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94 results on '"Soffietti, R."'

3. Digital PCR quantification of MGMT methylation refines prediction of clinical benefit from alkylating agents in glioblastoma and metastatic colorectal cancer

Author

Barault, L., Amatu, A., Bleeker, F.E., Moutinho, C., Falcomatà, C., Fiano, V., Cassingena, A., Siravegna, G., Milione, M., Cassoni, P., De Braud, F., Rudà, R., Soffietti, R., Venesio, T., Bardelli, A., Wesseling, P., de Witt Hamer, P., Pietrantonio, F., Siena, S., Esteller, M., Sartore-Bianchi, A., and Di Nicolantonio, F.

Published
2015
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4. Lessons learned from people with neurological diseases at the time of COVID‐19: The EFNA‐EAN survey

Author

Bodini, B., Moro, E., Jaarsma, J., Cunningham, E., Sellner, J., Walsh, D., Bassetti, C. L., Beghi, E., Bereczki, D., Burlica, A., Cavallieri, F., Crean, M., Di Liberto, G., Helbok, R., Jenkins, T. M., Macerollo, A., Maia, L. F., Oreja-Guevara, C., Ozturk, S., Rakusa, M., Sauerbier, A., Soffietti, R., Taba, P., Pisani, A., Priori, A., von Oertzen, T. J., and Zedde, M.

Subjects
medicine.medical_specialty, Neurology, Short Communication, perspective, Neurological disorder, Disease, All Neurologists, COVID‐19, Surveys and Questionnaires, Pandemic, medicine, Disinvestment, Humans, people with neurological disease, survey, Social isolation, Disease management (health), Psychiatry, Pandemics, SARS-CoV-2, business.industry, COVID-19, chronic disorders, medical care, neurology, Nervous System Diseases, medicine.disease, Clinical trial, Neurology (clinical), medicine.symptom, business
Abstract

Background and purpose The European Federation of Neurological Associations (EFNA), in partnership with the NeuroCOVID‐19 taskforce of the European Academy of Neurology (EAN), has investigated the impact of the first wave of the COVID‐19 pandemic on individuals with neurological diseases, as well as the hopes and fears of these patients about the post‐pandemic phase. Methods An EFNA‐EAN survey was available online to any person living with a neurological disorder in Europe. It consisted of 18 items concerning the impact of the first wave of the COVID‐19 pandemic on the medical care of people with neurological disorders, and the hopes and fears of these individuals regarding the post‐pandemic phase. Results For 44.4% of the 443 survey participants, the overall care of their neurological disease during the pandemic was inappropriate. This perception was mainly due to significant delays in accessing medical care (25.7%), insufficiently reliable information received about the potential impact of COVID‐19 on their neurological disease (49.6%), and a substantial lack of involvement in their disease management decisions (54.3%). Participants indicated that their major concerns for the post‐pandemic phase were experiencing longer waiting times to see a specialist (24.1%), suffering from social isolation and deteriorating mental well‐being (23.1%), and facing delays in clinical trials with disinvestment in neuroscience research (13.1%). Conclusions Despite the great efforts of health services to cope with the first wave of the COVID‐19 pandemic, individuals with neurological conditions feel they have been left behind. These findings provide invaluable insights for improving the care of patients with neurological disorders in the further course of the COVID‐19 pandemic., For 44.4% of individuals with neurological disorders participating in the survey, the overall care of their neurological disease during the pandemic was inappropriate due to significant delays in accessing medical care, insufficient information about the potential impact of COVID‐19 on their neurological disease, and a lack of involvement in their disease management decisions. Survey participants indicated that their major concerns for the post‐pandemic phase were experiencing longer waiting times to see a specialist, suffering from social isolation and deteriorating mental well‐being, and facing delays in clinical trials. Overall, despite the great efforts of health services to cope with the first wave of the COVID‐19 pandemic, people with neurological disorders feel they have been left behind.

Published
2021
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5. Still a long way to go to achieve multidisciplinarity for the benefit of patients: commentary on the ESMO position paper (Annals of Oncology 25(1): 9–15, 2014)

Author

Valentini, V., Abrahamsson, P.-A., Aranda, S. K., Astier, A., Audisio, R. A., Boniol, M., Bonomo, L., Brunelli, A., Bultz, B., Chiti, A., De Lorenzo, F., Eriksen, J. G., Goh, V., Gospodarowicz, M. K., Grassi, L., Kelly, J., Kortmann, R. D., Kutluk, T., Plate, A., Poston, G., Saarto, T., Soffietti, R., Torresin, A., van Harten, W. H., Verzijlbergen, J. F., von Kalle, C., and Poortmans, P.

Published
2014
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6. European Journal of Neurology / EAN consensus statement for management of patients with neurological diseases during the COVID19 pandemic

Author

von Oertzen, Tim J., Macerollo, A., Leone, M. A., Beghi, E., Crean, M., Oztuk, S., Bassetti, C., Twardzik, A., Berecki, D., Di Liberto, G., Helbok, R., Oreja-Guevara, C., Pisani, A., Sauerbier, A., Sellner, J., Soffietti, R., Zedde, M., Bianchi, E., Bodini, B., Cavallieri, F., Campiglio, L., Maia, L. F., Priori, A., Rakusa, M., and Taba, P.

Subjects
COVID19, neurology, practice guideline, education, human, chronic disease
Abstract

Background and purpose: The recent SARSCoV2 pandemic has posed multiple challenges to the practice of clinical neurology including recognition of emerging neurological complications and management of coexistent neurological diseases. In a fastevolving pandemic, evidencebased studies are lacking in many areas. This paper presents European Academy of Neurology (EAN) expert consensus statements to guide neurologists caring for patients with COVID19. Methods: A refined Delphi methodology was applied. In round 1, statements were provided by EAN scientific panels (SPs). In round 2, these statements were circulated to SP members not involved in writing them, asking for agreement/disagreement. Items with agreement >70% were retained for round 3, in which SP cochairs rated importance on a fivepoint Likert scale. Results were graded by importance and reported as consensus statements. Results: In round one, 70 statements were provided by 23 SPs. In round two, 259/1061 SP member responses were received. Fiftynine statements obtained >70% agreement and were retained. In round three, responses were received from 55 cochairs of 29 SPs. Whilst general recommendations related to prevention of COVID19 transmission had high levels of agreement and importance, opinion was more varied concerning statements related to therapy. Conclusion: This is the first structured consensus statement on good clinical practice in patients with neurological disease during the COVID19 pandemic that provides immediate guidance for neurologists. In this fastevolving pandemic, a rapid response using refined Delphi methodology is possible, but guidance may be subject to change as further evidence emerges. (VLID)5891876 Version of record

Published
2021
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16. Primary CNS Lymphomas: Challenges in Diagnosis and Monitoring

Author

Chiavazza, C., Pellerino, A., Ferrio, F., Cistaro, A., Soffietti, R., and Rudà, R.

Subjects
Article Subject
Abstract

Primary Central Nervous System Lymphoma (PCNSL) is a rare neoplasm that can involve brain, eye, leptomeninges, and rarely spinal cord. PCNSL lesions most typically enhance homogeneously on T1-weighted magnetic resonance imaging (MRI) and appear T2-hypointense, but high variability in MRI features is commonly encountered. Neurological symptoms and MRI findings may mimic high grade gliomas (HGGs), tumefactive demyelinating lesions (TDLs), or infectious and granulomatous diseases. Advanced MRI techniques (MR diffusion, spectroscopy, and perfusion) and metabolic imaging, such as Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) or amino acid PET (usually employing methionine), may be useful in distinguishing these different entities and monitoring the disease course. Moreover, emerging data suggest a role for cerebrospinal fluid (CSF) markers in predicting prognosis and response to treatments. In this review, we will address the challenges in PCNSL diagnosis, assessment of response to treatments, and evaluation of potential neurotoxicity related to chemotherapy and radiotherapy.

Published
2018
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17. P05.47 Long-lasting response in spinal metastases from ALK rearranged Non-Small-Cell Lung Cancer treated with different ALK inhibitors

Author

Pellerino, A, Rudà, R, Franchino, F, Marchese, G, Bruno, F, Mo, F, and Soffietti, R

Subjects
Poster Presentations, Cancer Research, Oncology, hemic and lymphatic diseases, Neurology (clinical)
Abstract

BACKGROUND: About 35–50 % of ALK-rearranged NSCLC patients develop brain metastases (BM), while leptomeningeal metastases (LM) occur in 5% of patients, and spinal intramedullary metastases in < 1%. Few data are available regarding the efficacy of ALK inhibitors in neoplastic spinal disease from NSCLC. MATERIAL AND METHODS: In March 2014 a 55 year-old woman developed multiple BM after 2 years from the diagnosis of an ALK-rearranged NSCLC who was receiving crizotinib, a first-generation ALK inhibitor. Crizotinib was continued associated with WBRT with a near-CR (RANO criteria) lasting 12 months. One year later a spinal MRI displayed multiple intramedullary enhancing lesions and diffuse leptomeningeal spread along the cauda equina, with CSF positivity for neoplastic cells. Ceritinib, a second-generation ALK inhibitor, was started and a CR both on MRI and CSF was obtained lasting 18 months. In December 2017 the patient developed a bladder dysfunction and paralytic ileus due to multiple intramedullary spinal and leptomeningeal recurrences. Considering the higher BBB penetration of lorlatinib, a third-generation ALK inhibitor, the patient started the drug and achieved a significant improvement of the urinary incontinence and intestinal transit after 3 months Conversely, no change of the extent of spinal disease was observed on MRI. At this time, the patient is continuing treatment with lorlatinib and she is free of recurrence since 5 months. RESULTS: The development of CNS disease in ALK-rearranged NSCLC has been suggested to be a natural evolution of the disease and/or is correlated to low CNS penetration of the molecular drugs that control the systemic disease. The PROFILE trials (1005 and 1007) have shown longer OS in patients with BM who received crizotinib beyond progression, but data are lacking on the activity of second- and third-generation ALK inhibitors. CONCLUSION: This is the first report of a prolonged clinical and radiological response using sequentially different ALK inhibitors in a patient with concurrent LM and spinal intramedullary metastases from an ALK-rearranged NSCLC.

Published
2018
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18. EAN consensus statement for management of patients with neurological diseases during the COVID‐19 pandemic.

Author

von Oertzen, T. J., Macerollo, A., Leone, M. A., Beghi, E., Crean, M., Oztuk, S., Bassetti, C., Twardzik, A., Bereczki, D., Di Liberto, G., Helbok, R., Oreja‐ Guevara, C., Pisani, A., Sauerbier, A., Sellner, J., Soffietti, R., Zedde, M., Bianchi, E., Bodini, B., and Cavallieri, F.

Subjects
COVID-19 pandemic, NEUROLOGICAL disorders, COMORBIDITY, COVID-19, PANDEMICS
Abstract

Background and purpose: The recent SARS‐CoV‐2 pandemic has posed multiple challenges to the practice of clinical neurology including recognition of emerging neurological complications and management of coexistent neurological diseases. In a fast‐evolving pandemic, evidence‐based studies are lacking in many areas. This paper presents European Academy of Neurology (EAN) expert consensus statements to guide neurologists caring for patients with COVID‐19. Methods: A refined Delphi methodology was applied. In round 1, statements were provided by EAN scientific panels (SPs). In round 2, these statements were circulated to SP members not involved in writing them, asking for agreement/disagreement. Items with agreement >70% were retained for round 3, in which SP co‐chairs rated importance on a five‐point Likert scale. Results were graded by importance and reported as consensus statements. Results: In round one, 70 statements were provided by 23 SPs. In round two, 259/1061 SP member responses were received. Fifty‐nine statements obtained >70% agreement and were retained. In round three, responses were received from 55 co‐chairs of 29 SPs. Whilst general recommendations related to prevention of COVID‐19 transmission had high levels of agreement and importance, opinion was more varied concerning statements related to therapy. Conclusion: This is the first structured consensus statement on good clinical practice in patients with neurological disease during the COVID‐19 pandemic that provides immediate guidance for neurologists. In this fast‐evolving pandemic, a rapid response using refined Delphi methodology is possible, but guidance may be subject to change as further evidence emerges. [ABSTRACT FROM AUTHOR]

Published
2021
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19. The international European Academy of Neurology survey on neurological symptoms in patients with COVID‐19 infection.

Author

Moro, E., Priori, A., Beghi, E., Helbok, R., Campiglio, L., Bassetti, C. L., Bianchi, E., Maia, L. F., Ozturk, S., Cavallieri, F., Zedde, M., Sellner, J., Bereczki, D., Rakusa, M., Di Liberto, G., Sauerbier, A., Pisani, A., Macerollo, A., Soffietti, R., and Taba, P.

Subjects
COVID-19, SYMPTOMS, COVID-19 pandemic, NEUROLOGICAL disorders, INFECTION
Abstract

Background and purpose: Although the main clinical features of COVID‐19 infection are pulmonary, several associated neurological signs, symptoms and diseases are emerging. The incidence and characteristics of neurological complications are unclear. For this reason, the European Academy of Neurology (EAN) core COVID‐19 Task Force initiated a survey on neurological symptoms observed in patients with COVID‐19 infection. Methods: A 17‐question online survey was made available on the EAN website and distributed to EAN members and other worldwide physicians starting on 9 April 2020. Results: By 27 April 2020, proper data were collected from 2343 responders (out of 4199), of whom 82.0% were neurologists, mostly from Europe. Most responders (74.7%) consulted patients with COVID‐19 mainly in emergency rooms and in COVID‐19 units. The majority (67.0%) had evaluated fewer than 10 patients with neurological manifestations of COVID‐19 (neuro COVID‐19). The most frequently reported neurological findings were headache (61.9%), myalgia (50.4%), anosmia (49.2%), ageusia (39.8%), impaired consciousness (29.3%) and psychomotor agitation (26.7%). Encephalopathy and acute cerebrovascular disorders were reported at 21.0%. Neurological manifestations were generally interpreted as being possibly related to COVID‐19; they were most commonly recognized in patients with multiple general symptoms and occurred at any time during infection. Conclusion: Neurologists are currently and actively involved in the management of neurological issues related to the COVID‐19 pandemic. This survey justifies setting up a prospective registry to better capture the prevalence of patients with neuro COVID‐19, neurological disease characteristics and the contribution of neurological manifestations to outcome. [ABSTRACT FROM AUTHOR]

Published
2020
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20. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma

Author

Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJB, Belanger K, Brandes AA, Marosi C, Bogdahn U, Curschmann J, Janzer RC, Ludwin SK, Gorlia T, Allgeier A, Lacombe D, Cairncross JG, Eisenhauer E, Mirimanoff RO, Van Den Weyngaert D, Kaendler S, Krauseneck P, Vinolas N, Villa S, Wurm RE, Maillot MHB, Spagnolli F, Kantor G, Malhaire JP, Renard L, De Witte O, Scandolaro L, Vecht CJ, Maingon P, Lutterbach J, Kobierska A, Bolla M, Souchon R, Mitine C, Tzuk-Shina T, Kuten A, Haferkamp G, de Greve J, Priou F, Menten J, Rutten I, Clavere P, Malmstrom A, Jancar B, Newlands E, Pigott K, Twijnstra A, Chinot O, Reni M, Boiardi A, Fabbro M, Campone M, Bozzino J, Frenay M, Gijtenbeek J, Delattre JY, De Paula U, Hanzen C, Pavanato G, Schraub S, Pfeffer R, Soffietti R, Kortmann RD, Taphoorn M, Torrecilla JL, Grisold W, Huget P, Forsyth P, Fulton D, Kirby S, Wong R, Fenton D, Cairncross G, Whitlock P, Burdette-Radoux S, Gertler S, Saunders S, Laing K, Siddiqui J, Martin LA, Gulavita S, Perry J, Mason W, Thiessen B, Pai H, Alam ZY, Eisenstat D, Mingrone W, Hofer S, Pesce G, Dietrich PY, Thum P, Baumert B, Ryan G, Stupp, R, Mason, Wp, van den Bent, Mj, Weller, M, Fisher, B, Taphoorn, Mjb, Belanger, K, Brandes, Aa, Marosi, C, Bogdahn, U, Curschmann, J, Janzer, Rc, Ludwin, Sk, Gorlia, T, Allgeier, A, Lacombe, D, Cairncross, Jg, Eisenhauer, E, Mirimanoff, Ro, Van Den Weyngaert, D, Kaendler, S, Krauseneck, P, Vinolas, N, Villa, S, Wurm, Re, Maillot, Mhb, Spagnolli, F, Kantor, G, Malhaire, Jp, Renard, L, De Witte, O, Scandolaro, L, Vecht, Cj, Maingon, P, Lutterbach, J, Kobierska, A, Bolla, M, Souchon, R, Mitine, C, Tzuk-Shina, T, Kuten, A, Haferkamp, G, de Greve, J, Priou, F, Menten, J, Rutten, I, Clavere, P, Malmstrom, A, Jancar, B, Newlands, E, Pigott, K, Twijnstra, A, Chinot, O, Reni, M, Boiardi, A, Fabbro, M, Campone, M, Bozzino, J, Frenay, M, Gijtenbeek, J, Delattre, Jy, De Paula, U, Hanzen, C, Pavanato, G, Schraub, S, Pfeffer, R, Soffietti, R, Kortmann, Rd, Taphoorn, M, Torrecilla, Jl, Grisold, W, Huget, P, Forsyth, P, Fulton, D, Kirby, S, Wong, R, Fenton, D, Cairncross, G, Whitlock, P, Burdette-Radoux, S, Gertler, S, Saunders, S, Laing, K, Siddiqui, J, Martin, La, Gulavita, S, Perry, J, Mason, W, Thiessen, B, Pai, H, Alam, Zy, Eisenstat, D, Mingrone, W, Hofer, S, Pesce, G, Dietrich, Py, Thum, P, Baumert, B, Ryan, G, Neurology, and Plastic and Reconstructive Surgery and Hand Surgery

Subjects
Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Adrenal Cortex Hormones, Adrenal Cortex Hormones/therapeutic use Adult Aged Antineoplastic Agents, Alkylating/adverse effects/*therapeutic use Brain Neoplasms/*drug therapy/mortality/*radiotherapy Chemotherapy, Adjuvant Dacarbazine/adverse effects/*analogs & derivatives/*therapeutic use Disease Progression Female Glioblastoma/*drug therapy/mortality/*radiotherapy Humans Male Middle Aged Proportional Hazards Models Radiotherapy, Computer-Assisted/adverse effects Survival Analysis, medicine, Temozolomide, Humans, Survival rate, Pseudoprogression, Antineoplastic Agents, Alkylating, Aged, Proportional Hazards Models, business.industry, Brain Neoplasms, Hazard ratio, General Medicine, Middle Aged, Debulking, medicine.disease, Survival Analysis, Radiotherapy, Computer-Assisted, Surgery, Radiation therapy, Dacarbazine, Chemotherapy, Adjuvant, Concomitant, Disease Progression, Female, business, Glioblastoma, medicine.drug, Anaplastic astrocytoma
Abstract

BACKGROUND: Glioblastoma, the most common primary brain tumor in adults, is usually rapidly fatal. The current standard of care for newly diagnosed glioblastoma is surgical resection to the extent feasible, followed by adjuvant radiotherapy. In this trial we compared radiotherapy alone with radiotherapy plus temozolomide, given concomitantly with and after radiotherapy, in terms of efficacy and safety. METHODS: Patients with newly diagnosed, histologically confirmed glioblastoma were randomly assigned to receive radiotherapy alone (fractionated focal irradiation in daily fractions of 2 Gy given 5 days per week for 6 weeks, for a total of 60 Gy) or radiotherapy plus continuous daily temozolomide (75 mg per square meter of body-surface area per day, 7 days per week from the first to the last day of radiotherapy), followed by six cycles of adjuvant temozolomide (150 to 200 mg per square meter for 5 days during each 28-day cycle). The primary end point was overall survival. RESULTS: A total of 573 patients from 85 centers underwent randomization. The median age was 56 years, and 84 percent of patients had undergone debulking surgery. At a median follow-up of 28 months, the median survival was 14.6 months with radiotherapy plus temozolomide and 12.1 months with radiotherapy alone. The unadjusted hazard ratio for death in the radiotherapy-plus-temozolomide group was 0.63 (95 percent confidence interval, 0.52 to 0.75; P

Published
2005
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21. Review: Peering through a keyhole: liquid biopsy in primary and metastatic central nervous system tumours.

Author

Bertero, L., Siravegna, G., Rudà, R., Soffietti, R., Bardelli, A., and Cassoni, P.

Subjects
TUMORS, BIOPSY, CENTRAL nervous system, IRINOTECAN
Abstract

Tumour molecular profiling by liquid biopsy is being investigated for a wide range of research and clinical purposes. The possibility of repeatedly interrogating the tumour profile using minimally invasive procedures is helping to understand spatial and temporal tumour heterogeneity, and to shed a light on mechanisms of resistance to targeted therapies. Moreover, this approach has been already implemented in clinical practice to address specific decisions regarding patients' follow‐up and therapeutic management. For central nervous system (CNS) tumours, molecular profiling is particularly relevant for the proper characterization of primary neoplasms, while CNS metastases can significantly diverge from primary disease or extra‐CNS metastases, thus compelling a dedicated assessment. Based on these considerations, effective liquid biopsy tools for CNS tumours are highly warranted and a significant amount of data have been accrued over the last few years. These results have shown that liquid biopsy can provide clinically meaningful information about both primary and metastatic CNS tumours, but specific considerations must be taken into account, for example, when choosing the source of liquid biopsy. Nevertheless, this approach is especially attractive for CNS tumours, as repeated tumour sampling is not feasible. The aim of our review was to thoroughly report the state‐of‐the‐art regarding the opportunities and challenges posed by liquid biopsy in both primary and secondary CNS tumours. [ABSTRACT FROM AUTHOR]

Published
2019
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30. Naviko paieška esant paraneoplaziniam sindromui: EFNS darbo grupės pranešimas.

Author

Titulaer, M. J., Soffietti, R., Dalinau, J., Gilhus, N. E., Giometto, B., Grauš, F., Grisold, W., Honnorat, J., Smitt, P. A. E. Sillevis, Vedeler, R. Tanasescu C. A., Voltz, R., and Verschuuren, J. J. G. M.

Subjects
*NEUROLOGICAL disorders, *SMALL cell lung cancer, *POSITRON emission tomography, *CHEST examination, *TOMOGRAPHY, *BREAST cancer, *MAMMOGRAMS
Abstract

Paraneoplaziniai neurologiniai sindromai (PNS) beveik visada nustatomi anksčiau nei piktybinis navikas. Esant PNS, naviko paieška itin svarbi, nes nurodo prognozę ir leidžia parinkti tinkamą gydymą. Taigi, auglį reikia nustatyti kiek galima anksčiau. Tikslai: Pateikti navikų, susijusių su klasikiniais PNS, paieškos rekomendacijas. Smulkiųjų ląstelių plaučių vėžys, timoma, krūties vėžys, kiaušidžių vėžys ir teratoma bei sėklidžių navikai aptariami kartu su paraneoplaziniu limbiniu encefalitu, poūme sensorine neuronopatija, poūme autonomine neuropatija, paraneoplazine smegenėlių degeneracija, paraneoplaziniu opsoklonusumioklonusu, Lambert-Eaton miasteniniu sindromu (LEMS), miastenija ir paraneoplaziniu padidėjusiu periferinių nervų jaudrumu. Metodai: Yra daug IV klasės tyrimų; vienas tyrimas siekė III lygio įrodymus. Nepateikta įrodymais pagrįstų A-C lygių rekomendacijų, bet bendru sutarimu pateiktos geros praktikos nuorodos. Rekomendacijos: Antikūnų tipas ir, kiek rečiau, klinikinis sindromas apsprendžia esamo naviko riziką ir tipą. Krūtinės ląstos atrankiniams tyrimams rekomenduojama atlikti krūtinės ląstos kompiuterinę tomografiją (KT), jei ji neigiama, tuomet tikslinga atlikti fluorodeoksigliukozės -- pozitronų emisijos tomografiją (FDG-PET). Krūties vėžio atrankiniam tyrimui taikoma mamografija, vėliau MRT. Dubens sričiai tirti pirmojo pasirinkimo yra ultragarso metodas (UG), vėliau, esant reikalui, tikslinga atlikti KT. Asmenims, sergantiems dermatomiozitu, reikia atlikti krūtinės ląstos / pilvo KT, dubens UG ir moterims mamografija, jaunesniems nei 50 metų vyrams sėklidžių UG bei kolonoskopiją vyrams ir moterims daugiau kaip 50 metų amžiaus. Jei pirminiai atrankiniai tyrimai yra neigiami, šiuos tyrimus reikia pakartoti po 3-6 mėnesių, ir atlikti juos kas 6 mėnesius iki 4 metų. Esant LEMS, pakanka atrankos tyrimus atlikti 2 metus. Esant tiems sindromams, kai tik dalis pacientų turi piktybinį auglį, vėžio žymenys turi papildomos vertės nustatant galimą naviką. [ABSTRACT FROM AUTHOR]

Published
2011

33. Europos neurologų draugijų federacijos nuorodos apie galvos smegenų metastazių gydymą: EFNS darbo grupės pranešimas.

Author

Soffietti, R., Cornu, P., Delattre, J. Y., Grant, R., Graus, F., Grisold, W., Heimans, J., Hildebrand, J., Hoskin, P., Kalljo, M., Krauseneck, P., Marosi, C., Siegal, T., and Vecht, C.

Abstract

Darbo tikslai buvo sukurti įrodymais pagrįstas nuorodas bei parodyti nesutarimus dėl pacientų su galvos smegenų metastazėmis gydymo. Moksliniai duomenys buvo surinkti iš Cochrane bibliotekos, bibliografinių duomenų bazių, apžvalginių straipsnių bei ankstesnių nuorodų, kurias paskelbė mokslinės draugijos ir organizacijos. Histologinė diagnozė yra būtina,jei pirminis navikas nėra žinomas arba kompiuterinės tomografijos/ magnetinio rezonanso vaizdai yra netipiški. Deksametazonas yra pasirinktinas kortikosteroidas smegenž edemai gydyti. Vaistai nuo epilepsijos neturi būti skiriami profilaktiškai. Chirurginis gydymas turėtų būti svarstomas esant ne daugiau kaip trims metastazėms,jis efektyviai pailgina ižgyvenamumą,jei sisteminės ligos nėra ar ji kontroliuojama, ir jei funkcinė ligonio būklė yra gera. Jei metastazių skersmuo neviršija 3-3,5 cm, reikėtų svarstyti stereotaksinės radiochirurgijos galimybę. Diskutuojama dėl visų smegenų spindulinųs terapijos (VSST) skyrimo po chirurginio ar radiochirurginio gydymo: jei sisteminis navikas pagydytas ar kontroliuojamas, ir Karnofskio funkcinės būklės įvertis yra 70 ardaugiau balų, galima susilaikyti nuo pirminės VSST arba skirti ankstyvą VSST įprastomis frakcijomis siekiant išvengti vėlyvo neurotoksiškumo. Vien VSST yra pasirinkimo gydymo metodas pacientams su viena ar daugybinėmis smegenų metastazėmis, nepasiduodančiomis chirurginiam ar radiochirurginiam gydymui. Chemoterapija gali būti pradinis gydymo metodas pacientams, turintiems chemoterapijai jautrių navikų metastazes galvos smegenyse. [ABSTRACT FROM AUTHOR]

Published
2007

34. The position of the neurologist in neuro-oncology1.

Author

Grisold, W, Heimans, J. J, Postma, T. J, Grant, R, and Soffietti, R

Subjects
NEUROLOGY, ONCOLOGY, NEUROLOGISTS, NEUROSCIENCES
Abstract

Neuro-oncology is a growing new subspeciality with a strong interdisciplinary character. This position paper explains the role of neurology in the multidisciplinary field of neurosurgeons, radiotherapists and general oncologists, dealing with neuro-oncological patients. The paper delineates the varied spectrum of the field of neuro-oncology which expands from primary brain tumours, to metastatic and non-metastatic effects of systemic cancer on the central and peripheral nervous system, neurotoxicity due to cancer treatment and issues of quality of life. It has been written by the scientific neuro-oncology panel of the European Federation of Neurological Societies (EFNS) to delineate the situation of neuro-oncology in Europe, and facilitate the understanding and implementation of this subspeciality in the future. [ABSTRACT FROM AUTHOR]

Published
2002
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