LES GLIOMES DU TRONC CEREBRAL DE L'ADULTE (DES NEUROLOGIE)

PARIS6-Bibl.Pitié-Salpêtrie (751132101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Single and simultaneous multiple intracerebral hemorrhages: a radiological review

International audienceSimultaneous multiple intracerebral hemorrhage (SMICH) is defined as ICH in two or more discrete noncontiguous acute intraparenchymal locations on initial CT. About 5% of ICH patients present with SMICH. ICH/SMICH etiology is classically divided into disorders of primary or secondary origin. About half of primary SMICH cases are caused by cerebral amyloid angiopathy or hypertensive arteriopathy. In this review, we will discuss the radiological features associated with the different causes of primary and secondary ICH and SMICH. Due to its rarity and the associated high morbidity and mortality, we will focus in particular on SMICH

FMISO-PET-derived brain oxygen tension maps: application to glioblastoma and less aggressive gliomas

Abstract Quantitative imaging modalities for the analysis of hypoxia in brain tumors are lacking. The objective of this study was to generate absolute maps of tissue ptO2 from [18F]-FMISO images in glioblastoma and less aggressive glioma patients in order to quantitatively assess tumor hypoxia. An ancillary objective was to compare estimated ptO2 values to other biomarkers: perfusion weighted imaging (PWI) and tumor metabolism obtained from 1H-MR mono-voxel spectroscopy (MRS). Ten patients with glioblastoma (GBM) and three patients with less aggressive glioma (nGBM) were enrolled. All patients had [18F]-FMISO and multiparametric MRI (anatomic, PWI, MRS) scans. A non-linear regression was performed to generate ptO2 maps based on normal appearing gray (NAGM) and white matter (NAWM) for each patient. As expected, a marked [18F]-FMISO uptake was observed in GBM patients. The ptO2 based on patient specific calculations was notably low in this group (4.8 ± 1.9 mmHg, p < 0.001) compared to all other groups (nGBM, NAGM and NAWM). The rCBV was increased in GBM (1.4 ± 0.2 when compared to nGBM tumors 0.8 ± 0.4). Lactate (and lipid) concentration increased in GBM (27.8 ± 13.8%) relative to nGBM (p < 0.01). Linear, nonlinear and ROC curve analyses between ptO2 maps, PWI-derived rCBV maps and MRS-derived lipid and lactate concentration strengthens the robustness of our approaches

Immunotherapy with CpG-ODN in neoplastic meningitis: A phase I trial

International audienc

Minimal clinically important difference for the EORTC QLQ-C30 and QLQ-BN20 questionnaires in glioblastoma patients using several distribution and anchor-based methods

Abstract published in Quality of Life Research, 26(Suppl 1):134:135, 2017International audienceMany researches have been conducted in the last decades on the determination of the minimal clinically important difference(MCID) for health-related quality of life (HRQOL) scores. Several methods have been proposed, generally classified in distribution oranchor-based methods. A joint use of both distribution and anchorbased approaches, using several distributions and anchors, should be recommended to study the consistency and reliability of the results. Our objective was to explore and to compare sevenapproaches from the distribution and anchor based methods of the MCID in EORTC questionnaires using a small sample size, tohighlight the advantages and disadvantages of each of them and the consistency of the results. Methods: Data from a randomized phase II clinical trial in unresectable glioblastoma patients were used. Patients completed the EORTC QLQ-C30 questionnaire and the QLQ-BN20 brain cancer module at baseline and during the treatment. Four distribution-based approaches were applied usingbaseline scores: 0.2 standard deviation (SD), 0.3 SD, 0.5 SD and the standard error of measurement. Three anchors were used: the patient rating of change (PRC), global HRQOL change (GHC) using item 30 of the QLQ-C30 and the Karnofsky performance status (PS). Correlation between HRQOL and the anchors were checked. Results: Among the 134 patients involved in this study,102 patients (76 %) had at least one HRQOL score available at baseline and were included in the analysis based on the distribution.For the distributions, the minimal and maximal MCID were (4–18) and (2–16) for the QLQ-C30 and QLQ-BN20 questionnairesrespectively. Regarding the anchor, the role functioning dimension of the QLQ-C30 questionnaire was correlated with both PS andGHC anchors (r[0.30). The MCID calculated for this dimension was 5 points for deterioration and 2 points for improvement.Conclusions: The strength of our study is the diversity of anchors explored in order to estimate the MCID (evaluated by the patienthimself and one evaluated by the clinicians), but the sample size is challenging in this context of poor prognostic disease using anchor based approaches. These results will be compared to other published results for brain cancer tumor with QLQ-BN20

Temozolomide Plus Bevacizumab in Elderly Patients with Newly Diagnosed Glioblastoma and Poor Performance Status: An ANOCEF Phase II Trial (ATAG)

International audienceLESSONS LEARNED:Results suggest that the combination of bevacizumab plus temozolomide is active in terms of response rate, survival, performance, quality of life, and cognition in elderly patients with glioblastoma multiforme with poor performance status.Whether this combination is superior to temozolomide alone remains to be demonstrated by a randomized study.BACKGROUND:The optimal treatment of glioblastoma multiforme (GBM) in patients aged ≥70 years with a Karnofsky performance status (KPS) 70). Cognition and quality of life significantly improved over time during treatment. Grade ≥3 hematological adverse events occurred in 13 (20%) patients, high blood pressure in 16 (24%), venous thromboembolism in 3 (4.5%), cerebral hemorrhage in 2 (3%), and intestinal perforation in 2 (3%).CONCLUSION:This study suggests that TMZ + Bev treatment is active in elderly patients with GBM with low KPS and has an acceptable tolerance level.© AlphaMed Press; the data published online to support this summary is the property of the authors

Identification of three clinical neurofibromatosis 1 subtypes: Latent class analysis of a series of 1351 patients

International audienc

Identification of three clinical neurofibromatosis 1 subtypes: Latent class analysis of a series of 1351 patients

International audienc