Neurology

Neuro-Oncology   

Questions discussed in this category



With the recent publication in IJROBP showing a greater than 50% response rate, have you started integrating this into your practice? 

Do you ever allow patients to receive a couple of cycles of systemic therapy first if there is high burden of disease? What is the maximum time after ...

What is the harm of waiting for another recurrence after a second GTR to delay the toxicity of radiation and chemotherapy? The patient is a woman <...

In a patient with metastatic cancer to the lumbar spine and epidural disease on CT who presents back pain and leg weakness: Is a whole spine MRI in...

Do all patients with brain metastases get started on anticonvulsants?  Do you decide based on extent of edema, tumor size, or something else?&nb...

Specifically, headaches thought not to be related to increased ICP.

Is there diminished radiotherapy efficacy in tumor control after certain timeframe has passed for malignant meningiomas with no signs of recurrent dis...

For example a 1 or 2 mm brain metastasis? Would you consider waiting for these to enlarge slightly for reasons such as more certainty they are real, l...

If a patient has a metastatic lesion in close proximity to one hippocampus, would you offer sparing of the contralateral hippocampus? Do your dose con...

Is your approach different than that to a primary essential tremor?

History of 4th ventricle choroid plexus papilloma s/p GTR, now with recurrent disease in the 4th ventricle and the left lateral ventricle (7 nodules i...

Would you consider empiric SRS if biopsy/resection is not feasible? When would you consider liquid biopsy?

If so, how long do you continue medication and when do you discontinue? Does treatment with surgical resection versus radiation alone change your man...

What is your preferred dose/fractionation following a previous course of radiotherapy?

What would be your next treatment for a young adult patient with medulloblastoma refractory to repeat resection, craniospinal irradiation, and initial...

 If not, then what is your preferred treatment and would you integrate SRS into it? 

Do you ever add prophylactic Keppra (levetiracetam) for glioblastoma patients without a seizure history based on data such as this study (nature.com) ...

If so, what percent likelihood do you quote patients for this risk with SRS, SRT and fully fractionated therapy?

Do you routinely discontinue the device or continue if they are otherwise tolerating the treatment well? 

NCCN lists PCV as category 1 (and now with analysis in Abstract 2002 from ASCO 2019 showing benefit in IDH mutated), and temozolomide as 2B, yet temoz...

For medical oncologists, would you offer a PD-1/L1 inhibitor? For other subspecialties, how would you counsel the oncologist regarding the risk of usi...

For stroke-like migraine attacks after radiation therapy (SMART syndrome), does your management of these patient's change with recurrent episodes? How...

Do you biopsy immediately, stop treatment, biopsy at a later time, or depend solely on the data you already have?

Is there any additional benefit to radiation in addition to steroids in a patient who is not a surgical candidate?

Has the recently published interim analysis of the CATNON trial altered your utilization of temozolomide? Does IDH status change your treatment appro...

Do you consider the small, but statistically significant, improvement in OS to outweigh the side effects of treatment?

What factors play into your decision whether to re-treat the brain with craniospinal radiotherapy vs irradiation of the spine only vs other measures (...

E.g. The case in question is for a patient planned for thoracic RT for LS-SCLC. Any medications that may help or just give much bigger expansions to c...

When do you favor RT? What is your preferred dose/fractionation?

How does length of time from prior chemoradiotherapy influence your management?

In a palliative setting, how long would you wait to initiate WBRT?


Papers discussed in this category


Stroke, 2008 Jul 17

J Neuroimaging, 2020 Feb 10

Lancet,

International journal of radiation oncology, biology, physics, 2018-03-15

J Clin Oncol, 2021 Dec 13

J Clin Oncol, 2020 Jul 24

Pract Radiat Oncol, 2022 Sep-Oct

Lancet Oncol, 2016 Sep 27

Neuro Oncol, 2021 May 05

Radiother Oncol, 2021 May 06

The New England journal of medicine, 2014-02-20

The New England journal of medicine, 2014-02-20

Neuro-oncology, 2016-09

Onco Targets Ther, 2017 Jan 18

Neuropsychologia, 2016 Aug 16

Neuroimage, 2006 Aug 10

Neuron, 2009 Jan 15

Radiother Oncol, 2022 Oct 20

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2013-01-20

The New England journal of medicine, 2005-03-10

The New England journal of medicine, 2016-04-07

J Clin Oncol, 2012 Oct 15

J Clin Oncol,

Neuro Oncol, 2016 Jul 01

Pediatric emergency care, 2008-04

Clin Nucl Med,

World J Surg Oncol, 2019 Mar 27

Asian J Neurosurg,

Journal of neurosurgery, 2005-09

Surgical neurology, 2000-05

Cureus, 2020 Jun 11

Stereotact Funct Neurosurg, 2019 Nov 26

N Engl J Med,

Acta Oncol, 2015 Oct 23

Int J Radiat Oncol Biol Phys, 2020 Jun 13

Neuro-oncology, 2013-10

Acta Neurochir (Wien), 2019 Jan 29

J. Clin. Oncol., 2020 Feb 14

Cancer, 2020 May 19

N Engl J Med,

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2012-09-01

Lancet Oncol, 2021 May 14

Strahlenther Onkol,

International journal of radiation oncology, biology, physics, 2018-06-01

Surgical neurology international, 2018

J Neurooncol, 2019 Oct 01

Progress in neurological surgery, 2013

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 1993-03

Neurosurgery,

Cancer, 2011 Feb 01

JAMA, 2017-12-19

Cancer, 2012-02-15

Neurosurgery, 2010-11

Neurosurgery, 2008-01

Neurosurgery, 2009-01

J Neurooncol, 2013 Nov

Neurosurgery, 2016-07

World neurosurgery, 2016-07

Strahlenther Onkol, 2017 Jun 15

World Neurosurg, 2016-03-01

J. Neurosurg., 2016-12-01

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia, 2017-12

Neurosurgery, 2018-06-01

Journal of radiosurgery and SBRT, 2013

Int. J. Radiat. Oncol. Biol. Phys., 2019 Nov 29

J Natl Compr Canc Netw, 2020 Nov 2

Radiat Oncol, 2021 Feb 17

Neuro Oncol,

J Neurosurg,

World Neurosurg, 2017 Mar 12

World Neurosurg,

The New England journal of medicine, 2018-08-23

Lancet Oncol, 2020 Apr 03

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016-03-01

Sci Rep, 2020 Jul 01

Neuro Oncol,

N Engl J Med,

Pediatr Blood Cancer, 2021 Apr 12

Journal of neuro-oncology, 2012-01

Journal of neurosurgery, 2018-01

Journal of neurosurgery, 2013-04

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2019-05-01

Cochrane Database Syst Rev, 2020 Apr 28

Journal of neuro-oncology, 2022 Aug 04

The spine journal : official journal of the North American Spine Society, 2017-10

Adv Radiat Oncol, 2021 May-Jun

Current opinion in oncology, 2009-07

Cancer, 2012-05-01

Advances in radiation oncology, 2022 Dec 24

N Engl J Med, 2023 Jun 04

Neuroepidemiology, 2011 Jun 16

Journal of neurosurgical sciences, 2019 Jun

Fitoterapia, 2012 Oct 23

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2019-04-20