bluuebunny/crossref_metadata_2025_split huggingface dataset:
ACT-18 SHOULD THE DOSE OF TEMOZOLOMIDE BE DECREASED FOR PATIENTS WITH HIGH-GRADE GLIOMAS WHO ARE ON HEMODIALYSIS?
Authors: Muto Jun , Matsutani Tomoo , Matsuda Ryosuke , Kinoshita Masashi , Oikawa Mitsuteru , Johan Pallud , Adachi Kazuhide , Hirose Yuichi , Sasaki Hikaru 
Published: December 2019

Abstract

BACKGROUND
The pharmacokinetics of temozolomide in patients with severe renal impairments (creatinine clearance less than 36 mL/min/m2) or in hemodialysis patients has not been investigated. Temozolomide and its metabolic products are mainly excreted in urine, as retention of these in the body may result in increased adverse events in hemodialysis patients harboring a high-grade glioma.

METHODS
Eight hemodialysis patients with high-grade gliomas from seven institutions were included in the study. Patient characteristics, treatment schedule, clinical course, pathological/molecular findings, and adverse events were evaluated.

RESULTS
The histopathological diagnoses were Isocitrate dehydrogenase (IDH) wild-type glioblastoma in four cases, Not other specified (NOS) glioblastoma in two cases and IDH-mutant anaplastic astrocytoma in one case. Five of the seven patients completed radiotherapy (48–60 Gy) with concomitant temozolomide (75 mg/m2) followed by adjuvant 5-day temozolomide (150 mg/m2) every 28 days. During the entire course of treatment with temozolomide, severe (Common Terminology Criteria for Adverse Events (CTCAE) more than grade 3) lymphocytopenia occurred in 57%(41.7–61%: non hemodialysis patients data, the same as below), neutropenia in 0%(1–15.4%) and thrombocytopenia in 14%(0–16.7%) of the patients. Generally, the frequency and degree of myelosuppression do not increase in hemodialysis patients with high-grade gliomas. Two of the seven (28.5%) patients died of infectious disease despite having no direct correlation to myelosuppression that is similar rate of 21.9% of the death results from infection in hemodialysis patients in Japan.

CONCLUSIONS
The high-grade glioma patients under study on hemodialysis did not require decreasing doses of Temozolomide during concomitant radiochemotherapy and maintenance therapy. However, careful clinical and hematological observation is required to avoid critical hematotoxicity and infection.
ACT-22 CLINICAL RESULT AND CONSIDERATION OF 70 CASES OF INSULAR GLIOMA
Authors: Maruyama Takashi , Muragaki Yoshihiro , Sato Taiishi , Nitta Masayuki , Tsuzuki Shunsuke , Ikuta Soko , Nagahama Yasunori , Kawamata Takakazu 
Published: December 2019

Abstract
Our policy for insular glioma has achieved more than 90% removal. The policy influence grade 2 to postpone farther treatment and grade 3 to extend prognosis. In this study, we analyzed our clinical data to be sure how this policy effect to insular glioma. First-onset tumor since 2006 to 2015 were collected and following parameters were analyzed retrospectively, such as the tumor, extension, surgical removal rate, complications, pathological and genomic diagnosis. Of all 70 cases, the average age was 41 years old (24–76). The pathological diagnosis and number of patients were DAmt 20, DAwt 1, AAmt 8, AAwt 5, AO 5, O 18. PFS of each pathological grade(2,3,4) were 55,5m, 42,6m and 4,7m, OS were nr, nr, 32,8 months. 57 cases of IDHmt showed 60,2m of PFS and n.r of OS. 10 cases of IDHwt showed 19,9m PFS and 35,8m OS. The average and median removal rate were 91.4% and 95%. The number of complication case were mild 9 and moderate 2 at 3 months after surgery. The invasion pattern from temporal stem showed that frontal base invasion cases was resulted as poor prognosis comparing with temporal or parietal extension. Number of patients with IDHwt, Oligodedroglial tumor and GBM were relatively low. Surgical complications are mainly caused in the first half of the proficiency process, 15% had paralysis due to LSA infarction. Most of grade 2 cases were treated without post-operative treatment and the prognosis was almost same as grade 3 cases which were treated by chemo and radiation therapy such as 55m, 43m of PFS and n.r of OS. AA wt and GBM showed almost same OS of 32m.We have reconsidered a new classification based on temporal stem extension from surgical point of view. Insular glioma is somewhat different from the other location glioma.
PEDT-06 THERAPEUTIC STRATEGY FOR DISSEMINATED PILOCYTIC ASTROCYTOMAS
Authors: Suzuki Tomonari , Mizuno Rena , Uchida Eita , Shirahata Mitsuaki , Adachi Junichi , Mishima Kazuhiko , Fujimaki Takamitsu , Yanagisawa Takaaki , Nishikawa Ryo 
Published: December 2019

Abstract

BACKGROUND
Pilocytic astrocytoma is one of the common tumors found during childhood. However, the clinical course of disseminated pilocytic astrocytoma is not clearly known. Here, we present two cases with disseminated pilocytic astrocytoma and discuss the treatment strategy. Patients We treated a 7-year-old female (case 1) and 9-year-old male (case 2) with hypothalamic pilocytic astrocytomas. The results of magnetic resonance imaging showed diffuse spinal dissemination at diagnosis. Chemotherapy with vincristine and carboplatin was administered as the firstline therapy. The tumors showed some shrinkage, and symptoms improved. During chemotherapy, the patients developed allergies to carboplatin. Therefore, we changed the chemotherapy treatment to vincristine. Other adverse events were not observed. In Case 1, we observed an intratumoral hemorrhage and hydrocephalus due to occlusion of the foramen Monro. Endoscopic surgery was performed, and no clinical deficit was observed. Case 2 underwent ventricular peritoneal shunt procedure for communicating hydrocephalus and a reoperation for shunt malfunction because of dense cerebrospinal fluid with elevated protein levels. The patients have not undergone radiotherapy until now. They had no severe clinical symptoms and went to school for 5 and 10 years, respectively, after the diagnoses.

CONCLUSION
Chemotherapy for disseminated pilocytic astrocytoma is effective and may help in avoiding radiotherapy. Chemotherapy should be administered before radiotherapy, considering long-term complications.
IMT-02 VEGF RECEPTORS EXPRESSION AND REPORT OF CLINICAL TRIAL OF PEPTIDE VACCINE IN SKULL BASE CHORDOMA
Authors: Morimoto Yukina , Toda Masahiro , Tamura Ryota , Ohara Kentarou , Oishi Yumiko , Yoshida Kazunari 
Published: December 2019

Abstract
Chordoma is a rare refractory neoplasm that arises from the embryological remnants of the notochord. Vascular endothelial growth factor (VEGF) is a potent activator of angiogenesis that is associated with the tumor-immune microenvironment. To evaluate the characteristics of vascular and tumor cells in chordoma, we first analyzed the expression of VEGF receptor (VEGFR) 1, VEGFR2, CD34, and Brachyury in a cell line and 54 tumor tissues. Patients with primary skull base chordomas were divided into the two groups as per the tumor growth rate. The expressions of VEGF-A, VEGFR1, and VEGFR2 on tumor cells; tumor infiltrative immune cells, including regulatory T cells (Tregs) and tumor-associated macrophages (TAMs); and immune-checkpoint molecules (PD-1/PD-L1) were analyzed with the clinical courses. Both VEGFR1 and VEGFR2 were strongly expressed not only on vascular endothelial cells, but also on tumor cells. The recurrent cases showed significantly higher VEGFR1 expressions on tumor cells than the primary cases. The expression of VEGF-A, and the numbers of CD163+ TAMs and Foxp3+ Tregs were significantly higher in the patients with rapid progressive course than the patients with slow progressive course. Based on the present results, VEGFRs-targeted therapy may show efficacy in regulating growth of chordomas.
IMT-03 CLINICAL TRIAL FOR NEWLY DIAGNOSED MALIGNANT GLIOMA WITH WT1-W10 VACCINATION
Authors: Kawanishi Yu , Udaka Keiko , Yawata Toshio , Nakai Eiichi , Fukuda Hitoshi , Fukui Naoki , Ueba Tetsuya 
Published: December 2019

Abstract

OBJECT
Wilms’ tumor 1 (WT1) peptide vaccination is considered a potentially effective therapy against malignant glioma. We conducted a Phase I/II study to investigate the safety and feasibility of novel WT1 peptide (W10) vaccination therapy for patients with newly diagnosed malignant glioma.

METHODS
WT1 vaccination therapy was performed for patients with malignant glioma who have undergone concurrent radiotherapy and temozolomide therapy. A mixture of WT1 peptide with inactivated pertussis whole cell vaccine was injected intradermally once a week for at least 12 weeks.

RESULTS
Twenty-seven patients (12 men, 15 women; median 65 years) with the following tumors were enrolled: WHO grade IV (15), WHO grade III (12). PFS and OS of glioblastoma cases were 12.7 months 21.9 months, respectively. PFS of the MGMT unmethylated group was shorter than the methylated group. Interestingly enough, overall survival in the MGMT unmethylated group was not significantly different from the methylated group. Analysis of recurrent cases after immunotherapy showed decreased expression of WT1 antigen and increased Treg. They were suggested as a cause of treatment resistance. No serious adverse events were observed except for Grade 1 erythema at the injection sites.

CONCLUSIONS
This study of a novel WT1 vaccination therapy demonstrated safety and feasibility in the management of newly diagnosed malignant gliomas.
STMO-15 OUR THERAPEUTIC STRATEGIES FOR GLIOBLASTOMA: INTRAOPERATIVE SUPPORT SYSTEMS [INTRAOPERATIVE MRI, PET, 5-AMINOLEVULINIC ACID (5-ALA)] AND NEOADJUVANT CHEMOTHERAPY
Authors: Miyake Keisuke , Ogawa Tomoya , Fujimori Takeshi , Ogawa Daisuke , Okada Masaki , Hatakeyama Tetsuhiro , Tamiya Takashi 
Published: December 2019

Abstract

OBJECTIVE
Neuronavigation systems with MRI and multiple PET examinations (methionine [MET], fluorothymidine [FLT], and fluoromisonidazole [FMISO]) have become our standard techniques for glioma surgeries. Residual tumors are identified and removed using intraoperative MRI (IoMRI) to maximize tumor removal. This time, we performed tumor removal after Bevacizumab (Bev) therapy for glioblastoma with low KPS at admission and compared extraction rate and residual volume of MRI and PET examinations, and prognosis between with and without Bev therapy.

METHODS
We selected 12 glioblastoma patients with low KPS at admission and performed multiple PET examinations and IoMRI from January 2016 to July 2019. We divided them into the pre-Bev group that performed tumor removal after neoadjuvant Bev therapy and the non-Bev group that did not use Bev. We compared the extraction rate and residual volume of MRI and PET examinations, and prognosis between the pre-Bev group and the non-Bev group.

RESULTS
The pre-Bev group was 6 cases and the non-Bev group was 6 cases. The number of KPS for the pre-Bev group just before surgery was (90; 3 cases, 80; 2 cases, 70; 1 case) and (50; 2 cases, 40; 4 cases) for the non-Bev group. For comparison between the pre Bev group and the non-Bev group, the extraction rate (%) was T1-Gd (97.6, 91.5), MET (95.4, 99.9), FLT (96.2, 90.2), FMISO (97, 92), residual volume (ml) was T1-Gd (0.6, 1.7), MET (1.2, 2.9), FLT (1.0, 2.1), FMISO (0.5, 1.1), and for prognosis, median PFS (month) is (10.1, 4.9) and median OS (months) was (15.7, 13.3).

CONCLUSIONS
For glioblastoma patients with low KPS at admission, the neoadjuvant Bev therapy improved KPS just before surgery. The neoadjuvant Bev therapy improved the extraction rate and reduced residual volume of MRI and PET examinations and leads to the prolonged prognosis of PFS and OS.
RT-01 TREATMENT RESULTS OF SALVAGE GAMMA KNIFE STEREOTACTIC RADIOSURGERY AND BEVACIZUMAB (AVAGAMMA THERAPY) FOR RECURRENT GLIOBLASTOMA
Authors: Sato Kenichi , Takanashi Masami , Ozaki Yoshimaru , Asanome Taku , Sugio Hironori , Ishida Yuuki , Nakamura Hirohiko 
Published: December 2019

Abstract

PURPOSE
We report the treatment results of AVAgamma therapy combining gamma knife (GK) and bevacizumab for recurrent glioblastoma.

SUBJECTS
From August 2013 to April 2018, 42 patients (183 lesions) with recurrent glioblastoma treated with AVAgamma therapy as salvage therapy at the time of relapse after initial treatment. The average age is 61.1 years, with 25 men and 17 women. The tumor volume is 100 ml or less, and KPS is 40% or more as the indication of AVAgamma therapy. When the irradiation volume of GK is 15 ml or less, a single irradiation with a boundary dose of 20 Gy was performed, and when the irradiation volume was 15 ml or more, a single irradiation boundary dose was divided into two divided irradiations of 12 to 15 Gy. The mean therapeutic borderline dose was 24 Gy. Bevacizumab was administered 10 mg / kg or 15 mg / kg 1 to 10 times after GK.

METHODS
Median progression-free survival (mPFS), 6-month progression-free survival (PFS-6m), 6-month survival (OS-6m), median survival (mOS) from treatment with AVAgamma Considered mOS from initial treatment. [Results]: The mPFS from AVAgamma therapy was 5 months, PFS-6m was 37%, OS-6m was 84%, and mOS was 9 months. The mOS from initial treatment were 25 months. In relapsing glioma RPA classification, NABTT CNC class 5 mOS is 5.6 months, class 6 mOS is 6.4 months, but mOS from AVAgamma therapy is 9 months in class 5, 9 months in class 6. The survival time has been extended.

DISCUSSION
By AVAgamma therapy, it was thought that recurrent lesions were locally controlled and life prognosis was prolonged.

CONCLUSION
AVAgamma therapy is thought to prolong the survival of recurrent glioblastoma and play an important role as salvage treatment.
MPC-02 REVIEW OF MEDULLOBLASTOMA FOR THE ASSESSMENT OF CONSENSUS IN PATHOLOGICAL DIAGNOSIS USING JPMNG CASES
Authors: Sasaki Atsushi , Hirato Jyunko , Inoue Takeshi , Kanemura Yonehiro , Kodama Yoshinori , Ichimura Koichi , Sakamoto Hiroaki , Nishikawa Ryo 
Published: December 2019

Abstract
Medulloblastoma (MB) is now classified by WHO 2016 classification as “genetically defined” and “histologically defined” variants. The aim of this study is to search for consensus on pathological diagnosis and assess the correlation between the central pathological diagnosis and the molecular subgrouping. We performed the pathological and molecular analyses in a total of 176 JPMNG (The Japan Pediatric Molecular Neuro-Oncology Group) cases. The diagnosis of MB was made by three expert neuropathologists (AS, JH, and TH) without knowledge of the molecular data. Subgroup affiliation was determined by expression profiling of 22 medulloblastoma subgroup-specific genes using the nanoString nCounter system. Histologically, classic MBL accounted for approximately 80% of all MB cases. Genetic analyses of 176 cases revealed four distinct molecular subgroups: WNT (14%), SHH (27%), group 3 (16%), and group 4 (43%). The central review reached a diagnosis of AT/RT for 3 cases that had been diagnosed as MB by the local pathologists. Immunohistochemically, WNT MBs showed nuclear accumulation of β-catenin protein, but the immunoreactivity was patchy in approximately one-quarter of WNT cases. GAB1 often exhibited little or no reactivity in the SHH subgroup. No reliable staining was observed for YAP1. All D/N MBL (16 cases) or MBEN (6 cases) were defined as SHH tumors. All MBEN cases were in infants (&lt;3 years of age), and genetically subdivided into SHH-TP53 wild-type tumors. Variable degrees of anaplasia, including LC/A MB, occur across the genetic subgroups, and the LC/A MB WNT type was rare (2/24=8.3%) among WNT subgroups. This study demonstrated that the combination of morphological and molecular analyses can precisely diagnose MB. More robust, surrogate markers should be developed as ancillary diagnostic testing for subgroup classification. Further exploration of the clinical significance of the variable degree of LC/A histology and some subtypes (i.e. LC/A, WNT) will be necessary for risk stratification.
NI-03 USEFULNESS OF IMP-SPECT IN PREOPERATIVE GRADE EVALUATION OF INTRAORBITAL TUMOR
Authors: Okonogi Shinichi , Kubota Shuuhei , Sakaeyama Yuuki , Ueda Keita , Nemoto Masaaki , Nagao Tateki , Sugo Nobuo 
Published: December 2019

Abstract

INTRODUCTION
The frequency of intraorbital tumors is small as 0.9% of all brain tumors, but its pathological type is diverse. Among them, the diagnosis of whether particularly malignant tumor scan clinically, is extremely important. Nuclear medical testing is essential for non-invasive differential diagnosis in brain tumors. SPECT, good malignancy differentiation, evaluation of malignancy, usefulness such as differentiation of non-tumorous lesions have been reported many. However, there are few reports that SPECT was useful in preoperative differential diagnosis of orbital tumors. Since 123IMP-SPECT was useful in preoperative differential diagnosis of intraorbital tumors, we report some literature considerations.

METHOD
Among the 27 cases of intraorbital tumors that were operated on in our clinic between August 2005 and August 2016, 14 cases of SPECT prior to surgery were examined for the usefulness of preoperative differential diagnosis. Breakdown of cases, as the malignant tumor, two cases of malignant lymphoma, MALT lymphoma 2 cases, adenoid cystic carcinoma 1 case, in one case plasma cytoma, as a benign tumor, false tumors 4 cases, three hemangioma cases, neurocytoma 1 case it was.

RESULTS
In IMP early image, accumulation of clear IMP was observed in all six cases of malignant tumors. In benign tumors, there is no accumulation in hemangioma and neurosheath, there is a strong accumulation in one of the four cases in false tumors, it was observed mild accumulation in the remaining two cases. Tumor to normal ratio of IMP early image was an average of 2.39 in six malignant tumors and 1.52 in 8 benign tumors.

CONCLUSION
This time, we examined the usefulness of 123IMP-SPECT in preoperative differential diagnosis of intraorbital tumors. The T/N ratio of intraorbital malignant tumors is higher than benign tumors, and it was thought to help to evaluate preoperative malignancy of intraorbital tumors.
NI-07 VALIDATION OF MACHINE LEARNING BASED HIGH GRADE GLIOMA MR SEGMENTATION VIA METHIONINE PET
Authors: Kinoshita Manabu , Ozaki Tomohiko , Arita Hideyuki , Kagawa Naoki , Kanemura Yonehiro , Fujimoto Yasunori , Sakai Mio , Watanabe Yoshiyuki , Nakanishi Katsuyuki , Shimosegawa Eku , Hatazawa Jun , Kishima Haruhiko 
Published: December 2019

Abstract
Treatment planning and lesion-follow up are generally conducted by contrast-enhanced MRI in glioma patient care. On the other hand, there are, however, substantial concerns whether MRI actually reflects the extension or activity of this neoplasm, which information should be fundamentally important at every step when treating this disease. As a matter of fact, the authors of this investigation have already shown that there is no difference in tumor cell density within areas with and without contrast enhancement (J Neurosurg. 2016,125(5):1136–1142.) and furthermore that the geometry of MRI based-radiation treatment planning is significantly altered when methionine PET is integrated for this purpose (J Neurosurg. 2018 published on-line). Regardless of these concerns, there is great interest in the research community to construct a machine learning based fully automated brain tumor segmentation tool specific for gliomas using MRI. The authors attempted to validate this method by comparing MRI-based automated brain tumor segmentation and methionine PET. Consecutively collected 45 high-grade gliomas (GBM-26, grade3-19) were analyzed. BraTumIA, an automated brain tumor segmentation tool, was used for machine learning based lesion segmentation. At the same time, lesions were segmented using various thresholds on methionine PET. The authors observed 40% of pseudo-positive and 90% of pseudo-negative error on BraTumIA based lesion segmentation when methionine PET was considered as ground truth with a cut-off of 1.3 in T/N ratio. Pseudo-negative error was as high as 60% even if the threshold was elevated to 2.0. Although machine learning based glioma segmentation is expected to expand in both research and clinical use, the observed results caution the use of MRI as ground truth of spatial extension of glioma and researchers should be reminded that this imaging modality may obscure the true behavior of the disease within the patient in some cases.
NI-20 IS GLIOMATOSIS CEREBRI DIAGNOSED AS GRADEII IN NEUROIMAGING A POTENTIALLY GRADEII GLIOMA?
Authors: Owashi Etsuko , Takei Hiroaki , Ikegame Yuka , Asano Yoshitaka , Miwa Kazuhiro , Ito Takeshi , Yokoyama Kazutoshi , Shinoda Jun , Maruyama Takashi , Muragaki Yoshihiro , Yano Hirohito , Iwama Toru 
Published: December 2019

Abstract
The 2007 World Health Organization (WHO) classification defined gliomatosis cerebri (GC) as a rare entity and an extensively infiltrating diffuse glioma involving three or more cerebral lobes. Although the revised 2016 WHO classification removed GC as a separate glioma entity due to the common histopathological findings shared with other gliomas, GC exhibits a distinct growth pattern and worse prognosis compared with other grade-matched gliomas. We retrospectively reviewed five patients with GC and five patients with insulo-opercular diffuse astrocytoma (IODA) who underwent both proton magnetic resonance spectroscopy (MRS) and [11C]-methionine positron emission tomography (MET-PET).
The patients were diagnosed with GC or IODA by T2-weighted magnetic resonance imaging /fluid-attenuated inversion recovery from April 2014 to August 2019 at our institution. The locations of lesions where single-voxel MRS to measure the N-acetylaspartate (NAA)/choline (Cho) ratio and MET-PET to measure the tumor/normal (T/N) ratio were performed were the same in every patient.
The mean age of all patients was 46.3±13.7 years. The mean ages of the GC (three males and two females) and IODA (two males and three females) groups were 54.0±14.0 and 38.6±8.7 years, respectively. The mean NAA/Cho ratios in the GC and IODA groups were 1.010±0.441 and 0.594±0.449, respectively. The mean T/N ratios in the GC and IODA groups were 1.201±0.050 and 1.169±0.009, respectively.
The higher NAA/Cho ratio in the GC lesions may reflect the abundance of normal neural tissue in GC compared with IODA. Nonetheless, the T/N ratios of the two groups were comparable. The discrepancy suggests that GC cells have higher tumor metabolic activity than IODA cells. Therefore, when GC is simply classified as grade II glioma based on neuroimaging diagnosis, the possibility of underestimating its malignant potential at the single-cell level should be considered.