COMBINED CHEMOTHERAPY INCLUDING PROCARBAZINE (NATULAN) IN THE TREATMENT OF ANAPLASTIC OLIGODENDROGLIOMAS

Our investigation has demonstrated the high efficiency of combined chemotherapy (CT) including procarbazine + lomustine or procarbazine + lomustine + vincristine in patients with anaplastic oligodendrogliomas. Postoperative CT has been recently recommended for patients with deletion of chromosomes 1p and 19q, by taking into account the good prognosis of a therapeutic effect, better parameters of time till progression in this patient group, and a risk for cognitive impairments after brain radiotherapy

Clinical and radiological characteristics in fatal third ventricle colloid cyst. Literature review

Background: Colloid cysts are a benign tumor that is almost exclusively found in the third ventricle and may cause hydrocephalus and rarely life-threatening acute deterioration and even sudden death. With very few cases of sudden death reported in literature not much is known about the patient and cyst characteristics in these patients. The authors present a review of 65 cases of colloid cyst attributed deaths in literature. Materials and methods: A literature search for sudden death with radiologically or pathologically identified colloid cyst was done on PubMed, google scholar, Medbase and clinicaltrials.org research drives. Patient demographics, symptoms and cyst characteristics were recorded and analyzed. A Bivaret Pearson correlation coefficient was used to analyze and compare the relationship between each antecedent symptom, cyst size, and, cyst hemorrhage in patients who subsequently succumbed and died in order to ascertain possible relation. Results: Most patients had a history of sudden severe headaches (p = 0.01) with associated vomiting (p = 0.03). Radiologically, cyst associated ventriculomegaly was seen in 97% (P = 0.78) was a notable feature. Even more, the cyst size (p = 0.01) and associated hemorrhage (p = 0.02) were also major notable feature preceding sudden death in both gender group. Conclusion: Acute deterioration in colloid cysts is rare, but can be fatal. Associated symptoms include severe headache and vomiting. Seizures are commonly seen in patients in the first two decades. Given the risk of acute deterioration and mortality, headaches should be thoroughly investigated and all patients diagnosed with a colloid cyst > 1 cm should be offered surgical management regardless of symptom profile. © 2020 Elsevier Lt

ADVANCES IN THE NEUROSURGICAL AND COMBINED TREATMENT OF PATIENTS WITH ACROMEGALY

Aim. The study was carried out to identify and analyze the factors of a positive outcome of surgical and radiation treatment of acromegaly. METHODS. The work was performed on clinical material and summarizes treatment results of 256 patients (90 males and 166 females). 86% of patients underwent surgical treatment, 14% of patients received radiation therapy during 2002-2018. Significance of factors of a positive outcome of treatment was carried out using the RStudio program. RESULTS. The results of the study revealed that: 1. Significant factors (p <0.05) of a positive outcome of surgical treatment of acromegaly are somatostatin analogs (SSA) therapy before surgery, a small tumor size (microadenomas), and the absence of extrasellar tumor spread. 2. The most significant factor in achieving remission of acromegaly after non-radical adenomectomy is postoperative therapy with SSA (p <0.05). 3. Aggressive pituitary tumors invading surrounding structures, high baseline IGF-1 levels, unfavorable histological findings, macroadenomas, growth hormone levels above 10 mu g/L before therapy, and extrasellar tumor spread were associated with less favorable outcomes of acromegaly radiation therapy (RT) (p <0.05). The most significant factor in achieving remission of acromegaly is SSA therapy after RT (p <0.05). CONCLUSION. Surgical treatment is the optimal primary treatment for acromegaly. Drug therapy with SSA is effective and the preferred treatment after non-radical surgery

Comparing Two Improved Techniques With the Traditional Surgical Techniques for Intra and Extramedullary Spinal Tumor Resection: A Report of 280 Cases

Objectives: Spinal tumors remain a challenging problem in modern neurosurgery. The high rate of postoperative morbidity associated with intramedullary tumors makes the need for safer surgical techniques invaluable. This study analyses our experience with the treatment of spinal cord tumors and compares traditional management and a new different surgical approach to intramedullary tumors with an associated hydrosyringomyelia. Materials and Methods: This retrospective study compared standard surgical techniques and 2 newer modified techniques for intra and extramedullary spinal tumors at the Neurosurgery center for spinal cord tumors of the Republic of Uzbekistan. Preoperative neurological status was recorded with the ASIA/ISNCSCI scale. Postoperative outcome was graded using the Nurrick score. Results: Of the 280 cases, there were 220 (78.5%) extramedullary and 60 (21.5%) with intramedullary spinal tumors. The control and main group had 159 (56.8%) and 121 (43.2%) patients, respectively. Severe compression myelopathy (ASIA- A, B, C) was 217 (77.5%) patients i.e., ASIA A-39 (13.9%); B-74 (26.4%), and C-104 (37.1%). In 74 extramedullary tumors (33.6%) treated with the new method, good postoperative outcomes in 44 cases (59.5%) with OR = 1.9; 95% CI 1.1–3.3 (p < 0.05). Thirty-seven (61.7%) intramedullary tumors were treated with the newer modified technique. There was no difference with the standard method (p = 0.15). However, when comparing postoperative Nurick grade 1–2 with grade 3–4, the newer strategy was superior with improvement in 24 (65%) patients, OR = 3.46; 95% CI 1.2–10.3 (p < 0.05). Conclusion: When compared with standard methods, the proposed newer modified strategy of surgical treatment of spinal cord tumors with the insertion of a syringosubarachnoid shunt in the presence of an associated hydrosyringomyelia is associated with better postoperative outcome (Nurick 1 and 2) in 64.8%. Copyright © 2022 Djumanov, Kariev, Chmutin, Antonov, Chmutin, Musa, Maier and Shumadalova

Combination chemotherapy in the treatment of breast cancer patients with metastatic brain involvement and a poor prognosis

Radiotherapy (RT) is a standard treatment for breast cancer (BC) patients with metastatic brain involvement. All patients (n = 15) had already received chemotherapy (CT) for the underlying disease when they were found to have brain metastases. To develop effective CT regimens for patients with recurrent brain metastases, who have received RT to the brain, is a serious problem. Combination CT with gemcitabine and cisplatin showed a high efficacy (complete and partial regressions were achieved in 47.7% of cases) and fair survival rates (median 10 months) in a group of patients with BC brain metastases and a poor prognosis

Stroke in children. Formation of the pediatric register: international and regional experience

The problem of pediatric stroke has become relevant in recent decades. The method of the register helps to assess the epidemiological situation, the effectiveness of treatment and prevention of stroke in children. The article provides an analysis of the existing registers of pediatric stroke in different countries and the experience of the regional Moscow register