Search Results

You are looking at 1 - 10 of 29 items for :

  • All content x
  • By Author: Barnett, Gene H. x
Clear All
Free access

Symeon Missios, Kimon Bekelis, and Gene H. Barnett

, Kamian K , Mohammadi AM , Ahluwalia MS , Barnett GH : MRI-guided laser interstitial thermal therapy in neuro-oncology: a review of its current clinical applications . Oncology 87 : 67 – 82 , 2014 39 Rahmathulla G , Recinos PF , Valerio JE , Chao S , Barnett GH : Laser interstitial thermal therapy for focal cerebral radiation necrosis: a case report and literature review . Stereotact Funct Neurosurg 90 : 192 – 200 , 2012 40 Reimer P , Bremer C , Horch C , Morgenroth C , Allkemper T , Schuierer G : MR

Free access

Matthew M. Grabowski, Pablo F. Recinos, Amy S. Nowacki, Jason L. Schroeder, Lilyana Angelov, Gene H. Barnett, and Michael A. Vogelbaum

neurosurgical oncology practice (M.A.V.), thus representing a wide range of experience in the field. Determination of volumes was made without consideration of clinical outcome. The volumes taken by the attending neurosurgeon were considered the standard measurements that were used for all statistical calculations aside from those related to interobserver variability and correlations. T2/F-RV was assessed by the attending neurosurgeon only. All volumes were defined in three dimensions using preoperative and postoperative MR images obtained on 1.5-T scanners. Postoperative

Full access

Ovidiu Marina, John H. Suh, Chandana A. Reddy, Gene H. Barnett, Michael A. Vogelbaum, David M. Peereboom, Glen H. J. Stevens, Heinrich Elinzano, and Samuel T. Chao

radiation therapy. Patients were then stratified by RTOG RPA class 8 and treatment intervention to better compare the effectiveness of the interventions. Methods Patient Population Patients evaluated for GBM at the Cleveland Clinic were retrospectively identified from databases provided by the Departments of Radiation Oncology and Pathology. The institutional review board at the same institution approved the study. Hospital charts and radiation records were reviewed, with patients being included in the study if they had a pathology report confirming the GBM

Full access

Andrew A. Kanner, Michael A. Vogelbaum, Marc R. Mayberg, Joseph P. Weisenberger, and Gene H. Barnett

: Stereotaxic frame and computer software for CT-directed neurosurgical localization. Invest Radiol 15 : 308 – 312 , 1980 Brown RA, Roberts TS, Osborn AG: Stereotaxic frame and computer software for CT-directed neurosurgical localization. Invest Radiol 15: 308–312, 1980 15. Curran WJ Jr , Scott CB , Horton J , et al : Does extent of surgery influence outcome for astrocytoma with atypical or anaplastic foci (AAF)? A report from three Radiation Therapy Oncology Group (RTOG) trials. J Neurooncol 12 : 219 – 227

Full access

Michael A. Vogelbaum, Cathy Brewer, Gene H. Barnett, Alireza M. Mohammadi, David M. Peereboom, Manmeet S. Ahluwalia, and Shenqiang Gao

OBJECTIVE

Progress in management of high-grade gliomas (HGGs) has been hampered by poor access of potential therapeutics to the CNS. The Cleveland Multiport Catheter (CMC), which deploys 4 independent delivery microcatheters, was developed to be a reliable, high-volume delivery device for delivery of therapeutic agents to the brain and other solid organs. The authors undertook this first-in-human clinical trial effort to evaluate the delivery characteristics of the CMC in patients with HGGs.

METHODS

A series of pilot studies were launched after approval of a sponsor-investigator IND (investigational new drug) application to evaluate the delivery of topotecan and gadolinium-DTPA (Gd-DTPA) via the CMC in patients with recurrent HGG. The first pilot trial evaluated delivery into enhancing tumor and nonenhancing, tumor-infiltrated brain. Two catheters were placed with the use of a conventional frameless stereotactic technique following a biopsy to confirm tumor recurrence, and drug infusion was performed both intraoperatively and postoperatively for a total of 96 hours with the same rate for all microcatheters. Delivery was assessed by intermittent MRI.

RESULTS

Three patients were enrolled in the first pilot study. MRI demonstrated delivery from all 6 catheters (24 microcatheters). The volume of distribution (Vd) of Gd-DTPA was heavily dependent upon CMC location (enhancing vs nonenhancing) with an approximately 10-fold difference in Vd observed (p = 0.005). There were no hemorrhages related to catheter placement or removal, and all 3 patients completed the protocol-defined treatment.

CONCLUSIONS

The CMC is capable of providing backflow-resistant drug delivery to the brain and brain tumors. The volume of distribution is heavily dependent upon the integrity of the blood-brain barrier. Assessment of delivery is essential for development of loco-regionally applied therapeutics in the CNS.

Clinical trial registration no.: NCT02278510 (clinicaltrials.gov)

Full access

Michael A. Vogelbaum, Cathy Brewer, Gene H. Barnett, Alireza M. Mohammadi, David M. Peereboom, Manmeet S. Ahluwalia, and Shenqiang Gao

OBJECTIVE

Progress in management of high-grade gliomas (HGGs) has been hampered by poor access of potential therapeutics to the CNS. The Cleveland Multiport Catheter (CMC), which deploys 4 independent delivery microcatheters, was developed to be a reliable, high-volume delivery device for delivery of therapeutic agents to the brain and other solid organs. The authors undertook this first-in-human clinical trial effort to evaluate the delivery characteristics of the CMC in patients with HGGs.

METHODS

A series of pilot studies were launched after approval of a sponsor-investigator IND (investigational new drug) application to evaluate the delivery of topotecan and gadolinium-DTPA (Gd-DTPA) via the CMC in patients with recurrent HGG. The first pilot trial evaluated delivery into enhancing tumor and nonenhancing, tumor-infiltrated brain. Two catheters were placed with the use of a conventional frameless stereotactic technique following a biopsy to confirm tumor recurrence, and drug infusion was performed both intraoperatively and postoperatively for a total of 96 hours with the same rate for all microcatheters. Delivery was assessed by intermittent MRI.

RESULTS

Three patients were enrolled in the first pilot study. MRI demonstrated delivery from all 6 catheters (24 microcatheters). The volume of distribution (Vd) of Gd-DTPA was heavily dependent upon CMC location (enhancing vs nonenhancing) with an approximately 10-fold difference in Vd observed (p = 0.005). There were no hemorrhages related to catheter placement or removal, and all 3 patients completed the protocol-defined treatment.

CONCLUSIONS

The CMC is capable of providing backflow-resistant drug delivery to the brain and brain tumors. The volume of distribution is heavily dependent upon the integrity of the blood-brain barrier. Assessment of delivery is essential for development of loco-regionally applied therapeutics in the CNS.

Clinical trial registration no.: NCT02278510 (clinicaltrials.gov)

Full access

Michael A. Vogelbaum, Lilyana Angelov, Shih-Yuan Lee, Liang Li, Gene H. Barnett, and John H. Suh

College of Surgeons Oncology Group Z0300). The results and conclusions of this study are limited by the fact that it is a retrospective analysis of the experience at a single institution. Further prospective evaluation of the dose-dependent efficacy of SRS is necessary to confirm our findings, and additional studies should be combined with a dose-escalation strategy for certain situations (for example, radioresistant histological types or unresectable tumors). One difficulty with assessment of local control after radio-surgery is the similarity in the appearance of

Free access

Manmeet Ahluwalia, Gene H. Barnett, Di Deng, Stephen B. Tatter, Adrian W. Laxton, Alireza M. Mohammadi, Eric Leuthardt, Roukoz Chamoun, Kevin Judy, Anthony Asher, Marco Essig, Jorg Dietrich, and Veronica L. Chiang

. Pathology results of the biopsies were obtained from the pathology reports at each institution. All 6 centers used the NeuroBlate system for LITT, as previously described. 15 The system employs a robotically controlled 1064-nm laser probe and uses MRI thermometry to inform the surgeon of predicted zones of protein denaturation and cell death. Outcome Measures The primary outcome was local central nervous system (CNS) progression-free survival (PFS) as defined by standard Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM) criteria. 9 All pre- and

Free access

Rupesh Kotecha, Lilyana Angelov, Gene H. Barnett, Chandana A. Reddy, John H. Suh, Erin S. Murphy, Gennady Neyman, and Samuel T. Chao

primary treatment of lesions localized in the calvaria or skull base. We also describe a novel bolus-based treatment technique that we developed to treat superficial lesions in the calvarial bones. Methods We reviewed databases from the Cleveland Clinic Burkhardt Brain Tumor and Neuro-Oncology Center and Department of Radiation Oncology and identified 21 patients who had undergone GKS for calvarial and skull base metastases during 2001–2013. The metastatic lesions were classified by their originating site: calvaria or skull base. Lesions in the frontal, parietal

Full access

Mayur Sharma, Jason L. Schroeder, Paul Elson, Antonio Meola, Gene H. Barnett, Michael A. Vogelbaum, John H. Suh, Samuel T. Chao, Alireza M. Mohammadi, Glen H. J. Stevens, Erin S. Murphy, and Lilyana Angelov

the maximum dimension of the tumor, according to the Radiation Therapy Oncology Group (protocol 90-05) guidelines. 45 Following GKRS, 4–6 weeks after the procedure, patients underwent clinical examination and MRI and then every 3 months thereafter. The median follow-up duration in our study was 10.1 months (range 0.8–51.4 months). Outcomes and Endpoints Overall survival (OS) and progression-free survival (PFS) from the date of salvage SRS were the primary and secondary endpoints, respectively. OS and PFS were measured from the time of salvage SRS to death and the