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QUESTION What evidence is available regarding the use of whole brain radiation therapy (WBRT), stereotactic radiosurgery (SRS), surgical resection or chemotherapy for the treatment of recurrent/progressive brain metastases? TARGET POPULATION This recommendation applies to adults with recurrent/progressive brain metastases who have previously been treated(More)
QUESTION Should patients with newly-diagnosed metastatic brain tumors undergo open surgical resection versus whole brain radiation therapy (WBRT) and/or other treatment modalities such as radiosurgery, and in what clinical settings? TARGET POPULATION These recommendations apply to adults with a newly diagnosed single brain metastasis amenable to surgical(More)
QUESTION Do prophylactic anticonvulsants decrease the risk of seizure in patients with metastatic brain tumors compared with no treatment? TARGET POPULATION These recommendations apply to adults with solid brain metastases who have not experienced a seizure due to their metastatic brain disease. RECOMMENDATION Level 3 For adults with brain metastases(More)
Malignant gliomas are characterized by a short median survival which is largely impacted by the resistance of these tumors tochemo- and radiotherapy. Recent studies suggest that a small subpopulation of cancer stem cells, which are highly resistant to gamma-radiation, has the capacity to repopulate the tumors and contribute to their malignant progression.(More)
QUESTION Do steroids improve neurologic symptoms in patients with metastatic brain tumors compared to no treatment? If steroids are given, what dose should be used? Comparisons include: (1) steroid therapy versus none. (2) comparison of different doses of steroid therapy. TARGET POPULATION These recommendations apply to adults diagnosed with brain(More)
In addition to the primary culturing of cancer stem cells (CSCs) from tumor tissues, CSCs are found in established tumor cell lines. However, it is unclear how culture conditions affect CSC enrichment. Additionally, the differentiation potential of cell line-derived CSCs has not been well studied. In our study, the(More)
Neurocognitive function, neurological symptoms, functional independence, and health-related quality of life are major concerns for patients with brain metastases. The inclusion of these endpoints in trials of brain metastases and the methods by which these measures are assessed vary substantially. If functional independence or health-related quality of life(More)
BACKGROUND The standard treatment of resected brain metastasis is whole-brain radiotherapy (WBRT). To avoid the potential toxicity of WBRT and to improve local control, we have used radiosurgery alone to the surgical cavity. OBJECTIVE To demonstrate the rates of local control, new intracranial metastasis, and overall survival using this treatment scheme(More)
The objective of this article is to present a concise summary of the most recent evidence-based guidelines in the management of metastatic brain tumors developed by the American Association of Neurologic Surgeons (AANS), Congress of Neurologic Surgeons (CNS), and the AANS/CNS Joint Section on Tumors in 2010. Target populations include patients with newly(More)
OBJECTIVE Marrow stromal cells (MSCs) have the potential to migrate toward sites of injury or disease in the central nervous system. Encouraging results have been obtained by using MSCs to deliver therapeutic molecules. However, most brain tumor animal models--unlike in actual human disease states--use cells with limited invasion properties. In the present(More)