Radiosurgical Options in Neuro-oncology: A Review on Current Tenets and Future Opportunities. Part II: Adjuvant Radiobiological Tools

Ganau, Mario; Foroni, Roberto; Gerosa, Massimo; Ricciardi, Giuseppe Kenneth; Longhi, Michele; Nicolato, A.

doi:10.5301/tj.5000215

Cited by 37 publications

(30 citation statements)

References 46 publications

(43 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, the precise biochemical processes of radiationinduced CNS injury are still unknown 7,43,52,85,140,149 . Initial reports of SRS safety and side effects were derived from animal models and other types of brain irradiation 22,26,49,59,126 . More recently, models for predicting the likelihood of complications after SRS came to be based on actual clinical experience 55,80,133,155 .…”

Section: Factors Influencing Complicationsmentioning

confidence: 99%

The Downside of Radiosurgery, Possible Complications

Pereira¹,

Modesto²

2018

jbnc

View full text Add to dashboard Cite

As a consequence of various last century scientific and technological advances radiotherapy and stereotactic radiosurgery (SRS) have emerged as safe and efficacious techniques for the treatment of various intracranial pathologies. Recent improvements such as in brain and tumor imaging, patient immobilization, 3D planning and radiation delivery allow it to target lesions more accurately and minimize radiation delivered to normal brain, leading to drastic improvements in terms of safety and post-therapy complication. Despite that SRS still implies in moderate to severe side effects in one fifth to one fourth of patients. Fortunately the most common SRS complications, such as edema, blood brain barrier breakdown and MRI abnormalities are self-limited and amenable to treatment. The precise pathophysiological processes of SRS complications are still under research, however multiple factors including treatment dose, modality and planning complexity, target size, shape and location are known to affect treatment results. The most reported potential SRS complications are ischemic stroke, brain or lesion hemorrhage, radiosurgeryinduced neoplasm, radiation necrosis, white matter changes, cranial nerve dysfunction and cognition problems. SRS induced neurological complications may persist only in as much as 5% of patients.

show abstract

Section: Factors Influencing Complicationsmentioning

confidence: 99%

The Downside of Radiosurgery, Possible Complications

Pereira¹,

Modesto²

2018

jbnc

View full text Add to dashboard Cite

show abstract

“…To this extent, as anticipated above, LGG represent a substantially different issue: here oncotypes may be considered “late responding” radiobiological targets due to their relatively small proportion of cells in a proliferative phase of the cell cycle [ 31 , 32 ]. In a recent clinical trial, using a protocol for fractionated SRS an 83% rate of partial or complete tumor regression and 11% of stabilization of disease were achieved [ 33 ].…”

Section: Technical Advancements Potentials and Limitsmentioning

confidence: 99%

“…Therefore SRS seems to combine the effectiveness of the conformal 3D dose distributions with a reduced toxicity of fractionation; however, given the persistent possibility of malignant transformation of these lesions and cognitive impairment this therapeutic option remains debated [ 34 ]. Hopefully, the scientific contribution of several clinical trials aimed at better defining the radiobiological parameters of HGG and LGG is recently leading to some attempts to create tumor control probability models meant to revolutionize in the near future the radiotherapic and radiosurgical protocols that we are currently using in the clinical practice [ 32 , 35 ].…”

Section: Technical Advancements Potentials and Limitsmentioning

confidence: 99%

Management of Gliomas: Overview of the Latest Technological Advancements and Related Behavioral Drawbacks

Ganau

Paris

Ligarotti

et al. 2015

Behavioural Neurology

View full text Add to dashboard Cite

The advancements in basic sciences and the availability of sophisticated technological aids to surgical removal of gliomas have led over the last few years to the rise of innovative surgical strategies, the identification of better prognostic/predictive biomolecular factors, and the development of novel drugs and all are meant to profoundly impact the outcome of patients diagnosed with these aggressive tumours. Unfortunately, the treatment protocols available nowadays still confer only a small survival advantage at a potentially high cost in terms of overall well-being. In this review we identified the potential and limits of the most promising research trends in the management of glioma patients, also highlighting the related externalities. Finally, we focused our attention on the imbalance between the technical and behavioral aspects pertinent to this research area, which ultimately represent the two sides of the same coin.

show abstract

“…The observation that >80.0% of the recurrences are located adjacent to the resection cavity suggests utility for therapeutic platforms targeting this region (10)(11)(12)(13). The recent United States Food and Drug Administration (FDA) approval of 5-aminolevulinic acid (5-ALA) for fluorescence guided resection (FGR) of tumors renewed interests in leveraging this agent as a means to administer photodynamic therapy (PDT).…”

Section: Introductionmentioning

confidence: 99%

Photodynamic Therapy for the Treatment of Glioblastoma

2020

View full text Add to dashboard Cite

Glioblastoma is the most common form of adult brain cancer and remains one of the deadliest of human cancers. The current standard-of-care involves maximal tumor resection followed by treatment with concurrent radiation therapy and the chemotherapy temozolomide. Recurrence after this therapy is nearly universal within 2 years of diagnosis. Notably, >80% of recurrence is found in the region adjacent to the resection cavity. The need for improved local control in this region, thus remains unmet. The FDA approval of 5-aminolevulinic acid (5-ALA) for fluorescence guided glioblastoma resection renewed interests in leveraging this agent as a means to administer photodynamic therapy (PDT). Here we review the general principles of PDT as well as the available literature on PDT as a glioblastoma therapeutic platform.

show abstract

Radiosurgical Options in Neuro-oncology: A Review on Current Tenets and Future Opportunities. Part II: Adjuvant Radiobiological Tools

Cited by 37 publications

References 46 publications

The Downside of Radiosurgery, Possible Complications

The Downside of Radiosurgery, Possible Complications

Management of Gliomas: Overview of the Latest Technological Advancements and Related Behavioral Drawbacks

Photodynamic Therapy for the Treatment of Glioblastoma

Contact Info

Product

Resources

About