Speakers

Current Status and Achievements of Clinical Trials for Brain Tumors in Japan
1108 10:20-10:30
Neuro-oncology/305
The Japan Clinical Oncology Group (JCOG) Brain Tumor Group was established in 2003. Since its inception, it has been conducting clinical trials aimed at developing standard treatments for gliomas, primary central nervous system malignant lymphomas, and metastatic brain tumors. There are 49 participating institutions, including major brain tumor treatment facilities in Japan. To date, JCOG Brain Tumor Group have conducted nine trials: four have been completed, five are ongoing, and three is currently enrolling participants. The Japan Children’s Cancer Group (JCCG) Brain Tumor Committee was established in 2014. The JCCG Brain Tumor Committee is primarily composed of specialists in neurosurgery, pediatrics, and radiation therapy. About 100 facilities participate, including major pediatric brain tumor treatment centers in Japan. The JCCG’s pediatric solid tumor observational study covers all pediatric solid tumors, registering patients anonymously at the time of onset, conducting central diagnostic reviews, and collecting clinical information and follow-up data. The JCCG Brain Tumor Committee conducts clinical trials on registered patients from this observational study. They are currently conducting clinical trials aimed at developing standard treatments for primary central nervous system germ cell tumors, medulloblastomas, AT/RT (atypical teratoid/rhabdoid tumors), and ependymomas. Five trials are underway, with one in the follow-up phase and four actively enrolling participants. This report outlines the current status and achievements of these clinical trials conducted in Japan.

Current Status and Future Prospects of Endoscopic Surgery for Intraparenchymal Brain Tumors
1108 15:55-16:05
Skull Base/304A
Objective: Endoscopic surgery for intraparenchymal brain tumors is a minimally invasive procedure that offers an expanded view in the deep brain regions. This technique involves inserting a port and performing tumor resection within the port, which limits the surgical field and hemostasis operations. Consequently, it has not yet matured as a standard surgical method. This report examines the indications, challenges, and future prospects of endoscopic surgery for intraparenchymal brain tumors based on the treatment outcomes at our hospital. Methods: We targeted 118 cases of intraparenchymal brain tumors that underwent endoscopic port surgery at our hospital since July 2007. The surgeries were performed using iPlan (Brainlab) to select the entry point, target point, approach axis, and port size. The port was stereotactically inserted using VarioGuide (Brainlab) through a small craniotomy to approach the tumor. We examined the relationship between tumor resection rates and their locations, histological types, and characteristics. Results: Tumor resections were performed 51 times in 47 cases of intraparenchymal brain tumors. There were 10 cases of large tumors exceeding 3 cm. Four cases involved staged surgeries. Resection rates were as follows: complete resection in 12 cases, subtotal resection in 10 cases, and partial resection in 29 cases. Surgical complications included one case of venous cerebral infarction and two cases of white matter injury. Tumors with higher resection rates were cystic and soft, with histological types including low-grade gliomas and central neurocytomas. Discussion: In endoscopic surgery for intraparenchymal brain tumors, large, highly hemorrhagic, and hard tumors were difficult to resect, often resulting in partial resection. For intraparenchymal tumors not involving the ventricles, limited surgical field expansion made it challenging to confirm tumor boundaries. In cases where intraoperative MRI was used to evaluate residual lesions, the intended tumor resection was achieved. This surgical method allows for minimally invasive tumor resection, and further development of equipment related to resection and hemostasis is expected to mature the surgical technique.