# Neuro-Oncology and Brain Tumors — GCMD Library living collection

Updated: n/a · 6 episodes · 21 cited statements

## Episodes
### Glioblastoma Management
- [Essential Evidence for Glioblastoma: A Must-Know for Neurosurgery Exams](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639) — video · 11:06 · [machine version](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639.md)
- [Time-dependent cytokine landscapes in an ex vivo microfluidic glioblastoma platform](https://qa.library.globalcastmd.com/article/time-dependent-cytokine-landscapes-in-an-ex-vivo-microfluidic-glioblastoma-platf-13615) — article · [machine version](https://qa.library.globalcastmd.com/article/time-dependent-cytokine-landscapes-in-an-ex-vivo-microfluidic-glioblastoma-platf-13615.md)
- [Investigating the effects of arginine methylation inhibitors on microdissected brain tumour biopsies maintained in a miniaturised perfusion system](https://qa.library.globalcastmd.com/article/investigating-the-effects-of-arginine-methylation-inhibitors-on-microdissected-b-13617) — article · [machine version](https://qa.library.globalcastmd.com/article/investigating-the-effects-of-arginine-methylation-inhibitors-on-microdissected-b-13617.md)
- [HULL'S MAGIC BOX: BUILDING THE CASE FOR CLINICAL TRIALS USING ARGININE METHYLATION INHIBITORS AGAINST GBM](https://qa.library.globalcastmd.com/article/hull-s-magic-box-building-the-case-for-clinical-trials-using-arginine-methylatio-13620) — article · [machine version](https://qa.library.globalcastmd.com/article/hull-s-magic-box-building-the-case-for-clinical-trials-using-arginine-methylatio-13620.md)
- [Our novel glioblastoma  microfluidic platform](https://qa.library.globalcastmd.com/watch/our-novel-glioblastoma-microfluidic-platform-13640) — video · 4:32 · [machine version](https://qa.library.globalcastmd.com/watch/our-novel-glioblastoma-microfluidic-platform-13640.md)

### Radiosurgery and Radiation Therapy
- [Efficacy and safety of stereotactic radiosurgery versus whole brain radiotherapy for the treatment of brain metastasis: a systematic review and meta-analysis](https://qa.library.globalcastmd.com/article/efficacy-and-safety-of-stereotactic-radiosurgery-versus-whole-brain-radiotherapy-13616) — article · [machine version](https://qa.library.globalcastmd.com/article/efficacy-and-safety-of-stereotactic-radiosurgery-versus-whole-brain-radiotherapy-13616.md)

## Chapters
- [0:00](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=0) Introduction and Evidence-Based Medicine Framework (Ep 1)
- [1:01](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=61) Stupp Protocol: Standard of Care (Ep 1)
- [2:15](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=135) RANO Criteria for Extent of Resection (Ep 1)
- [4:40](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=280) 5-Aminolevulinic Acid Fluorescence-Guided Surgery (Ep 1)
- [7:14](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=434) Awake Craniotomy for Eloquent Area Tumors (Ep 1)
- [7:56](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=476) Intraoperative MRI (Ep 1)
- [9:00](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=540) Bevacizumab Anti-VEGF Therapy (Ep 1)
- [9:50](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=590) Tumor Treating Fields (Ep 1)
- [0:00](https://qa.library.globalcastmd.com/watch/our-novel-glioblastoma-microfluidic-platform-13640?t=0) Introduction and rationale for patient-derived GBM tissue platform (Ep 5)
- [0:59](https://qa.library.globalcastmd.com/watch/our-novel-glioblastoma-microfluidic-platform-13640?t=59) Tissue collection and microfluidic chip setup (Ep 5)
- [2:09](https://qa.library.globalcastmd.com/watch/our-novel-glioblastoma-microfluidic-platform-13640?t=129) Cytokine profiling methodology (Ep 5)
- [2:41](https://qa.library.globalcastmd.com/watch/our-novel-glioblastoma-microfluidic-platform-13640?t=161) Tissue viability results (Ep 5)
- [3:30](https://qa.library.globalcastmd.com/watch/our-novel-glioblastoma-microfluidic-platform-13640?t=210) Cytokine response to treatment and conclusions (Ep 5)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- Awake craniotomy offers significant advantages over general anesthesia for glioblastoma near eloquent brain by allowing real-time patient interaction to map and preserve critical functions like speech and movement. (clinical) [Ep 1 · 7:17](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=437)
- Awake craniotomy helps maximize tumor resection while minimizing postoperative neurological deficits. (clinical) [Ep 1 · 7:36](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=456)
- Drawbacks of awake craniotomy include need for careful patient selection, potential discomfort and anxiety during surgery, and longer operative times in some cases. (clinical) [Ep 1 · 7:45](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=465)
- Intraoperative MRI is not available in all hospitals and requires strong infrastructure and investment to install in neurosurgical theater. (clinical) [Ep 1 · 8:18](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=498)
- Traditional methods like animal models and cell cultures fall short in replicating the complexity of glioblastoma microenvironment — Ammar (opinion) [Ep 5 · 0:16](https://qa.library.globalcastmd.com/watch/our-novel-glioblastoma-microfluidic-platform-13640?t=16)
- Patient GBM tissue can closely mimic the microenvironment of glioblastoma and allow testing of therapeutic interventions — Ammar (opinion) [Ep 5 · 0:34](https://qa.library.globalcastmd.com/watch/our-novel-glioblastoma-microfluidic-platform-13640?t=34)
- The microfluidic chip maintains GBM tissue from patients for 8 days and in some cases 12 days in the lab — Ammar (clinical) [Ep 5 · 0:46](https://qa.library.globalcastmd.com/watch/our-novel-glioblastoma-microfluidic-platform-13640?t=46)
- GBM tissue is collected during surgery with patient consent, placed in nutrient media immediately, and transferred to lab within one hour — Ammar (clinical) [Ep 5 · 0:59](https://qa.library.globalcastmd.com/watch/our-novel-glioblastoma-microfluidic-platform-13640?t=59)
- The microfluidic system uses a cylindrical shape with inner tube connected to syringe with nutrient media, with or without treatment, and effluent tube collecting released cytokines — Ammar (clinical) [Ep 5 · 1:26](https://qa.library.globalcastmd.com/watch/our-novel-glioblastoma-microfluidic-platform-13640?t=86)
- The treatment tested was temozolomide plus protein arginine methylation inhibitors — Ammar (clinical) [Ep 5 · 1:36](https://qa.library.globalcastmd.com/watch/our-novel-glioblastoma-microfluidic-platform-13640?t=96)
- The Harvard syringe pump delivers nutrient media at a rate of 3 microliters per minute over 8 to 12 days — Ammar (clinical) [Ep 5 · 1:47](https://qa.library.globalcastmd.com/watch/our-novel-glioblastoma-microfluidic-platform-13640?t=107)
- Effluent containing cytokines is collected every 24 hours and stored at -80°C to maintain cytokine integrity — Ammar (clinical) [Ep 5 · 1:58](https://qa.library.globalcastmd.com/watch/our-novel-glioblastoma-microfluidic-platform-13640?t=118)
- The RDN Systems protein profiler membrane allows testing of 105 human cytokines in a single membrane in duplicate form — Ammar (clinical) [Ep 5 · 2:09](https://qa.library.globalcastmd.com/watch/our-novel-glioblastoma-microfluidic-platform-13640?t=129)
- Part of the 105 cytokines detected by protein profiler membrane are validated by ELISA — Ammar (clinical) [Ep 5 · 2:25](https://qa.library.globalcastmd.com/watch/our-novel-glioblastoma-microfluidic-platform-13640?t=145)
- Data has been collected from 13 patients over 12 days — Ammar (epidemiological) [Ep 5 · 2:32](https://qa.library.globalcastmd.com/watch/our-novel-glioblastoma-microfluidic-platform-13640?t=152)
- H&E staining shows GBM tissue cells maintain integrity after 8 days on the chip and also at 12 days — Ammar (clinical) [Ep 5 · 2:45](https://qa.library.globalcastmd.com/watch/our-novel-glioblastoma-microfluidic-platform-13640?t=165)
- GBM tissue viability in the microfluidic chip shows minimal difference over the first 4 days — Ammar (clinical) [Ep 5 · 3:07](https://qa.library.globalcastmd.com/watch/our-novel-glioblastoma-microfluidic-platform-13640?t=187)
- After 96 hours (4 days), GBM tissue begins to decrease and change patterns, with more pronounced changes at 12 days — Ammar (clinical) [Ep 5 · 3:19](https://qa.library.globalcastmd.com/watch/our-novel-glioblastoma-microfluidic-platform-13640?t=199)
- EGF and MMP9 are significantly reduced under the novel treatment (temozolomide plus protein arginine methylation inhibitors) compared to control — Ammar (clinical) [Ep 5 · 3:30](https://qa.library.globalcastmd.com/watch/our-novel-glioblastoma-microfluidic-platform-13640?t=210)
- Serpin E3-like 1, a cytokine mainly related to colon cancer, is abundant in GBM and increases against treatment, potentially indicating a role in resistance — Ammar (clinical) [Ep 5 · 3:50](https://qa.library.globalcastmd.com/watch/our-novel-glioblastoma-microfluidic-platform-13640?t=230)
- The microfluidic model is a potential GBM model to test therapeutic interventions and assess effects over 8 to 12 days — Ammar (opinion) [Ep 5 · 3:59](https://qa.library.globalcastmd.com/watch/our-novel-glioblastoma-microfluidic-platform-13640?t=239)

## Host summaries
Recaps by a host of what the experts said — not the host's own clinical position.
- The Stupp protocol was published in 2005 as a landmark paper combining radiotherapy and chemotherapy with maximal surgical resection as the gold standard. — The host summarizing the discussion [Ep 1 · 1:07](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=67)
- The Stupp protocol radiotherapy consists of 60 Gy over 6 weeks with 2 Gy daily Monday to Friday (30 fractions total). — The host summarizing the discussion [Ep 1 · 1:33](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=93)
- Concurrent phase temozolomide in the Stupp protocol is 75 mg daily for six weeks. — The host summarizing the discussion [Ep 1 · 1:50](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=110)
- Adjuvant temozolomide monotherapy is 150-200 mg per meter squared on days 1-5 of each 28-day cycle for a total of 6 cycles. — The host summarizing the discussion [Ep 1 · 1:57](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=117)
- RANO (Response Assessment in Neuro-Oncology) criteria classify resections based on residual contrast-enhancing tumor on T1 and non-contrast-enhancing hyperintense tissue on FLAIR, believed to represent glioblastoma infiltrative tissue. — The host summarizing the discussion [Ep 1 · 2:21](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=141)
- RANO Class 1 (supramaximal contrast-enhancing resection) leaves 0 cubic centimeters of contrast-enhancing and less than 5 cubic centimeters of non-contrast-enhancing tissue, with median overall survival of 24 months. — The host summarizing the discussion [Ep 1 · 3:09](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=189)
- RANO Class 2A (maximal surgical resection) leaves 0 cubic centimeters of contrast-enhancing and more than 5 cubic centimeters of non-contrast-enhancing tissue. — The host summarizing the discussion [Ep 1 · 3:39](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=219)
- RANO Class 2B (maximal surgical resection) leaves less than 1 cubic centimeter of contrast-enhancing tissue, with median overall survival of 19 months. — The host summarizing the discussion [Ep 1 · 3:55](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=235)
- RANO Class 3 (submaximal contrast-enhancing resection) leaves less than 5 or more than 5 cubic centimeters of contrast-enhancing tissue on T1 postoperatively, with median overall survival of 15 months. — The host summarizing the discussion [Ep 1 · 4:07](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=247)
- RANO Class 4 (biopsy) has no reduction of tumor volume and gives 10 months median overall survival if the patient had chemoradiotherapy. — The host summarizing the discussion [Ep 1 · 4:31](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=271)
- 5-ALA crosses the blood-brain barrier and enters mitochondria where it becomes protoporphyrinogen IX and protoporphyrin IX. In glioblastoma, ferrochelatase enzyme is less effective, leading to accumulation of protoporphyrin IX. — The host summarizing the discussion [Ep 1 · 5:01](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=301)
- Protoporphyrin IX emits bright pink fluorescence when exposed to blue light microscope with wavelength 405 to 633 nanometers, allowing tumor visualization during surgery. — The host summarizing the discussion [Ep 1 · 5:46](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=346)
- 5-ALA is administered as 1.5 g powder reconstituted in 50 mL drinking water (30 mg/mL oral solution) at a dosage of 20 mg per kg, given 2 to 4 hours before surgery. — The host summarizing the discussion [Ep 1 · 6:11](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=371)
- A randomized controlled trial of fluorescence-guided surgery with 5-ALA showed complete contrast-enhancing resection in 65% of patients using 5-ALA compared to 36% using white light. — The host summarizing the discussion [Ep 1 · 6:50](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=410)
- 5-ALA fluorescence guidance allowed higher 6-month progression-free survival compared to white light surgery. — The host summarizing the discussion [Ep 1 · 7:10](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=430)
- Intraoperative MRI allows real-time imaging during surgery, enhancing the surgeon's ability to achieve maximum resections and increasing the rate of complete resections. — The host summarizing the discussion [Ep 1 · 8:02](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=482)
- Senft 2011 study on intraoperative MRI showed more patients had complete tumor resection than the control group, and postoperative rate of neurological deficits did not differ between groups. — The host summarizing the discussion [Ep 1 · 8:33](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=513)
- VEGF (vascular endothelial growth factor) is responsible for stimulating endothelial cell proliferation and migration in glioblastoma microenvironment. — The host summarizing the discussion [Ep 1 · 9:00](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=540)
- Bevacizumab reduces regression of existing microvessels and inhibits growth of new blood vessels, acting like dexamethasone but with more potent effect. — The host summarizing the discussion [Ep 1 · 9:10](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=550)
- Bevacizumab increases overall survival by only a few months. — The host summarizing the discussion [Ep 1 · 9:23](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=563)
- Bevacizumab is FDA-approved in the United States. — The host summarizing the discussion [Ep 1 · 9:32](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=572)
- The European Medicines Agency and UK NICE guidance have not proven bevacizumab as a cost-effective treatment. — The host summarizing the discussion [Ep 1 · 9:35](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=575)
- Tumor treating fields is a non-invasive modality applying mild electric fields that disturb cancer cell division. — The host summarizing the discussion [Ep 1 · 9:50](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=590)
- Tumor treating fields combined with temozolomide shows significant improvement in progression-free survival. — The host summarizing the discussion [Ep 1 · 9:50](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=590)
- There is currently a trial in the UK running to see the effectiveness of tumor treating fields and to prove it for inclusion in NICE guidelines. — The host summarizing the discussion [Ep 1 · 10:10](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=610)
- Tumor treating fields plus temozolomide versus temozolomide alone increased progression-free survival by 2.7 months. — The host summarizing the discussion [Ep 1 · 10:19](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=619)
- Tumor treating fields plus temozolomide versus temozolomide alone improved overall survival by 4.9 months. — The host summarizing the discussion [Ep 1 · 10:19](https://qa.library.globalcastmd.com/watch/essential-evidence-for-glioblastoma-a-must-know-for-neurosurgery-exams-13639?t=619)

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