Radiation Oncology News

Early Radiation Therapy in Atypical and Malignant Meningiomas The WHO classification is...

Tue, 07 May 2013 04:13:23 -0400

Early Radiation Therapy in Atypical and Malignant Meningiomas

The WHO classification is correlated with prognosis and outcome of meningiomas.

High grade meningiomas (WHO °II + °III) are associated with aggressive local tumorgrowth, wherefore optimized local treatment options are nessesary.

Adeberg and colleques analysed in a single institution trial the outcome of Radiotherapy in patients with high grade meningiomas (atypical: n=62; malignant: n=23). 60% received radiotherapy after surgical resection, 32 % in progression of desease and 8% in primary situation. GTV was defined as macroscopic leason/ resection cavity, adding 1-2cm margin for the CTV and another 1-5mm for the PTV. Patients treated with photon therapy received a median dose of 59,4 Gy.

Results:

The therapy was well tolerated with mild side effects.

5 year - OS correlates with the histological grading: 81% and 53% for atypical and anaplastic meningiomas, PFS after 5 years was 50% and 13%. The differences were significant (p=0,022 and p=0,017).

Conclusion:

Radiotherapy, the target volume definition and dose is indicated in subject to the histological grading.

In malignant and atypical meningiomas early radiation after surgical resection increases PFS and OS. Intensity modulated Radiotherapy should be used for dose escalation in high grade meningiomas.

http://www.ncbi.nlm.nih.gov/pubmed/22137023#

By SGer

Evaluation of Mortality and Morbidity of Three Multimodality Regimes in Case of Stage IIIA Non-Small Cell Lung Cancer

Wed, 01 May 2013 12:54:00 -0400

In this retrospective assessment three multimodal treatment regimens for stage IIIA non-small cell lung cancer (NSCLC) have been analysed regarding morbidity and mortality. For definitive chemoradiation (D-CRT) concurrent chemoradiotherapy with a total up to a 60 Gy was performed. The trimodality-groups received 45 to 50,4 Gy (Tri-45) or >60 Gy (Tri-60) with concurrent chemoradiothrapy followed by resection.

In summary the treatment related morbidity and mortality rates for D-CRT were 74% [65 of 88] and 2,3% [2 of 88] whereas postoperative morbidity and mortality rates for Tri-45 and Tri-60 were 48% [27 of 57] and 1,8% [1 of 56], respectively. In conclusion neoadjuvant CRT was not associated with increased morbidity and mortality compared to definitive CRT - however the overall morbidity profile of chemoradiotherapy regardless of being definitive of neoadjuvant needs to be considered.

Link: http://www.ncbi.nlm.nih.gov/pubmed/23545194

By VHan & FMan

Additional Use of Cetuximab in Patients with Oesophageal Cancer and Concurrent Chemoradiotherapy

Wed, 01 May 2013 12:50:30 -0400

In this multicentre randomized phase 2/3 trial 258 patients were recruited with non-metastatic, histologically confirmed carcinoma of oesophagus (WHO 0-1; Stage I-III disease). Patients were randomly assigned to receive definitive CRT alone or CRT with cetuximab (400mg/m² on day 1 and 250mg/m² weekly). CRT was composed of capecitabine 625mg/m² twice daily (d1-21) and cisplatin 60mg/m² (d1) for four cycles. Concomitantly radiotherapy with 50 Gy in 25 fractions within third and forth cycle was performed. In a nutshell fewer patients were treatment failure free in the CRT+ cetuximab-group and had a shorter median overall survival (22.1 month [95% CI 15.1 – 24.5] vs 25.4 month [20.5 – 37.9]; adj. HR 1.53 [95% CI 1.03-2.27]; p=0.035) compared with CRT alone. More non-haematological grade 3 or 4 toxicities were detected in the CRT + cetuximab-group. All in all addition of cetuximab to standard definitive CRT for patients with oesophageal cancer cannot be recommended.

LINK: http://www.ncbi.nlm.nih.gov/pubmed/23623280

By VHan & FMan

Surgery vs. Concurrent Radiochemotherapy – A Comparison in Case of Advanced Oropharyngeal Cancer

Wed, 01 May 2013 12:47:00 -0400

In this study the therapeutic outcome of surgery is compared with those of radiochemo therapy for patients with advanced oropharyngeal cancer using a matched-pair analysis. According to age, gender, subtide, and T and N classification finally 186 patients were matched between April 2005 to March 2007 by the Japan Clinical Oncology Group to underwent surgery or chemoradiation. The major endpoint was overall survival (OS). Additional endpoints were progression-free survival (PFS), local control rate (LCR) and swallowing function after initial therapy. 93 patients underwent surgery and 93 chemoradiation (with an median dose of 67Gy [range 60-72]) with additional chemotherapy. The statistical evaluation showed that in terms of 5-year OS, PFS and LCR there was no significant difference. The swallowing function was significant better in patients treated with chemoradiation than in those treated with surgery (p= 0.015). In summary this study showed that chemoradiation is as effective as surgery in the treatment of advanced oropharyngeal cancer and protects swallowing function significantly better.

Link: http://www.ncbi.nlm.nih.gov/pubmed/23485940

By VHan & FMan

MR-Spectroscopy might help to define a boost volume for stereotactic radiotherapy in glioblastoma.

Sun, 28 Apr 2013 06:52:07 -0400

The optimal management of glioblastoma multiforme is still under ongoing investigation as the prognosis of this primary tumor of the brain is still poor (although some progress has been made). Usually the T1 contrast-enhancing region is considered as tumor in planning the radiotherapy, however a MRI-technique called “MR spectroscopy” (MRS) may be helpful to find areas of increased tumor-associated metabolic activity and thus might be helpful in better defining the tumor and a possible boost volume. Einstein and colleagues conducted a prospective Phase II trial where 35 patients where treated with a 15-25 Gy single fraction stereotactic boost to this MRS-positive region before starting fractionated radiotherapy (60 Gy à 2 Gy). Aprox. 50 % of the patients received temozolomide simultaneously.Grade 3-4 toxicities (including one stroke) occured in about 10% of patients.

Median survival in this cohort was 15.8 months, 75 % of the patients with RPA class III were still alive after 18 months.

This study demonstrates the feasibility of a stereotactic boost upfront and underlines a possible role of MR-spectroscopy in better defining the tumor. Further studies are needed to evaluate the role of this dose-escalating approach.

http://www.ncbi.nlm.nih.gov/pubmed/22445005

By cmai

Dependency of Colorectal Cancer on a TGF-β-Driven Program in Stromal Cells for Metastasis Initiation

Sun, 28 Apr 2013 06:41:08 -0400

The relevance of TGF-β signaling for disease progression is well known in tumors which retain a functional TGF-β pathway. However, around 40%-50% of all colorectal cancers (CRCs) exhibit mutational inactivation of TGF-β signaling pathway. Calon et al. investigated what CRCs gain from high TGF-β levels once the pathway is fully inactivated. They clearly showed that TGF-β secreted by CRCs into the microenvironment of the tumor activated a TGF-β responsive pathway in stromal cells that is associated with a significant higher risk of CRC relapse. Patients with low TGFB expression levels in their primary tumor remained mostly disease-free during a 10 years follow up study. Therefore, high TGF-β levels are robust predictors for disease relapse. In in vivo mice models, inhibition of TGF-β stromal signaling prevented metastasis initiation but not tumor growth. Hence, the success of pharmacological blockade of TGF-β signaling in order to prevent relapse of the disease and metastasis formation in terms of clinical purposes remains questionable.

http://www.ncbi.nlm.nih.gov/pubmed/23153532

AErn

Keywords: TGF-β signaling, colorectal cancer, stroma, metastasis, relapse

Short-term versus long-term hormone therapy plus radiotherapy or prostatectomy for prostate cancer: a systematic review and meta-analysis

Sun, 28 Apr 2013 06:36:16 -0400

This meta-analysis investigated 9 randomized controlled trial to compare the efficacy of short term HAT (duration < 6 mo) versus long term HAT (duration > 6 mo) plus radiotherapy (RT) or prostatectomy (RP).

RT + short-term HAT vs RT + long-term HAT (7 trials):

There was no difference in OS and DFS between short-term and long-term HAT, but long-term HAT showed a trend towards improved OS. Clinical progression rate, the rate of biochemical failure and prostate cancer-specific mortality was significantly higher in the short-term HAT group. There were discrepant results of adverse events.

RP + short term HAT vs RP + long-term HAT (2 trials):

Long-term HAT was superior to short-term HAT in positive surgical margin rate and prostate volume before RP. There was no significant difference in PSA level before RP between the two groups. The results of longer follow-up time were absent.

Conclusion: Long-term HAT may have a greater benefit, but showed no improved OS and the adverse reactions are inevitable.

By KNik

http://www.ncbi.nlm.nih.gov/pubmed/23380891

Neoadjuvant Chemotherapy in patients with breast cancer: Predictors of Locoregional Recurrence: NSABP B18+27

Wed, 03 Apr 2013 06:33:52 -0400

A smal number of patients with operable breast cancer receive neoadjuvant chemotherapy. So there is limited information on rates and predictors of locoregional recurrence (LRR) in these patients. Eleftherios and colleques analysed the results of following two trials including 3088 patients with breast cancer (T1-3 N0-1M0) receiving neoadjuvant chemotherapy between 1988 and 2000:

1. NSABP B-18: 742 patients undergoing 4 cycles of AC

2. NSABP B-27: 2346 (in 3 groups) patients were treated with 4 x AC neoadjuvant +/- 4x Docetaxel präoperative or postoperative

In both studies, patients undergoing lumpectomy received radiation therapy, patients treated with mastectomy received no radiation. The median follow up was 12 years:

Results:

Patients in the neoadjuvant CHX arms had LRR rates of 12,6% and 10,3 % (mastectomy vs. lumpectomy + RT) after 10 years. Significant independent factors of LRR were tumor size and clinical nodal status before therapy and pathological nodal status/breast tumor response and age (only in patients receiving RT).

The risk of LRR is althought increased with increasing number of positive nodes after neoadjuvant chemotherapy.

These informations can be used for predicting risk of LRR and for indicating the optimal use of RT after neoadjuvant chemotherapy.

http://www.ncbi.nlm.nih.gov/pubmed/23032615

By SGer

Nonoperative management of rectal cancer with complete clinical response after neoadjuvant therapy.

Wed, 03 Apr 2013 06:24:00 -0400

In a retrospective analysis the Department of Surgery of the Memorial Sloan-Kettering Cancer Center evaluated the controversial discussed nonoperative management (NOM) of rectal cancer after a complete clinical response (cCR) to neoadjuvant therapy as a promising treatment option for stage I to III rectal cancer. 32 patients which were treated by NOM after completing neoadjuvant CRT and cCR were compared to 57 patients with pCR after neoadjuvant CRT and rectal resection. There was no local recurrence in the surgery group; 6 local failures in the NOM-group were controlled by salvage rectal resection with no further local recurrence of disease, so rectal resection was successfully avoided in 81% of patients in the NOM-group. NOM combined with salvage surgery achieved similar local and distant disease control. However prospective trials are needed to verify these results.

By MWol

Link: http://www.ncbi.nlm.nih.gov/pubmed/23154394

Keywords: complete clinical response, neoadjuvant therapy, rectal cancer

Comparison between weekly and 3 weekly Cisplatin concurrent with RT in postoperative high risk squamous cell carcinoma of the oral cavity

Tue, 26 Mar 2013 13:35:45 -0400

This well designed prospective randomized Phase III trial wanted to answer, in terms of efficacy and toxicity, the question about the most appropriate way to apply cisplatin together with RT in the adjuvant setting. Unfortunately, the study was ended after only 55 patients were recruited (out of 371 scheduled) due to slow recruitment.

All patients had a high risk SCC of the oral cavity, defined by pathologically documented extracapsular spreading (ECS) of the involved lymph node (LN), a positive surgical margin or LN staging>=N2, and were irradiated with 66,0 Gy in 33 fractions.

The patients received either 100mg/m2 cisplatin once every 3 weeks (Arm A, “standard arm” because the two largest-scale randomized trials used this regimen: Cooper and Bernier, NEJM 2004) or 40mg/m2 once per week (Arm B, “experimental arm”, analog to the radiochemotherapy regimes in the primary situation of nasopharyngeal cancer or cervical cancers). 88,5% of patients in arm A and 62,5% of those in arm B received >=200mg/m2 Cisplatin in total.

No differences in outcome were recorded between the two therapy-arms. The acute toxicity was lower in the “standard arm”(3 weekly cisplatin) than in the weekly low-dose cisplatin. Conclusion: the “standard arm” is still standard.

http://www.ncbi.nlm.nih.gov/pubmed/23245290

By MPaz

Hyperfractionated versus conventional radiotherapy in standard-risk medulloblastoma

Tue, 26 Mar 2013 13:33:31 -0400

The results from the randomized multicenter HIT-SIOP-PNET 4 Trial are presented. 344 children from 122 different European centers were postoperatively staged and randomly assigned to treatment with hyperfractionated radiotherapy (HFRT= 36,0Gy craniospinal+ 24,0Gy cerebellum + 8,0Gy boost tumorregion; 68,0Gy total dose; 2x1,0Gy/daily) or conventional fractionated radiotherapy (CFRT= 23,4 Gy craniospinal + 30,6 Gy cerebellum; 54,0Gy total dose; 1,8Gy/daily) followed by chemotherapy with CCNU, Cisplatin and Vincristin.

After a median follow-up of 4,8 years, survival rates were similar in both treatment groups. A postoperative residual tumor >1,5cm and a delay of more than 7 weeks to the start of the RT had a worse prognosis. Severe hearing loss was not significantly different.

The final data about neurocognitive toxicity are not presented. Till these data are available, a conventional fractionated radiotherapy is standard and admissible.

Note: according to other smaller studies (Carrie 2009 and Gupta 2012), children who received HFRT had better executive function than children in CFRT.

http://www.ncbi.nlm.nih.gov/pubmed/22851561

By MPaz

Single dose of carboplatin is not inferior to radiotherapy in Stage I seminoma

Tue, 26 Mar 2013 13:29:39 -0400

Stage I seminoma is the most common testicular germ cell tumor; Radiotherapy used to play a central role in the treatment of this highly curable malignancy. Treatment strategies after orchiectomie now are surveillance, adjuvant radiotherapy or chemotherapy (carboplatin);

To compare the latter two strategies, a non-inferiority trial has been conducted; almost 1500 patients were randomly assigned to either a single dose carboplatin (AUC7) infusion or radiotherapy (20-30 Gy).

Oliver and colleagues now present the 6,5 year follow-up data of this trial confirming the non-inferiority of carboplatin to radiation therapy; relapse-free survival was comparable in both groups (Chx 95% vs RT 96%); In the chemotherapy group, less side-effects have been reported. Interestingly, the use of carboplatin also reduced the risk of contralateral germ cell tumors.

In conclusion, adjuvant chemotherapy is a valid alternative to adjuvant radiotherapy in stage I seminoma.

In the recent guidelines by the European germ cell consensus group, surveillance is recommended in most (low risk) cases as 88% of the patients are cured by orchiectomie alone. In case of a relapse, rates of curation are still high.

Links:

http://www.ncbi.nlm.nih.gov/pubmed/21282539 (Article)

http://www.ncbi.nlm.nih.gov/pubmed/18191324 (European Guideline by Consensus Group)

By CMai

#seminoma #radiotherapy #chemotherapy #LMU

Escalated radiation dose alone vs. concurrent chemoradiation for locally advanced and unresectable rectal cancer: results from phase II randomized study

Sun, 17 Mar 2013 11:54:20 -0400

Aim of this trial was to determine whether neoadjuvant concurrent chemoradiation or boosted radiotherapy alone results in a higher resectability rate in patients with initially unresectable rectal adenocarcinoma.

Patients were randomized either to receive external beam radiotherapy (EBRT) to the pelvis (45Gy/1.8Gy) with concurrent oral Capecitabine (1,700mg/m²; d1-14 & d22-35) (CRT group; Arm 1; n= 46 pat.) or EBRT to the pelvis (45Gy/1.8Gy) alone followed by a localized radiotherapy boost (20Gy/2Gy) to the primary tumor site (RT with boost group; Arm 2; n= 44 pat.). Resectability was then evaluated by CT scan 6 – 8 weeks later. Only 40 patients, who then seemed to be resectable, underwent operation. No exenterations were performed.

Resectability rates were low in both arms: R0-resection was achieved in 20 (43%) patients in Arm 1 vs. 15 (34%) patients in Arm 2 (p>0,05). Factors, that significantly affected resectability in both groups were extension of tumor to pelvic bones and signet ring cell pathology. Complete pathological control was seen in 7% in Arm 1 and in 11% in Arm 2. There was significantly greater postoperative morbidity in Arm 2 (16 vs. 40%), though acute toxicity was comparably the same in both groups.

Neoadjuvant escalated dose radiation, compared with neoadjuvant chemoradiation did not result in higher complete R0 tumor resectability in locally advanced inoperable rectal cancer.

More studies need to be undertaken to address the question of preoperative dose escalation with IMRT technique and of more aggressive preoperative chemotherapy in advanced rectal cancers.

By NHeg

http://www.ncbi.nlm.nih.gov/pubmed/23358929

Additional use of Temozolomid or Erlotinib in combination with WBRT and SRS in case of Non-Small Cell Lung Cancer and 1 to 3 Brain Metastases

Sun, 17 Mar 2013 11:51:50 -0400

Every year 16-34% of patients with non-small cell lung cancer (NSCLC) experience brain metastases. The standard treatment of 1-3 brain metastases contains radiosurgery (SRS), whole brain radiation therapy (WBRT) or a combination but no chemotherapy. In this trial the use of temozolomid (TMZ) or erlotinib (ETN) beside radiation therapy (RT) to improve overall survival (OS) and to detect assumed effects to central nervous system (CNS) progression is explored. TMZ and ETN cross the blood-brain barrier and are already used in NSCLC therapy regimes. Between October 2004 and August 2009, 126 patients were randomized to arm 1 (whole brain radiotherapy (WBRT) + stereotactic radiosurgery (SRS)), arm 2 (WBRT+SRS+TMZ), or arm 3 (WBRT+SRS+ETN). The study closed early because of accrual limitation. After assessment of the available results the use of TMZ or ETN caused no improvement in OS or time to CNS progression compared to RT alone. Summing up there is an absence of benefit but significant increase in grade of toxicities when adding TMZ or ETN to RT (WBRT+SRS). Because of that ETN or TMZ should not be applied parallel to RT of the brain in patients with NSCLC and 1-3 brain metastases.

By VHan

http://www.ncbi.nlm.nih.gov/pubmed/23391814

Extremity soft tissue sarcomas: RT – why, when and where?

Sun, 17 Mar 2013 11:49:40 -0400

The authors of the given paper reviewed the published data on the indications and timing (pre- vs. postoperative RT) of RT in patients with extremity soft tissue sarcomas (ESTS). Moreover, they produced recommendations for the delineation of target volumes for pre- and postoperative RT.

Evidence is strong that RT improves local control in the treatment of ESTS. However, LC in ESTS reflects a complex interaction among surgical skill, sarcoma biology, radiation sensitivity and the radiation technique applied. Survival benefit (especially in patients with large, high-grade sarcomas) for the addition of RT to surgery has been shown in a large SEER analysis.

Early wound complications seem to occur more often after preoperative RT. Nevertheless, these effects are usually reversible. In contrast, the more serious late effects (fibrosis, joint stiffness and lymphedema) occurred in the group irradiated postoperatively.

The recommended delineation of the CTV in the pre- and postoperative setting is to expand the GTV (preoperative extension) in all directions by 1.5 cm, except longitudinally, where the expansion is 4 cm. Surgical scars and edema should be included. CTV does not need to be expanded further than the surface of adjacent bones, fasciae, and joints – unless involved. Boost CTV is defined as GTV + 2cm longitudinally, respectively + 1.5 cm in all other directions. The CTV to PTV expansion margins are dependent on immobilization, image guidance and the reproducibility of the treatment setup.

The authors conclude in emphasizing the importance of considering individual patient factors in the treatment of ESTS.

http://www.ncbi.nlm.nih.gov/portal/utils/pageresolver.fcgi?recordid=1362173575980933

By CMac

A Cancer Care Outcomes Research and Surveillance Consortium (CanCORS) Study in metastasized NSCLC patients

Sun, 17 Mar 2013 11:48:01 -0400

Chen and colleagues investigeted the use or palliative radiotherapy in stage IV NSCLC patients. These were enrolled into this prospecitve study from 2003 - 2005. Altogether 5,528 patients were sampled and 1,574 enrolled in this study. Single-fraction treatment for bone metastases was only performed in 6% of cases and patients being treated within centers or integrated networks were more frequently treated with a lower number of fractions (chest/bone). This study concludes that a substantial amount of patients receives a higher number of fractions than usually recommended.

By MNiy

Link: http://www.ncbi.nlm.nih.gov/pubmed/23295799

Key Words: palliative; NSCLC; radiosurgery

Frequency, survival and risk factors of AT/RT patients (CNS) from the German HIT registry

Sun, 17 Mar 2013 11:47:06 -0400

Von Hoff and colleagues performed a retrospective analysis on patients with CNS atypical teratoid/rhabdoid tumor (AT/RT); patients from the German HIT database were included from 1988 to 2004. Altogether 56 children could be identified. Frequency of this disease was compared to PNETs and medulloblastomas whereas the ratio was 1:12.2 for all children and 1:1.5 for children younger than 1 year at diagnosis. Median survival of the total cohort was 1.2 years. Several factors were tested on their prognostic significance concerning OS and EFS. Among the unfavorable factors, younger age, M+, infratentorial location and < CR post chemotherapy could be derived as univariately significant, younger age and M+ in multivariate analysis, too.

by MNiy

Link: http://www.ncbi.nlm.nih.gov/pubmed/21796761

Key words: AT/RT; HIT; atypical teratoid, rhabdoid

SCR7, a novel inhibitor of human ligase IV, interferes with double strand break repair, impedes cancer progression, and confers apoptotic cell death.

Sun, 24 Feb 2013 07:04:34 -0500

Double strand breaks (DSBs) are considered the most lethal kind of DNA damage as they can give rise to severe chromosomal aberrations. Non-homologous end-joining (NHEJ) is one major DNA damage repair pathway the cell has in order to deal with DSBs. NHEJ mainly depends on the activity of DNA ligase IV as this enzyme possesses the ability to re-ligate broken DNA strands. In issue 151 of Cell, Srivastava and colleagues describe the identification and the characterization of a novel, DNA ligase IV-specific inhibitor termed SCR7. Due to the lack of structural data on DNA ligase IV, the authors used superimposition to gain insight to the structure of the DNA-binding domain (DBD) of DNA ligase IV. Based on the structural data obtained by this approach, the authors screened for molecules that interfered with the DNA-binding capacity of DNA ligase IV. SCR7, the most potent candidate, was subsequently shown to inhibit ligase IV in vitro and in vivo. The authors show that administration of SCR7 can promote both, tumor regression as well as prolongation of survival in a breast cancer mouse model system. Moreover, SCR7 exhibits radiosensitizing potential when combined with fractionated radiotherapy or DNA-damaging drugs (e.g. etoposide). Finally, the authors show that SCR7 facilitates efficient induction of cell death in cancer cell lines by triggering the intrinsic apoptosis pathway. As this paper describes the very first inhibitor specific for NHEJ, it offers a great perspective for the future, e.g. in terms of improving the efficacy of conventional radiotherapy by co-adminstration of SCR7 or one of its derivates.

http://www.ncbi.nlm.nih.gov/pubmed/23260137

MOrt

Double-strand break repair, nonhomologous end-joining (NHEJ), inhibitor, DNA-ligase IV, tumor regression, apoptosis

Neoadjuvant IMRT in Lower Extremity Soft Tissue Sarcoma

Sun, 24 Feb 2013 07:03:14 -0500

In a Phase 2 Study O’Sullivan and colleagues investigated therapy associated morbidities after preoperative image-guided IMRT and surgical resection in lower extremity soft tissue sarcoma. Total dose was 50 Gy in 25 daily fractions over 5 weeks.

The ‘‘future scar’’ was outlined by the surgeon and highlighted with radio-opaque markers to guide delineation of the ‘‘future surgical skin flaps’’ in the RT planning system. The surgeon later contoured the proposed surgical flaps on the RT planning CT, considering tissues to be elevated for either exposure or wound closure, while taking account of tissues requiring excision.The radiation oncologist defined the gross tumor volume GTV, CTV (4 cm proximally and distally from the GTV and 1.5 cm radially and included peritumoral edema) and PTV (CTV + 0,5cm 3D expansion only due to daily cone-beam CT).

Compared to a historical control the primary endpoint (development of acute wound complication) was numerically lower but did not reach statistical significance (30,5% vs. 43%; p=0,2). Primary closure technique was possible more often (93.2% vs. 71.4%; p=0.002) and secondary operations for WCs were somewhat reduced (33% vs. 43%; p=0.55).

Preoperative IG-IMRT attempting to minimize doses to uninvolved normal tissues, significantly diminished the need for tissue transfer and should be further investigated in future.

By LSch

http://www.ncbi.nlm.nih.gov/pubmed/23423841

Keywords: neoadjuvant, IMRT, sarcoma

The Cancer Genome Atlas expression profiles of low-grade gliomas

Sun, 17 Feb 2013 16:22:00 -0500

The Cancer Genome Atlas expression profiles of low-grade gliomas Gonda and colleagues used the cancer genome atlas (TCGA) portal to compare G-CIMP, mRNA as well as miRNA expression patterns between low-grade astrocytomas and oligodendrogliomas. Besides classical biomarkers such as TP53 mutation, 1p19q codeletion and IDH1 mutation several further expression profiles have been determined in order to better differentiate between oligodendrogliomas and low-grade astrocytomas. Among these markers, G-CIMP (CpG island methylator phenotype) was present especially in oligodendrogliomas and 338 genes were identified in astrocytomas being upregulated compared to oligodendrogliomas; a higher expression of these genes seems to be associated with mitogenic activity, replication and inflammatory processes. MiRNA profiles of astrocytomas were similar to GBM samples whereas these features were not found in oligodendrogliomas. All in all, further prospective validation of these patterns is needed to define their role additionally to conventional molecular methods and histopathologic diagnostic features. Link: http://www.ncbi.nlm.nih.gov/pubmed/23373453 by MNiy Key Words: genome atlas; expression profiles; low-grade glioma; LGG