Despite intensive therapy regi men,brain cancers present with a poor prognosis,with an esti-mated median survival time of less than 15 months in case of glioblastoma.Early detection and improved surgical resctions are...Despite intensive therapy regi men,brain cancers present with a poor prognosis,with an esti-mated median survival time of less than 15 months in case of glioblastoma.Early detection and improved surgical resctions are suggested to enhance prognosis;several tools are being explored to achieve the purpose.Raman spectroscopy(RS),a nondestructive and noninv asive technique,has been extensively explored in brain cancers.This review summarizes RS based studies in brain cancers,categorized into studies on animal models,ex tivo human samples,and in tito human subjects.Findings suggest RS as a promising tool which can aid in improving the accuracy of brain tumor surgery.Further adv ancements in instrumentation,market assessment,and clinical trials can facilitate translation of the technology as a noninvasive intraopenative guidance tool.展开更多
Brain cancer,also known as intracranial cancer,is one of the most invasive and fatal cancers affecting people of all ages.Despite the great advances in medical technology,improvements in transporting drugs into brain ...Brain cancer,also known as intracranial cancer,is one of the most invasive and fatal cancers affecting people of all ages.Despite the great advances in medical technology,improvements in transporting drugs into brain tissue have been limited by the challenge of crossing the blood-brain barrier(BBB).Fortunately,recent endeavors using gold-based nanomaterials(GBNs)have indicated the potential of these materials to cross the BBB.Therefore,GBNs might be an attractive therapeutic strategy against brain cancer.Herein,we aim to present a comprehensive summary of current understanding of the critical effects of the physicochemical properties and surface modifications of GBNs on BBB penetration for applications in brain cancer treatment.Furthermore,the most recent GBNs and their impressive performance in precise bioimaging and efficient inhibition of brain tumors are also summarized,with an emphasis on the mechanism of their effective BBB penetration.Finally,the challenges and future outlook in using GBNs for brain cancer treatment are discussed.We hope that this review will spark researchers'interest in constructing more powerful nanoplatforms for brain disease treatment.展开更多
Brain cancer detection and classification is done utilizing distinct medical imaging modalities like computed tomography(CT),or magnetic resonance imaging(MRI).An automated brain cancer classification using computer a...Brain cancer detection and classification is done utilizing distinct medical imaging modalities like computed tomography(CT),or magnetic resonance imaging(MRI).An automated brain cancer classification using computer aided diagnosis(CAD)models can be designed to assist radiologists.With the recent advancement in computer vision(CV)and deep learning(DL)models,it is possible to automatically detect the tumor from images using a computer-aided design.This study focuses on the design of automated Henry Gas Solubility Optimization with Fusion of Handcrafted and Deep Features(HGSO-FHDF)technique for brain cancer classification.The proposed HGSO-FHDF technique aims for detecting and classifying different stages of brain tumors.The proposed HGSO-FHDF technique involves Gabor filtering(GF)technique for removing the noise and enhancing the quality of MRI images.In addition,Tsallis entropy based image segmentation approach is applied to determine injured brain regions in the MRI image.Moreover,a fusion of handcrafted with deep features using Residual Network(ResNet)is utilized as feature extractors.Finally,HGSO algorithm with kernel extreme learning machine(KELM)model was utilized for identifying the presence of brain tumors.For examining the enhanced brain tumor classification performance,a comprehensive set of simulations take place on the BRATS 2015 dataset.展开更多
Pediatric central nervous system tumors are the most common tumors in children,it constitute 15%–20%of all malignancies in children and are the leading cause of cancer related deaths in children.Proteogenomics is an ...Pediatric central nervous system tumors are the most common tumors in children,it constitute 15%–20%of all malignancies in children and are the leading cause of cancer related deaths in children.Proteogenomics is an emerging field of biological research that utilizes a combination of proteomics,genomics,and transcriptomics to aid in the discovery and identification of biomarkers for diagnosis and therapeutic purposes.Integrative proteogenomics analysis of pediatric tumors identified underlying biological processes and potential treatments as well as the functional effects of somatic mutations and copy number variation driving tumorigenesis.展开更多
Objective:Migrasomes,an emerging class of migration-facilitating membranous extracellular vesicles,remain largely uncharted in the intricate landscape of tumor metastasis.This study aimed to illuminate the roles and m...Objective:Migrasomes,an emerging class of migration-facilitating membranous extracellular vesicles,remain largely uncharted in the intricate landscape of tumor metastasis.This study aimed to illuminate the roles and mechanisms underlying cancer cell-derived migrasomes in breast cancer brain metastasis(BCBM).Methods:Migrasomes were isolated and purified from BCBM cells(231-BR)and non-specific organotropic parental counterparts(MDA-MB-231),specifically designated as Mig-BCBM and Mig-BC,respectively.The role of Mig-BCBM in BCBM was investigated using an in vitro endothelial cell layer permeability model and a BCBM mouse model.The regulatory mechanism underlying Mig-BCBM was assessed using RT-qPCR,western blotting,immunofluorescence,ex vivo fluorescence imaging,and a series of rescue experiments.Results:Mig-BCBM potently augmented the permeability of vascular endothelial layers,which facilitated the efficient migration of 231-BR cells across endothelial barriers in vitro.The administration of Mig-BCBM significantly disrupted the blood-brain barrier(BBB)and accelerated BCBM progression in vivo,as evidenced in mouse models,compared to the Mig-BC and control groups.Mechanistically,Mig-BCBM harbored ATF6,a critical transducer of endoplasmic reticulum(ER)stress.Upon internalization into hCMEC/D3 cells,ATF6 elicited robust ER stress responses,culminating in downregulation of ZO-1 and VE-cadherin.Digital PCR analysis disclosed significant upregulation of ATF6 in serum migrasomes derived from BCBM patients compared to migrasomes from breast cancer patients and healthy individuals.Conclusions:This study uncovered a pivotal role of cancer cell-derived in BCBM by harnessing ATF6-mediated ER stress to disrupt the BBB and promote metastasis,suggesting novel diagnostic and therapeutic strategies targeting migrasomes and migrasome cargo.展开更多
Brain metastasis and primary glioblastoma multiforme represent the most common and lethal malignant brain tumors.Its median survival time is typically less than a year after diagnosis.One of the major challenges in tr...Brain metastasis and primary glioblastoma multiforme represent the most common and lethal malignant brain tumors.Its median survival time is typically less than a year after diagnosis.One of the major challenges in treating these cancers is the efficiency of the transport of drugs to the central nervous system.The blood-brain barrier is cooperating with advanced stages of malignancy.The blood-brain barrier poses a significant challenge to delivering systemic medications to brain tumors.Nanodrug delivery systems have emerged as promising tools for effectively crossing this barrier.Additionally,the development of smart nanoparticles brings new hope for cancer diagnosis and treatment.These nanoparticles improve drug delivery efficiency,allowing for the creation of targeted and stimuli-responsive delivery methods.This review highlights recent advancements in nanoparticle and smart nanoparticle technologies for brain cancer treatment,exploring the range of nanoparticles under development,their applications,targeting strategies,and the latest progress in enhancing transport across the blood-brain barrier.It also addresses the ongoing challenges and potential benefits of these innovative approaches.展开更多
In medical imaging,accurate brain tumor classification in medical imaging requires real-time processing and efficient computation,making hardware acceleration essential.Field Programmable Gate Arrays(FPGAs)offer paral...In medical imaging,accurate brain tumor classification in medical imaging requires real-time processing and efficient computation,making hardware acceleration essential.Field Programmable Gate Arrays(FPGAs)offer parallelism and reconfigurability,making them well-suited for such tasks.In this study,we propose a hardware-accelerated Convolutional Neural Network(CNN)for brain cancer classification,implemented on the PYNQ-Z2 FPGA.Our approach optimizes the first Conv2D layer using different numerical representations:8-bit fixed-point(INT8),16-bit fixed-point(FP16),and 32-bit fixed-point(FP32),while the remaining layers run on an ARM Cortex-A9 processor.Experimental results demonstrate that FPGA acceleration significantly outperforms the CPU(Central Processing Unit)based approach.The obtained results emphasize the critical importance of selecting the appropriate numerical representation for hardware acceleration in medical imaging.On the PYNQ-Z2 FPGA,the INT8 achieves a 16.8%reduction in latency and 22.2%power savings compared to FP32,making it ideal for real-time and energy-constrained applications.FP16 offers a strong balance,delivering only a 0.1%drop in accuracy compared to FP32(94.1%vs.94.2%)while improving latency by 5%and reducing power consumption by 11.1%.Compared to prior works,the proposed FPGA-based CNN model achieves the highest classification accuracy(94.2%)with a throughput of up to 1.562 FPS,outperforming GPU-based and traditional CPU methods in both accuracy and hardware efficiency.These findings demonstrate the effectiveness of FPGA-based AI acceleration for real-time,power-efficient,and high-performance brain tumor classification,showcasing its practical potential in next-generation medical imaging systems.展开更多
Current treatments for cancer and the central nervous system diseases are limited, partly due to the difficulties posed by the insolubility, poor distribution of drugs among cells and lack of selectivity of drugs, the...Current treatments for cancer and the central nervous system diseases are limited, partly due to the difficulties posed by the insolubility, poor distribution of drugs among cells and lack of selectivity of drugs, the inability of drugs to cross cellular barriers and blood brain barrier（BBB）. Carbon nanotubes（CNTs） possess many distinct properties including good electronic properties, remarkably penetrating capability on the cell membrane, high drug-loading and pH-dependent therapeutic unloading capacities,thermal properties, large surface area and easy modification with molecules, which render them as a suitable candidate to deliver drugs to cancer and brain. CNTs as a drug delivery could achieve a high efficacy, enhance specificity and diminish side effects. Whereas CNTs have been primarily employed in cancer treatment, a few studies have focused on the treatment and diagnosis of the central nervous system diseases using CNTs. Here, we review the current progress of in vitro and in vivo researches of CNTs-based drug delivery to cancer involving CNTs-based tumor-targeted drug delivery systems（DDS）, photodynamic therapy（PDT） and photothermal therapy（PTT）. Meanwhile, we also review the current progress of in vitro and in vivo researches of CNTs-based drug delivery to brain.展开更多
Objective:Brain metastasis is considered rare in metastatic colorectal cancer(mCRC);thus,surveillance imaging does not routinely include the brain.The reported incidence of brain metastases ranges from 0.6% to 3.2%.Me...Objective:Brain metastasis is considered rare in metastatic colorectal cancer(mCRC);thus,surveillance imaging does not routinely include the brain.The reported incidence of brain metastases ranges from 0.6% to 3.2%.Methods:The South Australian mCRC Registry(SAmCRC)was analyzed to assess the number of patients presenting with brain metastasis during their lifetime.Due to small numbers,a descriptive analysis is presented.Results:Only 59 patients of 4,100 on the registry at the time of analysis had developed brain metastasis(1.4%).The clinical characteristics of those with brain metastasis were as follows:the median age was 65.3 years and 51% were female.Where the V-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog(KRAS)mutation status of the tumor was known,the majority harbored a KRAS mutation(55%);31(53%)underwent craniotomy and 55(93%)underwent whole-brain radiotherapy.The median survival time from diagnosis of brain metastasis was 4.2 months(95% confidence interval 2.9–5.5).Patients who underwent craniotomy and radiotherapy had superior survival compared to those who underwent whole-brain radiotherapy(8.5 months vs.2.2 months,respectively).Data from the SAmCRC(a population-based registry)confirm that brain metastases are rare and the median time to development is approximately 2 years.Conclusions:Brain metastasis is a rare outcome in advanced CRC.Patients within the registry tended to be female,young in age,and harbored with higher rates of KRAS mutations.Whether routine surveillance brain scanning should be considered remains controversial given the relative rarity of developing brain metastases in mCRC and ultimately,most patients with central nervous system involvement die from their extracranial disease.展开更多
High expression of fibrinogen and platelets are often observed in non–small cell lung cancer(NSCLC) patients with local regional or distant metastasis. However, the role of these factors remains unclear. The aims of ...High expression of fibrinogen and platelets are often observed in non–small cell lung cancer(NSCLC) patients with local regional or distant metastasis. However, the role of these factors remains unclear. The aims of this study were to evaluate the prognostic significance of plasma fibrinogen concentration and platelet count, as well as to determine the overall survival of NSCLC patients with brain metastases. A total of 275 NSCLC patients with brain metastasis were enrolled into this study. Univariate analysis showed that high plasma fibrinogen concentration was associated with age ≥ 65 years(P = 0.011), smoking status(P = 0.009), intracranial symptoms(P = 0.022), clinical T category(P = 0.010), clinical N category(P = 0.003), increased partial thromboplastin time(P < 0.001), and platelet count(P < 0.001). Patients with low plasma fibrinogen concentration demonstrated longer overall survival compared with those with high plasma fibrinogen concentration(median, 17.3 months versus 11.1 months; P ≤ 0.001). A similar result was observed for platelet counts(median, 16.3 months versus 11.4 months; P = 0.004). Multivariate analysis showed that both plasma fibrinogen concentration and platelet count were independent prognostic factors for NSCLC with brain metastases(R2 = 1.698, P < 0.001 and R2 = 1.699, P < 0.001, respectively). Our results suggest that high plasma fibrinogen concentration and platelet count indicate poor prognosis for NSCLC patients with brain metastases. Thus, these two biomarkers might be independent prognostic predictors for this subgroup of NSCLC patients.展开更多
Prostate cancer is the most common non-cutaneous malignancy for men. The skeleton is the most common metastatic site but, following an improvement in survival, metastases in uncommon sites are being found more frequen...Prostate cancer is the most common non-cutaneous malignancy for men. The skeleton is the most common metastatic site but, following an improvement in survival, metastases in uncommon sites are being found more frequently in clinical practice, especially brain metastases. Despite the new drugs now available for metastatic castration resistant prostate cancer, no clinical evidence exists about their effectiveness on brain metastases. We describe the clinical history of 3 patients treated with cabazitaxel plus whole brain radiotherapy. These case reports demonstrate that cabazitaxel is highly active and well tolerated in brain metastases.展开更多
Purpose: To determine whether the new treatments for breast cancer CNS metastases improve survival by comparing the survival between two cohorts: 2000-2005 and 2006-2011. Patients and Methods: A retrospective, compara...Purpose: To determine whether the new treatments for breast cancer CNS metastases improve survival by comparing the survival between two cohorts: 2000-2005 and 2006-2011. Patients and Methods: A retrospective, comparative, correlational chart review was performed. Data from 172 women diagnosed with CNS metastases between 2000 and 2011, was evaluated. Results: Approximately 10% of patients diagnosed with invasive breast cancer between 2000 and 2011 developed CNS metastases. The cohort was separated into four groups: luminal A (ER+ and/or PR+, HER2-), luminal B (ER+ and/or PR+, HER2+), HER2+ (ER -, PR-, HER2+) and TN (ER-, PR-, HER2-). There was a statistically significant difference in the overall survival between luminal A and luminal B (5.55 months vs. 15.3 months, respectively, p = 0.048). There was also a statistically significant difference in the overall survival between luminal B and TN (15.3 months vs. 7.49 months, respectively, p = 0.0181). There was no significant difference in overall survival between luminal B and HER2+ (15.3 months vs. and 10.98 months, respectively, p = 0.105), TN and HER2+ (7.49 months vs. 10.98 months, respectively, p = 0.514), and between luminal A and TN or HER2+ (5.55 months vs. 7.49 months, respectively, p = 0.428, or 5.55 months vs. 10.98 months, respectively, p = 0.491). Overall median survival of the patients in 2000-2005 and 2006-2011 were 6.64 months vs. 10.58 months, respectively (p = 0.0592). Conclusion: The results of our study showed that despite the new therapies there is little improvement in survival for brain metastasis in breast cancer.展开更多
BACKGROUND Breast cancer brain metastasis(BCBM)is an advanced breast disease that is difficult to treat and is associated with a high risk of death.Patient prognosis is usually poor,with reduced quality of life.In thi...BACKGROUND Breast cancer brain metastasis(BCBM)is an advanced breast disease that is difficult to treat and is associated with a high risk of death.Patient prognosis is usually poor,with reduced quality of life.In this context,we report the case of a patient with HER-2-positive BCBM treated with a macromolecular mAb(ine-tetamab)combined with a small molecule tyrosine kinase inhibitor(TKI).CASE SUMMARY The patient was a 58-year-old woman with a 12-year history of type 2 diabetes.She was compliant with regular insulin treatment and had good blood glucose control.The patient was diagnosed with invasive carcinoma of the right breast(T3N1M0 stage IIIa,HER2-positive type)through aspiration biopsy of the ipsilateral breast due to the discovery of a breast tumor in February 2019.Immunohistochemistry showed ER(-),PR(-),HER-2(3+),and Ki-67(55-60%+).Preoperative neoadjuvant chemotherapy,i.e.,the AC-TH regimen(epirubicin,cyclophosphamide,docetaxel-paclitaxel,and trastuzumab),was administered for 8 cycles.She underwent modified radical mastectomy of the right breast in November 2019 and received tocilizumab targeted therapy for 1 year.Brain metastasis was found 9 mo after surgery.She underwent brain metastasectomy in August 2020.Immunohistochemistry showed ER(-)and PR.(-),HER-2(3+),and Ki-67(10-20%+).In November 2020,the patient experienced headache symptoms.After an examination,tumor recurrence in the original surgical region of the brain was observed,and the patient was treated with inetetamab,pyrotinib,and capecitabine.Whole-brain radiotherapy was recommended.The patient and her family refused radiotherapy for personal reasons.In September 2021,a routine examination revealed that the brain tumor was considerably larger.The original systemic treatment was continued and combined with intensity-modulated radiation therapy for brain metastases,followed by regular hospitalization and routine examinations.The patient’s condition is generally stable,and she has a relatively high quality of life.This case report demonstrates that in patients with BCBM and resistance to trastuzumab,inetetamab combined with pyrotinib and chemotherapy can prolong survival.CONCLUSION Inetetamab combined with small molecule TKI drugs,chemotherapy and radiation may be an effective regimen for maintaining stable disease in patients with BCBM.展开更多
Objective The aim of this study was to define the maximum-tolerated dose (MTD) and observe the toxicity of escalating topotecan combined whole brain radiotherapy for brain metastasis in lung cancer.
Several studies have largely focused on the significant role of the nervous and immune systems in the process of tumorigenesis, including tumor growth, proliferation, apoptosis, and metastasis. The brain-gut-axis is a...Several studies have largely focused on the significant role of the nervous and immune systems in the process of tumorigenesis, including tumor growth, proliferation, apoptosis, and metastasis. The brain-gut-axis is a new paradigm in neuroscience, which describes the biochemical signaling between the gastrointestinal (GI) tract and the central nervous system. This axis may play a critical role in the tumorigenesis and development of GI cancers. Mechanistically, the bidirectional signal transmission of the brain-gut-axis is complex and remains to be elucidated. In this article, we review the current findings concerning the relationship between the brain-gut axis and GI cancer cells, focusing on the significant role of the brain-gut axis in the processes of tumor proliferation, invasion, apoptosis, autophagy, and metastasis. It appears that the brain might modulate GI cancer by two pathways: the anatomical nerve pathway and the neuroendocrine route. The simulation and inactivation of the central nervous, sympathetic, and parasympathetic nervous systems, or changes in the innervation of the GI tract might contribute to a higher incidence of GI cancers. In addition, neurotransmitters and neurotrophic factors can produce stimulatory or inhibitory effects in the progression of GI cancers. Insights into these mechanisms may lead to the discovery of potential prognostic and therapeutic targets.展开更多
BACKGROUND Brain metastasis(BM)from colorectal cancer(CRC)is rarely encountered clinically,and its prognosis has not been fully evaluated.AIM To construct a scoring system and accurately predict the survival of patien...BACKGROUND Brain metastasis(BM)from colorectal cancer(CRC)is rarely encountered clinically,and its prognosis has not been fully evaluated.AIM To construct a scoring system and accurately predict the survival of patients with synchronous BM at diagnosis of CRC.METHODS A retrospective study of 371 patients with synchronous BM from CRC was performed,using the data from 2010 to 2014 from the Surveillance,Epidemiology,and End Results database.Survival time and prognostic factors were statistically analyzed by the Kaplan-Meier method and Cox proportional hazards models,respectively.A scoring system was developed using the independent prognostic factors,and was used to measure the survival difference among different patients.RESULTS For the 371 patients,the median overall survival was 5 mo,survival rates were 27%at 1 year and 11.2%at 2 years.Prognostic analysis showed that age,carcinoembryonic antigen level and extracranial metastasis to the liver,lung or bone were independent prognostic factors.A scoring system based on these three prognostic factors classified the patients into three prognostic subgroups(scores of 0-1,2-3,and 4).The median survival of patients with scores of 0-1,2-3 and 4 was 14,5 and 2 mo,respectively(P<0.001).Subgroup analysis showed that there were significant differences in prognosis among the groups.Score 2-3 vs 0-1:hazard ratio(HR)=2.050,95%CI:1.363-3.083;P=0.001;score 4 vs 0-1:HR=3.721,95%CI:2.225-6.225;P<0.001;score 2-3 vs 4:HR=0.551,95%CI:0.374-0.812;P=0.003.CONCLUSION The scoring system effectively distinguishes long-term and short-term survivors with synchronous BM from CRC.These results are helpful in providing a reference for guiding therapy.展开更多
Objective：To assess prognostic factors and validate the effectiveness of recursive partitioning analysis （RPA） classes and graded prognostic assessment （GPA） in 290 non-small cell lung cancer （NSCLC） patients w...Objective：To assess prognostic factors and validate the effectiveness of recursive partitioning analysis （RPA） classes and graded prognostic assessment （GPA） in 290 non-small cell lung cancer （NSCLC） patients with brain metastasis （BM）.Methods：From Jan 2008 to Dec 2009,the clinical data of 290 NSCLC cases with BM treated with multiple modalities including brain irradiation,systemic chemotherapy and tyrosine kinase inhibitors （TKIs） in two institutes were analyzed.Survival was estimated by Kaplan-Meier method.The differences of survival rates in subgroups were assayed using log-rank test.Multivariate Cox＇s regression method was used to analyze the impact of prognostic factors on survival.Two prognostic indexes models （RPA and GPA） were validated respectively.Results：All patients were followed up for 1-44 months,the median survival time after brain irradiation and its corresponding 95% confidence interval （95% CI） was 14 （12.3-15.8） months.1-,2-and 3-year survival rates in the whole group were 56.0%,28.3%,and 12.0%,respectively.The survival curves of subgroups,stratified by both RPA and GPA,were significantly different （P0.001）.In the multivariate analysis as RPA and GPA entered Cox＇s regression model,Karnofsky performance status （KPS） ≥ 70,adenocarcinoma subtype,longer administration of TKIs remained their prognostic significance,RPA classes and GPA also appeared in the prognostic model.Conclusion：KPS ≥70,adenocarcinoma subtype,longer treatment of molecular targeted drug,and RPA classes and GPA are the independent prognostic factors affecting the survival rates of NSCLC patients with BM.展开更多
Objective: To observe the efficacy of stereotactic radiotherapy (SRT) in lung cancer patients with brain metas-tases and explore the nursing for those patients. Methods: From June 2002 to December 2006, 43 patients of...Objective: To observe the efficacy of stereotactic radiotherapy (SRT) in lung cancer patients with brain metas-tases and explore the nursing for those patients. Methods: From June 2002 to December 2006, 43 patients of lung cancer with brain metastases were treated with SRT, 8 of them were treated with the association of whole-brain radiotherapy (WBRT) and 6 of them were treated with combination of chemotherapy. During the period of SRT, the patients were applied with active psychological nursing and diet nursing. We also tried to prevent patients from epicranium injury, and meanwhile, patients were asked to took active convalesce exercise. Results: All patients finished SRT without serious reaction and complication. Local control rate was 81.4%, nervous system symptoms relief rate was 76.7% and KPS score was raised significantly. Survival time ranged from 2 to 34 months, median survival time was 8.5 months, and 6-month, 1-and 2-year survival rates were 58.9%, 26.2%, and 6.0% respectively. Conclusion: SRT was one of the effective palliation treatments for the lung cancer patients with brain metastases, and with the assistance of effective nursing, which would prolong their survival time and improved quality of life.展开更多
We performed simultaneous one-stage thoraciccranial surgery on ten cases of lung cancer with brain metastases during the period of 1990 to 1994. Surgical mortality was 0% with low morbidity. By the end of the follow-u...We performed simultaneous one-stage thoraciccranial surgery on ten cases of lung cancer with brain metastases during the period of 1990 to 1994. Surgical mortality was 0% with low morbidity. By the end of the follow-up in February 1995, 4 patients died, with a mean survival of 8.25 months, and 6 patients survived, with a mean survival of 16 months and the longest one being approximately 36 months. Our results showed that, if patient's general condition permits, simultaneous onestage thoraco-cranial operation is feasible for the treatment of lung cancer involved the Periphery with solitary intracranial metastasis. Postoperative adjuvant chemotherapy is indicated to achieve better results.展开更多
Objective： The aim of this study is to compare the effectiveness of surgery with stereotactic radiosurgery （SRS） for patients with a single synchronous brain metastasis from successfully treated non-small cell lung...Objective： The aim of this study is to compare the effectiveness of surgery with stereotactic radiosurgery （SRS） for patients with a single synchronous brain metastasis from successfully treated non-small cell lung cancer. Methods： Between 1995 and 2002, 53 patients underwent resection of both primary non-small cell lung cancer and the associated single brain metastasis. There were 33 men and 20 women with a mean age of 57 years （range, 32-85 years）. At the time of diagnosis, 42 patients experienced lung cancer related symptoms, whereas 11 patients experienced brain metastases-related symptoms. 42 patients had received thoracic surgery first, and 11 patients had undergone neurosurgery or radiosurgery first. Pneumonectomy was performed in 9 out of 42 patients （21.4%）, lobectomies in 30 （71.4%）, and wedge resection in 3 （7.2%）. 48 patients （90.5%） underwent complete lymphadenectomy. 35 patients underwent brain metastasectomy. 18 underwent SRS. Results： There was no postoperative mortality and severe complications after either lung or brain surgery. Histology showed 34 adenocarcinomas, 16 squamous cell carcinomas, and 3 large cell lung cancers. 15 patients （28.3%） had no evidence of lymph node metastases （No）, 20 patients （37.7%） had hilar metastases （N1）, and 18 patients （34%） had mediastinal metastases （N2）. The 1-, 2-, 3- and 5-year overall survival rates were 49%, 19%, 10%, and 5%, respectively. The corresponding data for neurosurgery group were 55%, 17%, 11%, and 6%, respectively. The median survival time was 13 months. For SRS group the corresponding data were 44.8%, 20.9% 10.5%, and 2%, respectively. The median survival time was 14 months. The differences between the two groups were not significant （P〉0.05）. In lymph node negative patients （No）, the overall 5-year survival rate was 10%, as compared with a 1% survival rate in patients with lymph node metastases （N1-2）. The difference was significant （P〈0,01）. For adenocarcinomas, the 5-year survival rate was 5%. The correspondent data for squamous cell lung cancers was 3%. The difference was not significant （P〉0.05）. Conclusion： Although the overall survival rate for patients who have brain metastases from NSCLC is poor, surgical resection or radiosurgery may be beneficial in a select group of patients with synchronous brain metastases and lung cancer without lymph node metastases.展开更多
文摘Despite intensive therapy regi men,brain cancers present with a poor prognosis,with an esti-mated median survival time of less than 15 months in case of glioblastoma.Early detection and improved surgical resctions are suggested to enhance prognosis;several tools are being explored to achieve the purpose.Raman spectroscopy(RS),a nondestructive and noninv asive technique,has been extensively explored in brain cancers.This review summarizes RS based studies in brain cancers,categorized into studies on animal models,ex tivo human samples,and in tito human subjects.Findings suggest RS as a promising tool which can aid in improving the accuracy of brain tumor surgery.Further adv ancements in instrumentation,market assessment,and clinical trials can facilitate translation of the technology as a noninvasive intraopenative guidance tool.
基金supported by the National Natural Science Foundation of China(NSFC)(Grant Nos.82001959 and 31630027)NSFC-German Research Foundation(DFG)project(Grant No.31761133013)+6 种基金appreciate support from the“Ten Thousand Elite Plan”(Grant No.Y9E21Z11)CAS International Collaboration Plan(Grant No.E0632911ZX)the National Key Research&Development Program of China(Grant No.2018YFE0117800)the Key Laboratory of Biomedical Effects of Nanomaterials and NanosafetyCAS(Grant No.NSKF202003)Fujian Provincial Key Laboratory of Innovative Drug Target Research(Grant No.FJ-YW-2021KF04)financial support from the Nanqiang Outstanding Young Talents Program from Xiamen University。
文摘Brain cancer,also known as intracranial cancer,is one of the most invasive and fatal cancers affecting people of all ages.Despite the great advances in medical technology,improvements in transporting drugs into brain tissue have been limited by the challenge of crossing the blood-brain barrier(BBB).Fortunately,recent endeavors using gold-based nanomaterials(GBNs)have indicated the potential of these materials to cross the BBB.Therefore,GBNs might be an attractive therapeutic strategy against brain cancer.Herein,we aim to present a comprehensive summary of current understanding of the critical effects of the physicochemical properties and surface modifications of GBNs on BBB penetration for applications in brain cancer treatment.Furthermore,the most recent GBNs and their impressive performance in precise bioimaging and efficient inhibition of brain tumors are also summarized,with an emphasis on the mechanism of their effective BBB penetration.Finally,the challenges and future outlook in using GBNs for brain cancer treatment are discussed.We hope that this review will spark researchers'interest in constructing more powerful nanoplatforms for brain disease treatment.
基金This research work was funded by Institutional fund projects under grant no.(IFPHI-180-612-2020)Therefore,the authors gratefully acknowledge technical and financial support from the Ministry of Education and King Abdulaziz University,DSR,Jeddah,Saudi Arabia.
文摘Brain cancer detection and classification is done utilizing distinct medical imaging modalities like computed tomography(CT),or magnetic resonance imaging(MRI).An automated brain cancer classification using computer aided diagnosis(CAD)models can be designed to assist radiologists.With the recent advancement in computer vision(CV)and deep learning(DL)models,it is possible to automatically detect the tumor from images using a computer-aided design.This study focuses on the design of automated Henry Gas Solubility Optimization with Fusion of Handcrafted and Deep Features(HGSO-FHDF)technique for brain cancer classification.The proposed HGSO-FHDF technique aims for detecting and classifying different stages of brain tumors.The proposed HGSO-FHDF technique involves Gabor filtering(GF)technique for removing the noise and enhancing the quality of MRI images.In addition,Tsallis entropy based image segmentation approach is applied to determine injured brain regions in the MRI image.Moreover,a fusion of handcrafted with deep features using Residual Network(ResNet)is utilized as feature extractors.Finally,HGSO algorithm with kernel extreme learning machine(KELM)model was utilized for identifying the presence of brain tumors.For examining the enhanced brain tumor classification performance,a comprehensive set of simulations take place on the BRATS 2015 dataset.
基金the National Institutes of Health,USA(NIH,P30 DK063491).
文摘Pediatric central nervous system tumors are the most common tumors in children,it constitute 15%–20%of all malignancies in children and are the leading cause of cancer related deaths in children.Proteogenomics is an emerging field of biological research that utilizes a combination of proteomics,genomics,and transcriptomics to aid in the discovery and identification of biomarkers for diagnosis and therapeutic purposes.Integrative proteogenomics analysis of pediatric tumors identified underlying biological processes and potential treatments as well as the functional effects of somatic mutations and copy number variation driving tumorigenesis.
基金supported by the National Natural Science Foundation of China(Grant No.81702884)Natural Science Foundation of Shandong Province(Grant Nos.ZR2022MH272,ZR2020QH216,and ZR2023QH115)Medicine and Health Science and Technology Foundation of Shandong Province(Grant Nos.202402060623 and 202202080721).
文摘Objective:Migrasomes,an emerging class of migration-facilitating membranous extracellular vesicles,remain largely uncharted in the intricate landscape of tumor metastasis.This study aimed to illuminate the roles and mechanisms underlying cancer cell-derived migrasomes in breast cancer brain metastasis(BCBM).Methods:Migrasomes were isolated and purified from BCBM cells(231-BR)and non-specific organotropic parental counterparts(MDA-MB-231),specifically designated as Mig-BCBM and Mig-BC,respectively.The role of Mig-BCBM in BCBM was investigated using an in vitro endothelial cell layer permeability model and a BCBM mouse model.The regulatory mechanism underlying Mig-BCBM was assessed using RT-qPCR,western blotting,immunofluorescence,ex vivo fluorescence imaging,and a series of rescue experiments.Results:Mig-BCBM potently augmented the permeability of vascular endothelial layers,which facilitated the efficient migration of 231-BR cells across endothelial barriers in vitro.The administration of Mig-BCBM significantly disrupted the blood-brain barrier(BBB)and accelerated BCBM progression in vivo,as evidenced in mouse models,compared to the Mig-BC and control groups.Mechanistically,Mig-BCBM harbored ATF6,a critical transducer of endoplasmic reticulum(ER)stress.Upon internalization into hCMEC/D3 cells,ATF6 elicited robust ER stress responses,culminating in downregulation of ZO-1 and VE-cadherin.Digital PCR analysis disclosed significant upregulation of ATF6 in serum migrasomes derived from BCBM patients compared to migrasomes from breast cancer patients and healthy individuals.Conclusions:This study uncovered a pivotal role of cancer cell-derived in BCBM by harnessing ATF6-mediated ER stress to disrupt the BBB and promote metastasis,suggesting novel diagnostic and therapeutic strategies targeting migrasomes and migrasome cargo.
文摘Brain metastasis and primary glioblastoma multiforme represent the most common and lethal malignant brain tumors.Its median survival time is typically less than a year after diagnosis.One of the major challenges in treating these cancers is the efficiency of the transport of drugs to the central nervous system.The blood-brain barrier is cooperating with advanced stages of malignancy.The blood-brain barrier poses a significant challenge to delivering systemic medications to brain tumors.Nanodrug delivery systems have emerged as promising tools for effectively crossing this barrier.Additionally,the development of smart nanoparticles brings new hope for cancer diagnosis and treatment.These nanoparticles improve drug delivery efficiency,allowing for the creation of targeted and stimuli-responsive delivery methods.This review highlights recent advancements in nanoparticle and smart nanoparticle technologies for brain cancer treatment,exploring the range of nanoparticles under development,their applications,targeting strategies,and the latest progress in enhancing transport across the blood-brain barrier.It also addresses the ongoing challenges and potential benefits of these innovative approaches.
基金supported by Northern Border University Researchers Supporting Project number(NBU-FFR-2025-432-03),Northern Border University,Arar,Saudi Arabia.
文摘In medical imaging,accurate brain tumor classification in medical imaging requires real-time processing and efficient computation,making hardware acceleration essential.Field Programmable Gate Arrays(FPGAs)offer parallelism and reconfigurability,making them well-suited for such tasks.In this study,we propose a hardware-accelerated Convolutional Neural Network(CNN)for brain cancer classification,implemented on the PYNQ-Z2 FPGA.Our approach optimizes the first Conv2D layer using different numerical representations:8-bit fixed-point(INT8),16-bit fixed-point(FP16),and 32-bit fixed-point(FP32),while the remaining layers run on an ARM Cortex-A9 processor.Experimental results demonstrate that FPGA acceleration significantly outperforms the CPU(Central Processing Unit)based approach.The obtained results emphasize the critical importance of selecting the appropriate numerical representation for hardware acceleration in medical imaging.On the PYNQ-Z2 FPGA,the INT8 achieves a 16.8%reduction in latency and 22.2%power savings compared to FP32,making it ideal for real-time and energy-constrained applications.FP16 offers a strong balance,delivering only a 0.1%drop in accuracy compared to FP32(94.1%vs.94.2%)while improving latency by 5%and reducing power consumption by 11.1%.Compared to prior works,the proposed FPGA-based CNN model achieves the highest classification accuracy(94.2%)with a throughput of up to 1.562 FPS,outperforming GPU-based and traditional CPU methods in both accuracy and hardware efficiency.These findings demonstrate the effectiveness of FPGA-based AI acceleration for real-time,power-efficient,and high-performance brain tumor classification,showcasing its practical potential in next-generation medical imaging systems.
基金supported by grants from the Fundamental Research Funds for the Central Universities,HUST(No.2016YXZD043)the National Science&Technology Pillar Program during the 12th Five-Year Plan Period,China(No.2012BAI32B03)
文摘Current treatments for cancer and the central nervous system diseases are limited, partly due to the difficulties posed by the insolubility, poor distribution of drugs among cells and lack of selectivity of drugs, the inability of drugs to cross cellular barriers and blood brain barrier（BBB）. Carbon nanotubes（CNTs） possess many distinct properties including good electronic properties, remarkably penetrating capability on the cell membrane, high drug-loading and pH-dependent therapeutic unloading capacities,thermal properties, large surface area and easy modification with molecules, which render them as a suitable candidate to deliver drugs to cancer and brain. CNTs as a drug delivery could achieve a high efficacy, enhance specificity and diminish side effects. Whereas CNTs have been primarily employed in cancer treatment, a few studies have focused on the treatment and diagnosis of the central nervous system diseases using CNTs. Here, we review the current progress of in vitro and in vivo researches of CNTs-based drug delivery to cancer involving CNTs-based tumor-targeted drug delivery systems（DDS）, photodynamic therapy（PDT） and photothermal therapy（PTT）. Meanwhile, we also review the current progress of in vitro and in vivo researches of CNTs-based drug delivery to brain.
文摘Objective:Brain metastasis is considered rare in metastatic colorectal cancer(mCRC);thus,surveillance imaging does not routinely include the brain.The reported incidence of brain metastases ranges from 0.6% to 3.2%.Methods:The South Australian mCRC Registry(SAmCRC)was analyzed to assess the number of patients presenting with brain metastasis during their lifetime.Due to small numbers,a descriptive analysis is presented.Results:Only 59 patients of 4,100 on the registry at the time of analysis had developed brain metastasis(1.4%).The clinical characteristics of those with brain metastasis were as follows:the median age was 65.3 years and 51% were female.Where the V-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog(KRAS)mutation status of the tumor was known,the majority harbored a KRAS mutation(55%);31(53%)underwent craniotomy and 55(93%)underwent whole-brain radiotherapy.The median survival time from diagnosis of brain metastasis was 4.2 months(95% confidence interval 2.9–5.5).Patients who underwent craniotomy and radiotherapy had superior survival compared to those who underwent whole-brain radiotherapy(8.5 months vs.2.2 months,respectively).Data from the SAmCRC(a population-based registry)confirm that brain metastases are rare and the median time to development is approximately 2 years.Conclusions:Brain metastasis is a rare outcome in advanced CRC.Patients within the registry tended to be female,young in age,and harbored with higher rates of KRAS mutations.Whether routine surveillance brain scanning should be considered remains controversial given the relative rarity of developing brain metastases in mCRC and ultimately,most patients with central nervous system involvement die from their extracranial disease.
基金supported by grants from Ministry of Science and Technology Projects of China(No.2012AA021502)Provincial Science and Technology Projects of Guangdong(No.2012B031800295)
文摘High expression of fibrinogen and platelets are often observed in non–small cell lung cancer(NSCLC) patients with local regional or distant metastasis. However, the role of these factors remains unclear. The aims of this study were to evaluate the prognostic significance of plasma fibrinogen concentration and platelet count, as well as to determine the overall survival of NSCLC patients with brain metastases. A total of 275 NSCLC patients with brain metastasis were enrolled into this study. Univariate analysis showed that high plasma fibrinogen concentration was associated with age ≥ 65 years(P = 0.011), smoking status(P = 0.009), intracranial symptoms(P = 0.022), clinical T category(P = 0.010), clinical N category(P = 0.003), increased partial thromboplastin time(P < 0.001), and platelet count(P < 0.001). Patients with low plasma fibrinogen concentration demonstrated longer overall survival compared with those with high plasma fibrinogen concentration(median, 17.3 months versus 11.1 months; P ≤ 0.001). A similar result was observed for platelet counts(median, 16.3 months versus 11.4 months; P = 0.004). Multivariate analysis showed that both plasma fibrinogen concentration and platelet count were independent prognostic factors for NSCLC with brain metastases(R2 = 1.698, P < 0.001 and R2 = 1.699, P < 0.001, respectively). Our results suggest that high plasma fibrinogen concentration and platelet count indicate poor prognosis for NSCLC patients with brain metastases. Thus, these two biomarkers might be independent prognostic predictors for this subgroup of NSCLC patients.
文摘Prostate cancer is the most common non-cutaneous malignancy for men. The skeleton is the most common metastatic site but, following an improvement in survival, metastases in uncommon sites are being found more frequently in clinical practice, especially brain metastases. Despite the new drugs now available for metastatic castration resistant prostate cancer, no clinical evidence exists about their effectiveness on brain metastases. We describe the clinical history of 3 patients treated with cabazitaxel plus whole brain radiotherapy. These case reports demonstrate that cabazitaxel is highly active and well tolerated in brain metastases.
文摘Purpose: To determine whether the new treatments for breast cancer CNS metastases improve survival by comparing the survival between two cohorts: 2000-2005 and 2006-2011. Patients and Methods: A retrospective, comparative, correlational chart review was performed. Data from 172 women diagnosed with CNS metastases between 2000 and 2011, was evaluated. Results: Approximately 10% of patients diagnosed with invasive breast cancer between 2000 and 2011 developed CNS metastases. The cohort was separated into four groups: luminal A (ER+ and/or PR+, HER2-), luminal B (ER+ and/or PR+, HER2+), HER2+ (ER -, PR-, HER2+) and TN (ER-, PR-, HER2-). There was a statistically significant difference in the overall survival between luminal A and luminal B (5.55 months vs. 15.3 months, respectively, p = 0.048). There was also a statistically significant difference in the overall survival between luminal B and TN (15.3 months vs. 7.49 months, respectively, p = 0.0181). There was no significant difference in overall survival between luminal B and HER2+ (15.3 months vs. and 10.98 months, respectively, p = 0.105), TN and HER2+ (7.49 months vs. 10.98 months, respectively, p = 0.514), and between luminal A and TN or HER2+ (5.55 months vs. 7.49 months, respectively, p = 0.428, or 5.55 months vs. 10.98 months, respectively, p = 0.491). Overall median survival of the patients in 2000-2005 and 2006-2011 were 6.64 months vs. 10.58 months, respectively (p = 0.0592). Conclusion: The results of our study showed that despite the new therapies there is little improvement in survival for brain metastasis in breast cancer.
文摘BACKGROUND Breast cancer brain metastasis(BCBM)is an advanced breast disease that is difficult to treat and is associated with a high risk of death.Patient prognosis is usually poor,with reduced quality of life.In this context,we report the case of a patient with HER-2-positive BCBM treated with a macromolecular mAb(ine-tetamab)combined with a small molecule tyrosine kinase inhibitor(TKI).CASE SUMMARY The patient was a 58-year-old woman with a 12-year history of type 2 diabetes.She was compliant with regular insulin treatment and had good blood glucose control.The patient was diagnosed with invasive carcinoma of the right breast(T3N1M0 stage IIIa,HER2-positive type)through aspiration biopsy of the ipsilateral breast due to the discovery of a breast tumor in February 2019.Immunohistochemistry showed ER(-),PR(-),HER-2(3+),and Ki-67(55-60%+).Preoperative neoadjuvant chemotherapy,i.e.,the AC-TH regimen(epirubicin,cyclophosphamide,docetaxel-paclitaxel,and trastuzumab),was administered for 8 cycles.She underwent modified radical mastectomy of the right breast in November 2019 and received tocilizumab targeted therapy for 1 year.Brain metastasis was found 9 mo after surgery.She underwent brain metastasectomy in August 2020.Immunohistochemistry showed ER(-)and PR.(-),HER-2(3+),and Ki-67(10-20%+).In November 2020,the patient experienced headache symptoms.After an examination,tumor recurrence in the original surgical region of the brain was observed,and the patient was treated with inetetamab,pyrotinib,and capecitabine.Whole-brain radiotherapy was recommended.The patient and her family refused radiotherapy for personal reasons.In September 2021,a routine examination revealed that the brain tumor was considerably larger.The original systemic treatment was continued and combined with intensity-modulated radiation therapy for brain metastases,followed by regular hospitalization and routine examinations.The patient’s condition is generally stable,and she has a relatively high quality of life.This case report demonstrates that in patients with BCBM and resistance to trastuzumab,inetetamab combined with pyrotinib and chemotherapy can prolong survival.CONCLUSION Inetetamab combined with small molecule TKI drugs,chemotherapy and radiation may be an effective regimen for maintaining stable disease in patients with BCBM.
文摘Objective The aim of this study was to define the maximum-tolerated dose (MTD) and observe the toxicity of escalating topotecan combined whole brain radiotherapy for brain metastasis in lung cancer.
文摘Several studies have largely focused on the significant role of the nervous and immune systems in the process of tumorigenesis, including tumor growth, proliferation, apoptosis, and metastasis. The brain-gut-axis is a new paradigm in neuroscience, which describes the biochemical signaling between the gastrointestinal (GI) tract and the central nervous system. This axis may play a critical role in the tumorigenesis and development of GI cancers. Mechanistically, the bidirectional signal transmission of the brain-gut-axis is complex and remains to be elucidated. In this article, we review the current findings concerning the relationship between the brain-gut axis and GI cancer cells, focusing on the significant role of the brain-gut axis in the processes of tumor proliferation, invasion, apoptosis, autophagy, and metastasis. It appears that the brain might modulate GI cancer by two pathways: the anatomical nerve pathway and the neuroendocrine route. The simulation and inactivation of the central nervous, sympathetic, and parasympathetic nervous systems, or changes in the innervation of the GI tract might contribute to a higher incidence of GI cancers. In addition, neurotransmitters and neurotrophic factors can produce stimulatory or inhibitory effects in the progression of GI cancers. Insights into these mechanisms may lead to the discovery of potential prognostic and therapeutic targets.
基金Supported by National Key Research and Development Program of the Ministry of Science and Technology of China,No.2016YFC0905303,2016YFC0905300Beijing Science and Technology Program,No.D171100002617004
文摘BACKGROUND Brain metastasis(BM)from colorectal cancer(CRC)is rarely encountered clinically,and its prognosis has not been fully evaluated.AIM To construct a scoring system and accurately predict the survival of patients with synchronous BM at diagnosis of CRC.METHODS A retrospective study of 371 patients with synchronous BM from CRC was performed,using the data from 2010 to 2014 from the Surveillance,Epidemiology,and End Results database.Survival time and prognostic factors were statistically analyzed by the Kaplan-Meier method and Cox proportional hazards models,respectively.A scoring system was developed using the independent prognostic factors,and was used to measure the survival difference among different patients.RESULTS For the 371 patients,the median overall survival was 5 mo,survival rates were 27%at 1 year and 11.2%at 2 years.Prognostic analysis showed that age,carcinoembryonic antigen level and extracranial metastasis to the liver,lung or bone were independent prognostic factors.A scoring system based on these three prognostic factors classified the patients into three prognostic subgroups(scores of 0-1,2-3,and 4).The median survival of patients with scores of 0-1,2-3 and 4 was 14,5 and 2 mo,respectively(P<0.001).Subgroup analysis showed that there were significant differences in prognosis among the groups.Score 2-3 vs 0-1:hazard ratio(HR)=2.050,95%CI:1.363-3.083;P=0.001;score 4 vs 0-1:HR=3.721,95%CI:2.225-6.225;P<0.001;score 2-3 vs 4:HR=0.551,95%CI:0.374-0.812;P=0.003.CONCLUSION The scoring system effectively distinguishes long-term and short-term survivors with synchronous BM from CRC.These results are helpful in providing a reference for guiding therapy.
文摘Objective：To assess prognostic factors and validate the effectiveness of recursive partitioning analysis （RPA） classes and graded prognostic assessment （GPA） in 290 non-small cell lung cancer （NSCLC） patients with brain metastasis （BM）.Methods：From Jan 2008 to Dec 2009,the clinical data of 290 NSCLC cases with BM treated with multiple modalities including brain irradiation,systemic chemotherapy and tyrosine kinase inhibitors （TKIs） in two institutes were analyzed.Survival was estimated by Kaplan-Meier method.The differences of survival rates in subgroups were assayed using log-rank test.Multivariate Cox＇s regression method was used to analyze the impact of prognostic factors on survival.Two prognostic indexes models （RPA and GPA） were validated respectively.Results：All patients were followed up for 1-44 months,the median survival time after brain irradiation and its corresponding 95% confidence interval （95% CI） was 14 （12.3-15.8） months.1-,2-and 3-year survival rates in the whole group were 56.0%,28.3%,and 12.0%,respectively.The survival curves of subgroups,stratified by both RPA and GPA,were significantly different （P0.001）.In the multivariate analysis as RPA and GPA entered Cox＇s regression model,Karnofsky performance status （KPS） ≥ 70,adenocarcinoma subtype,longer administration of TKIs remained their prognostic significance,RPA classes and GPA also appeared in the prognostic model.Conclusion：KPS ≥70,adenocarcinoma subtype,longer treatment of molecular targeted drug,and RPA classes and GPA are the independent prognostic factors affecting the survival rates of NSCLC patients with BM.
文摘Objective: To observe the efficacy of stereotactic radiotherapy (SRT) in lung cancer patients with brain metas-tases and explore the nursing for those patients. Methods: From June 2002 to December 2006, 43 patients of lung cancer with brain metastases were treated with SRT, 8 of them were treated with the association of whole-brain radiotherapy (WBRT) and 6 of them were treated with combination of chemotherapy. During the period of SRT, the patients were applied with active psychological nursing and diet nursing. We also tried to prevent patients from epicranium injury, and meanwhile, patients were asked to took active convalesce exercise. Results: All patients finished SRT without serious reaction and complication. Local control rate was 81.4%, nervous system symptoms relief rate was 76.7% and KPS score was raised significantly. Survival time ranged from 2 to 34 months, median survival time was 8.5 months, and 6-month, 1-and 2-year survival rates were 58.9%, 26.2%, and 6.0% respectively. Conclusion: SRT was one of the effective palliation treatments for the lung cancer patients with brain metastases, and with the assistance of effective nursing, which would prolong their survival time and improved quality of life.
文摘We performed simultaneous one-stage thoraciccranial surgery on ten cases of lung cancer with brain metastases during the period of 1990 to 1994. Surgical mortality was 0% with low morbidity. By the end of the follow-up in February 1995, 4 patients died, with a mean survival of 8.25 months, and 6 patients survived, with a mean survival of 16 months and the longest one being approximately 36 months. Our results showed that, if patient's general condition permits, simultaneous onestage thoraco-cranial operation is feasible for the treatment of lung cancer involved the Periphery with solitary intracranial metastasis. Postoperative adjuvant chemotherapy is indicated to achieve better results.
文摘Objective： The aim of this study is to compare the effectiveness of surgery with stereotactic radiosurgery （SRS） for patients with a single synchronous brain metastasis from successfully treated non-small cell lung cancer. Methods： Between 1995 and 2002, 53 patients underwent resection of both primary non-small cell lung cancer and the associated single brain metastasis. There were 33 men and 20 women with a mean age of 57 years （range, 32-85 years）. At the time of diagnosis, 42 patients experienced lung cancer related symptoms, whereas 11 patients experienced brain metastases-related symptoms. 42 patients had received thoracic surgery first, and 11 patients had undergone neurosurgery or radiosurgery first. Pneumonectomy was performed in 9 out of 42 patients （21.4%）, lobectomies in 30 （71.4%）, and wedge resection in 3 （7.2%）. 48 patients （90.5%） underwent complete lymphadenectomy. 35 patients underwent brain metastasectomy. 18 underwent SRS. Results： There was no postoperative mortality and severe complications after either lung or brain surgery. Histology showed 34 adenocarcinomas, 16 squamous cell carcinomas, and 3 large cell lung cancers. 15 patients （28.3%） had no evidence of lymph node metastases （No）, 20 patients （37.7%） had hilar metastases （N1）, and 18 patients （34%） had mediastinal metastases （N2）. The 1-, 2-, 3- and 5-year overall survival rates were 49%, 19%, 10%, and 5%, respectively. The corresponding data for neurosurgery group were 55%, 17%, 11%, and 6%, respectively. The median survival time was 13 months. For SRS group the corresponding data were 44.8%, 20.9% 10.5%, and 2%, respectively. The median survival time was 14 months. The differences between the two groups were not significant （P〉0.05）. In lymph node negative patients （No）, the overall 5-year survival rate was 10%, as compared with a 1% survival rate in patients with lymph node metastases （N1-2）. The difference was significant （P〈0,01）. For adenocarcinomas, the 5-year survival rate was 5%. The correspondent data for squamous cell lung cancers was 3%. The difference was not significant （P〉0.05）. Conclusion： Although the overall survival rate for patients who have brain metastases from NSCLC is poor, surgical resection or radiosurgery may be beneficial in a select group of patients with synchronous brain metastases and lung cancer without lymph node metastases.
