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Leland Rogers, Peixin Zhang, Michael A. Vogelbaum, Arie Perry, Lynn S. Ashby, Jignesh M. Modi, Anthony M. Alleman, James Galvin, David Brachman, Joseph M. Jenrette, John De Groot, Joseph A. Bovi, Maria Werner-Wasik, Jonathan P. S. Knisely and Minesh P. Mehta

, but, based on a recently published secondary endpoint analysis of pathology concordance from NRG Oncology RTOG 0539, the WHO 2000 and 2007 standards appear to have been broadly followed, at least among institutions enrolling patients in NRG Oncology RTOG cooperative group trials. 40 Several cooperative group meningioma protocols have been launched, but they either have met with disappointing results or have failed to reach accrual goals. 10 , 21 , 25 , 27 The Southwest Oncology Group (SWOG) completed a Phase III trial, with results published in 2015 by Ji and

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Rafael De la Garza-Ramos, Mario Benvenutti-Regato and Enrique Caro-Osorio

I n the last decades, spinal oncology has emerged as a separate subspecialty, 114 reflecting years of research focused on innovative techniques for controlling spinal tumors and managing the pain and pathophysiology arising from these types of cancers. 84 Although management of some diseases may involve few specialists, patients with spinal tumors are usually treated by a multidisciplinary team, including neurosurgeons, orthopedic surgeons, oncologists, radiation oncologists, and neurologists. 84 Thus, the spinal oncology literature encompasses numerous

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Miguel Marigil and Mark Bernstein

N eurosurgery has been exponentially evolving during the last 50 years. 1 , 25 Development of tools such as neuromonitoring and neuronavigation, along with the implementation of new neuroanesthesia protocols, have helped to shorten surgical times and enhance postoperative care, enabling more rapid recovery and early discharges. 30 , 44 , 52 All of these improvements have led to a redefinition of the primary goal of care in neuro-oncology, with the aim of preserving neurological function and ultimately offering the patient a better quality of life. 16 , 26 , 31

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M. Peter Heilbrun and John R. Adler Jr.

radiosurgery. The primary principles of radiation therapy are embodied in the “4 Rs.” Nevertheless, there have been numerous technical advances in the field of radiation oncology, especially in the past decade, that are starting to challenge some traditional radiotherapeutic concepts. Image-guided localization, as well as better planning algorithms and field shaping, enables better control of cancerous lesions while limiting side effects to surrounding tissue, regardless of the underlying radiobiology. Most radiation oncologists have come to embrace the concept of using

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Howard Colman, Manfred Westphal and John H. Sampson

N euro-oncology is a complex field that benefits from multidisciplinary expertise from many different clinical and other specialties. The complexities in neuro-oncology stem from many sources. One of the most important sources is the complexity of the brain itself and the central role it plays in life and well being. As a result, all modalities of tumor treatment have to balance the beneficial effects of the therapy against the potential negative effects on worsening neurological deficits and/or functional status. Another complexity arises from the wide variety

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Toru Serizawa, Yoshinori Higuchi, Osamu Nagano, Tatsuo Hirai, Junichi Ono, Naokatsu Saeki and Akifumi Miyakawa

survival time; RTOG = Radiation Therapy Oncology Group. TABLE 3: Prognostic values for overall survival Variable High-Risk Group Univariate Analysis Multivariate Analysis p Value HR (95% CI) p Value HR (95% CI) age ≥65 yrs 0.0108 1.118 (1.061–1.217) sex male <0.0001 1.447 (1.323–1.578) initial KPS score <70% <0.0001 2.807 (2.441–3.243) <0.0001 2.124 (1.867–2.410) primary lesion not lung or breast <0.0001 1.510 (1.365–1.668) <0.0001 1.392 (1.253–1.545) no. of brain

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Melike Mut, M. Beatriz S. Lopes and Mark Shaffrey

Dr. Lucien Rubinstein is best remembered for his significant contributions to the field of neuropathology, particularly in the classification of nervous system tumors. His accomplishments in basic neuro-oncology and in the formulation of diagnostic principles reflected a unique talent for synthesizing fundamental clinicopathological concepts based on skillful diagnostic investigation and a thorough understanding of neurobiology. Dr. Rubinstein was the leader in the establishment of cell cultures from central nervous system (CNS) tumors. He meticulously analyzed both light and electron microscopic features of CNS tumors, recorded his findings, and patiently drew sketches to be shared generously with his colleagues and students. As a pioneer in neuropathology, in his work Dr. Rubinstein set the foundation for many enduring concepts in neurosurgery, neuro-oncology, neurology, and basic tumor biology.

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Patricia L. Robertson, Karin M. Muraszko, Emiko J. Holmes, Richard Sposto, Roger J. Packer, Amar Gajjar, Mark S. Dias and Jeffrey C. Allen

, Morris-Jones P : Adjuvant chemotherapy for medulloblastoma: the first multi-centre control trial of the International Society of Paediatric Oncology (SIOP I) . Eur J Cancer 26 : 464 – 469 , 1990 68 Turgut M : Transient “cerebellar” mutism . Childs Nerv Syst 14 : 161 – 166 , 1998 69 Van Calenbergh F , Van de Laar A , Plets C , Goffin J , Casaer P : Transient cerebellar mutism after posterior fossa surgery in children . Neurosurgery 37 : 894 – 898 , 1995 70 Vandeinse D , Hornyak JE : Linguistic and cognitive deficits

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Leland Rogers, Peixin Zhang, Michael A. Vogelbaum, Minesh P. Mehta and on behalf of the authors

TO THE READERSHIP: An error appeared in the article by Rogers et al. ( Rogers L, Zhang P, Vogelbaum MA, et al: Intermediate-risk meningioma: initial outcomes from NRG Oncology RTOG 0539. J Neurosurg 129:35–47, 2018 ). Within Fig. 1 , Group 2 (Intermediate Risk) was erroneously noted to include patients with a newly diagnosed subtotally resected (STR) WHO Grade II tumor. These patients were not enrolled in Group 2, rather they were included in Group 3 (High Risk). The correct figure is shown below. Fig. 1. Protocol schema, accrual data, and subgroup definitions

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José Pedro Lavrador, Shami Acharya, Anastasios Giamouriadis, Francesco Vergani, Keyoumars Ashkan and Ranjeev Bhangoo

TO THE EDITOR: We read with great interest the initial results from NRG Oncology RTOG 0539 published by Rogers et al. 9 on the treatment of intermediate-risk meningioma ( Rogers L, Zhang P, Vogelbaum MA, et al: Intermediate-risk meningioma: initial outcomes from NRG Oncology RTOG 0539. J Neurosurg 129:35–47, July 2018 ). The authors provide a brief description of the trial and the division of meningioma patients into 3 risk groups according to the chance of recurrence and their treatment (low, observation; intermediate, 54 Gy in 30 fractions; and high, 60 Gy