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Limon D, Bokstein F, Blumenthal D, Ben Harush C, Ram Z, Grossman R. P14.79 Randomized phase II trial of Tumor Treating Fields plus radiation therapy plus temozolomide compared to radiation therapy plus temozolomide in patients with newly diagnosed glioblastoma. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
BACKGROUND
In last decade, there were numerous attempts to improve the outcome of patients with glioblastoma (GBM), but even after maximal surgical resection, radiation therapy (RT) and temozolomide (TMZ), followed by maintenance TMZ for 6 months the median OS is 14.6 months. In the EF-14 Phase III trial, the addition of Tumor Treating Fields (TTFields) at 200 kHz to maintenance TMZ increased the median OS to 20.9 months, compared with 16.0 months with maintenance TMZ alone (HR, 0.63; 95% CI, 0.53–0.76; p<0.001). Based on these results, the currently accepted standard of care for newly diagnosed GBM (ndGBM) is surgical resection if safely feasible, followed by RT with concomitant TMZ, and then followed by maintenance TMZ in combination with TTFields. Preclinical investigations have shown a radio-sensitizing effect of TTFields on glioma cells, suggesting synergistic effects between TTFields and radiotherapy. In a pilot study of 10 patients with ndGBM, we demonstrated that there was no increased treatment-related toxicity when TTFields were given in combination with RT/TMZ. The only TTFields-related adverse event was skin toxicity below the arrays. Preliminary progression free survival (PFS) data was encouraging. Based on the results of the pilot study, we designed this prospective, randomized Phase II study to further investigate if the addition of TTFields TMZ/RT treatment in ndGBM patients improves treatment efficacy and delays disease progression.
MATERIAL AND METHODS
Following debulking surgery or biopsy, 60 adult patients (≥18 years) with histologically confirmed GBM, KPS≥70 and life expectancy of at least 3 months will be randomized 1:1 to either a) RT with concomitant TMZ and TTFields (200 kHz) for 6 weeks followed by up to 6 months of maintenance TMZ in combination with TTFields (experimental arm) up to 24 months; or b) RT with concomitant TMZ alone followed by maintenance TMZ in combination with TTFields (control arm). Exclusion criteria: patients with early progressive disease, significant comorbidities precluding maintenance RT or TMZ or patients with an implanted electronic device. The primary endpoint is progression free survival at 12 months (PFS12). Treatment with TTFields will be continued until second progression or 24 months (the earlier of the two). All patients will be followed for survival. Grading and severity of all adverse events will be recorded using CTCAE V5.0. The sample size of 60 patients provides 80% power with a two-sided alpha level of 0.05 to detect a PFS12 of 46.5% with RT/TMZ/TTFields compared to 29.4% with RT/TMZ followed, respectively, by maintenance TMZ/TTFields (calculated from the RT/TMZ followed by maintenance TMZ/TTFields arm of the EF-14 trial). It is forecasted to take 24 months to fully recruit. Follow-up will continue for >12 months from recruitment of the last patient.
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Affiliation(s)
- D Limon
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - F Bokstein
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - D Blumenthal
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - C Ben Harush
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Z Ram
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - R Grossman
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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Grossman R, Bokstein F, Blumenthal D, Ben Harush C, Limon D, Ram Z. P14.71 Tumor Treating Fields combined with radiotherapy and temozolomide for newly diagnosed glioblastoma: final safety and efficacy results from a pilot study. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
Tumor Treating Fields (TTFields) are a non-invasive, loco-regional, anti-mitotic treatment consisting of low intensity alternating electric fields. The combination of TTFields with maintenance temozolomide significantly improved survival versus temozolomide alone in the phase 3 EF-14 study in newly diagnosed glioblastoma (ndGBM). In preclinical studies, TTFields increased the number of glioma cells undergoing cellular death following radiotherapy (RT) by inhibiting DNA damage repair, suggesting a radio-sensitizing effect of TTFields. This pilot study is the first to evaluate the safety and feasibility of administering TTFields concomitant to RT and TMZ in ndGBM patients.
MATERIAL AND METHODS
Patients diagnosed with ndGBM were treated with TTFields/RT/TMZ followed by maintenance TMZ and TTFields for up to 24 months. TTFields (200kHz) were delivered for >18 hours/day while the transducer arrays were removed during delivery of RT. TMZ was administered at a dose of 75 mg/m2/daily for 6 weeks and RT at a total dose of 60 Gy. The primary endpoint was safety of the combined TTFields/RT/TMZ; secondary endpoints included progression-free survival (PFS), overall survival (OS) and toxicity. Adverse events (AEs) were graded according to CTCAE V4.0.
RESULTS
10 ndGBM patients that recovered from maximal debulking surgery or biopsy were enrolled at a single center in Israel between April and December 2017. Five patients (50%) had undergone gross total resection while the rest had biopsy only. Eight of the patients were male, median age was 59, median KPS was 80 and median dose of RT was 60 Gy. Six patients (60%) reported at least one AE. The most common AE was TTFields-related skin toxicity, reported in four patients (40%), all of which were grade 1–2 in severity. Two patients reported serious AEs (seizures and general deterioration) that were considered unrelated to TTFields. Median PFS with RT/TMZ/TTFields was 10.5 months. Median OS has not yet been reached.
CONCLUSION
The proportion of patients with TTFields-related skin toxicity was similar to that reported in ndGBM patients in the randomized Phase III study (52%), where patients started TTFields at least 4 weeks after RT. No other TTFields-related toxicities were reported and there were no increase in RT- or TMZ-related toxicities as a result of combining TTFields with RT in addition to TMZ. Based on the safety and preliminary efficacy results of this pilot study, a phase II randomized study has been initiated to investigate the efficacy of concomitant RT/TMZ/TTFields in 60 ndGBM patients.
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Affiliation(s)
- R Grossman
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - F Bokstein
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - D Blumenthal
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - C Ben Harush
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - D Limon
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Z Ram
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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Grossman R, Bokstein F, Ben Harosh C, Blumenthal D, Limon D, Ram Z. P01.028 Tumor treating fields and radiotherapy for newly diagnosed glioblastoma: Safety results from a pilot study. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- R Grossman
- Tel Aviv Medical Center, Tel Aviv, Israel
| | - F Bokstein
- Tel Aviv Medical Center, Tel Aviv, Israel
| | | | | | - D Limon
- Tel Aviv Medical Center, Tel Aviv, Israel
| | - Z Ram
- Tel Aviv Medical Center, Tel Aviv, Israel
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Siegal T, Bokstein F, Blumenthal DT, Zach L, Leibovici A, Yust-Katz S, Lossos A, Tzuk-Shina T, Lokiec A, Ram Z. P01.076 Experience with tumor treating fields (TTFields, Optune®) in Israel - patient compliance and adverse effects. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T Siegal
- Rabin Medical Center, Petah Tikva, Israel
| | - F Bokstein
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | | | - L Zach
- Sheba Medical Center, Ramat Gan, Israel
| | | | | | - A Lossos
- Hadassah Medical Center, Jerusalem, Israel
| | | | - A Lokiec
- Rambam Medical Center, Haifa, Israel
| | - Z Ram
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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Mauda-Havakuk M, Shofty B, Ben-Shachar S, Ben-Sira L, Constantini S, Bokstein F. Spinal and Paraspinal Plexiform Neurofibromas in Patients with Neurofibromatosis Type 1: A Novel Scoring System for Radiological-Clinical Correlation. AJNR Am J Neuroradiol 2017; 38:1869-1875. [PMID: 28798215 DOI: 10.3174/ajnr.a5338] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 06/02/2017] [Indexed: 01/20/2023]
Abstract
BACKGROUND AND PURPOSE Neurofibromatosis type 1 is a common tumor predisposition syndrome. The aim of this study was to characterize the radiologic presentation of patients with neurofibromatosis type 1 with widespread spinal disease and to correlate it to clinical presentation and outcome. MATERIALS AND METHODS We conducted a historical cohort study of adult patients with neurofibromatosis type 1 with spinal involvement. Longitudinal clinical evaluation included pain and neurologic deficits. Radiologically, spinal involvement was classified according to a novel classification system, and a radiologic risk score was calculated. RESULTS Two hundred fifty-seven adult patients with neurofibromatosis type 1 are followed in our center. Thirty-four of these patients qualified for inclusion in this study. Three independent factors were found to be associated with increased risk for neurologic deficit: 1) bilateral tumors at the same level in the cervical region that approximated each other, 2) paraspinal tumors at the lumbar region, and 3) intradural lesions. On the basis of these factors, we calculated a combined risk score for neurologic deficits for each patient. We found a clear correlation between patient status and the calculated radiologic risk score. Patients with neurologic deficits were found to have a higher risk score (9 ± 8.3) than patients without neurologic deficits (2.5 ± 2.9, P < .05). Patients who progressed during the follow-up period had significantly higher scores at presentation than patients with stable conditions (9.9 ± 8.73 versus 3.9 ± 5.3, respectively; P < .05). CONCLUSIONS In this series, neurologic deficit is correlated with tumor burden and subtype. We found no direct correlation with tumor burden and pain. Our novel radiologic classification scoring system may be used to predict increased risk for neurologic morbidity.
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Affiliation(s)
- M Mauda-Havakuk
- From the Gilbert Israeli NF Center (M.M.-H., B.S., S.B.-S., L.B.-S., S.C., F.B.).,Pediatric Radiology Unit (M.M.-H., L.B.-S.)
| | - B Shofty
- From the Gilbert Israeli NF Center (M.M.-H., B.S., S.B.-S., L.B.-S., S.C., F.B.) .,Pediatric Neurosurgery (B.S., S.C.)
| | - S Ben-Shachar
- From the Gilbert Israeli NF Center (M.M.-H., B.S., S.B.-S., L.B.-S., S.C., F.B.)
| | - L Ben-Sira
- From the Gilbert Israeli NF Center (M.M.-H., B.S., S.B.-S., L.B.-S., S.C., F.B.).,Pediatric Radiology Unit (M.M.-H., L.B.-S.)
| | - S Constantini
- From the Gilbert Israeli NF Center (M.M.-H., B.S., S.B.-S., L.B.-S., S.C., F.B.).,Pediatric Neurosurgery (B.S., S.C.)
| | - F Bokstein
- From the Gilbert Israeli NF Center (M.M.-H., B.S., S.B.-S., L.B.-S., S.C., F.B.).,Neuro-Oncology Service (F.B.), Dana Children's Hospital, Tel-Aviv Medical Center, and Tel-Aviv University, Tel-Aviv, Israel
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Blumenthal DT, Artzi M, Liberman G, Bokstein F, Aizenstein O, Ben Bashat D. Classification of High-Grade Glioma into Tumor and Nontumor Components Using Support Vector Machine. AJNR Am J Neuroradiol 2017; 38:908-914. [PMID: 28385884 DOI: 10.3174/ajnr.a5127] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 01/03/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Current imaging assessment of high-grade brain tumors relies on the Response Assessment in Neuro-Oncology criteria, which measure gross volume of enhancing and nonenhancing lesions from conventional MRI sequences. These assessments may fail to reliably distinguish tumor and nontumor. This study aimed to classify enhancing and nonenhancing lesion areas into tumor-versus-nontumor components. MATERIALS AND METHODS A total of 140 MRI scans obtained from 32 patients with high-grade gliomas and 6 patients with brain metastases were included. Classification of lesion areas was performed using a support vector machine classifier trained on 4 components: enhancing and nonenhancing, tumor and nontumor, based on T1-weighted, FLAIR, and dynamic-contrast-enhancing MRI parameters. Classification results were evaluated by 2-fold cross-validation analysis of the training set and MR spectroscopy. Longitudinal changes of the component volumes were compared with Response Assessment in Neuro-Oncology criteria. RESULTS Normalized T1-weighted values, FLAIR, plasma volume, volume transfer constant, and bolus-arrival-time parameters differentiated components. High sensitivity and specificity (100%) were obtained within the enhancing and nonenhancing areas. Longitudinal changes in component volumes correlated with the Response Assessment in Neuro-Oncology criteria in 27 patients; 5 patients (16%) demonstrated an increase in tumor component volumes indicating tumor progression. These changes preceded Response Assessment in Neuro-Oncology assessments by several months. Seven patients treated with bevacizumab showed a shift to an infiltrative pattern of progression. CONCLUSIONS This study proposes an automatic classification method: segmented Response Assessment in Neuro-Oncology criteria based on advanced imaging that reliably differentiates tumor and nontumor components in high-grade gliomas. The segmented Response Assessment in Neuro-Oncology criteria may improve therapy-response assessment and provide earlier indication of progression.
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Affiliation(s)
- D T Blumenthal
- From the Neuro-Oncology Service (D.T.B., F.B.).,Sackler Faculty of Medicine (D.T.B., M.A., F.B., D.B.B.)
| | - M Artzi
- Functional Brain Center (M.A., O.A., D.B.B.), Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine (D.T.B., M.A., F.B., D.B.B.)
| | - G Liberman
- Department of Chemical Physics (G.L.), Weizmann Institute, Tel Aviv, Israel
| | - F Bokstein
- From the Neuro-Oncology Service (D.T.B., F.B.).,Sackler Faculty of Medicine (D.T.B., M.A., F.B., D.B.B.)
| | - O Aizenstein
- Functional Brain Center (M.A., O.A., D.B.B.), Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - D Ben Bashat
- Functional Brain Center (M.A., O.A., D.B.B.), Tel Aviv Sourasky Medical Center, Tel Aviv, Israel .,Sackler Faculty of Medicine (D.T.B., M.A., F.B., D.B.B.).,Sagol School of Neuroscience (D.B.B.), Tel Aviv University, Tel Aviv, Israel
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Blumenthal DT, Bokstein F. P16.01 Surgery for recurrent high grade glioma after treatment with bevacizumab. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Molad JA, Blumenthal DT, Bokstein F, Findler M, Finkel I, Bornstein NM, Yust-Katz S, Auriel E. Mechanisms of post-radiation injury: cerebral microinfarction not a significant factor. J Neurooncol 2016; 131:277-281. [DOI: 10.1007/s11060-016-2291-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Accepted: 10/09/2016] [Indexed: 10/20/2022]
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Daniels D, Guez D, Last D, Talianski A, Kanner AA, Blumenthal DT, Bokstein F, Cohen ZR, Mardor Y, Zach L. P06.14 Early biomarkers from conventional MRI and TRAMs for predicting response to bevacizumab in recurrent high-grade gliomas. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Daniels D, Guez D, Last D, Hoffmann C, Nass D, Talianski A, Tsarfaty G, Salomon S, Kanner AA, Blumenthal DT, Bokstein F, Harnof S, Yekutieli D, Zamir S, Cohen ZR, Zach L, Mardor Y. Early Biomarkers from Conventional and Delayed-Contrast MRI to Predict the Response to Bevacizumab in Recurrent High-Grade Gliomas. AJNR Am J Neuroradiol 2016; 37:2003-2009. [PMID: 27390321 DOI: 10.3174/ajnr.a4866] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 05/02/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND PURPOSE The interpretation of the radiologic response of bevacizumab-treated patients with recurrent high-grade gliomas represents a unique challenge. Delayed-contrast MR imaging was recently introduced for calculating treatment-response-assessment maps in patients with brain tumors, providing clear separation between active tumor and treatment effects. We studied the application of standard and delayed-contrast MR imaging for assessing and predicting the response to bevacizumab. MATERIALS AND METHODS Twenty-four patients with recurrent high-grade gliomas were scanned before and during bevacizumab treatment by standard and delayed-contrast MR imaging. The mean change in lesion volumes of responders (overall survival, ≥1 year) and nonresponders (overall survival, <1 year) was studied. The lesion volumes at baseline and the changes in lesion volumes 1 month after treatment initiation, calculated from standard and delayed-contrast MRIs, were studied as possible predictors of outcome. In scans acquired at progression, the average change in lesion volume from previous follow-up in standard and delayed-contrast MRIs was compared. RESULTS Response and progression patterns were identified from the mean change in lesion volumes, depicted from conventional T1WI, delayed contrast-enhanced MR imaging, and DSC MR imaging. Thresholds for early prediction of response were calculated by using these sequences. For each predictor, sensitivity, specificity, positive predictive values, and negative predictive values were calculated, reaching 85.7%, 87.5%, 75%, and 93.3% for conventional T1WI; 100%, 87.5%, 77.8%, and 100% for delayed-contrast MR imaging; and 75%, 78.6%, 50%, and 91.7% for DSC MR imaging. The benefit of delayed-contrast MR imaging in separating responders and nonresponders was further confirmed by using log-rank tests (conventional T1WI, P = .0022; delayed-contrast MR imaging, P < .0001; DSC MR imaging, P = .0232) and receiver operating characteristic analyses. At progression, the increase in lesion volumes in delayed-contrast MR imaging was 37.5% higher than the increase in conventional T1WI (P < .01); these findings suggest that progression may be depicted more effectively in treatment-response-assessment maps. CONCLUSIONS The benefit of contrast-enhanced MR imaging for assessing and predicting the response to bevacizumab was demonstrated. The increased sensitivity of the treatment-response-assessment maps reflects their potential contribution to the management of bevacizumab-treated patients with recurrent high-grade glioma.
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Affiliation(s)
- D Daniels
- Advanced Technology Center (D.G., D.L., D.D., S.S., Y.M.) .,Sackler Faculty of Medicine (L.Z., D.D., C.H., G.T., Z.R.C., Y.M., S.H.)
| | - D Guez
- Advanced Technology Center (D.G., D.L., D.D., S.S., Y.M.)
| | - D Last
- Advanced Technology Center (D.G., D.L., D.D., S.S., Y.M.)
| | - C Hoffmann
- Radiology Institute (C.H., G.T.).,Sackler Faculty of Medicine (L.Z., D.D., C.H., G.T., Z.R.C., Y.M., S.H.)
| | - D Nass
- Pathology Institute (D.N.), Sheba Medical Center, Ramat-Gan, Israel
| | | | - G Tsarfaty
- Radiology Institute (C.H., G.T.).,Sackler Faculty of Medicine (L.Z., D.D., C.H., G.T., Z.R.C., Y.M., S.H.)
| | - S Salomon
- Advanced Technology Center (D.G., D.L., D.D., S.S., Y.M.)
| | - A A Kanner
- Stereotactic Radiosurgery Unit (A.A.K.), Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | | | | | - S Harnof
- Department of Neurosurgery (Z.R.C., S.H.).,Sackler Faculty of Medicine (L.Z., D.D., C.H., G.T., Z.R.C., Y.M., S.H.)
| | - D Yekutieli
- School of Mathematical Sciences (D.Y., S.Z.), Tel-Aviv University, Tel-Aviv, Israel
| | - S Zamir
- School of Mathematical Sciences (D.Y., S.Z.), Tel-Aviv University, Tel-Aviv, Israel
| | - Z R Cohen
- Department of Neurosurgery (Z.R.C., S.H.).,Sackler Faculty of Medicine (L.Z., D.D., C.H., G.T., Z.R.C., Y.M., S.H.)
| | - L Zach
- From the Oncology Institute (L.Z., A.T.).,Sackler Faculty of Medicine (L.Z., D.D., C.H., G.T., Z.R.C., Y.M., S.H.)
| | - Y Mardor
- Advanced Technology Center (D.G., D.L., D.D., S.S., Y.M.).,Sackler Faculty of Medicine (L.Z., D.D., C.H., G.T., Z.R.C., Y.M., S.H.)
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Brenner A, Cohen Y, Vredenburgh J, Peters K, Blumenthal D, Bokstein F, Breitbart E, Bangio L, Sher N, Harats D, Wen P. NT-07 * PHASE 1-2 DOSE-ESCALATION STUDY OF VB-111, AN ANTI-ANGIOGENIC GENE THERAPY, AS MONOTHERAPY AND IN COMBINATION WITH BEVACIZUMAB, IN PATIENTS WITH RECURRENT GLIOBLASTOMA. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou265.7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Blumenthal D, Bokstein F, Zelikovitsh B, Mordechai A, Lossos A, Taliansky A, Zach L, Tzuk-Shina T, Lavon I. GE-04 * MGMT METHYLATION IS A POSITIVE PROGNOSTIC MARKER IN PATIENTS WITH ANAPLASTIC ASTROCYTOMA TREATED WITH CONCURRENT TEMOZOLOMIDE AND RADIATION. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou256.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Shofty B, Bokstein F, Ram Z, Ben-Sira L, Freedman S, Kesler A, Constantini S, Shofty B, Mauda-Havakuk M, Ben-Bashat D, Dvir R, Pratt LT, Weizman L, Joskowicz L, Tal M, Ravid L, Ben-Sira L, Constantini S, Dodgshun A, Maixner W, Sullivan M, Hansford J, Ma J, Wang B, Toledano H, Muhsinoglu O, Luckman J, Michowiz S, Goldenberg-Cohen N, Schroeder K, Rosenfeld A, Grant G, McLendon R, Cummings T, Becher O, Gururangan S, Aguilera D, Mazewski C, Janss A, Castellino RC, Schniederjan M, Hayes L, Brahma B, MacDonald T, Osugi Y, Kiyotani C, Sakamoto H, Yanagisawa T, Kanno M, Kamimura S, Kosaka Y, Hirado J, Takimoto T, Nakazawa A, Hara J, Hwang E, Mun A, Kilburn L, Chi S, Knipstein J, Oren M, Dvir R, Hardy K, Rood B, Packer R, Kandels D, Schmidt R, Geh M, Breitmoser-Greiner S, Gnekow AK, Bergthold G, Bandopadhayay P, Rich B, Chan J, Santagata S, Hoshida Y, Ramkissoon S, Ramkissoon L, Golub T, Tabak B, Ferrer-Luna R, Weng PY, Stiles C, Grill J, Kieran MW, Ligon KL, Beroukhim R, Fisher MJ, Levin MH, Armstrong GT, Broad JH, Zimmerman R, Bilaniuk LT, Feygin T, Liu GT, Gan HW, Phipps K, Spoudeas HA, Kohorst M, Warad D, Keating G, Childs S, Giannini C, Wetjen N, Rao; AN, Nakamura H, Makino K, Hide T, Kuroda JI, Shinojima N, Yano S, Kuratsu JI, Rush S, Madden J, Hemenway M, Foreman N, Sie M, den Dunnen WFA, Lourens HJ, Meeuwsen-de Boer TGJ, Scherpen FJG, Kampen KR, Hoving EW, de Bont ESJM, Gnekow AK, Kandels D, Walker DA, Perilongo G, Grill J, Stokland T, Sehested AM, van Schouten AYN, de Paoli A, de Salvo GL, Pache-Leschhorn S, Geh M, Schmidt R, Gnekow AK, Gass D, Rupani K, Tsankova N, Stark E, Anderson R, Feldstein N, Garvin J, Deel M, McLendon R, Becher O, Karajannis M, Wisoff J, Muh C, Schroeder K, Gururangan S, del Bufalo F, Carai A, Macchiaiolo M, Messina R, Cacchione A, Palmiero M, Cambiaso P, Mastronuzzi A, Anderson M, Leary S, Sun Y, Buhrlage S, Pilarz C, Alberta J, Stiles C, Gray N, Mason G, Packer R, Hwang E, Biassoni V, Schiavello E, Bergamaschi L, Chiaravalli S, Spreafico F, Massimino M, Krishnatry R, Kroupnik T, Zhukova N, Mistry M, Zhang C, Bartels U, Huang A, Adamski J, Dirks P, Laperriere N, Silber J, Hawkins C, Bouffet E, Tabori U, Riccardi R, Rizzo D, Chiaretti A, Piccardi M, Dickmann A, Lazzareschi I, Ruggiero A, Guglielmi G, Salerni A, Manni L, Colosimo C, Falsini B, Rosenfeld A, Etzl M, Miller J, Carpenteri D, Kaplan A, Sieow N, Hoe R, Tan AM, Chan MY, Soh SY, Orphanidou-Vlachou E, MacPherson L, English M, Auer D, Jaspan T, Arvanitis T, Grundy R, Peet A, Bandopadhayay P, Bergthold G, Sauer N, Green A, Malkin H, Dabscheck G, Marcus K, Ullrich N, Goumnerova L, Chi S, Beroukhim R, Kieran M, Manley P, Donson A, Kleinschmidt-DeMasters B, Aisner D, Bemis L, Birks D, Mulcahy-Levy J, Smith A, Handler M, Rush S, Foreman N, Davidson A, Figaji A, Pillay K, Kilborn T, Padayachy L, Hendricks M, van Eyssen A, Parkes J, Gass D, Dewire M, Chow L, Rose SR, Lawson S, Stevenson C, Jones B, Pai A, Sutton M, Pruitt D, Fouladi M, Hummel T, Cruz O, de Torres C, Sunol M, Morales A, Santiago C, Alamar M, Rebollo M, Mora J, Sauer N, Dodgshun A, Malkin H, Bergthold G, Manley P, Chi S, Ramkissoon S, MacGregor D, Beroukhim R, Kieran M, Sullivan M, Ligon K, Bandopadhayay P, Hansford J, Messina R, De Benedictis A, Carai A, Mastronuzzi A, Rebessi E, Palma P, Procaccini E, Marras CE, Aguilera D, Castellino RC, Janss A, Schniederjan M, McNall R, Kim S, MacDOnald T, Mazewski C, Zhukova N, Pole J, Mistry M, Fried I, Krishnatry R, Stucklin AG, Bartels U, Huang A, Laperriere N, Dirks P, Zelcer S, Sylva M, Johnston D, Scheinemann K, An J, Hawkins C, Nathan P, Greenberg M, Bouffet E, Malkin D, Tabori U, Kiehna E, Da Silva S, Margol A, Robison N, Finlay J, McComb JG, Krieger M, Wong K, Bluml S, Dhall G, Ayyanar K, Moriarty T, Moeller K, Farber D. LOW GRADE GLIOMAS. Neuro Oncol 2014; 16:i60-i70. [PMCID: PMC4046289 DOI: 10.1093/neuonc/nou073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2023] Open
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Park CK, Kim YH, Kim JW, Kim TM, Choi SH, Kim YJ, Choi BS, Lee SH, Kim CY, Kim IH, Lee DZ, Kheder A, Forbes M, Craven I, Hadjivassiliou M, Shonka NA, Kessinger A, Aizenberg MR, Weller M, Meisner C, Platten M, Simon M, Nikkhah G, Papsdorf K, Sabel M, Braun C, Reifenberger G, Wick W, Alexandru D, Haghighi B, Muhonen MG, Chamberlain MC, Sumrall AL, Burri S, Brick W, Asher A, Murillo-Medina K, Guerrero-Maldonado A, Ramiro AJ, Cervantes-Sanchez G, Erazo-Valle-Solis AA, Garcia-Navarro V, Sperduto PW, Shanley R, Luo X, Kased N, Sneed PK, Roberge D, Chao S, Weil R, Suh J, Bhatt A, Jensen A, Brown PD, Shih H, Kirkpatrick J, Gaspar LE, Fiveash J, Chiang V, Knisely J, Sperduto CM, Lin N, Mehta MP, Anderson MD, Raghunathan A, Aldape KD, Fuller GN, Gilbert MR, Robins HI, Wang M, Gilbert MR, Chakravarti A, Grimm S, Penas-Prado M, Chaudhary R, Anderson PJ, Elinzano H, Gilbert RA, Mehta M, Aoki T, Ueba T, Arakawa Y, Miyatake SI, Tsukahara T, Miyamoto S, Nozaki K, Taki W, Matsutani M, Shakur SF, Bit-Ivan E, Watkin WG, Farhat HI, Merrell RT, Zwinkels H, Dorr J, Kloet A, Taphoorn MJ, Vecht CJ, Bogdahn U, Stockhammer G, Mahapatra A, Hau P, Schuknecht B, van den Bent M, Heinrichs H, Yust-Katz S, Liu V, Sanghee K, Groves M, Puduvalli V, Levin V, Conrad C, Colman H, Hsu S, Yung AW, Gilbert MR, Kunz M, Armbruster L, Thon N, Jansen N, Lutz J, Herms J, Egensperger R, Eigenbrod S, Kretzschmar H, La CF, Tonn JC, Kreth FW, Brandes AA, Franceschi E, Agati R, Poggi R, Dall'Occa P, Bartolotti M, Di Battista M, Marucci G, Girardi F, Ermani M, Sherman W, Raizer J, Grimm S, Ruckser R, Tatzreiter G, Pfisterer W, Oberhauser G, Honigschnabel S, Aboul-Enein F, Ausch C, Kitzweger E, Hruby W, Sebesta C, Green RM, Woyshner EA, Suchorska B, Jansen NL, Janssen H, Kretzschmar H, Simon M, Hentschel B, Poepperl G, Kreth FW, Linn J, LaFougere C, Weller M, Tonn JC, Suchorska B, Jansen NL, Graute V, Eigenbrod S, Bartenstein P, Kreth FW, LaFougere C, Tonn JC, Hassanzadeh B, Tohidi V, Levacic D, Landolfi JC, Singer S, DeBraganca K, Omuro A, Grommes C, Omar AI, Jalan P, Pandav V, Bekker S, Fuente MIDL, Kaley T, Zhao S, Chen X, Soffietti R, Magistrello M, Bertero L, Bosa C, Crasto SG, Garbossa D, Lolli I, Trevisan E, Ruda R, Ruda R, Bertero L, Bosa C, Trevisan E, Pace A, Carapella C, Dealis C, Caroli M, Faedi M, Bomprezzi C, Thomas AA, Dalmau J, Gresa-Arribas N, Fadul CE, Kumthekar PU, Raizer J, Grimm S, Herrada J, Antony N, Richards M, Gupta A, Landeros M, Arango C, Campos-Gines AF, Friedman P, Wilson H, Streeter JC, Cohen A, Gilreath J, Sageser D, Ye X, Bell SD, McGregor J, Bourekas E, Cavaliere R, Newton H, Sul J, Odia Y, Zhang W, Shih J, Butman JA, Hammoud D, Kreisl TN, Iwamoto F, Fine HA, Berriel LG, Santos FN, Levy AC, Fanelli MF, Chinen LT, da Costa AA, Bourekas E, Wayne Slone H, Bell SD, McGregor J, Bokstein F, Blumenthal DT, Shpigel S, Phishniak L, Yust-Katz S, Garciarena P, Liue D, Yuan Y, Groves MD, Wong ET, Villano JL, Engelhard HH, Ram Z, Sahebjam S, Millar BA, Sahgal A, Laperriere N, Mason W, Levin VA, Hess KR, Choucair AK, Flynn PJ, Jaeckle KA, Kyritsis AP, Yung WKA, Prados MD, Bruner JM, Ictech S, Nghiemphu PL, Lai A, Green RM, Cloughesy TF, Zaky W, Gilles F, Grimm J, Bluml S, Dhall G, Rosser T, Randolph L, Wong K, Olch A, Krieger M, Finlay J, Capellades J, Verger E, Medrano S, Gonzalez S, Gil M, Reynes G, Ribalta T, Gallego O, Segura PP, Balana C, Gwak HS, Joo J, Kim S, Yoo H, Shin SH, Han JY, Kim HT, Yun T, Lee JS, Lee SH, Kim W, Vogelbaum MA, Wang M, Peereboom DM, Macdonald DR, Giannini C, Suh JH, Jenkins RB, Laack NN, Brackman DG, Shrieve DC, Souhami L, Mehta MP, Leibetseder A, Wohrer A, Ackerl M, Flechl B, Sax C, Spiegl-Kreinecker S, Pichler J, Widhalm G, Dieckmann K, Preusser M, Marosi C, Sebastian C, Alejandro M, Bernadette C, Naomi A, Kavan P, Sahebjam S, Garoufalis E, Guiot MC, Muanza T, Del Maestro R, Petrecca K, Sharma R, Curry R, Joyce J, Rosenblum M, Jaffe E, Matasar M, Lin O, Fisher R, Omuro A, Yin C, Iwamoto FM, Fraum TJ, Nayak L, Diamond EL, DeAngelis LM, Pentsova E, Vera-Bolanos E, Gilbert MR, Aldape K, Necesito-Reyes MJ, Fouladi M, Gajjar A, Goldman S, Metellus P, Mikkelsen T, Omuro A, Packer R, Partap S, Pollack IF, Prados M, Ian Robins H, Soffietti R, Wu J, Armstrong TS, Nakada M, Hayashi Y, Miyashita K, Kinoshita M, Furuta T, Sabit H, Kita D, Hayashi Y, Uchiyam N, Kawakami K, Minamoto T, Hamada JI, Diamond EL, Rosenblum M, Heaney M, Carrasquillo J, Krauthammer A, Nolan C, Kaley TJ, Gil MJ, Fuster J, Balana C, Benavides M, Mesia C, Etxaniz O, Canellas J, Perez-Martin X, Hunter K, Johnston SK, Bridge CA, Rockne RC, Guyman L, Baldock AL, Rockhill JK, Mrugala MM, Beard BC, Adair JE, Kiem HP, Swanson KR, Ranjan T, Desjardins A, Peters KB, Alderson L, Kirkpatrick J, Herndon J, Bailey L, Sampson J, Friedman AH, Friedman H, Vredenburgh JJ, Theeler BJ, Ellezam B, Melguizo-Gavilanes I, Shonka NA, Bruner JM, Puduvalli VK, Taylor JW, Flanagan E, O'Neill B, Seigal T, Omuro A, DeAngelis L, Baerhing J, Hoang-Xuan K, Chamberlain M, Batchelor T, Nishikawa R, Pinto F, Blay JY, Korfel A, Schiff D, Fu BD, Kong XT, Bota D, Omuro A, Beal K, Ivy P, Gutin P, Wu N, Kaley T, Karimi S, DeAngelis L, Pentsova H, Nolan C, Grommes C, Chan T, Mathew R, Droms L, Shimizu F, Tabar V, Grossman S, Yovino S, Campian J, Wild A, Herman J, Brock M, Balmanoukian A, Ye X, Portnow J, Badie B, Synold T, Lacey S, D'Apuzzo M, Frankel P, Chen M, Aboody K, Letarte N, Gabay MP, Bressler LR, Stachnik JM, Villano JL, Jaeckle KA, Anderson SK, Willson A, Moreno-Aspitia A, Colon-Otero G, Patel T, Perez E, Peters KB, Reardon DA, Vredenburgh JJ, Desjardins A, Herndon JE, Coan A, McSherry F, Lipp E, Brickhouse A, Massey W, Friedman HS, Alderson LM, Desjardins A, Ranjan T, Peters KB, Friedman HS, Vredenburgh JJ, Ranjan T, Desjardins A, Peters KB, Alderson L, Kirkpatrick J, Herndon J, Bailey L, Sampson J, Friedman AH, Friedman H, Vredenburgh J, Welch MR, Omuro A, Grommes C, Westphal M, Bach F, Reuter D, Ronellenfitsch M, Steinbach J, Pietsch T, Connelly J, Hamza MA, Puduvalli V, Neal ML, Trister AD, Ahn S, Bridge C, Lange J, Baldock A, Rockne R, Mrugala M, Rockhill JK, Lai A, Cloughesy T, Swanson KR, Neuwelt AJ, Nguyen TM, Tyson RM, Nasseri M, Neuwelt EA, Bubalo JS, Barnes PD, Phuphanich S, Hu J, Rudnick J, Chu R, Yu J, Naruse R, Ljubimova J, Sanchez C, Guevarra A, Naor R, Black K, Mahta A, Bhavsar TM, Herath K, Huang C, McClain J, Rizzo K, Sheehan J, Chamberlain M, Glantz M, McClain J, Glantz MJ, Zoccoli C, Nicholas MK, Xie T, White D, Liker S, Gajewski T, Selfridge J, Piccioni DE, Zurayk M, Mody R, Quan J, Li S, Chen W, Chou A, Liau L, Green R, Cloughesy T, Lai A, Gomez-Molinar V, Ruiz-Gonzalez S, Valdez-Vazquez R, Arrieta O, Stenner JI. CLIN-NEURO/MEDICAL ONCOLOGY. Neuro Oncol 2012. [DOI: 10.1093/neuonc/nos229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kim JH, Charkravarti A, Wang M, Aldape K, Sulman E, Bredel M, Hegi M, Gilbert M, Curran W, Werner-Wasik M, Mehta M, van den Bent MJ, Brandes AA, Taphoorn MJ, Kros JM, Kouwenhoven MC, Delattre JY, Bernsen HJ, Frenay M, Tijssen CC, Grisold W, Sipos L, Enting RH, French PJ, Dinjens WN, Vecht CJ, Allgeier A, Lacombe D, Gorlia T, Xuan KH, Chang JH, Oh MC, Kim EH, Kang SG, Cho J, Kim SH, Kim DS, Kim SH, Seo CO, Lee KS, Kim MM, Dabaja BS, Jeffrey Medeiros L, Allen P, Kim S, Fowler N, Peereboom DM, Seidman AD, Tabar V, Weil RJ, Thorsheim HR, Smith QR, Lockman PR, Steeg PS, Mallick S, Joshi N, Gandhi A, Jha P, Suri V, Julka PK, Sarkar C, Sharma D, Rath GK, Blumenthal DT, Talianski A, Fishniak L, Bokstein F, Taal W, Walenkamp AM, Taphoorn MJ, Beerepoot L, Hanse M, Buter J, Honkoop A, Groenewegen G, Boerman D, Jansen RL, van den Berkmortel FW, Brandsma D, Kros JM, Bromberg JE, van Heuvel I, Smits M, van der Holt B, Vernhout R, van den Bent M, Matienzo L, Batara J, Torcuator R, Yovino S, Balmanoukian A, Ye X, Campian J, Hess A, Fuchs E, Grossman SA, Leonard AK, Wolff J, Blanchard M, Laack N, Foote R, Brown P, Pan E, Yu D, Yue B, Potthast L, Smith P, Chowdhary S, Chamberlain M, Rockhill J, Sales L, Halasz L, Stewart R, Phillips M, Mathew M, Ott P, Rush S, Donahue B, Pavlick A, Golfinos J, Parker E, Huang P, Narayana A, Clark S, Carlson JA, Gaspar LE, Ney DE, Chen C, Kavanagh B, Damek DM, Martinez NL, DeAngelis LM, Abrey LE, Omuro A, Zhu JJ, Esquenazi-Levy Y, Friedman ER, Tandon N, Mathew M, Hitchen C, Dewyngaert K, Narayana A. CLIN-MEDICAL + RADIATION THERAPIES. Neuro Oncol 2012. [DOI: 10.1093/neuonc/nos227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Prithviraj GK, Sommers SR, Jump RL, Halmos B, Chambless LB, Parker SL, Hassam-Malani L, McGirt MJ, Thompson RC, Chambless LB, Parker SL, Hassam-Malani L, McGirt MJ, Thompson RC, Hunter K, Chamberlain MC, Le EM, Lee ELT, Chamberlain MC, Sadighi ZS, Pearlman ML, Slopis JM, Vats TS, Khatua S, DeVito NC, Yu M, Chen R, Pan E, Cloughesy T, Raizer J, Drappatz J, Gerena-Lewis M, Rogerio J, Yacoub S, Desjardin A, Groves MD, DeGroot J, Loghin M, Conrad CA, Hess K, Ni J, Ictech S, Hunter K, Yung WA, Porter AB, Dueck AC, Karlin NJ, Chamberlain MC, Olson J, Silber J, Reiner AS, Panageas KS, Iwamoto FM, Cloughesy TF, Aldape KD, Rivera AL, Eichler AF, Louis DN, Paleologos NA, Fisher BJ, Ashby LS, Cairncross JG, Roldan GB, Wen PY, Ligon KL, Shiff D, Robins HI, Rocque BG, Chamberlain MC, Mason WP, Weaver SA, Green RM, Kamar FG, Abrey LE, DeAngelis LM, Jhanwar SC, Rosenblum MK, Lassman AB, Cachia D, Alderson L, Moser R, Smith T, Yunus S, Saito K, Mukasa A, Narita Y, Tabei Y, Shinoura N, Shibui S, Saito N, Flechl B, Ackerl M, Sax C, Dieckmann K, Crevenna R, Widhalm G, Preusser M, Marosi C, Marosi C, Ay C, Preusser M, Dunkler D, Widhalm G, Pabinger I, Dieckmann K, Zielinski C, Belongia M, Jogal S, Schlingensiepen KH, Bogdahn U, Stockhammer G, Mahapatra AK, Venkataramana NK, Oliushine V, Parfenov V, Poverennova I, Hau P, Jachimczak P, Heinrichs H, Mammoser AG, Shonka NA, de Groot JF, Shibahara I, Sonoda Y, Kumabe T, Saito R, Kanamori M, Yamashita Y, Watanabe M, Ishioka C, Tominaga T, Silvani A, Gaviani P, Lamperti E, Botturi A, DiMeco F, Broggi G, Fariselli L, Solero CL, Salmaggi A, Green RM, Woyshner EA, Cloughesy TF, Shu F, Oh YS, Iganej S, Singh G, Vemuri SL, Theeler BJ, Ellezam B, Gilbert MR, Aoki T, Kobayashi H, Takano S, Nishikawa R, Shinoura N, Nagane M, Narita Y, Muragaki Y, Sugiyama K, Kuratsu J, Matsutani M, Sadighi ZS, Khatua S, Langford LA, Puduvalli VK, Shen D, Chen ZP, Zhang JP, Chen ZP, Bedekar D, Rand S, Connelly J, Malkin M, Paulson E, Mueller W, Schmainda K, Gallego O, Benavides M, Segura PP, Balana C, Gil M, Berrocal A, Reynes G, Garcia JL, Murata P, Bague S, Quintana MJ, Vasishta VG, Nagane M, Kobayashi K, Tanaka M, Tsuchiya K, Shiokawa Y, Bavle AA, Ayyanar K, Puduvalli VK, Prado MP, Hess KR, Hunter K, Ictech S, Groves MD, Gilbert MR, Liu V, Conrad CA, de Groot J, Loghin ME, Colman H, Levin VA, Alfred Yung WK, Hackney JR, Palmer CA, Markert JM, Cure J, Riley KO, Fathallah-Shaykh H, Nabors LB, Saria MG, Corle C, Hu J, Rudnick J, Phuphanich S, Mrugala MM, Lee LK, Fu BD, Bota DA, Kim RY, Brown T, Feely H, Hu A, Drappatz J, Wen PY, Lee JW, Carter B, Kesari S, Fu BD, Kong XT, Bota DA, Fu BD, Bota DA, Sparagana S, Belousova E, Jozwiak S, Korf B, Frost M, Kuperman R, Kohrman M, Witt O, Wu J, Flamini R, Jansen A, Curtalolo P, Thiele E, Whittemore V, De Vries P, Ford J, Shah G, Cauwel H, Edrich P, Sahmoud T, Franz D, Khasraw M, Brown C, Ashley DM, Rosenthal MA, Jiang X, Mou YG, Chen ZP, Oh M, kim E, Chang J, Juratli TA, Kirsch M, Schackert G, Krex D, Gilbert MR, Wang M, Aldape KD, Stupp R, Hegi M, Jaeckle KA, Armstrong TS, Wefel JS, Won M, Blumenthal DT, Mahajan A, Schultz CJ, Erridge SC, Brown PD, Chakravarti A, Curran WJ, Mehta MP, Hofland KF, Hansen S, Sorensen M, Schultz H, Muhic A, Engelholm S, Ask A, Kristiansen C, Thomsen C, Poulsen HS, Lassen UN, Zalatimo O, Weston C, Zoccoli C, Glantz M, Rahmanuddin S, Shiroishi MS, Cen SY, Jones J, Chen T, Pagnini P, Go J, Lerner A, Gomez J, Law M, Ram Z, Wong ET, Gutin PH, Bobola MS, Alnoor M, Silbergeld DL, Rostomily RC, Chamberlain MC, Silber JR, Martha N, Jacqueline S, Thaddaus G, Daniel P, Hans M, Armin M, Eugen T, Gunther S, Hutterer M, Tseng HM, Zoccoli CM, Glantz M, Zalatimo O, Patel A, Rizzo K, Sheehan JM, Sumrall AL, Vredenburgh JJ, Desjardins A, Reardon DA, Friiedman HS, Peters KB, Taylor LP, Stewart M, Blondin NA, Baehring JM, Foote T, Laack N, Call J, Hamilton MG, Walling S, Eliasziw M, Easaw J, Shirsat NV, Kundar R, Gokhale A, Goel A, Moiyadi AA, Wang J, Mutlu E, Oyan A, Yan T, Tsinkalovsky O, Jacobsen HK, Talasila KM, Sleire L, Pettersen K, Miletic H, Andersen S, Mitra S, Weissman I, Li X, Kalland KH, Enger PO, Sepulveda J, Belda C, Balana C, Segura PP, Reynes G, Gil M, Gallego O, Berrocal A, Blumenthal DT, Sitt R, Phishniak L, Bokstein F, Philippe M, Carole C, Andre MDP, Marylin B, Olivier C, L'Houcine O, Dominique FB, Philippe M, Isabelle NM, Olivier C, Frederic F, Stephane F, Henry D, Marylin B, L'Houcine O, Dominique FB, Errico MA, Kunschner LJ, Errico MA, Kunschner LJ, Soffietti R, Trevisan E, Ruda R, Bertero L, Bosa C, Fabrini MG, Lolli I, Jalali R, Julka PK, Anand AK, Bhavsar D, Singhal N, Naik R, John S, Mathew BS, Thaipisuttikul I, Graber J, DeAngelis LM, Shirinian M, Fontebasso AM, Jacob K, Gerges N, Montpetit A, Nantel A, Albrecht S, Jabado N, Mammoser AG, Shah K, Conrad CA, Di K, Linskey M, Bota DA, Thon N, Eigenbrod S, Kreth S, Lutz J, Tonn JC, Kretzschmar H, Peraud A, Kreth FW, Muggeri AD, Alderuccio JP, Diez BD, Jiang P, Chao Y, Gallagher M, Kim R, Pastorino S, Fogal V, Kesari S, Rudnick JD, Bresee C, Rogatko A, Sakowsky S, Franco M, Hu J, Lim S, Lopez A, Yu L, Ryback K, Tsang V, Lill M, Steinberg A, Sheth R, Grimm S, Helenowski I, Rademaker A, Raizer J, Nunes FP, Merker V, Jennings D, Caruso P, Muzikansky A, Stemmer-Rachamimov A, Plotkin S, Spalding AC, Vitaz TW, Sun DA, Parsons S, Welch MR, Omuro A, DeAngelis LM, Omuro A, Beal K, Correa D, Chan T, DeAngelis L, Gavrilovic I, Nolan C, Hormigo A, Lassman AB, Kaley T, Mellinghoff I, Grommes C, Panageas K, Reiner A, Barradas R, Abrey L, Gutin P, Lee SY, Slagle-Webb B, Glantz MJ, Sheehan JM, Connor JR, Schlimper CA, Schlag H, Stoffels G, Weber F, Krueger DA, Care MM, Holland K, Agricola K, Tudor C, Byars A, Sahmoud T, Franz DN, Raizer J, Rice L, Rademaker A, Chandler J, Levy R, Muro K, Grimm S, Nayak L, Iwamoto FM, Rudnick JD, Norden AD, Omuro A, Kaley TJ, Thomas AA, Fadul CE, Meyer LP, Lallana EC, Colman H, Gilbert M, Alfred Yung WK, Aldape K, De Groot J, Conrad C, Levin V, Groves M, Loghin M, Chris P, Puduvalli V, Nagpal S, Feroze A, Recht L, Rangarajan HG, Kieran MW, Scott RM, Lew SM, Firat SY, Segura AD, Jogal SA, Kumthekar PU, Grimm SA, Avram M, Patel J, Kaklamani V, McCarthy K, Cianfrocca M, Gradishar W, Mulcahy M, Von Roenn J, Helenowski I, Rademaker A, Raizer J, Galanis E, Anderson SK, Lafky JM, Kaufmann TJ, Uhm JH, Giannini C, Kumar SK, Northfelt DW, Flynn PJ, Jaeckle KA, Buckner JC, Omar AI, Panageas KS, Iwamoto FM, Cloughesy TF, Aldape KD, Rivera AL, Eichler AF, Louis DN, Paleologos NA, Fisher BJ, Ashby LS, Cairncross JG, Roldan GB, Wen PY, Ligon KL, Schiff D, Robins HI, Rocque BG, Chamberlain MC, Mason WP, Weaver SA, Green RM, Kamar FG, Abrey LE, DeAngelis LM, Jhanwar SC, Rosenblum MK, Lassman AB, Delios A, Jakubowski A, DeAngelis L, Grommes C, Lassman AB, Theeler BJ, Melguizo-Gavilanes I, Shonka NA, Qiao W, Wang X, Mahajan A, Puduvalli V, Hashemi-Sadraei N, Bawa H, Rahmathulla G, Patel M, Elson P, Stevens G, Peereboom D, Vogelbaum M, Weil R, Barnett G, Ahluwalia MS, Alvord EC, Rockne RC, Rockhill JK, Mrugala MM, Rostomily R, Lai A, Cloughesy T, Wardlaw J, Spence AM, Swanson KR, Zadeh G, Alahmadi H, Wilson J, Gentili F, Lassman AB, Wang M, Gilbert MR, Aldape KD, Beumer JJ, Wright J, Takebe N, Puduvalli VK, Hormigo A, Gaur R, Werner-Wasik M, Mehta MP, Gupta AJ, Campos-Gines A, Le K, Arango C, Richards M, Landeros M, Juan H, Chang JH, Kim JS, Cho JH, Seo CO, Baldock AL, Rockne R, Canoll P, Born D, Yagle K, Swanson KR, Alexandru D, Bota D, Linskey ME, Nabeel S, Raval SN, Raizer J, Grimm S, Rice L, Rosenow J, Levy R, Bredel M, Chandler J, New PZ, Plotkin SR, Supko JG, Curry WT, Chi AS, Gerstner ER, Stemmer-Rachamimov A, Batchelor TT, Ahluwalia MS, Hashemi N, Rahmathulla G, Patel M, Chao ST, Peereboom D, Weil RJ, Suh JH, Vogelbaum MA, Stevens GH, Barnett GH, Corwin D, Holdsworth C, Stewart R, Rockne R, Swanson K, Graber JJ, Kaley T, Rockne RC, Anderson AR, Swanson KR, Jeyapalan S, Goldman M, Boxerman J, Donahue J, Elinzano H, Evans D, O'Connor B, Puthawala MY, Oyelese A, Cielo D, Blitstein M, Dargush M, Santaniello A, Constantinou M, DiPetrillo T, Safran H, Plotkin SR, Halpin C, Merker V, Barker FG, Maher EA, Ganji S, DeBerardinis R, Hatanpaa K, Rakheja D, Yang XL, Mashimo T, Raisanen J, Madden C, Mickey B, Malloy C, Bachoo R, Choi C, Ranjan T, Yono N, Zalatimo O, Zoccoli C, Glantz M, Han SJ, Sun M, Berger MS, Aghi M, Gupta N, Parsa AT. MEDICAL AND NEURO-ONCOLOGY. Neuro Oncol 2011. [DOI: 10.1093/neuonc/nor152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Blumenthal DT, Shacham-Shmueli E, Bokstein F, Schmid DS, Cohrs RJ, Nagel MA, Mahalingam R, Gilden D. Zoster sine herpete: virologic verification by detection of anti-VZV IgG antibody in CSF. Neurology 2011; 76:484-5. [PMID: 21282595 DOI: 10.1212/wnl.0b013e31820a0d28] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- D T Blumenthal
- Department of Neurology, University of Colorado School of Medicine, 12700 E. 19th Avenue, Mail Stop B182, Aurora, CO 80045, USA
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Barker CA, Chang M, Lassman AB, Beal K, Chan TA, Hunter K, Grisdale K, Ritterhouse M, Moustakas A, Iwamoto FM, Kreisl TN, Sul J, Kim L, Butman J, Albert P, Fine HA, Chamberlain MC, Alexandru D, Glantz MJ, Kim L, Chamberlain MC, Bota DA, Takahashi K, Ikeda N, Kajimoto Y, Miyatake S, Kuroiwa T, Iwamoto F, Lamborn K, Kuhn J, Wen P, Yung WKA, Gilbert M, Chang S, Lieberman F, Prados M, Fine H, Lu-Emerson C, Norden AD, Drappatz J, Quant EC, Ciampa AS, Doherty LM, LaFrankie DC, Wen PY, Sherman JH, Moldovan K, Yeoh HK, Starke BM, Pouratian N, Shaffrey ME, Schiff D, O'Connor PC, Kroon HA, Recht L, Montano N, Cenci T, Martini M, D'Alessandris QG, Banna GL, Maira G, De Maria R, Larocca LM, Pallini R, Kim CH, Yang MS, Cheong JH, Kim JM, Shonka N, Gilbert M, Alfred Yung WK, Piao Y, Liu J, Bekele N, Wen P, Chen A, Heymach J, de Groot J, Gilbert MR, Wang M, Aldape K, Sorensen AG, Mikkelsen T, Bokstein F, Woo SY, Chmura SJ, Choucair AK, Mehta M, Perez Segura P, Gil M, Balana C, Chacon I, Munoz J, Martin M, Flowers A, Salner A, Gaziel TB, Soerensen M, Hasselbalch B, Poulsen HS, Lassen U, Peyre M, Cartalat-Carel S, Meyronet D, Sunyach MP, Jouanneau E, Guyotat J, Jouvet A, Frappaz D, Honnorat J, Ducray F, Wagle N, Nghiemphu PL, Lai A, Cloughesy TF, Kairouz VF, Elias EF, Chahine GY, Comair YG, Dimassi H, Kamar FG, Parchman AJ, Nock CJ, Bartolomeo J, Norden AD, Drappatz J, Ciampa AS, Doherty LM, LaFrankie DC, Ruland S, Quant EC, Beroukhim R, Wen PY, Graber JJ, Lassman AB, Kaley T, Johnson DR, Kimmel DW, Burch PA, Cascino TL, Giannini C, Wu W, Buckner JC, Dirier A, Abacioglu U, Okkan S, Pak Y, Guney YY, Aksu G, Soyuer S, Oksuzoglu B, Meydan D, Zincircioglu B, Yumuk PF, Alco G, Keven E, Ucer AR, Tsung AJ, Prabhu SS, Shonka NA, Alistar AT, van den Bent M, Taal W, Sleijfer S, van Heuvel I, Smitt PAS, Bromberg JE, Vernhout I, Porter AB, Dueck AC, Karlin NJ, Hiramatsu R, Kawabata S, Miyatake SI, Kuroiwa T, Easson MW, Vicente MGH, Sahebjam S, Garoufalis E, Guiot MC, Muanza T, Del Maestro R, Kavan P, Smolin AV, Konev A, Nikolaeva S, Shamanskaya Y, Malysheva A, Strelnikov V, Vranic A, Prestor B, Pizem J, Popovic M, Khatua S, Finlay J, Nelson M, Gonzalez I, Bruggers C, Dhall G, Fu BD, Linskey M, Bota D, Walbert T, Puduvalli V, Ozawa T, Brennan CW, Wang L, Squatrito M, Sasayama T, Nakada M, Huse JT, Pedraza A, Utsuki S, Tandon A, Fomchenko EI, Oka H, Levine RL, Fujii K, Ladanyi M, Holland EC, Raizer J, Avram MJ, Kaklamani V, Cianfrocca M, Gradishar W, Helenowski I, McCarthy K, Mulcahy M, Rademaker A, Grimm S, Landolfi JC, Chen S, Peeraully T, Anthony P, Linendoll NM, Zhu JJ, Yao K, Mignano J, Pfannl R, Pan E, Vera-Bolanos E, Armstrong TS, Bekele BN, Gilbert MR, Alexandru D, Glantz MJ, Kim L, Chamberlain MC, Bota DA, Albrecht V, Juerchott K, Selbig J, Tonn JC, Schichor C, Sawale KB, Wolff J, Vats T, Ketonen L, Khasraw M, Kaley T, Panageas K, Reiner A, Goldlust S, Tabar V, Green RM, Woyshner EA, Cloughesy TF, Abe T, Morishige M, Shiqi K, Momii Y, Sugita K, Fukuyoshi Y, Kamida T, Fujiki M, Kobayashi H, Lavon I, Refael M, Zrihan D, Siegal T, Elias EF, Kairouz VF, Chahine GY, Comair YG, Dimassi H, Kamar FG, Tham CK, See SJ, Toh CK, Kang SH, Park KJ, Kim CY, Yu MO, Park CK, Park SH, Chung YG, Park KJ, Yu MO, Kang SH, Cho TH, Chung YG, Sasaki H, Sano K, Nariai T, Uchino Y, Kitamura Y, Ohira T, Yoshida K, Kirson ED, Wasserman Y, Izhaki A, Mordechovich D, Gurvich Z, Dbaly V, Vymazal J, Tovarys F, Salzberg M, Rochlitz C, Goldsher D, Palti Y, Ram Z, Gutin PH, Furuse M, Miyatake SI, Kawabata S, Kuroiwa T, Torcuator RG, Ibaoc K, Rafael A, Mariano M, Reardon DA, Peters K, Desjardins A, Sampson J, Vredenburgh JJ, Gururangan S, Friedman HS, Le Rhun E, Kotecki N, Zairi F, Baranzelli MC, Faivre-Pierret M, Dubois F, Bonneterre J, Arenson EB, Arenson JD, Arenson PK, Pierick M, Jensen W, Smith DB, Wong ET, Gautam S, Malchow C, Lun M, Pan E, Brem S, Raizer J, Grimm S, Chandler J, Muro K, Rice L, McCarthy K, Mrugala M, Johnston SK, Chamberlain M, Marosi C, Handisurya A, Kautzky-Willer A, Preusser M, Elandt K, Widhalm G, Dieckmann K, Torcuator RG, Opinaldo P, Chua E, Barredo C, Cuanang J, Grimm S, Phuphanich S, Recht LD, Rosenfeld SS, Chamberlain MC, Zhu JJ, Fadul CE, Swabb EA, Pope C, Beelen AP, Raizer JJ, Kim IH, Park CK, Han JH, Lee SH, Kim CY, Kim TM, Kim DW, Kim JE, Paek SH, Kim IA, Kim YJ, Kim JH, Nam DH, Rhee CH, Lee SH, Park BJ, Kim DG, Heo DS, Jung HW, Desjardins A, Peters KB, Vredenburgh JJ, Friedman HS, Reardon DA, Becker K, Baehring J, Hammond SN, Norden AD, Fisher DC, Wong ET, Cote GM, Ciampa AS, Doherty LM, Ruland SF, LaFrankie DC, Wen PY, Drappatz J, Brandes AA, Franceschi E, Tosoni A, Poggi R, Agati R, Bartolini S, Spagnolli F, Pozzati E, Marucci G, Ermani M, Taillibert S, Guillevin R, Dehais C, Bellanger A, Delattre JY, Omuro A, Taillibert S, Hoang-Xuan K, Barrie M, Guiu S, Chauffert B, Cartalat-Carel S, Taillandier L, Fabbro M, Laigre M, Guillamo JS, Geffrelot J, Rouge TDLM, Bonnetain F, Chinot O, Gil MJ, de las Penas R, Reynes G, Balana C, Perez-Segura P, Garcia-Velasco A, Gallego O, Herrero A, de Lucas CFC, Benavides M, Perez-Martin X, Mesia C, Martinez-Garcia M, Muggeri AD, Cervio A, Rojas M, Arakaki N, Sevlever GE, Diez BD, Muggeri AD, Cerrato S, Martinetto H, Diez BD, Peereboom DM, Brewer CJ, Suh JH, Chao ST, Parsons MW, Elson PJ, Vogelbaum MA, Sade B, Barnett GH, Shonka NA, Yung WKA, Bekele N, Gilbert MR, Kobyakov G, Absalyamova O, Amanov R, Rauschkolb PK, Drappatz J, Batchelor TT, Meyer LP, Fadul CE, Lallana EC, Nghiemphu PL, Kohanteb P, Lai A, Green RM, Cloughesy TF, Mrugala MM, Lee LK, Graham CA, Fink JR, Spence AM, Portnow J, Badie B, Liu X, Frankel P, Chen M, Synold TW, Al Jishi AA, Golan J, Polley MYC, Lamborn KR, Chang SM, Butowski N, Clarke JL, Prados M, Grommes C, Oxnard GR, Kris MG, Miller VA, Pao W, Lassman AB, Renfrow J, DeTroye A, Chan M, Tatter S, Ellis T, McMullen K, Johnson A, Mott R, Lesser GJ, Cavaliere R, Abrey LE, Mason WP, Lassman AB, Perentesis J, Ivy P, Villalona M, Nayak L, Fleisher M, Gonzalez-Espinoza R, Reiner A, Panageas K, Lin O, Liu CM, Deangelis LM, Omuro A, Taylor LP, Ammirati M, Lamki T, Zarzour H, Grecula J, Dudley RW, Kavan P, Garoufalis E, Guiot MC, Del Maestro RF, Maurice C, Belanger K, Moumdjian R, Dufresne S, Fortin C, Fortin MA, Berthelet F, Renoult E, Belair M, Rouleau D, Gallego O, Benavides M, Segura PP, Balana C, Gil MJG, Berrocal A, Reynes G, Garcia JL, Mazarico J, Bague S. Medical and Neuro-Oncology. Neuro Oncol 2010. [DOI: 10.1093/neuonc/noq116.s6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ellingson BM, Pope WB, Lai A, Nghiemphu PL, Cloughesy TF, Juhasz C, Mittal S, Muzik O, Chugani DC, Chakraborty PK, Bahl G, Barger GR, Carrillo JA, Lai A, Nghiemphu P, Tran A, Moftakhar P, Cloughesy TF, Pope WB, Bruggers C, Moore K, Khatua S, Gumerlock MK, Stolzenberg E, Fung KM, Smith ML, Kedzierska K, Chacko G, Epstein RB, Holter J, Parvataneni R, Kadambi A, Park I, Elkhaled A, Essock-Burns E, Khayal I, Butowski N, Lamborn K, Chang S, Nelson S, Sanverdi E, Ozgen B, Oguz KK, Soylemezoglu F, Mut M, Zhu JJ, Pfannl R, Do-Dai D, Yao K, Mignano J, Wu JK, Linendoll N, Beal K, Chan T, Yamamda Y, Holodny A, Gutin PH, Zhang Z, Young RJ, Lupo JM, Essock-Burns E, Cha S, Chang SM, Butowski N, Nelson SJ, Laperriere N, Perry J, Macdonald D, Mason W, Easaw J, Del Maestro R, Kucharczyk W, Hussey D, Greaves K, Moore S, Pouliot JF, Rauschkolb PK, Smith SD, Belden CJ, Lallana EC, Fadul CE, Bosscher L, Slot M, Sanchez E, Uitdehaag BM, Vandertop WP, Peerdeman SM, Blumenthal DT, Bokstein F, Artzi M, Palmon M, Aizenstein O, Sitt R, Gurevich K, Kanner A, Ram Z, Corn B, Ben Bashat D, Slot M, Bosscher L, Sanchez E, Uitdehaag BM, Vandertop WP, Peerdeman SM, Martinez N, Gorniak R, Tartaglino L, Scanlan M, Glass J, Kleijn A, Chen JW, Sun PZ, Buhrman J, Rabkin SD, Weissleder R, Martuza RL, Lamfers ML, Fulci G, Lallana EC, Brong KA, Hekmatyar K, Jerome N, Wilson M, Fadul CE, Kauppinen RA, Mok K, Valenca MM, Sherafat E, Olivier A, Pentsova E, Rosenblum M, Holodny A, Palomba L, Omuro A, Murad GJ, Yachnis AT, Dunbar EM, Essock-Burns E, Li Y, Lupo J, Polley MY, Butowski N, Cha S, Chang S, Nelson S, Kohler N, Quisling R, Dunbar EM, Swanson KR, Gu S, Chakraborty G, Alessio A, Claridge J, Rockne RC, Muzi M, Krohn KA, Spence AM, Alvord EC, Anderson AR, Kinahan P, Boone AE, Rockne RC, Mrugala MM, Swanson KR, Gutova M, Khankaldyyan V, Herrmann KA, Harutyunyan I, Abramyants Y, Annala AJ, Najbauer J, Moats RA, Shackleford GM, Barish ME, Aboody KS. Radiology. Neuro Oncol 2010. [DOI: 10.1093/neuonc/noq116.s17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bokstein F, Kovner F, Ram Z, Templehoff H, Kanner AA, Blumenthal DT, Corn B. A common sense approach to radiation treatment planning of temporal lobe GBM. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.2044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2044 Background: Irradiation remains the cornerstone of management for glioblastoma multiforme (GBM). Guidelines adopted by the RTOG and EORTC advocate encompassing the primary tumor (sometimes with edema), and a 2 cm margin in the high dose volume. These recommendations have emerged from imaging studies and post-mortem analyses. A shortcoming of this approach is the exposure of critical structures (e.g. optic apparatus) to doses of radiation that may exceed organ tolerance. We sought to determine whether the temporal bone (rather than the aforementioned 2 cm radius) serves as a barrier to tumor spread when regarded as the anterior margin for temporal lobe lesions. We hypothesized that toxicity could be reduced without compromising tumor control. Methods: During the period 2003–2006, 250 patients with GBM were treated with surgery and primary irradiation at our institution. Chemotherapy (e.g., Stupp regimen) was given to approximately one-third of patients. 31 patients had lesions confined to the temporal lobe. All patients had MRI at baseline and at monthly intervals following a course of 60 Gy delivered by conformal techniques. The Clinical Target Volume included the primary lesion, the edema when present and a 2 cm margin except in the direction of the temporal bone. At follow-up (median = 10 months), patients were judged to have stable disease, local progression (i.e. failure within the temporal lobe), distant progression (i.e., brain failure beyond the temporal lobe) or combinations of the latter 2. Results: 11 patients have remained with stable disease. 17 have failed locally. 3 have manifested distant failure. Of the latter, only one patient failed in the infratemporal fossa. Conclusions: An acceptable level of recurrence (e.g., <5% beyond the temporal bone) is seen when the temporal bone, rather than a 2 cm margin is employed as the anterior border of the CTV. As GBM patients live longer in the era of combined modality therapy, a greater opportunity will exist to express radiation damage. The strategy proposed herein provides tumor control while respecting optic tolerance without resorting to complex, expensive approaches such as IMRT. No significant financial relationships to disclose.
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Affiliation(s)
- F. Bokstein
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - F. Kovner
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Z. Ram
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | | | - A. A. Kanner
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | | | - B. Corn
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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Taliansky-Aronov A, Bokstein F, Lavon I, Siegal T. Temozolomide treatment for newly diagnosed anaplastic oligodendrogliomas: a clinical efficacy trial. J Neurooncol 2006; 79:153-7. [PMID: 16855865 DOI: 10.1007/s11060-005-9020-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2005] [Accepted: 07/12/2005] [Indexed: 10/24/2022]
Abstract
PURPOSE Chemotherapy with alkylating agents is of proven efficacy in recurrent anaplastic oligodendroglioma (AO) with reported response rates ranging between 50% and 70%. The response of newly diagnosed AO to initial treatment with temozolomide (TMZ) has not yet been reported. This study evaluated the response and time to tumor progression of newly diagnosed AO initially treated with TMZ. PATIENTS AND METHODS Twenty patients with a median age of 47 (range: 26-65) received a median of 14 (range: 3-24) cycles of TMZ as their first modality of therapy following diagnosis of AO. Treatment was given every 28 days for 5 days at a starting dose of 200 mg/m2/d and was continued for 24 cycles unless toxicity or tumor progression required withdrawal of TMZ. MRI evaluations were repeated every 8 weeks and scales of Karnofsky performance status (KPS) and of neurological function were used to assess clinical response. RESULTS Clinical improvement was observed in 60% of the patients with statistically significant gain measured by KPS and the neurologic function scales. The objective response rate was 75%, and median time to tumor progression was 24 months. Maximal objective response was reached within a median of 6 months (range: 3-12). Tumors with 1p loss had longer progression free survival compared to tumors without deletions (PFS at 24 months: 1p LOH = 100%, 1p intact = 20%; P = 0.057). TMZ was well tolerated with only two events of grade 3/4 hematological toxicity. CONCLUSIONS Newly diagnosed AO demonstrates a high rate of response to initial therapy with TMZ, similar to the response reported for PCV combination therapy. Further studies are needed to determine the optimal duration of treatment and whether radiotherapy should immediately follow chemotherapy.
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Affiliation(s)
- A Taliansky-Aronov
- Leslie and Michael Gaffin Center for Neuro-Oncology, Hadassah Hebrew University Hospital, Ein-Kerem, Jerusalem, Israel
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Zylber-Katz E, Gomori JM, Schwartz A, Lossos A, Bokstein F, Siegal T. Pharmacokinetics of methotrexate in cerebrospinal fluid and serum after osmotic blood-brain barrier disruption in patients with brain lymphoma. Clin Pharmacol Ther 2000; 67:631-41. [PMID: 10872645 DOI: 10.1067/mcp.2000.106932] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate the pharmacokinetics of methotrexate in ventricular cerebrospinal fluid and serum after osmotic blood-brain barrier disruption and intra-arterial administration compared with intravenous or simple intra-arterial infusion in patients with primary central nervous system lymphoma. METHODS Serum and ventricular cerebrospinal fluid were sampled after methotrexate administration in 12 patients. Blood-brain barrier disruption was induced on 2 sequential days by mannitol (25%) infusion delivered to the vertebral or internal carotid artery territories followed by intra-arterial methotrexate (dose, 1.4 g/m2; 47 treatments). Sixteen treatments were given without barrier disruption by intravenous (3.5 g/m2; nine treatments) or intra-arterial (2.8 g/m2; seven treatments) infusion. RESULTS Ventricular cerebrospinal fluid-methotrexate peak levels after blood-brain barrier disruption of the vertebral and the internal carotid arteries territories were 19.3 +/- 2.9 and 8.5 +/- 0.7 micromol/L (P < .001), and the area under the curve from time 0 to infinity was 178.0 +/- 21.3 and 110.0 +/- 12.4 [micromol/L x h, respectively (P < .01). No significant differences were observed in serum levels. After intra-arterial infusion was performed without disruption, the serum peak level was higher than that achieved by intravenous treatment (518.2 +/- 67.7 versus 180.6 +/- 31.8 micromol/L; P < .001). No differences were observed in cerebrospinal fluid concentrations, which dropped below 1 micromol/L at 6 hours. The cerebrospinal fluid/serum ratio [AUC(%)] of methotrexate after blood-brain barrier disruption was three to four times greater than that by systemic administration. CONCLUSION Enhanced methotrexate delivery to the central nervous system can be attained by intra-arterial administration combined with osmotic disruption of the blood-brain barrier compared with simple intra-arterial or intravenous administration.
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Affiliation(s)
- E Zylber-Katz
- Division of Medicine, the Neuro-Oncology Center, Hadassah University Hospital, Jerusalem, Israel.
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Siegal T, Rubinstein R, Bokstein F, Schwartz A, Lossos A, Shalom E, Chisin R, Gomori JM. In vivo assessment of the window of barrier opening after osmotic blood-brain barrier disruption in humans. J Neurosurg 2000; 92:599-605. [PMID: 10761648 DOI: 10.3171/jns.2000.92.4.0599] [Citation(s) in RCA: 117] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Osmotic blood-brain barrier (BBB) disruption induced by intraarterial infusion of mannitol is used in conjunction with chemotherapy to treat human brain tumors. The time course to barrier closure, or the so-called therapeutic window, has been examined in animals but little information is available in humans. The authors, therefore assessed the time course to barrier closure after osmotic BBB disruption in humans. METHODS Disruption of the BBB was demonstrated using 99mTc-glucoheptonate (TcGH) single-photon emission computerized tomography (SPECT) scanning in 12 patients who were treated monthly with combination chemotherapy in conjunction with BBB disruption. The primary diagnosis was primary central nervous system lymphoma in seven patients and primitive neuroectodermal tumors in five. The TcGH (20 mCi) was injected at 1- to 480-minute intervals after osmotic BBB disruption, and patients underwent SPECT scanning after 4 hours. A total of 38 studies was performed. Good-to-excellent BBB disruption was obtained in 29 procedures and poor-to-moderate disruption was seen in the other nine studies. The TcGH indices correlated with the degree of BBB disruption as measured postprocedure on contrast-enhanced CT scans (r = 0.852). Mean baseline TcGH indices were 1.02+/-0.07. For the group of patients with good-to-excellent disruptions the mean indices at 1 minute postdisruption measured 2.19+/-0.18. After 40 minutes no significant change was noted (mean index 2.13+/-0.2). Then the indices declined more steeply and at 120 minutes after the disruption the index was 1.36+/-0.02. A very slow decline was noted between 120 and 240 minutes after mannitol infusion. At 240 minutes the barrier was still open for all good-to-excellent disruptions (index 1.33+/-0.08) but at 480 minutes the mean indices had returned to the baseline level. CONCLUSIONS Results of these in vivo human studies indicate that the time course to closure of the disrupted BBB for low-molecular-weight complexes is longer than previously estimated. The barrier is widely open during the first 40 minutes after osmotic BBB disruption and returns to baseline levels only after 6 to 8 hours following the induction of good or excellent disruption. These findings have important clinical implications for the design of therapeutic protocols.
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Affiliation(s)
- T Siegal
- Department of Nuclear Medicine, Hadassah Hebrew University Hospital, Jerusalem, Israel.
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Abstract
BACKGROUND It has been suggested that an aggressive treatment of patients with leptomeningeal metastases (LM) that groups radiotherapy and intra-cerebrospinal fluid (intra-CSF) chemotherapy has improved treatment outcomes. Based on their previous series of 137 patients treated with such an intensive standard protocol, the authors expected 20% of the patients to maintain their responses for at least 6 months after withdrawal of therapy. They also observed that, in patients with solid tumors, a partial response was compatable with sustained off-therapy response and that the maximal response was reached soon after completion of radiotherapy. The authors concluded that the role of intra-CSF chemotherapy, with its associated high rate of complications, is unclear. In this study, which was a further evaluation of this dilemma, they compared the outcomes of two prospective treatment protocols that were identical in their use of radiotherapy and systemic chemotherapy and varied only in their inclusion or exclusion of intra-CSF chemotherapy. METHODS Adult patients with LM from systemic solid tumors were prospectively included in the treatment protocol active at the time of their diagnosis. Group 1 comprised 54 patients treated by radiotherapy, intra-CSF chemotherapy, and systemic therapy, whereas Group 2 comprised 50 patients treated with radiotherapy, and systemic chemotherapy but no intra-CSF chemotherapy. RESULTS The analysis of treatment outcomes was performed retrospectively. The median patient age and distribution of primary neoplasms did not differ between the two groups. The proportion of early deaths that occurred during radiotherapy was similar for the two groups, as was the overall rate of response to treatment. The two groups also had the same median survival, which was 4 months for both groups, as well as the same proportion of long term survivors. Thirty-one percent of patients in Group 1 developed early complications related to intra-CSF chemotherapy, whereas patients in Group 2 were spared these complications. Delayed symptomatic leukoencephalopathy was observed in 20% of Group 1 patients compared with none in Group 2 (P = 0.02). CONCLUSIONS The exclusion of intra-CSF chemotherapy from the treatment schedule of patients with LM does not change their overall response to treatment, their median survival, or the proportion of long term survivors. It does, however, significantly reduce the rate of early and delayed treatment-related complications.
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Affiliation(s)
- F Bokstein
- Neuro-Oncology Clinic, Hadassah Hebrew University Hospital, Jerusalem, Israel
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Bokstein F, Neufeld MY, Nisipeanu P, Korczyn AD. Painful paroxysmal dystonia associated with focal epileptic activity. J Neurol Neurosurg Psychiatry 1995; 58:257-8. [PMID: 7876872 PMCID: PMC1073338 DOI: 10.1136/jnnp.58.2.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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