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Introduction Meningiomas have been described as slow-growing neoplasms with benign behavior derived from the connective tissue surrounding the brain and spinal cord. Meningiomas represent one-third of primary central nervous system (CNS) tumors. The World Health Organization (WHO) initially classified them into three groups based on their histopathological characteristics, recently incorporating molecular patterns. Small cohorts have been reported in Latin America compared to the international literature. Ignoring the epidemiology of meningiomas in this region and considering this limitation, we aim to study the epidemiology of meningiomas in our country, Mexico. Material and methods A historical cohort was carried out on 916 patients diagnosed with intracranial meningiomas from January 2008 to January 2021, considering sociodemographic, topographic, and histopathological characteristics. Results In this study, 69.4% (n=636) of patients were women with a mean overall age of 47.53 (SD=14.85) years; 79.6% (n=729) of the lesions were supratentorial with convexity meningiomas being the most prevalent at 32.6% (n=299). Histopathologically, transitional (45.7%) (n=419), meningothelial (22.1%) (n=202), and fibroblastic (16.7%) (n=153) meningiomas were the most frequent. We found significant differences between men and women in age (p=0.01), infra or supratentorial presentation (p<0.001), location of the lesion (p<0.001), and histopathological characteristics (p<0.001). Conclusions Our results are consistent with what has been reported; however, until now, it appears as the largest series reported in our country and Latin America.
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RESUMEN Los tumores primarios del cerebro constituyen un grupo heterogéneo de neoplasias con comportamiento biológico y con pronóstico muy diferente. Su incidencia se ha incrementado en los últimos años en todos los grupos de edades. Se realizó un estudio descriptivo prospectivo de 58 pacientes con tumores cerebrales primarios, atendidos en la consulta de Radioterapia del Centro Oncológico del Hospital Vladimir Ilich Lenin en el período de Noviembre del 2014 a Mayo del 2017, con el objetivo de determinar los síntomas físicos y las manifestaciones cognitivas en pacientes tratados por tumores cerebrales primarios. Se caracterizaron las variables de edad y sexo, diagnóstico histológico, tratamiento oncológico, síntomas físicos y manifestaciones cognitivas. El grupo de edad entre los 40 y 59 años fue el más afectado (51,72%), siendo en el sexo masculino más frecuente esta patología (65,52%). El tipo histológico que predominó fue el astrocitoma en un 77,11 %. Se empleó la radioterapia en el 100% de los pacientes, y concurrente al nimotuzumab en 43 pacientes. Los síntomas físicos más frecuentes fueron los trastornos del sueño (39,28%), y dentro de las manifestaciones cognitivas identificadas los problemas visuales alcanzaron el 35%. Los síntomas físicos y las manifestaciones cognitivas producidas, ya sea por el tumor primario o por el tratamiento oncológico en pacientes con tumores cerebrales primarios, son factores que influyen negativamente en la calidad de vida de estos pacientes.
ABSTRACT Primary tumors of the brain constitute a heterogeneous group of neoplasms with biological behavior and with a very different prognosis. Its incidence has increased in recent years in all age groups. A prospective descriptive study of 58 patients with primary brain tumors was performed, attended in the Radiotherapy office of the Vladimir Ilich Lenin Hospital Oncology in the period from November 2014 to May 2017, with the objective of determining the physical symptoms and Cognitive manifestations in patients treated for primary brain tumors. The variables of age and sex, histological diagnosis, cancer treatment, physical symptoms and cognitive manifestations were characterized. The age group between 40 and 59 years was the most affected (51.72%), being in the most frequent male sex this pathology (65.52%). The histological type that predominated was astrocytoma in 77.11%. Radiation therapy was used in 100% of patients, and concurrent to nimotuzumab in 43 patients. The most frequent physical symptoms were sleep disorders (39.28%), and within the cognitive manifestations identified visual problems reached 35%. The physical symptoms and cognitive manifestations produced, either by the primary tumor or by the cancer treatment in patients with primary brain tumors, are factors that negatively influence the quality of life of these patients.
RESUMO Os tumores primários do cérebro constituem um grupo heterogêneo de neoplasias com comportamento biológico e com prognóstico muito diferente. Sua incidência aumentou nos últimos anos em todas as faixas etárias. Foi realizado um estudo prospectivo descritivo de 58 pacientes com tumores cerebrais primários, atendidos no serviço de Radioterapia do Hospital Vladimir Ilich Lenin Oncologia no período de novembro de 2014 a maio de 2017, com o objetivo de determinar os sintomas físicos e Manifestações cognitivas em pacientes tratados por tumores cerebrais primários. Foram caracterizadas as variáveis idade e sexo, diagnóstico histológico, tratamento do câncer, sintomas físicos e manifestações cognitivas. A faixa etária entre 40 e 59 anos foi a mais afetada (51,72%), sendo no sexo masculino mais frequente essa patologia (65,52%). O tipo histológico que predominou foi o astrocitoma em 77,11%. A radioterapia foi usada em 100% dos pacientes e concomitante ao nimotuzumabe em 43 pacientes. Os sintomas físicos mais frequentes foram distúrbios do sono (39,28%) e, nas manifestações cognitivas, os problemas visuais identificados atingiram 35%. Os sintomas físicos e as manifestações cognitivas produzidas, seja pelo tumor primário ou pelo tratamento do câncer em pacientes com tumores cerebrais primários, são fatores que influenciam negativamente a qualidade de vida desses pacientes.
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Background: Central nervous system (CNS) tumors are a group of neoplasms that originate from various cells in the CNS. The increasing incidence and prevalence of this type of tumor in developing countries are striking; however, there are few current studies in Latin America including Mexico estimating the impact of these pathological entities on the general population. Objective: The objective of the study was to study the characteristics of primary CNS tumors over a period of 52 years. Methods: A review of records from patients with a histopathological diagnosis of CNS neoplasm over a period of 52 years was conducted at a tertiary-care academic medical center. Patients were grouped by sex, age, and the tumor's anatomical location. Results: A sample of 9615 patients with tumor lesions was obtained; 51% were female, 49% were male, and their mean age was 42 years. The tumors with the highest prevalence were neuroepithelial tumors (38.6%), followed by meningeal tumors (22.8%). Neuroepithelial tumors accounted for 64% in the group of patients under 40 years of age and 56% among those above 40 years of age. The most frequently involved location was supratentorial, in 78.9% of cases. Conclusions: Although retrospective in nature and based on a small sample, this study reports the epidemiology and characteristics of primary brain tumors in the Mexican population.
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Neoplasias Encefálicas/epidemiologia , Neoplasias do Sistema Nervoso Central/epidemiologia , Neoplasias Meníngeas/epidemiologia , Neoplasias Neuroepiteliomatosas/epidemiologia , Adulto , Distribuição por Idade , Neoplasias Encefálicas/patologia , Neoplasias do Sistema Nervoso Central/patologia , Feminino , Humanos , Incidência , Masculino , Neoplasias Meníngeas/patologia , México/epidemiologia , Pessoa de Meia-Idade , Neoplasias Neuroepiteliomatosas/patologia , Prevalência , Estudos Retrospectivos , Distribuição por Sexo , Adulto JovemRESUMO
The purpose of this prospective phase II/III trial was to study the effect of therapy intensification when combining procarbazine, lomustine, and vincristine (PCV) chemotherapy with a standard course of radiation therapy (RT) on cognitive functioning for patients with World Health Organization grade 2 low-grade gliomas (LGGs). Initial results of the trial demonstrated a progression-free survival benefit with adjuvant PCV, but no overall survival benefit in the intention-to-treat analysis. Because patients with LGGs have favorable prognostic indicators, the five-year overall survival rates range from 60%-70%. The effect of cancer treatment on neurocognitive function is a topic of increasing interest to healthcare providers and patients. The negative effect is commonly called "chemobrain" and refers to diminished concentration and compromised short-term memory following treatment. Chemobrain has been studied in other populations of patients with cancer (e.g., breast cancer) with associated statistically significant chemotherapy-associated compromised cognitive function when chemotherapy was added to RT.
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Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Encefálicas/tratamento farmacológico , Neoplasias Encefálicas/radioterapia , Glioma/tratamento farmacológico , Glioma/radioterapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Quimioterapia Adjuvante/efeitos adversos , Transtornos Cognitivos/induzido quimicamente , Feminino , Humanos , Lomustina/efeitos adversos , Lomustina/uso terapêutico , Masculino , Pessoa de Meia-Idade , Procarbazina/efeitos adversos , Procarbazina/uso terapêutico , Estudos Prospectivos , Vincristina/efeitos adversos , Vincristina/uso terapêutico , Adulto JovemRESUMO
Objetivo: Determinar la efectividad del co-registro de imágenes PET/RM (tomografía de emisión de positrones y resonancia magnética) en el diagnóstico de recidiva tumoral vs.. radionecrosis en pacientes con patología tumoral cerebral primaria previamente tratados. Material y métodos: El diagnóstico de tumor cerebral se determinó por RM e histopatología. Después de 3 a 5 meses postratamiento se realizó RM y PET como parte del seguimiento. El análisis de dichas imágenes se hizo de manera visual y semicuantitativa mediante la obtención de un índice de captación de 18F-FDG de tejido tumoral/ tejido cerebral sano. Resultados: Se estudiaron 57 pacientes; un total de 37 gliomas astrocíticos, 9 gliomas mixtos, 5 tumores embrionarios, 1 tumor meníngeo y 1 tumor oligodendroglial . Todas las imágenes de RM presentaban áreas de reforzamiento, dejando sospecha entre radionecrosis o viabilidad tumoral; con el co-registro PET/RM se diagnosticaron 21 estudios negativos (30 %) y 36 positivos (70 %). El índice tejido tumoral/tejido cerebral sano se correlacionó adecuadamente con los resultados visuales obtenidos. Conclusión: La RM sobreestima el área tumoral a valorar. La presencia de la actividad metabólica analizada mediante PET sobre las áreas de reforzamiento por RM permite determinar la presencia de viabilidad tumoral. Esto aumenta la certeza diagnóstica de ambas técnicas de imagen.
OBJECTIVE: To evaluate the role of PET and MRI fused image study inpatients with primary brain tumors previously treated, to determine the presence of radionecrosis vs residual tumor viability. METHODS: Primary brain tumors were diagnosed by biopse and MR. 18FDG-PET scan and T1 enhanced MRI follow-up studies were performed between 3 and 5 months after treatment. The 18F-FDG uptake was semiquantitavively calculated by a region-of-interest based Tumor hotspot/normal brain tissue index. RESULTS: Fifty-seven patients were studied, 37 had high grade gliomas; 9 had oligoastrocytomas; 5 had Embrionary tumors; I had a meningyoma and I had an oliodendroglial tumor. All MR studies showed tumor enhancement, without determine wether if it was radionecrosis or tumor viability. PET/MR fused study diagnosed 21 negative studies (30%) and 36 positive results (70%). Tumor hotspot/normal brain tissue index correlated well with the visual analysis registered. CONCLUSIONS: Visual analysis in the contrast enhanced MR overestimates the tumoral area, without defining a possible diagnosis between tumor viability and radionecrosis. Metabolic activity in the 18F-FDG PET study in the enhanced area, determines the presence of residual tumor viability. Therefore, coregistration can be used to obtain a more specific diagnosis optimizing the cinical use.