Net Guides: Central Nervous System

//THE ONLINE ONCOLOGIST™

PathologyOutlines: Central Nervous System-tumor

PathologyOutlines.com is a Website featuring an online textbook of surgical and clinical pathology that is regularly reviewed and revised. This chapter of the textbook focuses on cysts and tumors of the central nervous system (CNS). It begins with the various types of cysts. For each type, there are usually descriptions of the cyst location, unique traits, microscopic characteristics, gross size, and treatment. The entries for each type also generally include radiologic images, images of the gross mass, microscopic images, and occasionally case reports. If applicable, there are details on the positive and negative stains of the cyst, and differential diagnoses information. The tumor section of the chapter includes the same types of information for each type and grade of tumor, with the addition of cytology information for most tumors. This section also reports general information and statistics on tumors of the CNS as well as factors to consider when approaching diagnosis, World Health Organization (WHO) classification of CNS tumors, and WHO grading of astrocytomas.

http://www.pathologyoutlines.com/Cnstumor.html

//THE EDUCATED PATIENT™

American Brain Tumor Association

The American Brain Tumor Association (ABTA) provides funds to researchers, and support and information to patients with brain tumors and their families. The ABTA Website features a tumor and treatment section with information on a number of different brain tumor topics. This section includes descriptions of various tumor types, including glioblastomas, oligodendrogliomas, oligoastrocytomas, gliomas, meningiomas, and pituitary tumors. Other topics in this section include metastatic brain tumors, cysts, childhood brain tumors, symptoms, treatment, seizures, diagnosis, parts of the brain, living with a brain tumor, facts and statistics, causes and risk factors, and more. ABTA offers supportive resources, including pen pal programs, a Facebook page, survivor stories, and information on scholarships, health insurance, and financial assistance. The care and support section also has information on working with a brain tumor, reaching out for support, neuropsychology, therapeutic recreation, and other topics.

http://www.abta.org/

//ONLINE CME

Current and emerging treatment modalities for patients with glioblastoma

Credits: 1.25

Fee: None

Expires: April 7, 2011

The goal of this CME activity is to educate healthcare professionals involved in the diagnosis and treatment of patients with brain tumors on current treatment strategies for newly diagnosed or recurrent glioblastoma. Topics discussed in the activity include current approaches and unmet clinical needs in the management of these patients, treatment modalities, and the latest data on new treatment approaches and therapies in this setting. This CME includes a “test-and-teach case” approach, an activity that uses case studies with quizzes to test participants’ knowledge before providing them with the correct answer and supporting evidence. http://www.medscape.org/viewarticle/718942

//eABSTRACT

Trends in survival after surgery for breast cancer metastatic to the brain and spinal column in Medicare patients: a population-based analysis

Journal: Neurosurgery

Authors: Cahill KS, Chi JH, Day AL, Claus EB

Purpose: Metastases to the CNS are common in patients with breast cancer and are observed in as many as 30% of these patients at autopsy. The purpose of this study was to determine population-based survival times after surgical treatment for Medicare patients with breast cancer that has metastasized to the brain and spinal column. The study used the Surveillance, Epidemiology, and End Results (SEER)—Medicare database to identify female patients with metastatic breast cancer to the CNS who were undergoing neurosurgical treatment. The study also used Kaplan-Meier estimation and a Cox proportional hazards model to calculate estimates of survival.

Results:The study involved 643 patients who underwent neurosurgical treatment of metastatic disease from 1986-2005. Of these patients, 379 underwent spinal surgery and 264 underwent cranial surgery. The study found that patient deaths during hospital treatment were down by approximately 50% in the last decade. However, the 30-day mortality rate of 9.0% has not changed. The median postoperative survival was 7.8 months after cranial surgery, 9.4 months after laminectomy, and 15.7 months for spinal fusion. Survival following spinal fusion has gone up by approximately 50% in the past decade. The study found that patients with increased survival after cranial surgery were younger, had fewer comorbidities, and longer periods between diagnosis of breast cancer and surgical treatment. Patients with increased survival after spinal surgery had lower-grade lesions and also had longer periods between diagnosis and surgery. The authors concluded that 1 year after being surgically treated for metastases to the CNS, one-third of patients who underwent cranial surgery and half of patients who underwent spinal surgery were still alive, but the overall postoperative survival rate has increased over time only for spinal fusion procedures.

http://www.ncbi.nlm.nih.gov/pubmed/21164378

//CLINICAL TRIAL

Donepezil in treating patients who have undergone radiation therapy for brain tumors

Study Type: Interventional

Age/Sex Requirements: ≥18 years

Sponsor: Wake Forest University

ClinicalTrials.gov Identifier: NCT00369785

Purpose: This clinical trial is testing donepezil hydrochloride against placebo in the treatment of patients who have undergone radiation therapy for brain tumors. Donepezil is a drug that is designed to improve neurocognitive symptoms of radiation therapy, such as cognitive impairment, subjective confusion, and fatigue. The clinical trial also will evaluate the effect of donepezil versus placebo on patients’ mood and quality of life.

http://bit.ly/go2bYR

PHARMA FOCUS

Xeloda (capecitabine)

Xeloda is an oral chemotherapy drug that is used to treat colorectal cancer and metastatic breast cancer. Recent studies have found that Xeloda demonstrates efficacy in treating cases of breast cancer that have metastasized to the CNS. Common side effects of Xeloda include hand-and-foot syndrome, diarrhea, nausea, vomiting, stomatitis, abdominal pain, upset stomach, constipation, loss of appetite, and dehydration. Xeloda should not be taken by women who are pregnant, planning to become pregnant, or are nursing. For information about the drug, visit http://www.xeloda.com/. For research information, visit

http://meeting.ascopubs.org/cgi/content/abstract/25/18_suppl/1098