Stereotactic Radiosurgery for Recurrent Glioblastoma Multiforme

Glioblastoma multiforme (GBM) is the most aggressive intracranial tumor that primarily affects adults. Since the introduction of temozolomide in 2005, maximal resection surgery with concurrent chemoradiation has become the standard treatment method for patients with newly diagnosed GBM. Although newly discovered chemoagents have been demonstrated to improve the median survival time, GBM still recurs in most patients. Recurrent GBM is still a therapeutic challenge for clinical physicians. Surgical intervention and other conventional chemoagents have been applied to manage recurrent GBM. Stereotactic radiosurgery (SRS) provides a highly precise radiation dose to the tumor lesion and reduces the dose to the adjacent normal brain tissue. After standard treatment for newly diagnosed GBM is completed, conventional re-irradiation therapy is not suitable for patients with recurrent GBMs. Therefore, SRS may become an alternative option in the treatment of recurrent GBMs. In this review, we discuss the relevant literature regarding SRS for recurrent GBMs and provide treatment advice for clinical physicians

Understanding Simulations of Thin Accretion Disks by Energy Equation

We study the fluctuations of standard thin accretion disks by linear analysis of the time-dependent energy equation together with the vertical hydrostatic equilibrium and the equation of state. We show that some of the simulation results in Hirose et al. (2009b), such as the time delay, the relationship of power spectra, and the correlation between magnetic energy and radiation energy, can be well understood by our analytic results.Comment: 13 pages, 3 figure, accepted for publication in Ap

Variability of the giant X-ray bump in GRB 121027A and possible origin

The particular giant X-ray bump of GRB 121027A triggered by \emph{Swift} is quite different from the typical X-ray flares in gamma-ray bursts. There exhibit four parts of the observed structural variabilities in the rise and decay phase of the bump. Considering the quality of four parts of the data, we can only analyze the data from about 5300 s to about 6100 s in the bump using the stepwise filter correlation method (Gao et al. 2012), and find that the $86^{+5.9}_{-9.4}~\rm s$ periodic oscillation may exist, which is confirmed by the Lomb-Scargle method (Scargle 1982). Furthermore, a jet precession model (Liu et al. 2010) is proposed to account for such a variability.Comment: 5 pages, 3 figures, accepted for publication in MNRA

The influence of outflows on the 1/f-like luminosity fluctuations

In accretion systems, outflows may have significant influence on the luminosity fluctuations. In this paper, following the Lyubarskii's general scheme, we revisit the power spectral density of luminosity fluctuations by taking into account the role of outflows. Our analysis is based on the assumption that the coupling between the local outflow and inflow is weak on the accretion rate fluctuations. We find that, for the inflow mass accretion rate $\dot M \propto r^{s}$, the power spectrum of flicker noise component will present a power-law distribution $p(f) \propto f^{-(1+4s/3)}$ for advection-dominated flows. We also obtain descriptions of $p(f)$ for both standard thin discs and neutrino-cooled discs, which show that the power-law index of a neutrino-cooled disc is generally larger than that of a photon-cooled disc. Furthermore, the obtained relationship between $p(f)$ and $s$ indicates the possibility of evaluating the strength of outflows by the power spectrum in X-ray binaries and gamma-ray bursts. In addition, we discuss the possible influence of the outflow-inflow coupling on our results.Comment: 6 pages, 1 figure, accepted for publication in MNRA

Case report: Ruptured internal carotid artery fusiform aneurysm mimicking pituitary apoplexy after stereotactic radiosurgery

Pituitary adenomas are benign tumors of the anterior pituitary gland for which surgery or pharmacological treatment is the primary treatment. When initial treatment fails, radiation therapy should be considered. There are several case reports demonstrating radiation-induced vascular injury. We report an adult patient who presented with headache and diplopia for 6 months and a sellar tumor with optic chiasm compression. The patient received transnasal surgery, and the tumor was partially removed, which demonstrated adenoma. Stereotactic radiosurgery (SRS) was arranged. However, owing to progressive tumor growth, the patient received further transnasal surgery and stereotactic radiosurgery (SRS). After 14 years, the patient reported the sudden onset of headache and diplopia, and a ruptured fusiform aneurysm from the left internal carotid artery with pituitary apoplexy was diagnosed. The patient received transarterial embolization of the aneurysm. There were no complications after embolization, and this patient was ambulatory on discharge with blindness in the left eye and cranial nerve palsies. Aneurysm formation may be a complication of SRS, and it may occur after several years. Further research is needed to investigate the pathogenesis of radiosurgery and the development of cerebral aneurysms

Clinical Study Clinical Evaluation of CyberKnife in the Treatment of Vestibular Schwannomas

Objective. This study assessed the posttreatment tumor control and auditory function of vestibular schwannoma (VS) patients after CyberKnife (CK) and analyzed the possible prognostic factors of hearing loss. Methods. We retrospectively studied 117 VS patients, with Gardner-Robertson (GR) classification grades I to IV, who underwent CK between 2006 and 2012. Data including radiosurgery treatment parameters, pre-and postoperative tumor size, and auditory function were collected and examined. Results. With CK, 117 patients had excellent tumor control rates (99.1%), with a mean imaging followup of 61.1 months. Excluding 52 patients (GR III-IV pretreatment), 53 (81.5%) of the remaining 65 patients (initial GR I-II) maintained GR I or II hearing after CK, with a mean audiometric followup of 64.5 months. Twelve patients experienced hearing degradation (91.6% were GR II pretreatment); they appeared to have significantly larger tumor sizes, significantly smaller cochlear sizes, and higher prescribed cochlear doses, compared to the patients with preserved hearing. Conclusion. Our data showed that CK treatment provided an excellent tumor control rate and a comparable hearing preservation rate in VS patients. Patients with pretreatment GR II hearing levels, larger tumor volumes, smaller cochlear sizes, and higher prescribed cochlear doses may have poor hearing prognoses

DO INTERMEDIATE-MASS BLACK HOLES EXIST IN GLOBULAR CLUSTERS?

National Basic Research Program (973 Program) of China [2014CB845800]; National Natural Science Foundation of China [11073015, 11103015, 11222328, 11233006, 11333004, U1331101]The existence of intermediate-mass black holes (IMBHs) in globular clusters (GCs) remains a crucial problem. Searching for IMBHs in GCs reveals a discrepancy between radio observations and dynamical modelings: the upper mass limits constrained by radio observations are systematically lower than that of dynamical modelings. One possibility for such a discrepancy is that, as we suggest in this work, there exist outflows in accretion flows. Our results indicate that, for most sources, current radio observations cannot rule out the possibility that IMBHs may exist in GCs. In addition, we adopt an (M)over dot - L-R relation to revisit this issue, which confirms the results obtained by the fundamental plane relation