{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T23:26:27Z","timestamp":1769729187237,"version":"3.49.0"},"reference-count":50,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"7","license":[{"start":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T00:00:00Z","timestamp":1723420800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2024,8,12]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Spinal cord diffuse midline glioma (DMG) is a relatively rare disease with a poor prognosis and no effective treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 45-year-old man presented with rapidly progressive paraplegia in both lower extremities, along with bladder and bowel disturbance. Spinal magnetic resonance imaging (MRI) showed a heterogeneously contrast-enhanced mass at the T1\u20134 levels. A biopsy via T1\u20134 decompressive laminectomy with expansive duraplasty was performed. The histopathological diagnosis was DMG, H3K27-altered, World Health Organization grade 4. Radiation plus concomitant temozolomide was started; however, follow-up MRI showed tumor progression. Additional hypofractionated radiotherapy (HFRT; 24 Gy\/5 fractions) was performed, with bevacizumab (BEV) plus low-dose ifosfamide-carboplatin-etoposide (ICE) as second-line treatment. One month later, MRI showed tumor regression with significant improvement in the peritumoral edema. The chemotherapy regimen was repeated every 4\u20136 weeks, and the patient remained stable. After 13 courses of chemotherapy, the size of the spinal DMG increased markedly, with dissemination to the temporal lobe. The patient died approximately 21 months after the initial diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Spinal DMG is a malignant tumor with a poor prognosis. However, treatment with additional HFRT combined with BEV plus low-dose ICE may inhibit tumor progression to prolong the progression-free period and survival.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE2464\">https:\/\/thejns.org\/doi\/10.3171\/CASE2464<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case2464","type":"journal-article","created":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T02:46:14Z","timestamp":1723430774000},"source":"Crossref","is-referenced-by-count":0,"title":["Hypofractionated radiotherapy combined with bevacizumab plus low-dose ifosfamide, carboplatin, and etoposide as second-line chemoradiotherapy for progressing spinal diffuse midline glioma, H3K27-altered: illustrative case"],"prefix":"10.3171","volume":"8","author":[{"given":"Shintaro","family":"Nakayasu","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan"},{"name":"Department of Neurosurgery, Uji Tokushu-kai Hospital, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Tanji","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megumi","family":"Uto","sequence":"additional","affiliation":[{"name":"Departments of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuhide","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuhide","family":"Makino","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Etsuko","family":"Yamamoto Hattori","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukinori","family":"Terada","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noritaka","family":"Sano","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yohei","family":"Mineharu","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Mizowaki","sequence":"additional","affiliation":[{"name":"Departments of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiki","family":"Arakawa","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"6","key":"bib1","series-title":"Acta Neuropathol","first-page":"803","article-title":"The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary","volume":"131","author":"Louis","year":"2016","unstructured":"Louis DNPerry AReifenberger G, et al. 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Oncology. 2011;80(5-6):330-332."},{"issue":"1","key":"bib24","series-title":"J Neurosurg","first-page":"50","article-title":"Phase II study of ifosfamide, carboplatin, and etoposide in patients with a first recurrence of glioblastoma multiforme","volume":"112","author":"Aoki","year":"2010","unstructured":"Aoki TMizutani TNojima K, et al. Phase II study of ifosfamide, carboplatin, and etoposide in patients with a first recurrence of glioblastoma multiforme. J Neurosurg. 2010;112(1):50-56."},{"issue":"24","key":"bib25","series-title":"Cancers (Basel)","first-page":"6251","article-title":"Therapeutic targets in diffuse midline gliomas\u2014an emerging landscape","volume":"13","author":"Hayden","year":"2021","unstructured":"Hayden EHolliday HLehmann R, et al. Therapeutic targets in diffuse midline gliomas\u2014an emerging landscape. 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