Brain Diseases ; Humans ; Immune Checkpoint Inhibitors ; Peritoneal Neoplasms/secondary* ; Peritoneum/pathology* ; Stomach Neoplasms/surgery*

PURPOSE: Patients with non-small cell lung cancer (NSCLC) and simultaneously having brain metastases at the initial diagnosis, presenting symptoms related brain metastasis, survived shorter duration and showed poor quality of life. We analyzed our experiences on surgical treatment of brain metastasis in patients with NSCLC. MATERIALS AND METHODS: We performed a single-center, retrospective review of 36 patients with NSCLC and synchronous brain metastases between April 2006 and December 2011. Patients were categorized according to the presence of neurological symptoms and having a brain surgery. As a result, 14 patients did not show neurological symptoms and 22 patients presented neurological symptoms. Symptomatic 22 patients were divided into two groups according to undergoing brain surgery (neurosurgery group; n=11, non-neurosurgery group; n=11). We analyzed overall surgery (OS), intracranial progression-free survival (PFS), and quality of life. RESULTS: Survival analysis showed there was no difference between patients with neurosurgery (OS, 12.1 months) and non-neurosurgery (OS, 10.2 months; p=0.550). Likewise for intracranial PFS, there was no significant difference between patients with neurosurgery (PFS, 6.3 months) and non-neurosurgery (PFS, 5.3 months; p=0.666). Reliable neurological one month follow up by the Medical Research Council neurological function evaluation scale were performed in symptomatic 22 patients. The scale improved in eight (73%) patients in the neurosurgery group, but only in three (27%) patients in the non-neurosurgery group (p=0.0495). CONCLUSION: Patients with NSCLC and synchronous brain metastases, presenting neurological symptoms showed no survival benefit from neurosurgical resection, although quality of life was improved due to early control of neurological symptoms.
Adult ; Aged ; Aged, 80 and over ; Brain Neoplasms/physiopathology/*secondary/*surgery ; Carcinoma, Non-Small-Cell Lung/mortality/*pathology ; Demography ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Lung Neoplasms/*pathology ; Male ; Middle Aged ; Treatment Outcome

Metastasis of nasopharyngeal carcinoma (NPC) to the dura, an extremely rare condition, can be symptomatically silent and mistaken for a benign entity radiographically. Missed diagnosis can lead to serious consequences or prove immediately fatal. We report a woman with dural metastasis of NPC that mimicked a meningioma on radiography. Craniectomy with tumour resection was performed due to rapid progression from the onset of symptoms to disability. The patient was still alive two years after surgery. This case emphasises the need to keep in mind the possibility of dural metastasis of NPC in patients with abnormal imaging features. This would not only avoid wrong and optimistic diagnosis, but also allow for appropriate treatment in a timely manner. To our knowledge, this is the first report of metastasis of NPC to the dura. We provide detailed information on the neoplastic lesion, which masqueraded as a benign entity and caused potentially fatal consequences.
Adult ; Brain Neoplasms ; diagnosis ; secondary ; surgery ; Carcinoma ; Diagnosis, Differential ; Disease Progression ; Dura Mater ; pathology ; Female ; Humans ; Magnetic Resonance Imaging ; Meningioma ; diagnosis ; pathology ; Nasopharyngeal Neoplasms ; diagnosis ; pathology ; Neoplasm Metastasis

Adenoma ; pathology ; Brain Neoplasms ; secondary ; Chromogranin A ; metabolism ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Pituitary Neoplasms ; diagnosis ; metabolism ; pathology ; surgery ; Reoperation ; Synaptophysin ; metabolism ; Temporal Lobe ; pathology

OBJECTIVETo detect the expression of Robo1 in lung cancer tissues, adjacent non-cancerous tissues as well as lung cancer brain metastasis, and explore the correlation of Robo1 expression to lung cancer brain metastasis.

METHODSSP (streptavidin-peroxidase) staining method was used to examine the Robo1 expression in specimens from 80 cases of NSCLC, 52 cases of adjacent non-cancerous tissues and 72 cases of lung cancer with single brain metastasis (without metastasis in other organs). The Robo1 expression was further examined in 17 self control cases with lung cancer tissues and their brain metastasis tissues. The results were assessed by Kaplan-Meier analysis and log-rank test.

RESULTSThe positive expression rate of Robo1 among adjacent non-cancerous tissues, lung cancers tissues and the lung cancer brain metastasis tissues were 1.9% (1/52), 13.8% (11/80) and 40.3% (29/72), respectively, and significant differences were detected among them (P < 0.05). During the 17 self control cases, the positive expression rate of Robo1 in lung cancer tissue and their brain metastasis tissues were 17.6% and 64.7%, respectively, with a significant difference between them (P < 0.01). Among the 72 cases of lung cancer brain metastasis, the median survival time of cases with positive Robo1 expression was 10 months, significantly shorter than that of cases with negative expression of Robo1 (17 months, P < 0.05).

CONCLUSIONSThe positive expression rate of Robo1 was increased in sequence from the lowest in adjacent non-cancerous tissues, intermediate in the lung cancer tissues to highest in the lung cancer brain metastasis tissues. The expression of Robo1 in lung cancer brain metastasis is negatively correlated with the prognosis of patients with lung cancer brain metastasis. Robo1 may promote the genesis and progression of lung cancer and lung cancer brain metastasis as a cancer-promoting oncogene.

Adult ; Aged ; Brain Neoplasms ; metabolism ; secondary ; Carcinoma, Non-Small-Cell Lung ; metabolism ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; metabolism ; pathology ; surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Nerve Tissue Proteins ; metabolism ; Proportional Hazards Models ; Receptors, Immunologic ; metabolism ; Survival Rate

OBJECTIVETo evaluate the efficacy and prognostic factors of personalized treatment for breast cancer patients who failed chemotherapy.

METHODSSeventy-two patients with breast cancer who failed chemotherapy were treated at the Tumor Hospital of Harbin Medical University from January 2001 to January 2012. Among them, 42 cases received 5.6 cycles (range, 4-8 cycles) of postoperative adjuvant chemotherapy, and 30 cases received 12.2 cycles (range, 6-22 cycles), both postoperative adjuvant and salvage chemotherapy. All of the 72 patients of stage IV were given personalized treatment. Under guidance of the principle that multidisciplinary treatment improves control rate but does not or less damage the normal tissues and host immune function, precise radiotherapy combined with Chinese herbal medicine (CHM), biological agent and others were chosen for the patients.

RESULTSThe median survival time was 20 months. Univariate analysis showed that non-invasive ductal carcinoma, less metastasized organs, without brain, liver and lung metastasis, Karnofsky performance scores ≥ 80, not combined with chemotherapy, and multiple courses of Chinese herbal medicine and biolojical agent treatment had significant impact on survival (P < 0.05). Multivariate analysis showed that no brain metastasis, non-invasive ductal carcinoma, and Chinese herbal medicine and biological agent treatment ≥ 7 courses and not combined with chemotherapy had obvious significance (P < 0.05). The rate of grade 3 and 4 treatment-related hematological toxicity was 8.3% (6/72) and 5.6% (4/72), respectively. All the patients with grade 4 hematological toxicity were the cases of grade 3 at hospital admission. No grade 3 and 4 acute radiation damages of the lung and liver were noticed.

CONCLUSIONChinese herbal medicine combined with biological agents and others prolongs survival time in breast cancer patients who failed chemotherapy, and provides an alternative treatment modality for them.

Adult ; Aged ; Aromatase Inhibitors ; therapeutic use ; Bone Density Conservation Agents ; therapeutic use ; Bone Neoplasms ; drug therapy ; secondary ; Brain Neoplasms ; drug therapy ; secondary ; Breast Neoplasms ; drug therapy ; pathology ; radiotherapy ; surgery ; Carcinoma, Ductal, Breast ; drug therapy ; pathology ; radiotherapy ; secondary ; surgery ; Chemotherapy, Adjuvant ; Diphosphonates ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Imidazoles ; therapeutic use ; Lung Neoplasms ; drug therapy ; secondary ; Medicine, Chinese Traditional ; Middle Aged ; Neoplasm Staging ; Nitriles ; therapeutic use ; Radiotherapy, Adjuvant ; Radiotherapy, Conformal ; methods ; Remission Induction ; Retrospective Studies ; Survival Rate ; Treatment Failure ; Triazoles ; therapeutic use

In the study we assessed the distortion of 7.0 T magnetic resonance (MR) images in reference to 1.5 T MR images in the radiosurgery of metastatic brain tumors. Radiosurgery with Gamma Knife Perfexion(R) was performed for the treatment of a 54-yr-old female patient with multiple brain metastases by the co-registered images of the 7.0 T and 1.5 T magnetic resonance images (MRI). There was no significant discrepancy in the positions of anterior and posterior commissures as well as the locations of four metastatic brain tumors in the co-registered images between 7.0 T and 1.5 T MRI with better visualization of the anatomical details in 7.0 T MR images. This study demonstrates for the first time that 7.0 T MR images can be safely utilized in Perfexion(R) Gamma Knife radiosurgery for the treatment of metastatic brain tumors. Furthermore 7.0 T MR images provide better visualization of brain tumors without image distortion in comparison to 1.5 T MR images.
Adenocarcinoma/pathology/radiography ; Brain Neoplasms/pathology/secondary/*surgery ; Female ; Humans ; Lung Neoplasms/pathology/radiography ; *Magnetic Resonance Imaging ; Middle Aged ; *Radiosurgery ; Tomography, X-Ray Computed

12E7 Antigen ; Adolescent ; Adult ; Antigens, CD ; metabolism ; Biomarkers, Tumor ; metabolism ; Brain Neoplasms ; secondary ; Cell Adhesion Molecules ; metabolism ; Child ; Child, Preschool ; Diagnosis, Differential ; Extremities ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; In Situ Hybridization, Fluorescence ; Infant ; Ki-67 Antigen ; metabolism ; Male ; Neuroectodermal Tumors, Primitive ; metabolism ; pathology ; Oncogene Proteins, Fusion ; metabolism ; Repressor Proteins ; metabolism ; Sarcoma, Ewing ; metabolism ; pathology ; Sarcoma, Synovial ; diagnosis ; metabolism ; pathology ; surgery ; Soft Tissue Neoplasms ; diagnosis ; metabolism ; pathology ; surgery ; Vimentin ; metabolism ; Young Adult

OBJECTIVETo detect the expression of Robo1 in different breast tumors and its association with the breast cancer brain metastasis.

METHODSLabelled streptavidin-biotin (LSAB) staining was used to examine the Robo1 expression in specimens from 24 cases of invasive ductal carcinoma (IDC) with brain metastasis, 71 cases of IDC without brain metastasis, 22 cases of ductal carcinoma in situ (DCIS) and 23 cases of fibroadenoma.

RESULTSThe expression pattern of Robo1 in DCIS (59.1%) and IDC (45.3%) was significantly lower than that in adenofibroma (87.0%, P < 0.05). The expression of Robo1 in IDC with brain metastasis (12.5%) was significantly lower than that in IDC without brain metastasis (56.3%, P < 0.05). The expression of Robo1 was much higher in more than 50 year-old-group (57.8%) than that in less than 50 year-old-group (34.0%) of IDC patients. The overall survival time in patients with the Robo1 negative expression was significantly shorter than those with positive expression (P < 0.05). No correlation was found between the Robo1 expression and the tumor size, lymph node metastasis, pathologic stage, histological grade and clinical stage (P > 0.05).

CONCLUSIONSThe Robo1 expression correlates negatively with IDC brain metastasis, and correlates positively with the age and prognosis of IDC patients. Robo1 may be applied as a marker in evaluation of the IDC prognosis and brain metastasis.

Adult ; Age Factors ; Aged ; Brain Neoplasms ; secondary ; Breast Neoplasms ; metabolism ; pathology ; surgery ; Carcinoma, Ductal, Breast ; metabolism ; secondary ; surgery ; Carcinoma, Intraductal, Noninfiltrating ; metabolism ; secondary ; surgery ; Female ; Fibroadenoma ; metabolism ; Follow-Up Studies ; Humans ; Middle Aged ; Nerve Tissue Proteins ; metabolism ; Receptors, Immunologic ; metabolism ; Survival Rate

Although gynecomastia is a well-defined paraneoplastic syndrome in patients with non-small cell lung cancer, the association with pleomorphic carcinoma has not been reported. A 50-yr-old man presented with bilateral gynecomastia and elevated serum beta-human chorionic gonadotropin (beta hCG) level. Chest tomography showed a mass in the right middle lobe. Right middle lobectomy and mediastinal lymph node dissection were performed. beta hCG levels decreased rapidly after surgery. Histological examination revealed pleomorphic carcinoma with positive immunostaining for beta hCG. Serum beta hCG levels began to increase gradually on postoperatively 4th month. Computed tomography detected recurrence and chemotherapy was started. After second cycle of chemotherapy, beta hCG levels decreased dramatically again and tomography showed regression in mass. Patient died 6 months later due to brain metastasis. beta hCG expression may be associated with aggressive clinical course and increased risk of recurrence, also beta hCG levels may be used to evaluate therapy response in patients with pleomorphic carcinoma.
Brain Neoplasms/radiotherapy/secondary ; Carcinoma, Non-Small-Cell Lung/complications/*diagnosis/pathology ; Chorionic Gonadotropin, beta Subunit, Human/*blood ; Gynecomastia/*etiology ; Humans ; Lung Neoplasms/complications/*diagnosis/pathology ; Lymph Nodes/surgery ; Male ; Middle Aged ; Recurrence ; Risk Factors ; Tomography, X-Ray Computed