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Joseph A, Akinsete AM, Lasebikan NN, Adeneye S, Awofeso OM, Oladipo AT, Ajose AO, Ojo O, Merrell K, Ngwa W, Puthoff DS, Onitilo AA. The Landscape of Pediatric Radiation Oncology in Nigeria. JCO Glob Oncol 2024; 10:e2300219. [PMID: 38207247 DOI: 10.1200/go.23.00219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/11/2023] [Accepted: 10/23/2023] [Indexed: 01/13/2024] Open
Abstract
Radiation therapy (RT) is an essential part of the multidisciplinary treatment of pediatric cancer. Over the past five decades, significant advances have been made in the delivery of RT, with better dose delivery to disease targets while minimizing exposure to nearby organs at risk. These advances have led to improved treatment outcomes, increased survival, and reduced treatment-related toxicities. Advanced treatment techniques, however, require significant investment in infrastructural and personnel resources. This review documents what is currently available regarding expertise and infrastructure for pediatric radiation oncology practice in Nigeria. It was performed to serve as a foundation for the creation and design of tailored solutions (initiatives and policies) to increase pediatric radiation availability, accessibility, and equity in Nigeria and ultimately improve pediatric cancer treatment outcomes in the region.
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Affiliation(s)
- Adedayo Joseph
- NSIA-LUTH Cancer Centre, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Adeseye M Akinsete
- Hematology & Oncology Unit, Department of Pediatrics, College of Medicine University of Lagos, Lagos, Nigeria
| | | | - Samuel Adeneye
- NSIA-LUTH Cancer Centre, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Opeyemi M Awofeso
- Psychosocial Oncology & Palliative Care, Dana Farber Cancer Institute, Boston, MA
| | - Aishat T Oladipo
- NSIA-LUTH Cancer Centre, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Azeezat O Ajose
- NSIA-LUTH Cancer Centre, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Oluwatimileyin Ojo
- Long Island Jewish Medical Center and North Shore University Hospital, New Hyde Park, NY
| | - Kenneth Merrell
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | | | - David S Puthoff
- Marshfield Clinic Research Institute, Marshfield Clinic Health System, Marshfield, WI
| | - Adedayo A Onitilo
- Marshfield Clinic Research Institute, Marshfield Clinic Health System, Marshfield, WI
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Abdali A, Kalinin PL, Trunin YY, Astaf'Eva LE, Shkarubo AN, Chmutin GE, Chavda V, Golanov A, Abdali B, Chernov IV, Vats A, Chaurasia B. CyberKnife for the management of Cushing's disease: our institutional experience and review of literature. Br J Neurosurg 2021; 35:578-583. [PMID: 33955316 DOI: 10.1080/02688697.2021.1921107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Surgery is the primary treatment for Cushing's disease(CD). In cases with no biochemical remission after surgical resection or when recurrence occurs after a period of remission stereotactic radiosurgery (SRS) is used as alternative/adjuvant treatment. The aim of this study is to demonstrate the effectiveness of SRS and FSRS(Fractionated stereotactic radiosurgery) for the treatment of CD in a long term follow up. METHODS This is a retrospective study in which 41 patient (36 females and 5 males) who underwent surgery for CD from 2009 to 2019 were included. Out of 41 cases, 34 cases had microadenomas while 7 had macroadenomas. These patients had recurrence or persistence of hypercortisolism post-operatively. After multidisciplinary evaluation, these patients were treated by CyberKnife (SRS & FSRS). RESULTS Remission rate in our study was 60.97% with a median follow up period of 79.03 months. The median time to biochemical remission was 14 months. Tumour growth control was achieved in 95.12%. Hypopituitarism of different axes was seen in 34.14% patients. Secondary hypothyroidism was the most common pituitary insufficiency (34%) followed by secondary hypogonadism in 17%. CONCLUSION CyberKnife radiosurgery and hypofractionated radiosurgery can be used as an adjuvant treatment in patient with active disease and no biochemical remission after one or multiple surgical resections. Risk of radiation induced hypopituitarism and other complication is relatively low 34.14% and tumour growth control is significantly higher.
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Affiliation(s)
- Ashraf Abdali
- N.N. Burdenko National Medical Research Centre of Neurosurgery, Moscow, Russia
| | - Pavel L Kalinin
- N.N. Burdenko National Medical Research Centre of Neurosurgery, Moscow, Russia
| | - Yuriy Y Trunin
- N.N. Burdenko National Medical Research Centre of Neurosurgery, Moscow, Russia
| | - Ludmila E Astaf'Eva
- N.N. Burdenko National Medical Research Centre of Neurosurgery, Moscow, Russia
| | - Alexey N Shkarubo
- N.N. Burdenko National Medical Research Centre of Neurosurgery, Moscow, Russia
| | | | | | - Andrey Golanov
- N.N. Burdenko National Medical Research Centre of Neurosurgery, Moscow, Russia
| | | | - Ilya V Chernov
- N.N. Burdenko National Medical Research Centre of Neurosurgery, Moscow, Russia
| | - Atul Vats
- Department of Neurosurgery, James Cook University Hospital, Middlesbrough, UK
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Dasenbrock HH, Pendleton C, Cohen-Gadol AA, Wolinsky JP, Gokaslan ZL, Quinones-Hinojosa A, Bydon A. "No performance in surgery more interesting and satisfactory": Harvey Cushing and his experience with spinal cord tumors at the Johns Hopkins Hospital. J Neurosurg Spine 2011; 14:412-20. [PMID: 21250810 PMCID: PMC4612569 DOI: 10.3171/2010.10.spine10147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Although Harvey Cushing was a neurosurgical pioneer, his work on the spine remains largely unknown. In fact, other than his own publications, Cushing's patients with pathological lesions of the spine who were treated while he was at the Johns Hopkins Hospital, including those with spinal cord tumors, have never been previously described. The authors report on 7 patients with spinal cord tumors that Cushing treated surgically between 1898 and 1911: 2 extradural, 3 intradural extramedullary, and 2 intramedullary tumors. The authors also describe 10 patients in whom Cushing performed an "exploratory laminectomy" expecting to find a tumor, but in whom no oncological pathological entity was found. Cushing's spine surgeries were limited by challenges in making the correct diagnosis, lack of surgical precedent, and difficulty in achieving adequate intraoperative hemostasis. Other than briefly mentioning 2 of the 4 adult patients in his landmark monograph on meningiomas, these cases-both those involving tumors and those in which he performed exploratory laminectomies--have never been published before. Moreover, these cases illustrate the evolution that Harvey Cushing underwent as a spine surgeon.
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Affiliation(s)
| | - Courtney Pendleton
- The Johns Hopkins University School of Medicine, Johns Hopkins Medicine, Baltimore, Maryland
| | - Aaron A. Cohen-Gadol
- Clarian Neuroscience, Goodman-Campbell Brain & Spine, and Department of Neurological Surgery, Indiana University, Indianapolis, Indiana
| | - Jean-Paul Wolinsky
- Department of Neurosurgery, Johns Hopkins Medicine, Baltimore, Maryland
- Johns Hopkins Spinal Column Biomechanics & Surgical Outcomes Laboratory, Johns Hopkins Medicine, Baltimore, Maryland
| | - Ziya L. Gokaslan
- Department of Neurosurgery, Johns Hopkins Medicine, Baltimore, Maryland
- Johns Hopkins Spinal Column Biomechanics & Surgical Outcomes Laboratory, Johns Hopkins Medicine, Baltimore, Maryland
| | | | - Ali Bydon
- Department of Neurosurgery, Johns Hopkins Medicine, Baltimore, Maryland
- Johns Hopkins Spinal Column Biomechanics & Surgical Outcomes Laboratory, Johns Hopkins Medicine, Baltimore, Maryland
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Dasenbrock HH, Pendleton C, McGirt MJ, Sciubba DM, Gokaslan ZL, Quiñones-Hinojosa A, Bydon A. "Fulfilling the chief of his duties as a physician": Harvey Cushing, selective dorsal rhizotomy and elective spine surgery for quality of life. J Neurosurg Spine 2011; 14:421-7. [PMID: 21250816 PMCID: PMC4612574 DOI: 10.3171/2010.10.spine10152] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
At the beginning of the 20th century, the development of safer anesthesia, antiseptic techniques, and meticulous surgical dissection led to a substantial decrease in operative risk. In turn, the scope of surgery expanded to include elective procedures performed with the intention of improving the quality of life of patients. Between 1908 and 1912, Harvey Cushing performed 3 dorsal rhizotomies to improve the quality of life of 3 patients with debilitating neuralgia: a 54-year-old man with "lightning" radicular pain from tabes dorsalis, a 12-year-old boy cutaneous hyperesthesia and spasticity in his hemiplegic arm, and a 61-year-old man with postamputation neuropathic pain. Symptomatic improvement was seen postoperatively in the first 2 cases, although the third patient continued to have severe pain. Cushing also removed a prominent spinous process from each of 2 patients with debilitating headaches; both patients, however, experienced only minimal postoperative improvement. These cases, which have not been previously published, highlight Cushing's views on the role of surgery and illustrate the broader movement that occurred in surgery at the time, whereby elective procedures for quality of life became performed and accepted.
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Affiliation(s)
| | - Courtney Pendleton
- The Johns Hopkins University School of Medicine, Johns Hopkins Medicine, Baltimore, Maryland
| | - Matthew J. McGirt
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Daniel M. Sciubba
- Department of Neurosurgery, Johns Hopkins Medicine, Baltimore, Maryland
| | - Ziya L. Gokaslan
- Department of Neurosurgery, Johns Hopkins Medicine, Baltimore, Maryland
- Johns Hopkins Spinal Column Biomechanics & Surgical Outcomes Laboratory, Johns Hopkins Medicine, Baltimore, Maryland
| | | | - Ali Bydon
- Department of Neurosurgery, Johns Hopkins Medicine, Baltimore, Maryland
- Johns Hopkins Spinal Column Biomechanics & Surgical Outcomes Laboratory, Johns Hopkins Medicine, Baltimore, Maryland
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Dasenbrock HH, Pendleton C, Cohen-Gadol AA, Witham TF, Gokaslan ZL, Quinones-Hinojosa A, Bydon A. "No clinical puzzles more interesting": Harvey Cushing and spinal trauma, the Johns Hopkins Hospital 1896-1912. Neurosurgery 2011; 68:420-30; discussion 430. [PMID: 21135734 PMCID: PMC4612628 DOI: 10.1227/neu.0b013e318201be60] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Although Harvey Cushing played a central role in the establishment of neurosurgery in the United States, his work on the spine remains largely unknown. This article is not only the first time that Cushing's spinal cases while he was at Johns Hopkins have been reported, but also the first time his management of spinal trauma has been described. We report on 12 patients that Cushing treated from 1898 to 1911 who have never been reported before, including blunt and penetrating injuries, complete and incomplete spinal cord lesions, and both immediate and delayed presentations. Cushing performed laminectomies within 24 hours on patients with immediate presentations-both complete and incomplete spinal cord lesions. Among those with delayed presentations, Cushing did laminectomies on patients with incomplete spinal cord injuries. By the end of his tenure at Hopkins, Cushing advocated nonoperative treatment for all patients with complete spinal cord lesions. Four patients died while an inpatient, with meningitis and cystitis leading to the death of 1 and 3 patients, respectively. Cystitis was treated with intravesicular irrigation; an indwelling catheter was placed by a suprapubic cystostomy in four. Cushing was one of the first to report the use of x-ray in a spine patient, in a case that may have been one factor leading to his interest in the nervous system; Cushing also routinely obtained radiographs in those with spinal trauma. These cases illustrate Cushing's dedication to and rapport with his patients, even in the face of a dismal prognosis.
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Affiliation(s)
| | | | - Aaron A. Cohen-Gadol
- Clarian Neuroscience, Goodman-Campbell Brain & Spine
- Indiana University Department of Neurological Surgery, Indianapolis, Indiana
| | - Timothy F. Witham
- Spinal Column Biomechanics & Surgical Outcomes Laboratory, Johns Hopkins University, Baltimore, Maryland
- Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland
- School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Ziya L. Gokaslan
- Spinal Column Biomechanics & Surgical Outcomes Laboratory, Johns Hopkins University, Baltimore, Maryland
- Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland
- School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Alfredo Quinones-Hinojosa
- Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland
- School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Ali Bydon
- Spinal Column Biomechanics & Surgical Outcomes Laboratory, Johns Hopkins University, Baltimore, Maryland
- Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland
- School of Medicine, Johns Hopkins University, Baltimore, Maryland
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Seymour ZA, Cohen-Gadol AA. Cushing's lost cases of "radium bomb" brachytherapy for gliomas. J Neurosurg 2010; 113:141-8. [PMID: 20020842 DOI: 10.3171/2009.11.jns091393] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Although recent efforts to advance the treatment of gliomas through radiotherapy and chemotherapy may seem to be a relatively new area of growth and development, these efforts have been in progress since the therapeutic potential of radiation therapy was discovered in the late 19th century. Cushing's use of brachytherapy has been mentioned several times in the literature without receiving an appropriate in-depth analysis. The reasoning behind Cushing's initial use of brachytherapy was not fully examined, and a close analysis of the outcomes of this therapy was not made. In addition, Cushing's use of his "radium bomb" occurred more commonly than the 3 cases previously documented. The authors reviewed all the patient records available at the Cushing Brain Tumor Registry--which represents the most complete series of patient records from the Cushing era--and selected those patients who underwent treatment with Cushing's "radium bomb." The authors place these early attempts to optimize interstitial radiation of brain tumors in their historical perspective.
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Affiliation(s)
- Zachary A Seymour
- Clarian Neuroscience Institute, Indianapolis Neurosurgical Group, and Department of Neurosurgery, Indiana University, Indianapolis, Indiana 46202, USA
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Shrivastava RK, Segal S, Camins MB, Sen C, Post KD. Harvey Cushing's Meningiomas text and the historical origin of resectability criteria for the anterior one third of the superior sagittal sinus. J Neurosurg 2003; 99:787-91. [PMID: 14567620 DOI: 10.3171/jns.2003.99.4.0787] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The search for the origin of the commonly held principle in current neurosurgery regarding the resectability of the anterior one third of the superior sagittal sinus unravels the many fascinating developments that occurred in neurosurgery during the early 20th century. All these occurrences can be traced back to, and are uniquely contextualized in, Harvey Cushing's seminal text, Meningiomas, Their Classification, Regional Behaviour, Life History, and Surgical End Results. Written with Louise Eisenhardt and published in 1938, Meningiomas is a monograph of incredible description and detail. The meticulous categorization of meningiomas, their presentation, clinical outcome, and surgical therapies are even further supplemented by Cushing's personal commentary, questions, and recollections. Cushing's genius was evident in his ability not only to make insightful clinical observations, but also to synthesize these ideas within the neurosurgical context of his era. As he says in Meningiomas, "Thus the pathological curiosity of one day becomes in its proper time a commonplace... most of which are one and the same disorder--had, for their interpretation, to await the advent of the Neurosurgeon."
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Affiliation(s)
- Raj K Shrivastava
- Department of Neurosurgery, St Luke 's-Roosevelt Medical Center, New York New York 10019, USA.
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Black PM, Black CT. History of Neurosurgery for Intracranial Mass Lesions. Neurosurg Clin N Am 2001. [DOI: 10.1016/s1042-3680(18)30063-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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