Background: The profile of primary brain tumors and treatment modalities employed in Tanzania remains largely unknown. The study aimed to describe the baseline clinical-pathological profile and treatment modalities fo...Background: The profile of primary brain tumors and treatment modalities employed in Tanzania remains largely unknown. The study aimed to describe the baseline clinical-pathological profile and treatment modalities for primary brain tumors in adults treated at the Ocean Road Cancer Institute (ORCI) from 2017 to 2020. Materials and Methods: This was a retrospective study conducted at ORCI by reviewing 61 medical records of patients with primary brain tumors over the age of 15 from January 2017 to December 2020. A structured questionnaire was used to retrieve information on sociodemographic, clinical-pathological characteristics, and treatment modalities. The 2007 WHO classification system and the International Classification of Cancer Diseases (ICD-0-3) were used for classification and diagnosis. The X<sup>2</sup> test and Fisher’s exact test were used to compare the proportions and an independent t-test was used to compare the means. A P-value less than 0.05 was deemed statistically significant. The Results: The mean age of the females was 41.8 years and the mean age of males was 42.9 years. Overall M: F ratio was 1:1.2. Meningioma was the only tumor that was more commonly found in women with M:F of 1:2.1. The most prevalent symptom was headache (57.4%). Glioblastoma (GBM) was the most common tumor among adults (38%), followed by astrocytomas (23%) and meningioma (18%). Approximately 91.8% of all tumors occurred in the supratentorial region. The Frontal lobe was the most common site (29.5%). Approximately 81.9% of patients received surgery. The gross tumor resection (GTR) rate was 26.2%, and the subtotal tumor resection (STR) rate was 55.7%. Roughly 18% of the tumors were inoperable. An estimated 80.3% of respondents received radiation therapy. The radiotherapy technique was 3DCRT in two-thirds of the patients and the rest received conventional 2D radiotherapy. The mean equivalent dose in the 2 Gy fractions (EQD2) was 43.9 Gy. Respondents with low-grade intracranial tumors were treated with a mean EQD2 of 47.3 Gy, while those with high-grade intracranial tumors were treated with a mean EQD2 of 44.3 Gy and the difference was statistically significant. Only half of the patients who received adjuvant radiotherapy received it concurrently with chemotherapy. Temozolomide was the most widely used cytotoxic medication. Conclusion: Mean age of the patients was 41 years old. Most tumors were in the supratentorial area and GBM was the most common tumor. Only meningioma was a bit more common amongst females. Overall, radiotherapy doses and the gross tumor resection rates were low. Concurrent chemotherapy with radiotherapy was given to a few patients.展开更多
Background Although the first leading cause of death in China was malignant neoplasms （mortality, 374.1 per 100 000 person-years）, the full impact of primary brain tumors （PBT） on the healthcare system is not comp...Background Although the first leading cause of death in China was malignant neoplasms （mortality, 374.1 per 100 000 person-years）, the full impact of primary brain tumors （PBT） on the healthcare system is not completely described because there are a few well documented reports about the epidemiologic features of brain tumors. This study aimed to report a comprehensive assessment on the prevalence of PBT. Methods A multicenter cross-sectional study on brain tumor （MCSBT） in China was initiated in five regional centers： Daqing （northeast）, Puyang （north of China）, Shiyan （center of China）, Ma＇anshan （center of China） and Shanghai （southeast）. Prevalence rate was calculated by counting the number of people living with a PBT between October 1,2005 and September 30, 2006 and dividing by the total population of the five communities at January 1, 2006. Estimates of prevalence were expressed as percentages and grouped according to gender and to age in fifteen-year categories. Within these strata, the rates were estimated with 95% confidence intervals （C/） using the accurate calculation of CI for Poisson distribution. A chi-square test was used to compare the various frequencies with a 〈0.05. Age-standardized prevalence with the direct method was calculated with the ten-year age-specific prevalence and the age distribution of population prospects： the 2008 revision. Results We estimated that the overall prevalence of PBT was 24.56 per 100 000 （95% CI, 14.85 to 34.27）, and the overall prevalence of PBT in female population （30.57 per 100 000 and its 95% Cl ranged from 19.73 to 41.41） was higher than that in male population （18.84 per 100 000 and its 95% Cl ranged from 10.33 to 27.35）. However, the discrepancy between genders was not statistically significant because the 95% Cl overlapped. Of 272 cases of newly diagnosed PBT, the proportion of histological subtypes by age groups, gender was statistically different （X2=52.6510, P 〈0.0001）. More than half of all reported tumors （52.57%） were either gliomas or meningiomas. For the youngest （aged from 0-19） strata of the population, glioma appeared to occur more than other subtypes, accounting for 55.56% of all of cases. The majority of brain tumors presented in those aged from 20 to 59 years was pituitary adenomas （45.12%） and gliomas （31.10%）. Opposed to brain tumors in adults and teenage, gliomas only accounted for 22.22%. Meanwhile, the median ages at diagnosis of the patients with PBT were similar between males and females except for pituitary adenomas （male： 59 years old; female： 45 years old）. Conclusions Age standardized prevalence of PBT is 22.52 per 100 000 （95% CI, 13.22 to 31.82） for all populations, 17.64 per 100 000 （95% CI, 9.41 to 25.87） for men, and 27.94 per 100 000 （95% Cl, 17.58 to 38.30） for women. Age standardization to China＇s 2010 population yielded an estimated population of 304 954 cases with PBT. Our prevalence estimates provide a conservative basis on which to plan health care services and to develop programmatic strategies for surviving. Inthe future, it would be helpful to have long-term observed survival rates that would make the assumptions and the resulting imprecision in the current estimates unnecessary.展开更多
Local infiltration and distal dissemination of tumor cells hamper efficacy of current treatments against central nervous system(CNS)tumors and greatly influence mortality and therapy-induced long-term morbidity in sur...Local infiltration and distal dissemination of tumor cells hamper efficacy of current treatments against central nervous system(CNS)tumors and greatly influence mortality and therapy-induced long-term morbidity in survivors.A number of in vitro and ex vivo assay systems have been established to better understand the infiltration and metastatic processes,to search for molecules that specifically block tumor cell infiltration and metastatic dissemination and to pre-clinically evaluate their efficaciousness.These systems allow analytical testing of tumor cell viability and motile and invasive capabilities in simplified and well-controlled environments.However,the urgent need for novel anti-metastatic therapies has provided an incentive for the further development of not only classical in vitro methods but also of novel,physiologically more relevant assay systems including organotypic brain slice culture.In this review,using publicly available peer-reviewed primary research and review articles,we provide an overview of a selection of in vitro and ex vivo techniques widely used to study growth and dissemination of primary metastatic brain tumors.Furthermore,we discuss how our steadily increasing knowledge of tumor biology and the tumor microenvironment could be integrated to improve current research methods for metastatic brain tumors.We believe that such rationally improved methods will ultimately increase our understanding of the biology of brain tumors and facilitate the development of more efficacious anti-metastatic treatments.展开更多
文摘Background: The profile of primary brain tumors and treatment modalities employed in Tanzania remains largely unknown. The study aimed to describe the baseline clinical-pathological profile and treatment modalities for primary brain tumors in adults treated at the Ocean Road Cancer Institute (ORCI) from 2017 to 2020. Materials and Methods: This was a retrospective study conducted at ORCI by reviewing 61 medical records of patients with primary brain tumors over the age of 15 from January 2017 to December 2020. A structured questionnaire was used to retrieve information on sociodemographic, clinical-pathological characteristics, and treatment modalities. The 2007 WHO classification system and the International Classification of Cancer Diseases (ICD-0-3) were used for classification and diagnosis. The X<sup>2</sup> test and Fisher’s exact test were used to compare the proportions and an independent t-test was used to compare the means. A P-value less than 0.05 was deemed statistically significant. The Results: The mean age of the females was 41.8 years and the mean age of males was 42.9 years. Overall M: F ratio was 1:1.2. Meningioma was the only tumor that was more commonly found in women with M:F of 1:2.1. The most prevalent symptom was headache (57.4%). Glioblastoma (GBM) was the most common tumor among adults (38%), followed by astrocytomas (23%) and meningioma (18%). Approximately 91.8% of all tumors occurred in the supratentorial region. The Frontal lobe was the most common site (29.5%). Approximately 81.9% of patients received surgery. The gross tumor resection (GTR) rate was 26.2%, and the subtotal tumor resection (STR) rate was 55.7%. Roughly 18% of the tumors were inoperable. An estimated 80.3% of respondents received radiation therapy. The radiotherapy technique was 3DCRT in two-thirds of the patients and the rest received conventional 2D radiotherapy. The mean equivalent dose in the 2 Gy fractions (EQD2) was 43.9 Gy. Respondents with low-grade intracranial tumors were treated with a mean EQD2 of 47.3 Gy, while those with high-grade intracranial tumors were treated with a mean EQD2 of 44.3 Gy and the difference was statistically significant. Only half of the patients who received adjuvant radiotherapy received it concurrently with chemotherapy. Temozolomide was the most widely used cytotoxic medication. Conclusion: Mean age of the patients was 41 years old. Most tumors were in the supratentorial area and GBM was the most common tumor. Only meningioma was a bit more common amongst females. Overall, radiotherapy doses and the gross tumor resection rates were low. Concurrent chemotherapy with radiotherapy was given to a few patients.
文摘Background Although the first leading cause of death in China was malignant neoplasms （mortality, 374.1 per 100 000 person-years）, the full impact of primary brain tumors （PBT） on the healthcare system is not completely described because there are a few well documented reports about the epidemiologic features of brain tumors. This study aimed to report a comprehensive assessment on the prevalence of PBT. Methods A multicenter cross-sectional study on brain tumor （MCSBT） in China was initiated in five regional centers： Daqing （northeast）, Puyang （north of China）, Shiyan （center of China）, Ma＇anshan （center of China） and Shanghai （southeast）. Prevalence rate was calculated by counting the number of people living with a PBT between October 1,2005 and September 30, 2006 and dividing by the total population of the five communities at January 1, 2006. Estimates of prevalence were expressed as percentages and grouped according to gender and to age in fifteen-year categories. Within these strata, the rates were estimated with 95% confidence intervals （C/） using the accurate calculation of CI for Poisson distribution. A chi-square test was used to compare the various frequencies with a 〈0.05. Age-standardized prevalence with the direct method was calculated with the ten-year age-specific prevalence and the age distribution of population prospects： the 2008 revision. Results We estimated that the overall prevalence of PBT was 24.56 per 100 000 （95% CI, 14.85 to 34.27）, and the overall prevalence of PBT in female population （30.57 per 100 000 and its 95% Cl ranged from 19.73 to 41.41） was higher than that in male population （18.84 per 100 000 and its 95% Cl ranged from 10.33 to 27.35）. However, the discrepancy between genders was not statistically significant because the 95% Cl overlapped. Of 272 cases of newly diagnosed PBT, the proportion of histological subtypes by age groups, gender was statistically different （X2=52.6510, P 〈0.0001）. More than half of all reported tumors （52.57%） were either gliomas or meningiomas. For the youngest （aged from 0-19） strata of the population, glioma appeared to occur more than other subtypes, accounting for 55.56% of all of cases. The majority of brain tumors presented in those aged from 20 to 59 years was pituitary adenomas （45.12%） and gliomas （31.10%）. Opposed to brain tumors in adults and teenage, gliomas only accounted for 22.22%. Meanwhile, the median ages at diagnosis of the patients with PBT were similar between males and females except for pituitary adenomas （male： 59 years old; female： 45 years old）. Conclusions Age standardized prevalence of PBT is 22.52 per 100 000 （95% CI, 13.22 to 31.82） for all populations, 17.64 per 100 000 （95% CI, 9.41 to 25.87） for men, and 27.94 per 100 000 （95% Cl, 17.58 to 38.30） for women. Age standardization to China＇s 2010 population yielded an estimated population of 304 954 cases with PBT. Our prevalence estimates provide a conservative basis on which to plan health care services and to develop programmatic strategies for surviving. Inthe future, it would be helpful to have long-term observed survival rates that would make the assumptions and the resulting imprecision in the current estimates unnecessary.
文摘Local infiltration and distal dissemination of tumor cells hamper efficacy of current treatments against central nervous system(CNS)tumors and greatly influence mortality and therapy-induced long-term morbidity in survivors.A number of in vitro and ex vivo assay systems have been established to better understand the infiltration and metastatic processes,to search for molecules that specifically block tumor cell infiltration and metastatic dissemination and to pre-clinically evaluate their efficaciousness.These systems allow analytical testing of tumor cell viability and motile and invasive capabilities in simplified and well-controlled environments.However,the urgent need for novel anti-metastatic therapies has provided an incentive for the further development of not only classical in vitro methods but also of novel,physiologically more relevant assay systems including organotypic brain slice culture.In this review,using publicly available peer-reviewed primary research and review articles,we provide an overview of a selection of in vitro and ex vivo techniques widely used to study growth and dissemination of primary metastatic brain tumors.Furthermore,we discuss how our steadily increasing knowledge of tumor biology and the tumor microenvironment could be integrated to improve current research methods for metastatic brain tumors.We believe that such rationally improved methods will ultimately increase our understanding of the biology of brain tumors and facilitate the development of more efficacious anti-metastatic treatments.
