PubMed Health⌕ Search

Biomedical subjects

Wolfgang Grisold

Publications and source records attributed to Wolfgang Grisold.

16 recordsLinked to original sources
PubMed2006

Adjuvant procarbazine, lomustine, and vincristine improves progression-free survival but not overall survival in newly diagnosed anaplastic oligodendrogliomas and oligoastrocytomas: a randomized European Organisation for Research and Treatment of Cancer phase III trial.

PURPOSE: Anaplastic oligodendrogliomas are more responsive to chemotherapy than high-grade astrocytomas. We investigated, in a multicenter randomized controlled trial, whether adjuvant procarbazine, lomustine, and vincristine (PCV) chemotherapy improves overall survival (OS) in newly diagnosed patients with anaplastic oligodendrogliomas or anaplastic oligoastrocytomas. PATIENTS AND METHODS: The primary end point of the study was OS; secondary end points were progression-free survival (PFS) and toxicity. Patients were randomly assigned to either 59.4 Gy of radiotherapy (RT) in 33 fractions only or to the same RT followed by six cycles of standard PCV chemotherapy (RT/PCV). 1p and 19q deletions were assessed with fluorescent in situ hybridization. RESULTS: A total of 368 patients were included. The median follow-up time was 60 months, and 59% of patients have died. In the RT arm, 82% of patients with tumor progression received chemotherapy. In 38% of patients in the RT/PCV arm, adjuvant PCV was discontinued for toxicity. OS time after RT/PCV was 40.3 months compared with 30.6 months after RT only (P = .23). RT/PCV increased PFS time compared with RT only (23 v 13.2 months, respectively; P = .0018). Twenty-five percent of patients were diagnosed with combined 1p/19q loss; 74% of this subgroup was still alive after 60 months. RT/PCV did not improve survival in the subgroup of patients with 1p/19q loss. CONCLUSION: Adjuvant PCV chemotherapy does not prolong OS but does increase PFS in anaplastic oligodendroglioma. Combined loss of 1p/19q identifies a favorable subgroup of oligodendroglial tumors. No genetic subgroup could be identified that benefited with respect to OS from adjuvant PCV.

Adult↗
PubMed2006

Editorial: Brain tumour treatment: the concept of inter- and multidisciplinary treatment.

The treatment of brain tumors has improved in recent years. The principles of treatment are accurate diagnosis by imaging and neuropathology, treatment by neurosurgery, neurooncology, medical oncology, radiotherapy and optimal care and supportive strategies in a multidisciplinary setting. The development of multidisciplinary neurooncologic teams and of centers of excellence will further improve treatment quality and care. The multidisciplinary team is not confined to medical treatment alone, but needs the expertise of specially trained nurses, psychologists, occupational therapists, speech therapists and social workers to meet the needs of patients and carers.

Brain Neoplasms↗
PubMed2005

[Vitamin B12 deficiency. New data on an old theme].

Cobalamin deficiency is a common finding. In the elderly the prevalence is 10-20%, but only 5-10% of these are clinically symptomatic. Typical clinical symptoms include macrocytic anemia, neuropsychiatric symptoms and glossitis. In many cases this triad is lacking, however. The serum cobalamin assay is the best first line test, but the results must be carefully interpreted, since a normal level does not exclude deficiency. Markers of cobalamin activity, such as serum homocysteine or methylmalonic acid may be helpful in this situation. The main cause of cobalamin deficiency is atrophic gastritis. It is either caused by an autoimmune process which leads to achlorhydria and severe intrinsic factor deficiency ("classical pernicious anemia") or by atrophic gastritis from other causes, in particular helicobacter pylori infection. In the latter cases the lack of gastric acid does not allow separation of cobalamin from proteins, but intrinsic factor, although low, is sufficient for cobalamin protection (food cobalamin malabsorption). Helicobacter pylori eradication may cure some of these patients. While in food cobalamin malabsorption syndrome small doses of oral cobalamin are effective, parenteral therapy or high oral doses are required for treatment of pernicious anemia. While almost all patients respond hematologically, only half of the patients with neurological signs, and a small minority of psychiatric patients respond to treatment. Patients with pernicious anemia and atrophic gastritis have a greatly increased long-term risk for gastric carcinoids.

Clinical Trials as Topic↗
PubMed2005

P450 enzyme inducing and non-enzyme inducing antiepileptics in glioblastoma patients treated with standard chemotherapy.

The co-administration of antiepileptic drugs (AED) and chemotherapeutic agents in patients with glioblastoma multiforme (GBM) is common. Interactions of chemotherapeutic agents and AED have not been investigated sufficiently. The purpose of this study is to evaluate the effects of enzyme inducing (EI-AED) and non-EI-AED in patients with GBM treated with standard chemotherapeutic agents on survival and haematotoxicity. One hundred and sixty eight glioblastoma patients with standard treatment including surgery, radiotherapy and chemotherapy were retrospectively analysed. Patients were separated into three groups: Group A patients without AED (n=88), Group B patients with EI-AED (n=43), and Group C patients with non-EI-AED (n=37). CCNU was the most frequently used first-line drug in all three groups (Group A: 77%; Group B: 81%; Group C: 78%). Second line treatment, mainly temozolomide, was applicated in 58 of patients and third-line treatment in 9. Carbamazepine was the most frequently administered AED in Group B (81%) and valproic acid in Group C (85%). For statistical analysis, only patients with CCNU first line treatment were calculated. A significant difference regarding survival was detected between Group B (10.8 month) and Group C (13.9 month), as well as increased haematotoxicity for Group C. These results indicate that AED influence the pharmacokinetics of chemotherapeutic drugs in patients with GBM. Valproic acid might be responsible for increasing haematotoxicity. Whether the difference regarding survival between Group B and Group C is due to a decrease of efficacy of chemotherapeutic agents by EI-AED, or due to increased efficacy of chemotherapeutic agents caused by the enzyme inhibiting properties of valproic acid, has to be evaluated in future studies.

Adult↗
PubMed2005

Trigeminal neuralgia in two patients with glioblastoma.

Headache in glioblastoma patients often indicates raised intracranial pressure by either tumor edema or tumor progression. We report local glioblastoma growth causing cranial nerve lesions as well as trigeminal neuralgia, and highlight pain management in these patients.

Brain Neoplasms↗
PubMed2004

Immunohistochemical panel of antibodies in the diagnosis of brain metastases of the unknown primary.

The primary tumor of brain metastases (BM) is unknown in up to one-half of BM at the time of neurosurgery. Fifty-four consecutive unselected BM were investigated immunohistochemically using antibodies against different intermediate filaments and tumor markers. By correlating the immunohistochemical results with the location of the primary tumor, a staining pattern characteristic of the most frequent BM could be established. Subsequently, 40 cases with known primary tumor were blinded and re-evaluated based on their immunohistochemical staining pattern. Lung (20.4%), colorectum (11.1%), melanoma (7.4%), and breast (7.4%) were the most common primaries. In 14 (25.9%) cases, the primary was unknown. The characteristic immunohistochemical profiles of BM were found to be positivity of cytokeratin 7 and thyroid transcription factor-1 (TTF-1) pointing to the lung, positivity of cytokeratin 20 and negativity of cytokeratin 7 pointing to the colorectum, positivity of vimentin and protein S100 and negativity of cytokeratins (CK) pointing to a melanoma, and positivity of cytokeratin 7 and CA 15-3 with negativity of TTF-1, CA 125 and CA 19-9 pointing to the breast. These primaries comprise the majority in our series. Using the established panel of immunohistochemical markers, we were able to identify the primary in 29 out of 40 (72.5%) BM correctly. To predict the primaries of BM, a combination of antibodies against different CK, vimentin, protein S100, TTF-1, and CA 15-3 is able to point to the primary site in BM of the unknown primary.

Antibodies↗
PubMed2003

Expiratory muscle weakness and assisted cough in ALS.

Elimination of airway secretion is a major issue in the care of patients with ALS. Sufficient cough flows have to be generated by expiratory muscles to allow airway clearance. Bulbar and expiratory muscle weakness are often reasons for failure of non-invasive ventilation (NIV) and may lead to tracheostomy. Expiratory aids may help to overcome these problems, at least for some time. We report a patient with advanced ALS, receiving nocturnal NIV, who gained much benefit from regular use of a mechanical in-exsufflation device.

Amyotrophic Lateral Sclerosis↗
PubMed2002

[The frequency of seizures in patients with primary brain tumors or cerebral metastases. An evaluation from the Ludwig Boltzmann Institute of Neuro-Oncology and the Department of Neurology, Kaiser Franz Josef Hospital, Vienna].

Epileptic seizures are common in patients with cerebral metastases as well as in patients with primary brain tumors. In cancer patients without primary brain tumors or brain metastasis, epileptic seizures may occur due to metabolic or toxic causes, or due to infections. We performed a retrospective analysis from our neurooncological database concerning the occurrence of seizures in patients with primary brain tumors, patients with cerebral metastases and in cancer patients without brain tumors. Patients with low grade gliomas, such as astrocytoma WHO I + II (69%), oligodendroglioma WHO II (50%), and mixed glioma WHO II-III (56%) were more likely to have seizures than patients with anaplastic glioma WHO III (44%), glioblastoma WHO IV (48%) or meningeoma (45%). In patients with brain metastasis, melanoma (67%), cancer of the lung (29%), and gastrointestinal tumors (21%) were the primaries with the highest frequency of seizures. In cancer patients without brain metastases or primary brain tumors, seizures occurred in 4%. In conclusion, the occurrence of epileptic seizures in patients suffering from primary brain tumors, as well as in patients with cerebral metastases, varied within the tumor entity. Therefore, especially in brain tumors where a higher probability of epileptic seizures is expected, they should be taken into account in the care of cancer patients.

Adult↗
PubMed2002

FACS analysis-a new and accurate tool in the diagnosis of lymphoma in the cerebrospinal fluid.

BACKGROUND: Fluorescence activated cell scanning (FACS) is a useful tool for identifying malignant cell clones of lymphoma cells in cerebrospinal fluid (CSF) by immunological phenotype. METHODS: We used FACS analysis for demonstrating it to be a quick and reliable technology that is available in most hematological laboratories. In this study, we demonstrate the clinical application of FACS analysis within a series of 15 lymphoma patients with suspected CSF involvement. CSF from three patients with another diagnosis than lymphoma serves as negative control. RESULTS AND CONCLUSION: A malignant cell clone cannot only be identified in CSF phenotypically, but also classified according to the immunological surface profile. As this method improves the diagnostic sensitivity and specificity, it should be implemented into routine diagnosis.

Adult↗