Clinical data during 20 were collected and the report will be published in 2017 as a supplement of the official journal of the Japan Neurosurgical Society.Īn analysis of gene expression profiles in malignant gliomas is being carried out in order to determine specific genes that have an influence on the effects of chemotherapy and radiation therapy in cooperation with the Division of Brain Tumor Translational Research, the National Cancer Center Research Institute (NCCRI).
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The Department of Neurosurgery and Neuro-Oncology, the National Cancer Center Hospital (NCCH), contributes as a managing office of the BTRJ and established on-line registration using the University Hospital Medical Information Network (UMIN) system in 2009. More than 100,000 patients have been registered and followed up. Patients with brain tumors have been registered in the Brain Tumor Registry of Japan (BTRJ) since 1969. Multiplicity of brain metastasis, the stage of the primary malignancy, and the patient performance status should be taken into careful consideration. The decision on the indication for surgery of metastatic brain tumors is not simple. High dose methotrexate is administered to patients with primary CNS lymphoma before radiotherapy. Temozolomide has been given to all malignant glioma patients during radiotherapy and repeated every month for two years. Concomitant use of chemotherapy is considered to enhance the anti-tumor effect of radiotherapy. Statistical analysis revealed that surgical removal of as much of the tumor as possible yielded better survival rates even for the most malignant glioblastomas, which usually recur soon after the surgery without radiotherapy. Patients with malignant brain tumors receive postoperative radiotherapy and chemotherapy.
Usually 15-20 patients are hospitalized and two or three of them undergo surgical treatment every week. In order to design a more effective chemotherapy regimen, molecular biological studies for drug resistance, growth factors, cell kinetic studies on individual tumors, and several clinical trials are ongoing.Ī weekly conference on the treatment of patients with brain tumors is held with doctors of the Department of Radiation Oncology and the Division of Brain Tumor Translational Research.
Patients with malignant brain tumors were treated with postoperative radiotherapy and chemotherapy. Awake surgeries were also performed, particularly for the removal of gliomas near the speech center. Intraoperative monitoring with motor- and sensory-evoked potential (MEP and SEP) recording as well as preoperative functional MRI and magnetic resonance (MR) tractography were also used to preserve patient neurological functions. The site of the craniotomy and the extent of tumor removal were visualized on the intraoperative magnetic resonance imaging (MRI) in real time, contributing to safer and more precise surgery.
Approximately 300 patients were admitted and 123 craniotomies for tumor removal were carried out in 2016 including 43 gliomas, 52 brain metastases, seven primary central nervous system (CNS) lymphomas, and six meningiomas (Table 1). Patients with primary and metastatic brain tumors are treated by four neurosurgeons and two senior residents in the Department of Neurosurgery and Neuro-Oncology.
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