11 research outputs found
Traitement des acouphènes invalidants par stimulation cérébrale corticale ( Etude de faisabilité. A propos d'un cas)
REIMS-BU Santé (514542104) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF
MĂ©ningiomes atypiques et malins, Ă propos de 36 cas
REIMS-BU Santé (514542104) / SudocSudocFranceF
Gonadotropin-Secreting Pituitary Macroadenoma Complicated With Hemorrhagic Apoplexy in 18F-FDG PET/CT
International audienc
Tau protein as a possible marker of cerebrospinal fluid leakage in cerebrospinal fluid rhinorrhoea: A pilot study
International audienc
FRACTIONATED STEREOTACTIC RADIOTHERAPY TREATMENT OF CAVERNOUS SINUS MENINGIOMAS: A STUDY OF 100 CASES
Purpose:We discuss our experiences with fractionated stereotactic radiotherapy (FSR) in the treatment of cavernous
sinus meningiomas.
Methods and Materials: From 1995 to 2006, we monitored 100 patients diagnosed with cavernous sinus meningiomas;
84 female and 16 male patients were included. The mean patient age was 56 years. The most common
symptoms were a reduction in visual acuity (57%), diplopia (50%), exophthalmy (30%), and trigeminal neuralgia
(34%). Surgery was initially performed on 26 patients. All patients were treated with FSR. A total of 45 Gy was
administered to the lesion, with 5 fractions of 1.8 Gy completed each week. Patient treatment was performed using
a Varian Clinac linear accelerator used for cranial treatments and a micro-multileaf collimator.
Results: No side effects were reported. Mean follow-up period was 33 months, with 20% of patients undergoing
follow-up evaluation of more than 4 years later. The tumor control rate at 3 years was 94%. Three patients required
microsurgical intervention because FSR proved ineffective. In terms of functional symptoms, an 81% improvement
was observed in patients suffering from exophthalmy, with 46% of these patients being restored to full
health. A 52% improvement was observed in diplopia, together with a 67% improvement in visual acuity and
a 50% improvement in type V neuropathy.
Conclusions: FSR facilitates tumor control, either as an initial treatment option or in combination with microsurgery.
In addition to being a safe procedure with few side effects, FSR offers the significant benefit of superior functional
outcomes
Delaying standard combined chemoradiotherapy after surgical resection does not impact survival in newly diagnosed glioblastoma patients
International audienceBACKGROUND:To assess the influence of the time interval between surgical resection and standard combined chemoradiotherapy on survival in newly diagnosed and homogeneously treated (surgical resection plus standard combined chemoradiotherapy) glioblastoma patients; while controlling confounding factors (extent of resection, carmustine wafer implantation, functional status, neurological deficit, and postoperative complications).METHODS:From 2005 to 2011, 692 adult patients (434 men; mean of 57.5 ± 10.8 years) with a newly diagnosed glioblastoma were enrolled in this retrospective multicentric study. All patients were treated by surgical resection (65.5% total/subtotal resection, 34.5% partial resection; 36.7% carmustine wafer implantation) followed by standard combined chemoradiotherapy (radiotherapy at a median dose of 60 Gy, with daily concomitant and adjuvant temozolomide). Time interval to standard combined chemoradiotherapy was analyzed as a continuous variable and as a dichotomized variable using median and quartiles thresholds. Multivariate analyses using Cox modeling were conducted.RESULTS:The median progression-free survival was 10.3 months (95% CI, 10.0-11.0). The median overall survival was 19.7 months (95% CI, 18.5-21.0). The median time to initiation of combined chemoradiotherapy was 1.5 months (25% quartile, 1.0; 75% quartile, 2.2; range, 0.1-9.0). On univariate and multivariate analyses, OS and PFS were not significantly influenced by time intervals to adjuvant treatments. On multivariate analysis, female gender, total/subtotal resection and RTOG-RPA classes 3 and 4 were significant independent predictors of improved OS.CONCLUSIONS:Delaying standard combined chemoradiotherapy following surgical resection of newly diagnosed glioblastoma in adult patients does not impact survival
Recurrent glioblastomas in the elderly after maximal first-line treatment: does preserved overall condition warrant a maximal second-line treatment?
Long-term results of carmustine wafer implantation for newly diagnosed glioblastomas: a controlled propensity-matched analysis of a French multicenter cohort
CERVOXY COLLInternational audienceBACKGROUND: The standard of care for newly diagnosed glioblastoma is maximal safe surgical resection, followed by chemoradiation therapy. We assessed carmustine wafer implantation efficacy and safety when used in combination with standard care. METHODS: Included were adult patients with (n = 354, implantation group) and without (n = 433, standard group) carmustine wafer implantation during first surgical resection followed by chemoradiation standard protocol. Multivariate and case-matched analyses (controlled propensity-matched cohort, 262 pairs of patients) were conducted. RESULTS: The median progression-free survival was 12.0 months (95% CI: 10.7-12.6) in the implantation group and 10.0 months (9.0-10.0) in the standard group and the median overall survival was 20.4 months (19.0-22.7) and 18.0 months (17.0-19.0), respectively. Carmustine wafer implantation was independently associated with longer progression-free survival in patients with subtotal/total surgical resection in the whole series (adjusted hazard ratio [HR], 0.76 [95% CI: 0.63-0.92], P = .005) and after propensity matching (HR, 0.74 [95% CI: 0.60-0.92], P = .008), whereas no significant difference was found for overall survival (HR, 0.95 [0.80-1.13], P = .574; HR, 1.06 [0.87-1.29], P = .561, respectively). Surgical resection at progression whether alone or combined with carmustine wafer implantation was independently associated with longer overall survival in the whole series (HR, 0.58 [0.44-0.76], P \textless .0001; HR, 0.54 [0.41-0.70], P \textless .0001, respectively) and after propensity matching (HR, 0.56 [95% CI: 0.40-0.78], P \textless .0001; HR, 0.46 [95% CI: 0.33-0.64], P \textless .0001, respectively). The higher postoperative infection rate in the implantation group did not affect survival. CONCLUSIONS: Carmustine wafer implantation during surgical resection followed by the standard chemoradiation protocol for newly diagnosed glioblastoma in adults resulted in a significant progression-free survival benefi
Long-term results of carmustine wafer implantation for newly diagnosed glioblastomas: a controlled propensity-matched analysis of a French multicenter cohort
Prognostic factors for survival in adult patients with recurrent glioblastoma: a decision-tree-based model
International audienc