoplastic gangliogliomas are rare mixed glial and neuronal cerebral tumors, especially described in infants below 4 years of age but exceptional cases have been reported in young adults.
  • Total surgical removal is sufficient for the treatment of these tumors and no radiotherapy or chemotherapy are indicated if complete resection is achieved.
  • At histological examination, this tumor exhibited extensive desmoplasia and comprised 2 types of tumoral cells: small cells with round nuclei, positive for NSE, neurofilaments and synaptophysin and sometimes presenting typical morphological features of neuronal differentiation, and large cells with abundant eosinophilic strongly staining for GFAP.
  • This observation emphazises on the fact that desmoplastic ganglioglioma can no more be considered as a specific entity of infancy and must be well recognised even in young adults because it may be misdiagnosed as malignant glioma.
  • [MeSH-major] Brain Neoplasms / diagnosis. Ganglioglioma / diagnosis. Parietal Lobe. Temporal Lobe
  • [MeSH-minor] Adult. Astrocytes / pathology. Cysts / diagnosis. Cysts / pathology. Humans. Male. Neurosurgical Procedures. Reoperation. Tomography, X-Ray Computed

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  • (PMID = 11126451.001).
  • [ISSN] 0390-5616
  • [Journal-full-title] Journal of neurosurgical sciences
  • [ISO-abbreviation] J Neurosurg Sci
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
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21. Rock JP, Scarpace L, Hearshen D, Gutierrez J, Fisher JL, Rosenblum M, Mikkelsen T: Associations among magnetic resonance spectroscopy, apparent diffusion coefficients, and image-guided histopathology with special attention to radiation necrosis. Neurosurgery; 2004 May;54(5):1111-7; discussion 1117-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • OBJECTIVE: In patients with malignant glioma previously treated with surgery, radiation, and chemotherapy, clinical and radiographic signs of recurrent disease often require differentiation between radiation necrosis and recurrent tumor.
  • Published work suggests that although magnetic resonance spectroscopy (MRS) can reliably differentiate pure tumor, pure necrosis, and spectroscopically normal tissues, it may not be particularly helpful because most patients have mixed histological findings comprised of necrosis and tumor.
  • Spectral data for pure tumor, pure necrosis, and mixed tumor and necrosis were derived from 65 spectroscopic observations in patients with previously treated gliomas (n = 16) and metastatic tumors (n = 2).
  • Spectral data for choline (Cho), N-acetylaspartate (NAA), creatine (Cr), and lipid-lactate were analyzed separately and in conjunction with ADCs in all patients (15 observations of pure tumor, 33 observations of pure necrosis, and 13 observations of mixed tumor and necrosis).
  • Histological specimens were obtained stereotactically at the time of surgery (<48 h after image acquisition) for recurrent disease and digitally co-registered with MRS data.
  • RESULTS: ADC values for pure tumor, pure necrosis, and mixed tumor and necrosis were 1.30, 1.60, and 1.42, respectively.
  • Cho/NAA less than 0.20, NAA/normal Cr greater than 1.56, and NAA/Cho greater than 1.32 increase the odds that a tissue biopsy will be pure necrosis versus mixed tumor and necrosis.
  • Although various values of all MRS ratios analyzed may provide positive correlations for histopathological differentiation of tissue between that of pure tumor and that of pure necrosis, the addition of ADC values to only NAA/Cho and NAA/normal Cr increases the odds of correct differentiation between pure tumor and pure necrosis.
  • The addition of ADC values does not provide additional information beyond that of MRS in distinguishing specimens of mixed tumor and necrosis from either pure tumor or pure necrosis.
  • However, although a trend toward correlation between ADC values and the various histopathological features was noted, the direct addition of ADC data does not seem to allow further discrimination, beyond that provided by MRS, among specimens of mixed tumor and necrosis and either pure tumor or pure necrosis.
  • [MeSH-major] Brain / pathology. Brain Neoplasms / diagnosis. Diffusion Magnetic Resonance Imaging. Magnetic Resonance Spectroscopy. Neoplasm Recurrence, Local / diagnosis. Radiation Injuries / diagnosis
  • [MeSH-minor] Adult. Diagnosis, Differential. Humans. Necrosis

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  • (PMID = 15113465.001).
  • [ISSN] 0148-396X
  • [Journal-full-title] Neurosurgery
  • [ISO-abbreviation] Neurosurgery
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
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22. Newton HB, Dalton J, Ray-Chaudhury A, Gahbauer R, McGregor J: Aggressive papillary glioneuronal tumor: case report and literature review. Clin Neuropathol; 2008 Sep-Oct;27(5):317-24
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  • Papillary glioneuronal tumors (PGNT) are a rare, recently described form of mixed neoplasm composed of glial and neuronal components.
  • Here we describe a newly diagnosed case of PGNT with a more aggressive phenotype that required irradiation and chemotherapy.
  • The patient was a 19-year-old female who developed progressive headaches and visual seizures.
  • The diagnosis was aggressive PGNT, and treatment consisted of conformal irradiation and concomitant temozolomide over 6 weeks.
  • This patient demonstrates that PGNT may, in rare cases, display an aggressive clinicopathologic phenotype that requires a therapeutic approach more consistent with a high-grade glioma.
  • [MeSH-major] Brain Neoplasms / pathology. Carcinoma, Papillary / pathology. Ganglioglioma / pathology
  • [MeSH-minor] Adult. Antineoplastic Agents / therapeutic use. Combined Modality Therapy. Dacarbazine / analogs & derivatives. Dacarbazine / therapeutic use. Female. Humans. Magnetic Resonance Imaging. Radiotherapy, Conformal

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  • (PMID = 18808063.001).
  • [ISSN] 0722-5091
  • [Journal-full-title] Clinical neuropathology
  • [ISO-abbreviation] Clin. Neuropathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 7GR28W0FJI / Dacarbazine; 85622-93-1 / temozolomide
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