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Biomedical subjects

Sajeel Chowdhary

Publications and source records attributed to Sajeel Chowdhary.

7 recordsLinked to original sources
PubMed2006

Ependymomas.

Optimal management of ependymomas includes surgical resection and evaluation of the extent of central nervous system involvement using cerebrospinal fluid cytology and craniospinal contrast-enhanced MRI. In instances of measurable residual disease, reoperation should be considered because survival of patients with ependymomas is significantly improved by performance of a complete resection. In patients not considered for further surgery and with residual disease, limited-field radiotherapy is usually administered. The role of craniospinal irradiation in patients with local disease and no evidence of metastasis is controversial because most tumor recurrences are local and at the site of the primary tumor. No clear role for adjuvant chemotherapy has been demonstrated. When used, chemotherapy for ependymomas has been administered primarily to children aged younger than 3 years as adjuvant therapy and to patients with recurrent disease who are not considered surgical candidates as salvage therapy. Recurrent ependymomas are managed by reoperation of tumors that are surgically accessible, by radiotherapy if not previously administered, and by salvage chemotherapy. The role of stereotactic radiotherapy administered as radiosurgery or brachytherapy is unclear because all reports are anecdotal. Because salvage chemotherapy is not curative, no standard therapy exists, and a variety of chemotherapy agents and drug schedules have been investigated.

Journal Article↗
PubMed2006

Oligodendroglial tumors.

Oligodendroglial tumors represent approximately 4-7% of all gliomas; however, in some series the incidence has been reported to be as high as 10-20% because of improved histological appreciation and recently recognized molecular signatures. Oligodendroglial tumors are classified as being low-grade oligodendroglial tumors, high-grade anaplastic oligodendroglial tumors or mixed oligo-astrocytic tumors. The mixed tumors can again be low-grade or high-grade. The recent European Organization for Research and Treatment of Cancer and Radiation Therapy Oncology Group randomized trials have provided level 1 evidence regarding the best management of these tumors. This review provides an overview of oligodendroglial tumors and discusses contemporary and evolving treatment strategies.

Brain Neoplasms↗
PubMed2006

Clinical utility and pharmacology of high-dose methotrexate in the treatment of primary CNS lymphoma.

Primary CNS non-Hodgkin lymphoma (PCNSL) has been shown to be increasing in incidence. This appears to be a consequence of the increasing population of those older than 65 years of age in whom PCNSL occurs most often. PCNSL often has a favorable response to treatment and aggressive management may result in extended survival and, in a proportion of patients less than 65 years of age, cure. The majority of neuro-oncologist's advocate utilizing high-dose methotrexate (HD-MTX) as a platform for the chemotherapy treatment of these neoplasms. In this review, the literature regarding HDHMTX as a treatment for PCNSL is summarized as are the pharmacological principles of HD-MTX.

Antimetabolites, Antineoplastic↗
PubMed2005

Leptomeningeal metastases: current concepts and management guidelines.

Neoplastic infiltration of the meninges occurs when malignant cells gain entry into the cerebrospinal fluid (CSF). This is clinically recognized in 4% to 7% of all cancer patients. Leptomeningeal metastases may involve any part of the neural axis via tumor seeding; thus, a multitude of clinical presentations involving one or more domains exist, including the cerebral hemisphere, cranial nerves, and spinal cord and roots. The diagnosis of CSF metastases is often delayed and not appreciated until fixed neurologic deficits become evident. Adequate cytologic analysis of CSF fluid, neuroradiography of brain and spine, and an appropriate clinical context are the key element in diagnosing leptomeningeal metastases. A major challenge of treating neoplastic meningitis is the importance of treating the entire neural axis and stratifying patients in poor risk or good risk categories. Treatment is palliative and involves stabilizing neurologic status and prolonging survival. Median survival for untreated patients is 4 to 6 weeks. Treatment in a broad perspective entails radiotherapy and chemotherapy (systemic and intra-CSF). Commonly used intra-CSF chemotherapy regimens use drugs such as methotrexate, cytarabine, thiotepa, and a sustained-release liposome-encapsulated form of cytarabine (Depocyt, SkyePharma, London, UK). Patients with neoplastic meningitis usually experience a limited survival, even when treated using close adherence to evaluation algorithms and treatment protocols. In randomized controlled clinical trials using currently available intra-CSF chemotherapeutic agents, median survival in carefully selected, study-eligible groups of patients was 2 to 6 months.

Algorithms↗
PubMed2002

Collision of a syncytial meningioma and malignant astrocytoma.

The coexistence of two or more primary brain tumors is a relatively rare occurrence. We report an 87-year-old woman with a 5-cm cystic-solid, peripherally enhancing, right frontal lobe mass. The woman presented with progressive hemiparesis, difficulty ambulating, and urinary incontinence. Histologic examination of the surgically excised lesion showed geographically distinct areas of syncytial meningioma (World Health Organization grade I) and malignant astrocytoma (World Health Organization grade III). Focally, infiltration of the meningioma by astrocytoma was observed. Differential diagnostic issues are considered and the literature reviewed.

Aged↗