9 research outputs found
Characteristics of the patients on admission and their outcomes up to one year post discharge.
<p>Characteristics of the patients on admission and their outcomes up to one year post discharge.</p
Image using the easymeasure stereology, point counting software showing the landmarks for temporal lobe measurements.
<p>(1) where the lateral ventricle splits into the temporal and frontal horns as the posterior limit for the right temporal lobe in a HSV encephalitis patient; (2) the mid point of the right temporal lobe measurement (in yellow the previously calculated left temporal lobe calculation); (3) the anterior limit of the temporal lobe and (4) the mid point section in (2) showing the volume of the overall damage including that outwith the temporal lobe, where HSV is seen to affect the right temporal lobe on this slice.</p
Coronal T2-weighted FLAIR images of a 45 year old woman with HSV encephalitis (Patient 3).
<p>On day 7 of admission a five-day course of corticosteroids was started. The same image slice is depicted from the day 2 scan (Image 1), from day 6 (Image 2) and from day 21 (Image 3)</p
A 2x2 table demonstrating whether volume changes increased or decreased in the two groups of patients, those treated with corticosteroids and those that were not.
<p>A 2x2 table demonstrating whether volume changes increased or decreased in the two groups of patients, those treated with corticosteroids and those that were not.</p
Flow chart of inclusion of patients in this study.
<p>Flow chart of inclusion of patients in this study.</p
Change in volume of most affected temporal lobe over time.
<p>Patients 1 and 3 received corticosteroids during their care in hospital.</p
Details of the scan parameters for each patient.
<p>Details of the scan parameters for each patient.</p
Change in volume of total oedema over time.
<p>Patients 1 and 3 received corticosteroids during their care in hospital.</p
The ROAM/EORTC-1308 trial: Radiation versus Observation following surgical resection of Atypical Meningioma: study protocol for a randomised controlled trial
Background: Atypical meningiomas are an intermediate grade brain tumour with a recurrence rate of 39-58 %. It is not known whether early adjuvant radiotherapy reduces the risk of tumour recurrence and whether the potential side-effects are justified. An alternative management strategy is to perform active monitoring with magnetic resonance imaging (MRI) and to treat at recurrence. There are no randomised controlled trials comparing these two approaches.
Methods/design: A total of 190 patients will be recruited from neurosurgical/neuro-oncology centres across the United Kingdom, Ireland and mainland Europe. Adult patients undergoing gross total resection of intracranial atypical meningioma are eligible. Patients with multiple meningioma, optic nerve sheath meningioma, previous intracranial tumour, previous cranial radiotherapy and neurofibromatosis will be excluded. Informed consent will be obtained from patients. This is a two-stage trial (both stages will run in parallel): Stage 1 (qualitative study) is designed to maximise patient and clinician acceptability, thereby optimising recruitment and retention. Patients wishing to continue will proceed to randomisation. Stage 2 (randomisation) patients will be randomised to receive either early adjuvant radiotherapy for 6 weeks (60 Gy in 30 fractions) or active monitoring. The primary outcome measure is time to MRI evidence of tumour recurrence (progression-free survival (PFS)). Secondary outcome measures include assessing the toxicity of the radiotherapy, the quality of life, neurocognitive function, time to second line treatment, time to death (overall survival (OS)) and incremental cost per quality-adjusted life year (QALY) gained.
Discussion: ROAM/EORTC-1308 is the first multi-centre randomised controlled trial designed to determine whether early adjuvant radiotherapy reduces the risk of tumour recurrence following complete surgical resection of atypical meningioma. The results of this study will be used to inform current neurosurgery and neuro-oncology practice worldwide.
Trial registration: ISRCTN71502099 on 19 May 2014.</p