Principles and practice of neuro-oncology : a multidisciplinary approach

Part II: MOLECULAR BIOLOGY......Page 6
Part III: Clinical Presentation and Supportive Care......Page 7
Part VI: RADIATION THERAPY......Page 8
Contributors......Page 10
1. Epidemiology and Etiology of Glioma: An Overview
......Page 26
REFERENCES
......Page 27
INTRODUCTION......Page 29
CLINICAL AND DEMOGRAPHIC CHARACTERISTICS......Page 31
INCIDENCE RATES......Page 32
TRENDS IN INCIDENCE RATES......Page 34
SURVIVAL......Page 35
REFERENCES......Page 37
CASE-CONTROL AND COHORT STUDIES OF FAMILIAL AGGREGATION OF GLIOMA......Page 39
HEREDITARY SYNDROMES PREDISPOSING FOR PBTs......Page 40
REFERENCES......Page 42
OCCUPATION......Page 43
SMOKING......Page 45
DIET......Page 46
MEDICATIONS......Page 47
REFERENCES......Page 48
PROSPECTIVE STUDIES......Page 51
SUMMARY......Page 53
REFERENCES......Page 54
EXPOSURE ASSESSMENT......Page 56
EPIDEMIOLOGICAL STUDIES OF MOBILE PHONE USE AND GLIOMA RISK......Page 57
OCCUPATIONAL STUDIES......Page 60
DISCUSSION......Page 61
REFERENCES......Page 62
INVERSE ASSOCIATION BETWEEN ALLERGIC CONDITIONS, IMMUNOGLOBULIN E, 
AND GLIOMA......Page 64
REFERENCES......Page 69
STUDIES OF TUMOR MARKERS IN RELATION TO SURVIVAL......Page 72
CONSTITUTIVE GENETIC POLYMORPHISMS AND GLIOMA SURVIVAL......Page 73
ACKNOWLEDGMENTS......Page 79
REFERENCES......Page 80
DEFINITION AND CLASSIFICATION OF CHILDHOOD BRAIN TUMORS......Page 82
DESCRIPTIVE EPIDEMIOLOGY......Page 84
SUGGESTED CAUSES OF HUMAN CHILDHOOD BRAIN TUMORS......Page 85
REFERENCES......Page 90
ASSOCIATION WITH BREAST CANCER......Page 96
MOLECULAR GENETICS......Page 97
INTERACTION WITH THE ENVIRONMENT......Page 98
REFERENCES......Page 101
11. Molecular Neuro-Oncology: Why is it Essential?......Page 104
INTRODUCTION: STEM CELL HYPOTHESIS......Page 106
DEFINITION AND SOURCES OF BTICs......Page 107
CELL SURFACE MARKERS OF BTICs AND ABERRANT SIGNALING IN BTICs OF GBM......Page 108
CONCLUSION......Page 110
REFERENCES......Page 111
PATHWAYS OF MALIGNANT PROGRESSION......Page 113
HALLMARKS OF MALIGNANT GLIOMAS......Page 115
MOLECULAR SUBTYPES OF INFILTRATING GLIOMAS......Page 119
REFERENCES......Page 120
GROWTH PATTERNS OF ASTROCYTIC NEOPLASMS......Page 125
VASCULAR HETEROGENEITY IN GBM......Page 126
HYPOXIC AND METABOLIC HETEROGENEITY IN GBM......Page 128
PROTON MAGNETIC RESONANCE PECTROSCOPY IMAGING OF TUMOR METABOLITES......Page 129
CELLULAR HETEROGENEITY......Page 130
GENETIC HETEROGENEITY......Page 132
CONCLUSION......Page 133
REFERENCES......Page 134
MECHANISMS OF GLIOMA INVASION......Page 137
QUESTIONS REMAINING/FUTURES STUDIES AND THERAPEUTIC IMPLICATIONS......Page 142
REFERENCES......Page 143
ANGIOGENESIS IN GLIOMAS
......Page 147
VASCULOGENESIS IN GLIOMAS......Page 154
ANTIANGIOGENIC THERAPIES IN PATIENTS WITH GLIOMAS
......Page 157
REFERENCES......Page 162
TECHNIQUES FOR MOUSE TRANSGENESIS......Page 170
ANIMAL MODELS OF CNS TUMORS......Page 173
REFERENCES......Page 176
IMMUNOCOMPETENT HOSTS......Page 178
HUMAN TUMOR XENOGRAFT MODELS......Page 179
EFFECT OF BIOLUMINESCENCE IMAGING......Page 180
REFERENCES......Page 181
PATHOLOGY......Page 183
GENETICS......Page 186
REFERENCES......Page 189
MULTIPLE SCHWANNOMA SYNDROMES......Page 192
PATHOLOGY......Page 193
MOLECULAR BIOLOGY......Page 195
REFERENCES......Page 196
INTRODUCTION......Page 199
HISTOPATHOLOGY......Page 203
MOLECULAR PATHOGENESIS......Page 205
REFERENCES......Page 207
MOLECULAR PATHOGENESIS OF NEUROFIBROMAS......Page 210
HISTOPATHOLOGY OF NEUROFIBROMA......Page 212
MOLECULAR PATHOGENESIS OF MPNSTS......Page 214
HISTOPATHOLOGY OF MPNST......Page 215
REFERENCES......Page 217
22. The ‘Cell of Origin’ for Common Pediatric Brain Tumors......Page 220
ORIGINS OF MEDULLOBLASTOMA......Page 221
ORIGINS OF EPENDYMOMA......Page 224
ORIGINS OF ASTROCYTOMA......Page 225
REFERENCES......Page 226
NEUROEPITHELIAL TUMORS......Page 229
REFERENCES......Page 238
DIFFUSE PONTINE BRAINSTEM GLIOMA......Page 240
HIGH-GRADE ASTROCYTOMAS......Page 241
MEDULLOBLASTOMA......Page 244
REFERENCES......Page 247
DISEASE STAGING......Page 250
MOLECULAR PATHOGENESIS......Page 251
ONCOGENE AMPLIFICATION AND ACTIVATION......Page 255
CANCER STEM CELLS......Page 258
RISK STRATIFICATION......Page 259
REFERENCES
......Page 260
VON-HIPPEL LINDAU......Page 264
NEVOID BASAL CELL CARCINOMA SYNDROME......Page 265
TURCOT SYNDROME......Page 267
LI-FRAUMENI......Page 268
COWDEN DISEASE......Page 269
REFERENCES......Page 270
NEUROFIBROMATOSIS 1......Page 274
NEUROFIBROMATOSIS 2......Page 277
REFERENCES......Page 278
PRESENTING SIGNS AND SYMPTOMS......Page 282
NEOPLASMS OF THE CEREBRAL HEMISPHERES......Page 283
NEOPLASMS OF THE PINEAL REGION......Page 284
COMMON DIAGNOSTIC DILEMMAS......Page 285
REFERENCES......Page 286
CLINICAL PRESENTATION, DIAGNOSIS, AND IMAGING......Page 287
CORRELATION TO SYSTEMIC DISEASE; PATHOLOGICAL DIAGNOSIS-SPECIAL STAINS; PROGNOSTIC FACTORS......Page 288
THEORIES OF SPREAD, MIGRATION, PROPENSITIES......Page 289
REFERENCES......Page 290
ETIOLOGY......Page 292
CLINICAL PRESENTATION......Page 293
NEURORADIOGRAPHIC FINDINGS......Page 294
REFERENCES......Page 296
PRESENTATION AND CLINICAL FEATURES OF PEDIATRIC GLIOMAS......Page 298
TREATMENT......Page 300
REFERENCES......Page 301
RADIOGRAPHIC APPEARANCE......Page 303
REFERENCES......Page 305
CLINICAL PRESENTATION: GENERAL CONSIDERATIONS......Page 307
CLINICAL PRESENTATIONS: SPECIAL CONSIDERATIONS......Page 308
REFERENCES......Page 314
CLINICAL PRESENTATION AND DIAGNOSTIC EVALUATION—NONFUNCTIONING PITUITARY ADENOMAS AND CRANIOPHARYNGIOMAS (SEE TABLE 34.2)......Page 316
HORMONALLY ACTIVE PITUITARY ADENOMAS: CD (SEE TABLE 34.3)......Page 317
DIAGNOSTIC EVALUATION OF SELLAR LESIONS......Page 318
SURGICAL ANATOMY OF THE SELLAR REGION AND DIAGNOSTIC IMAGING......Page 319
REFERENCES......Page 320
INCIDENCE AND TUMOR HISTOLOGY......Page 322
COMPARTMENTS AND ANATOMY......Page 323
CLINICAL PRESENTATION AND GENERAL OVERVIEW......Page 324
CLINICAL PRESENTATION: COMPARTMENT......Page 325
NEURORADIOGRAPHIC FINDINGS......Page 326
REFERENCES......Page 328
SEIZURES AND ANTICONVULSANT THERAPY......Page 329
CORTICOSTEROIDS......Page 331
THROMBOEMBOLIC COMPLICATIONS AND ANTICOAGULATION......Page 332
DYSPHAGIA AND SWALLOWING DISORDERS......Page 333
REFERENCES......Page 334
DISCUSSING DIAGNOSIS AND PROGNOSIS......Page 336
TO TREAT OR NOT TO TREAT?......Page 337
WHEN IS IT APPROPRIATE TO STOP THERAPY?......Page 338
CONCLUSIONS......Page 339
REFERENCES......Page 340
ROLE OF SUPPORT GROUPS......Page 341
ROLE OF CAREGIVERS......Page 342
ADDITIONAL READINGS......Page 344
EFFECT OF NEUROCOGNITIVE DEFICITS ON FUNCTION......Page 345
INTERVENTIONS......Page 346
REFERENCES......Page 349
CAUSES OF COGNITIVE DEFICITS
......Page 351
REFERENCES
......Page 356
PEDIATRIC NEUROPSYCHOLOGY: THE 
PAST 40 YEARS......Page 359
RISKS FOR NEUROPSYCHOLOGICAL DEFICITS......Page 360
NEUROCOGNITIVE CORRELATES......Page 362
IMPACT OF NEUROPSYCHOLOGICAL FUNCTIONING ON QUALITY OF LIFE......Page 363
REFERENCES......Page 364
APPROACH TO REHABILITATION......Page 367
COMMON FUNCTIONAL DEFICITS......Page 368
GENERAL EFFECTS OF CANCER ON FUNCTION......Page 369
REHABILITATION INTERVENTIONS......Page 370
REFERENCES......Page 373
TUMOR-RELATED SIDE EFFECTS......Page 374
CARE OF THE DYING PATIENT......Page 375
REFERENCES......Page 376
45. Functional Neuroanatomy......Page 378
PET IMAGING......Page 390
SERIAL ASSESSMENT OF BRAIN TUMORS......Page 391
REFERENCES......Page 392
PREOPERATIVE FUNCTIONAL MAPPING
......Page 396
FRONTAL LOBE
......Page 397
TEMPORAL LOBE
......Page 403
INFERIOR PARIETAL LOBULE......Page 404
BRAINSTEM
......Page 405
SPINAL CORD
......Page 406
REFERENCES......Page 407
ANTERIOR FOSSA......Page 410
MIDDLE FOSSA......Page 412
POSTERIOR FOSSA......Page 413
CENTRAL SKULL BASE......Page 414
REFERENCES......Page 416
BASICS OF CRANIAL SN......Page 417
CRANIOTOMY FOR TUMOR......Page 419
BIOPSY AND RELATED PROCEDURES......Page 421
REFERENCES......Page 422
A BRIEF HISTORY OF SURGICAL STEREOTAXIS......Page 425
TARGETS AND TECHNIQUES......Page 426
REFERENCES......Page 430
INTRAOPERATIVE IMAGING: THE RATIONALE......Page 432
INTRAOPERATIVE IMAGING TECHNOLOGIES......Page 433
REFERENCES......Page 442
FLUORESCENT AGENTS PREVIOUSLY USED FOR INTRAOPERATIVE IMAGING......Page 446
FLUORESCENCE-GUIDED SURGERY USING 5-AMINOLEVULINIC ACID......Page 447
REFERENCES......Page 451
MOTOR-FUNCTION MAPPING DURING ASLEEP CRANIOTOMY......Page 453
LANGUAGE FUNCTION MAPPING DURING AWAKE CRANIOTOMY......Page 455
REFERENCES......Page 458
ENDOSCOPIC SKULL-BASE SURGERY......Page 460
FUNCTIONAL ADENOMAS......Page 464
REFERENCES......Page 478
ATYPICAL PITUITARY ADENOMA AND PITUITARY CARCINOMA......Page 474
REFERENCES......Page 476
HEMANGIOBLASTOMA......Page 490
PRESENTATION......Page 491
IMAGING CHARACTERISITICS......Page 492
SURGICAL STRATEGY......Page 494
POSTOPERATIVE CARE AND COMPLICATIONS......Page 496
OUTCOMES AND ADJUVANT THERAPY......Page 497
REFERENCES......Page 499
PATHOLOGY......Page 502
IMAGING......Page 503
BIOPSY......Page 504
SURGERY FOR LGGS......Page 506
ADJUVANT TREATMENT......Page 507
REFERENCES......Page 508
HISTORICAL REVIEW OF PINEAL REGION SURGERY......Page 510
CLINICAL CONSIDERATIONS......Page 511
SURGICAL DECISION MAKING......Page 512
SURGICAL PROCEDURES......Page 513
REFERENCES......Page 518
SURGICAL APPROACHES TO THE LATERAL VENTRICLES......Page 521
ANTERIOR INTERHEMISPHERIC TRANSCALLOSAL APPROACH......Page 522
POSTERIOR INTERHEMISPHERIC TRANSCINGULAR APPROACH......Page 523
INTRAPARIETAL SULCUS / SUPERIOR PARIETAL LOBULE APPROACH......Page 524
TRANSFORAMINAL, TRANSCHOROIDAL, AND INTERFORNICEAL APPROACHes......Page 525
SURGICAL APPROACHES TO THE FOURTH VENTRICLE......Page 527
REFERENCES......Page 528
NORMAL ANATOMY OF THE INSULA......Page 530
TYPES OF INSULAR GLIOMAS......Page 531
CLASSIFICATIONS OF INSULAR TUMORS......Page 532
SURGICAL DECISION MAKING......Page 533
SURGICAL CONSIDERATIONS FOR COMPLICATION AVOIDANCE......Page 534
SURGICAL METHOD [9]......Page 536
SURGICAL OUTCOMES......Page 539
CONCLUSION......Page 541
REFERENCES......Page 542
SUPRATENTORIAL TUMORS......Page 543
SUPRASELLAR TUMORS......Page 545
INTRAVENTRICULAR TUMORS......Page 548
PINEAL REGION TUMORS......Page 550
POSTERIOR FOSSA TUMORS......Page 552
REFERENCES......Page 555
PREOPERATIVE EVALUATION......Page 559
MRI OF SPECIFIC LESIONS......Page 560
THE DECISION ON WHOM TO OPERATE?......Page 564
POSTOPERATIVE EVALUATION......Page 565
MANAGEMENT OF SELECTED LESIONS AFFECTING THE BRACHIAL PLEXUS......Page 566
REFERENCES......Page 569
GENERAL PRINCIPLES OF THERAPY......Page 572
TREATMENT OF TUMORAL VASOGENIC EDEMA......Page 573
DELIVERY OF CHEMOTHERAPY TO THE BRAIN......Page 574
DRUG RESISTANCE AND SUSCEPTIBILITY......Page 576
TOXICITY OF CHEMOTHERAPY......Page 577
REFERENCES......Page 578
LOW-GRADE GLIOMAS......Page 581
HIGH-GRADE GLIOMAS......Page 587
CONCLUSIONS......Page 597
REFERENCES......Page 598
HIGH-GRADE GLIOMAS......Page 604
LOW-GRADE GLIOMA......Page 607
REFERENCES......Page 611
INFRATENTORIAL PNET: MEDULLOBLASTOMA......Page 614
MEDULLOBLASTOMA IN THE VERY YOUNG CHILD......Page 617
SUPRATENTORIAL PRIMITIVE NEUROECTODERMAL TUMORS......Page 618
FUTURE DIRECTIONS......Page 620
REFERENCES......Page 621
NEUROPATHOLOGY......Page 624
MOLECULAR NEUROPATHOLOGY OF MENINGIOMAS......Page 625
NEUROIMAGING OF MENINGOMAS......Page 627
TREATMENT OF MENINGIOMAS......Page 628
REFERENCES......Page 630
BRAINSTEM GLIOMAS IN CHILDREN......Page 633
BRAINSTEM GLIOMAS AND NF 1......Page 636
REFERENCES......Page 637
INTRODUCTION......Page 640
CHORDOMA......Page 641
PARAGANGLIOMA......Page 642
ESTHESIONEUROBLASTOMA......Page 643
MALIGNANT PERIPHERAL NERVE 
SHEATH TUMORS......Page 644
REFERENCES......Page 645
SELLAR MASSES......Page 648
REFERENCES......Page 656
EXTRADURAL......Page 658
INTRADURAL-EXTRAMEDULLARY......Page 659
INTRAMEDULLARY......Page 660
REFERENCES......Page 661
INCIDENCE......Page 663
TREATMENT......Page 664
LEPTOMENINGEAL DISEASE......Page 670
REFERENCES......Page 672
DIAGNOSIS AND CLINICAL EVALUATION......Page 675
PATHOLOGY AND PROGNOSIS IN PCNSL......Page 677
THERAPY OF PCNSL......Page 678
AUTOLOGOUS STEM-CELL TRANSPLANT......Page 680
PRIMARY IOL......Page 682
REFERENCES......Page 683
GERMINOMAS......Page 686
REFERENCES......Page 687
MANAGEMENT......Page 689
REFERENCES......Page 690
TYPES OF TARGETED AGENTS......Page 691
CLINICAL TRIALS FOR TARGETED AGENTS......Page 692
REFERENCES......Page 693
ANGIOGENESIS......Page 694
VARIOUS ANTIANGIOGENIC AGENTS CURRENTLY BEING RESEARCHED IN BRAIN TUMORS......Page 695
REFERENCES......Page 698
TARGETED MOLECULAR AGENTS FOR MALIGNANT GLIOMAS......Page 701
IMPROVING THE EFFICACY OF TARGETED MOLECULAR AGENTS......Page 706
REFERENCES......Page 711
IMMUNOTHERAPY......Page 717
VIRUSES......Page 720
STRATEGIES TO ENHANCE EFFICACY OF GENE THERAPY AND VIROTHERAPY FOR BRAIN TUMORS......Page 724
MULTIMODAL BIOLOGIC THERAPY......Page 725
REFERENCES......Page 726
RETINOIC ACIDS (RETINOIDS)......Page 729
HDAC INHIBITORS......Page 731
REFERENCES......Page 732
BIOLOGICALLY BASED THERAPIES......Page 735
BODY-BASED THERAPIES......Page 738
REFERENCES......Page 739
THE BASIC PHYSICS OF RADIATION THERAPY......Page 744
GENERAL RADIOBIOLOGICAL PRINCIPLES......Page 745
RADIATION DELIVERY MECHANISM......Page 749
REFERENCES......Page 764
RADIATION DOSE......Page 769
RADIATION VOLUMES......Page 770
SIMULATION......Page 771
DOSE-LIMITING STRUCTURES......Page 772
GBM IN ELDERLY/POOR PERFORMANCE PATIENTS......Page 773
FUTURE DIRECTIONS......Page 774
REFERENCES......Page 775
IMPORTANCE OF MOLECULAR GENETICS......Page 777
TREATMENT APPROACH......Page 778
CHEMOTHERAPY......Page 779
CONCLUSION......Page 782
REFERENCES......Page 783
PROGNOSTIC FACTORS......Page 785
CLINICAL PRESENTATION......Page 787
TREATMENT OPTIONS......Page 788
RECURRENT DISEASE......Page 790
REFERENCES......Page 791
GANGLIOMAS......Page 794
REFERENCES......Page 795
CLINICAL PRESENTATION......Page 796
TREATMENT AND OUTCOME......Page 797
REFERENCES......Page 798
REVIEW OF DATA IN PEDIATRIC GRADE II ASTROCYTOMAS......Page 800
TREATMENT PLANNING......Page 801
TOXICITY......Page 802
REFERENCES......Page 803
EVOLUTION OF RADIOTHERAPY TREATMENT—CLINICAL TRIALS......Page 806
RADIOTHERAPY TECHNIQUE......Page 811
SUPRATENTORIAL PNET......Page 814
COMPLICATIONS OF RADIOTHERAPY......Page 815
REFERENCES......Page 816
TREATMENT AND OUTCOME......Page 820
REFERENCES......Page 822
IMAGING......Page 824
TREATMENT......Page 825
PROGNOSTIC VARIABLES......Page 828
REFERENCES......Page 830
MANAGEMENT OF VESTIBULAR SCHWANNOMA: A BRIEF HISTORICAL PERSPECTIVE......Page 833
STEREOTACTIC RADIOSURGERY......Page 835
FRACTIONATED STEREOTACTIC RADIATION THERAPY......Page 837
MANAGEMENT OF VESTIBULAR SCHWANNOMA IN THE PATIENT WITH NF2......Page 839
REFERENCES......Page 840
HEMANGIOPERICYTOMA......Page 843
REFERENCES......Page 844
EPIDEMIOLOGY......Page 845
MOLECULAR GENETICS AND HISTOPATHOLOGY......Page 846
TREATMENT AND OUTCOME......Page 849
SPECIAL CIRCUMSTANCES......Page 858
CONCLUSIONS......Page 861
REFERENCES......Page 862
RADIOTHERAPY FOR FAVORABLE BRAINSTEM TUMORS......Page 867
REFERENCES......Page 869
BACKGROUND......Page 871
DIAGNOSIS AND WORK-UP......Page 873
MANAGEMENT
......Page 874
TOXICITY......Page 880
CONCLUSIONS......Page 882
REFERENCES......Page 883
RADIATION INDICATIONS......Page 886
RADIOTHERAPY TECHNIQUES
......Page 887
RADIOTHERAPY-RELATED COMPLICATIONS......Page 889
RADIOTHERAPY FOR HISTOLOGIC 
SUBTYPES OF PITUITARY ADENOMA......Page 891
REFERENCES......Page 894
PRIMARY CENTRAL NERVOUS SYSTEM GERM CELL TUMORS......Page 899
PINEAL REGION TUMORS......Page 902
REFERENCES......Page 903
NATURAL HISTORY......Page 905
DIAGNOSTIC WORKUP......Page 906
PATHOLOGY......Page 907
PROGNOSTIC FACTORS......Page 908
TREATMENT......Page 909
RT TREATMENT EFFECTS......Page 913
REFERENCES......Page 914
DIAGNOSIS......Page 917
REFERENCES......Page 918
TECHNIQUES OF RADIATION THERAPY......Page 919
INDICATIONS AND OUTCOMES BY TUMOR TYPE......Page 920
REFERENCES......Page 923
PALLIATIVE WHOLE-BRAIN RADIOTHERAPY......Page 927
WHOLE-BRAIN RADIOTHERAPY AFTER SURGICAL RESECTION......Page 930
RADIOSURGERY......Page 931
RADIOSURGERY PLUS WHOLE-BRAIN RADIOTHERAPY......Page 932
FRACTIONATED STEREOTACTIC RADIOTHERAPY......Page 933
SPINE METASTASES......Page 934
METASTATIC SPINAL CORD COMPRESSION (MSCC)......Page 935
RADIOTHERAPY SUPPLEMENTED BY CHEMOTHERAPY OR PRECEEDING DECOMPRESSIVE SURGERY......Page 940
RADIOSURGERY......Page 941
REFERENCES......Page 942
Index......Page 948
List of Color Plates......Page 978
Color Plates
......Page 980