Publications by authors named "Alba A Brandes"

Background: Elderly patients (age > 65 years) with glioblastoma multiforme frequently are excluded from clinical studies, and prospective trials for patients with this age group do not exist to date.

Methods: The authors conducted a prospective trial in 79 consecutive elderly patients with glioblastoma who underwent surgery and received radiotherapy (59.44 grays in 33 fractions; Group A; n = 24 patients) or received the same radiotherapy plus adjuvant chemotherapy with procarbizine, lomustine, and vincristine (PCV; lomustine 110 mg/m(2) on Day 1, procarbazine 60 mg/m(2) on Days 8-21, and vincristine 1.

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The optimum therapeutic management in adult ependymoma remains undefined because of the low incidence of this disease and because most of reported series mainly refers to childhood, are retrospective, include a small number of patients and span several decades. The purpose of this article is to analyze, discuss and summarize the current available information regarding the therapeutic approach and the prognostic factors and to provide recommendations for ordinary clinical practice. Some important therapeutic issues like the irradiation dose and volume are also analyzed.

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Treatment of low-grade gliomas is one of the most challenging management dilemmas in neuro-oncology. Young age of onset and low rate of growth theoretically favor minimally invasive treatments. Yet, local recurrence and conversion to malignant glioma are the expected outcome within 4-8 years from diagnosis and impose the use of additional therapies, such as radiotherapy and chemotherapy.

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Low delivery of common chemotherapeutic drugs to the brain is considered to be a major obstacle for obtaining durable disease control in patients with high-grade gliomas. Intra-arterial drug injection after selective catheterization of cerebral arteries has been performed in some small clinical trials in order to achieve higher drug concentration in the tumor while minimizing systemic exposure. We reviewed the results in terms of response and toxicity from studies with intra-arterial administration of nitrosoureas and platinum derivatives, as well as the principal aspects and perspectives of the new strategy of blood-brain barrier disruption with osmotic agents or bradykinin analogs.

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Objectives: To investigate the efficacy of temozolomide (TMZ) in relationship to progression free survival at 6 months (PFS-6), median time to progression (TTP), response rate and toxicity, a phase II study was conducted in patients with recurrent glioblastoma multiforme (GBM) following surgery plus radiotherapy and a first-line regimen based on nitrosourea, procarbazine and vincristine.

Methods: Forty-two patients with GBM were administered TMZ at the dose of 150 mg/m(2)/daily for 5 days every 4 weeks.

Results: The PFS-6 and at 12 months (PFS-12) was 24% (95% Confidence Interval [CI] = 14-42%) and 8% (CI = 2-27%), respectively, with a median TTP of 11.

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Malignant gliomas cause 2% of cancer deaths in western countries, and even the most intensive combinations of radiotherapy and chemotherapy cannot be curative. New chemotherapeutic drugs and alternative therapeutic modalities are strongly needed. Huge efforts are directed towards the development of innovative strategies for targeting and mending the specific molecular alterations in tumor cells (translational research).

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