Extended exposure of the petroclival junction: The combined anterior transpetrosal and subtemporal/transcavernous approach.
Conclusion: The combined approach studied here is a useful skull base approach to the petroclival junction and can be applied to treat large or complex pathologies of the region. Detailed anatomical knowledge is essential. PMID: 30687570 [PubMed]
Abstract Re-irradiation can offer a potentially curative solution in case of progression after initial therapy, however a second course of radiotherapy can be associated with an increased risk of severe side-effects. Particle therapy with protons and especially carbon ions spares surrounding tissue better than most photon techniques, thus it is of high potential for re-irradiation. Irradiation of tumors of the brain, head and neck and skull bases involves several delicate risk organs, e.g. optic system, brainstem, salivary gland or swallowing muscles. Adequate local control rates with tolerable side-effects have b...
ConclusionsDespite a PFR at 12 weeks lower than expected, this randomized non comparative study shows a promising signal of benefit of REG in relapsed CS, with a median of PFS of 19 weeks and, an acceptable toxicity.Clinical trial identificationEudraCT: 2013-003910-42, NCT02389244.Legal entity responsible for the studyUNICANCER.FundingBayer HealthCare SAS.DisclosureF. Duffaud: Honoraria (self), Advisory / Consultancy: Bayer; Honoraria (self), Advisory / Consultancy: Roche; Advisory / Consultancy: Lilly; Travel / Accommodation / Expenses: Pharmamar; Travel / Accommodation / Expenses: Leo Pharma. J. Blay: Honoraria (self), H...
CONCLUSIONS: The authors present their preliminary experience with EPPAP for skull base tumors in the petrous part of the temporal bone and the lateral part of the occipital condyle involving the cranial nerves and internal carotid arteries. The microscope showed a higher-quality image and illumination in the low-power field. However, the endoscope could offer wider visualization of the surgical field and contribute to minimizing the size of the surgical pathways, necessity of brain retraction, and eventually the invasiveness of surgery. Thus, the EPPAP may be safe and effective for skull base tumors in the petrous region,...
High-dose fractionated proton therapy is used to manage patients with skull base tumors such as clival chordomas or chondrosarcomas [8,14]. Proton therapy is also used in the treatment of patients with lower grade gliomas , meningiomas, and subsets of head and neck cancer patients with particular dosimetric benefit, such as those with tumors of the paranasal sinuses . Clinical outcomes support the utility of proton therapy in the disease control of these tumors but little is known on potential late side effects of brain radiation necrosis.
Conditions: Pituitary Tumor; Meningioma; Rathke Cleft Cysts; Chordoma; Chondrosarcoma; Craniopharyngioma; Encephalocele; Esthesioneuroblastoma Intervention: Sponsor: Ohio State University Recruiting
CONCLUSIONS: LEM I and LEM IV-based RBE-weighted doses in the target volume may be significantly different. Replacing the applied model in patient treatments may therefore lead to local over- or underdosages in the tumor. If LEM IV is to be tested clinically, comparisons of the RBE-weighted dose distributions of both models are required for the individual patients to assess whether the LEM IV-plan would also be acceptable and prescribed dose as well as clinical outcome data have to be carefully reassessed. PMID: 31522880 [PubMed - as supplied by publisher]
Carbon ion radiotherapy of tumors of the skull base has gained increasing interest throughout the last two decades. Similar to protons, carbon ions allow for highly conformal irradiation of the tumor while sparing the surrounding normal tissue structures like brain stem, optic nerves and the chiasma due to their “inverted” depth dose profile, the so-called Bragg-peak . An additional rationale for selecting carbon ions results from their higher relative biological effectiveness (RBE) relative to photons and protons, which increases with penetration depth and reaches its maximum at the distal edge of t he Bragg-peak .
ConclusionsHuMax-IL8 is safe and well-tolerated. Ongoing studies are evaluating the combination of IL-8 blockade and other immunotherapies.Trial registrationNCTN, NCT02536469. Registered 23 August 2015,https://clinicaltrials.gov/ct2/show/NCT02536469?term=NCT02536469&rank=1.
Conclusion: For base-of-skull and pediatric craniopharyngioma cases, both physical and biological robustness analyses should be considered for IMPT: these analyses can substantially affect the sparing of OARs and comparisons against VMAT. All proton RBE modeling is subject to high levels of uncertainty, but the clinical community should remain cognizant possible RBE effects. Careful clinical and imaging follow-up, plus further research on end-of-range RBE mitigation strategies such as LET optimization, should be prioritized for these cohorts of proton patients. PMID: 31429359 [PubMed - as supplied by publisher]