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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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Adham M. Khalafallah, Adrian E. Jimenez, Carlos G. Romo, David Olayinka Kamson, Lawrence Kleinberg, Jon Weingart, Henry Brem, Stuart A. Grossman, and Debraj Mukherjee

M ultidisciplinary treatment is increasingly common in the management of oncological conditions as the care of cancer patients continues to become more complex, necessitating the coordinated efforts of a diverse team of medical specialists. 1–4 Multidisciplinary tumor boards (MDTBs), consisting of meetings in which experts from different fields discuss patient cases and offer treatment recommendations, is one way to achieve such care coordination. Previous research has examined the efficacy of MDTBs in specialties such as gynecological oncology

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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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Matthew T. Neal, Alexandra E. Richards, Kara L. Curley, Naresh P. Patel, Jonathan B. Ashman, Sujay A. Vora, and Maziyar A. Kalani

-grade malignancies, recurrent tumors, or in cases in which satisfactory oncological margins cannot be achieved. 3 When surgical intervention in the spinal oncology population requires stabilization with spinal hardware, conventional implant materials can be problematic. Commonly used metallic implant materials such as titanium alloys produce substantial artifacts on imaging that interfere with proper planning and delivery of RT. The presence of metals with a high number of atomic protons in the nucleus (high-Z materials), such as titanium or cobalt, can cause severe artifacts on

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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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José P. Lavrador, Graeme Pang, Francesco Vergani, Ranjeev Bhangoo, Richard Gullan, and Keyoumars Ashkan

TO THE EDITOR: Our group read with great enthusiasm the article published by Khalafallah et al. 1 focusing on the value of multidisciplinary meetings (MDMs) or tumor boards as an essential component of a comprehensive neuro-oncology service ( Khalafallah AM, Jimenez AE, Romo CG, et al. Quantifying the utility of a multidisciplinary neuro-oncology tumor board. J Neurosurg. Published online September 18, 2020. doi:10.3171/2020.5.JNS201299 ). We share the opinion that MDMs are one of the most significant advances in neuro-oncology—alongside or even more