OBJECTIVE: Temozolomide is a novel oral alkylating agent, which has been reported to be effective in treating patients with recurrent malignant gliomas. This study report an analysis of the activity and toxicity of temozolomide as second-line therapy for patients with recurrent and progressive malignant gliomas after surgery and standard radiation therapy with or without chemotherapy. METHODS: Twenty patients with malignant gliomas of which thirteen(65%) had glioblastoma multiforme(GBM), five(25%) with anaplastic astrocytoma(AA), and two(10%) with anaplastic oligodendroglioma(AO) were enrolled in this study. They had been treated in our institution since July, 2000 and had been previously irradiated with or without chemotherapy. For the patients with recurrent and progressive disease, temozolomide(150-200mg/m2/d x5 days) was administered every 28 days until the progression of the tumor or toxicity developed. RESULTS: The median number of treatment cycles was 3(total 86). Of the 20 patients, 2(10%) achieved a complete response(CR), 5(25%) achieved a partial response(PR), 5(25%) had stable disease(SD), and 8(40%) had progressive disease(PD). One patient achieved a CR, 3 patients achieved a PR, 2 patients had SD and 7 patients had PD in GBM, and 1 patient achieved a CR, 2 patients achieved a PR, 3 patients had SD, 1 patient had PD in the non-GBM patients. Median progression free survival(PFS) was 8 weeks in GBM and 22 weeks in the non-GBM patients. No hematological toxicity greater than grade 2 was observed, and hepatotoxicity of grade 2 was encountered in 1(5%) patient. CONCLUSION: Temozolomide demonstrate moderate activity in recurrent and progressive malignant brain tumors, and the response rate and PFS were better in the non-GBM tumors than in the GBM tumors. The treatment is well tolerated without any serious toxicity.
Brain Neoplasms ; Drug Therapy* ; Glioblastoma ; Glioma* ; Humans

A rare case of microgliomatosis(reticulum cell sarcoma) of the brain is reported. The tumor was located in the left parietal lobe and the right cerebellar hemisphere and the vermis. V-P Shunt was performed and left parietal craniotomy was done for removal of tumor. The patient received radiation therapy and chemotherapy for brain tumor with a good result Histogenesis and therapy of the microgliomatosis are briefly discussed.
Brain Neoplasms ; Brain* ; Craniotomy ; Drug Therapy ; Humans ; Parietal Lobe ; Rabeprazole

The authors have studied six patients with histologically proven primary malignant lymphoma of the brain which is still a rare primary brain tumor. The clinical, radiological and pathological findings with results of the treatment are presented. All cases showed a good response to radiation therapy. Therefore, the early diagnosis by computerized tomography scan followed by biopsy or excision is considered to be very important for the BEST results in the treatment. Related reports are discussed briefly.
Biopsy ; Brain Neoplasms ; Brain* ; Drug Therapy ; Early Diagnosis ; Humans ; Lymphoma*

Brain Neoplasms ; therapy ; Glioma ; therapy ; Humans ; Palliative Care

Brain metastases are common in lung cancer patients, indicating a poor prognosis and short survival time. In recent years, with the development of surgery, radiotherapy and medical therapy, the survival time of lung cancer patients with brain metastases has been prolonged owing to more and more treatment options. In order to reflect the progress in the treatment worldwide timely, and further improve the level of standardized treatment of lung cancer with brain metastases in China, Chinese Association for Clinical Oncologists and Medical Oncology Branch of Chinese International Exchange and Promotion Association for Medical and Healthcare organized experts to formulate "Clinical practice guideline for brain metastases of lung cancer in China (2021 version)" .
Brain Neoplasms/therapy* ; China ; Humans ; Lung Neoplasms ; Medical Oncology

In the treatment of the intracranial gliomas surgical intervention is recommended as the standard procedure which should be performed in all cases when the tumor is accessible. While surgery will not bring about a cure and clearly, radiation therapy and chemotherapy have made a significant impact of long-term survival in the treatment of the malignant gliomas, nevertheless surgery still remains the single most effective method for achieving a rapid reduction of tumor burden reducing increased intracranial pressure and provides a tissue diagnosis. Following surgery, the other antitumor programs have the best chance of achieving a significant increment of tumor cell kill, therefore, surgery has a distinct role to play in the multidisciplinable approach to the treatment of these highly aggressive malignant tumors. It is very unlikely that future advances will obviate the necessity for conventional surgery in the treatment of benign gliomas. The surgical management of gliomas with major emphasis on malignant ones is presented including the pathophysiology, radiological diagnosis, aim of surgery, surgical procedure and some different possibility of surgical treatment. Prospective future development of surgical treatment of brain tumor is also considered.
Brain Neoplasms ; Diagnosis ; Drug Therapy ; Glioma* ; Intracranial Pressure ; Tumor Burden

This report presents an analysis of 25 Korean patients with metastatic brain tumor seen at Seoul National University Hospital from 1968 to 1977. In the same period there were 386 cases of brain tumors, so about 6.5% of total brain tumors was metastatic. The results are as following ; 1) The sexes were represented almost equally, with 12 males and 13 females. In 21 cases(84%) the disease occurred between the ages of 31-60 years. 2) The most frequent site of primary malignancy was lung and the nexts were gastroin testinal tract, breast, liver and chorioepithelium in order. 3) About two-thirds of metastatic brain tumors were located in the middle cerebral artery supplying areas. 4) Averages interval between the clinical onset of primary and secondary growth was short inliver and lung cancer, and long in breast and stomach cancer. 5) In cases which can be treated surgically chemotherapy and radiation seemed to improved the prognosis.
Brain Neoplasms* ; Brain* ; Breast ; Drug Therapy ; Female ; Humans ; Liver ; Lung ; Lung Neoplasms ; Male ; Middle Cerebral Artery ; Prognosis ; Seoul ; Stomach Neoplasms

The overall goal of our research projects is to develop effective immunotherapeutic regimens, particularly combining vaccine and gene therapy/ cell therapy strategies. For the development of clinically effective immunotherapy for brain cancers, the following issues are considered to be particularly important: 1) Induction of effective immune responses against tumors (afferent arm of the immune response), 2) Delivery of immune effector cells to the target tumor sites and maintaining the activity of the effector cells (efferent arm), 3) For specific and safe immunotherapy, specific brain tumor rejection antigens have to be identified, 4) Feasibility, safety and efficacy need to be tested in a series of clinical trials. The following presentation summarizes my research projects and demonstrates how each plan will fit in the whole schema of designing successful immunotherapeutic strategies for brain cancers. In this presentation, I would like to focus on our clinical and basic studies related to the vaccine strategies for patients with glioma, and modulation of tumor-microenvironment using bone-marrow derived stroma cells as vehicles for cytokine- gene delivery.
*Biological Therapy ; Brain Neoplasms/*therapy ; Cancer Vaccines/*therapeutic use ; Cytokines/*genetics ; *Gene Therapy ; Humans

Brain SPECT with Tc-99m-Glucoheptonate(GH) and Tc-99m-HMPAO were performed in 41 patients with brain tumors to determine the difference of uptake ratio in various histological type of tumors. SPECT studies were carried out with a rotating gamma camera in 60 minutes after intravenous injection of 15mCi of Tc-99m-GH and Tc-99m-HMPAO respectively. We counted tumor/skull(T/S) ratio on Tc-99m-GH SPECT(30 cases) and tumor/normal(T/N) ratio on Tc-99m-HMPAO SPECT(33 cases) by the use of ROI(Region of Interest) analysis. In our present study, we obtained positive uptake scans in all cases of brain tumors performed Tc-99m-GH SPECT and there was statistically significant correlation among certain type of tumor and uptake ratio. On Tc-99m-HMPAO SPECT, most of brain tumors showed decreased uptake, even in the tumors showing increased vascularity on angiographys and no definite correlation was found between tumor type and uptake ratio. Conclusively, brain SPECT with Tc-99m-GH is considered to be simple but very sensitive method in detecting brain tumors and has some value in preoperative differentiation of tumor types. Tc99m-HMPAO SPECT could be used as a tool of predicting the response to chemotherapy or radiation therapy if it was performed preoperatively and during the postoperative course.
Brain Neoplasms* ; Brain* ; Drug Therapy ; Gamma Cameras ; Humans ; Injections, Intravenous ; Tomography, Emission-Computed, Single-Photon*

Proton beam therapy (PBT) was initiated in the particle accelerator located in the physics laboratory. As this modality moves from the research laboratory to hospital-based facilities, there has been a rapid growth in the number of proton medical facilities worldwide. The clinical advantage of proton radiotherapy over photon radiotherapy is the marked reduction in the radiation dose to the normal tissues due to the absence of an exit dose with a proton Bragg peak. Pediatric patients are considered to have the maximum clinical gain with the use of protons because their normal tissues will keep developing and growing with an anticipated long remaining life. In pediatric brain tumors, PBT is used aiming to preserve neurocognitive function as much as possible. In this article, the basic principles and benefits of PBT are introduced with the latest available clinical data on PBT for pediatric brain tumors.
Brain ; Brain Neoplasms ; Humans ; Imidazoles ; Nitro Compounds ; Particle Accelerators ; Proton Therapy ; Protons