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Eyvazzadeh N, Neshasteh-Riz A, Mahdavi SR. DNA damage of glioblastoma multiform cells induced by Beta radiation of iodine-131 in the presence or absence of topotecan: a picogreen and colonogenic assay. CELL JOURNAL 2015; 17:99-110. [PMID: 25870839 PMCID: PMC4393677 DOI: 10.22074/cellj.2015.516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Accepted: 02/08/2014] [Indexed: 11/20/2022]
Abstract
Objective Glioblastoma multiforme (GBM), one of the most common and aggressive
malignant brain tumors, is highly resistant to radiotherapy. Numerous approaches have
been pursued to find new radiosensitizers. We used a picogreen and colonogenic assay
to appraise the DNA damage and cell death in a spheroid culture of GBM cells caused by
iodine-131 (I-131) beta radiation in the presence of topotecan (TPT). Materials and Methods U87MG cells were cultured as spheroids with approximate
diameters of 300 μm. Cells were treated with beta radiation of I-131 (at a dose of 2 Gy)
and/ or TPT (1 μg/ml for 2 hours). The numbers of cells that survived were compared with
untreated cells using a colonogenic assay. In addition, we evaluated possible DNA damages by the picogreen method. The relation between DNA damage and cell death was
assessed in the experimental study of groups.
Results The findings showed that survival fraction (SF) in the I-131+TPT group
(39%) was considerably less than the I-131 group (58.92%; p<0.05). The number of
single strand breaks (SSB) and double strand breaks (DSB), in the DNA of U87MG
cells treated with beta radiation of I-131 and TPT (I-131+TPT) significantly increased
compared to cells treated with only I-131 or TPT (p<0.05). The amount of SSB repair was more than DSB repair (p<0.05). The relationship between cell death and
DNA damage was close (r≥0.6) and significant (p<0.05) in the irradiated and treated
groups. Also the maximum rate of DNA repair occurred 24 hours after the treatments.
A significant difference was not observed on other days of the restoration.
Conclusion The findings in the present study indicated that TPT can sensitize
U87MG cells to radiation and increase DNA damages. Potentially, TPT can cause
an increase in damage from DSB and SSB by its inhibitory effects on topoisomerase
enzyme and the cell cycle. The increased complex damages following the use of a
genotoxic agent and beta I-131 radiation, causes a significant increase the cell death
because of the difficult repair process. By assessing the relationship between DNA
damage and cell death, the picogreen method can be useful in predicting colonogenic
assay. Consequently, it is suggested that co-treatment with I-131 beta radiation and
TPT can improve GBM treatment.
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Affiliation(s)
- Nazila Eyvazzadeh
- Radiation Research Center, Faculty of Paramedicine, AJA University of Medical Sciences, Tehran, Iran
| | - Ali Neshasteh-Riz
- Department of Radiology, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Rabee Mahdavi
- Department of Medical Physics, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Abstract
ABSTRACT:Malignant astrocytomas are aggressive neoplasms with a dismal prognosis despite optimal treatment. Maximal resective surgery is traditionally complemented by radiation therapy. Chemotherapy is now used on patients as initial therapy when their functional status is congruent with further treatment. The classic agents used are nitrosoureas, but temozolomide has taken the front seat recently, with recent data demonstrating increased survival when this agent is used concurrently with radiation therapy in newly diagnosed glioblastoma patients. A new class of agents, refered to as biological modifiers, are increasingly used in clinical trials in an effort to affect the intrinsic biologic aberrations harboured by tumor cells. These drugs comprise differentiation agents, anti-angiogenic agents, matrix-metalloproteinase inhibitors and signal transduction inhibitors, among others. This article reviews the standard cytotoxic agents that have been used to treat malignant astrocytomas, and the different combination regimens offering promise. In addition, recent advances with biological modifiers are also discussed.
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Affiliation(s)
- David Mathieu
- Division of Neurosurgery/Neuro-Oncology, Department of Surgery, Sherbrooke University and Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
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Sabbatino F, Fusciello C, Somma D, Pacelli R, Poudel R, Pepin D, Leonardi A, Carlomagno C, Della Vittoria Scarpati G, Ferrone S, Pepe S. Effect of p53 activity on the sensitivity of human glioblastoma cells to PARP-1 inhibitor in combination with topoisomerase I inhibitor or radiation. Cytometry A 2014; 85:953-61. [PMID: 25182801 DOI: 10.1002/cyto.a.22563] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 08/09/2014] [Accepted: 08/13/2014] [Indexed: 01/19/2023]
Abstract
Poly (ADP-Ribose) polymerase-1 (PARP-1) is involved in the DNA repairing system by sensing and signaling the presence of DNA damage. Inhibition of PARP-1 is tested in combination with DNA damaging agents such as topoisomerase I inhibitors or ionizing radiations (RT) for the treatment of glioblastoma (GBM). Disruption of p53, widely prevalent in GBMs, plays a major role in DNA repairing system. The current study investigates whether p53 activity has an effect on the sensitivity of human GBM cells to PARP-1 inhibitors in combination with topoisomerase I inhibitor topotecan (TPT) and/or RT. Human GBM cell lines carrying a different functional status of p53 were treated with PARP-1 inhibitor NU1025, in combination with TPT and/or RT. Cytotoxic effects were examined by analyzing the antiproliferative activity, the cell cycle perturbations, and the DNA damage induced by combined treatments. PARP inhibition enhanced the antiproliferative activity, the cell cycle perturbations and the DNA damage induced by both TPT or RT in GBM cells. These effects were influenced by the p53 activity: cells carrying an active p53 were more sensitive to the combination of PARP inhibitor and RT, while cells carrying an inactive p53 displayed a higher sensitivity to the combination of PARP inhibitor and TPT. Our study suggests that p53 activity influences the differential sensitivity of GBM cells to combined treatments of TPT, RT, and PARP inhibitors. © 2014 International Society for Advancement of Cytometry.
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Affiliation(s)
- Francesco Sabbatino
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Via Sergio Pansini 5, Naples, Italy, 80131; Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, 02114
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A pilot study of glioblastoma multiforme in elderly patients: treatments, O-6-methylguanine-DNA methyltransferase (MGMT) methylation status and survival. Clin Neurol Neurosurg 2013; 115:1375-8. [PMID: 23333005 DOI: 10.1016/j.clineuro.2012.12.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Revised: 12/21/2012] [Accepted: 12/26/2012] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Elderly Glioblastoma multiforme (GBM) patients have a worse prognosis and receive variable treatments. MGMT gene promoter methylation is linked with improved survival in GBM. We examined treatments administered and survival including in relation to MGMT methylation status in elderly GBM patients. PATIENTS AND METHODS Patients ≥65 years with diagnosed GBM between 1/01/2007 and 30/04/2009 and undergoing either a biopsy, subtotal (STR) or gross total resection (GTR) were included. The collected information included MGMT status [methylated (ME) vs. unmethylated (UN)] and survival data. p<0.05 was considered significant. RESULTS 59 patients were identified with median age at diagnosis being 72.68 years (65.72-85.04). Treatment included surgery (25 GTR, 8 STR, 26 biopsy), chemoradiation (22) and radiotherapy alone (20). Overall median overall survival (MOS) was 219 days. MOS with chemoradiation was 316 days vs. 143 days without it (p=0.011). 47 patients had definite MGMT status (28 ME, 19 UN). In ME patients, 9/28 received temozolamide compared to 10/19 in UN category. Temozolamide administration in patients with definite MGMT status was based on WHO performance status (p=0.007). MOS in UN group was 308 days vs. 167 days in ME group (p=0.068). In a multivariate Cox model including use of temozolamide, WHO score and methylation status, only temozolamide use was significantly associated with a reduced risk for death (HR 0.443, 95% CI 0.200-0.982, p=0.045). CONCLUSIONS In this small cohort of patients, chemoradiation in suitable elderly GBM patients seemed to afford a survival benefit. MGMT methylation was not associated with an improved survival with temozolamide being the only factor leading to a better survival. Temozolamide use should be considered irrespective of MGMT status in this population with future large prospective studies needed to elucidate this further.
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Ahmadloo N, Kani AA, Mohammadianpanah M, Nasrolahi H, Omidvari S, Mosalaei A, Ansari M. Treatment outcome and prognostic factors of adult glioblastoma multiforme. J Egypt Natl Canc Inst 2012; 25:21-30. [PMID: 23499203 DOI: 10.1016/j.jnci.2012.11.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2012] [Revised: 11/08/2012] [Accepted: 11/12/2012] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION This study aimed to report the characteristics, prognostic factors and treatment outcome of 223 patients with glioblastoma multiforme (GBM). SUBJECTS AND METHOD This retrospective study was carried out by reviewing the medical records of 223 adult patients diagnosed at a tertiary academic hospital between 1990 and 2008. Patients' follow up ranged from 1 to 69 months (median 11 months). Surgery was attempted in all patients in whom complete resection in 15 patients (7%), subtotal resection in 77 patients (34%), partial resection in 73 patients (33%) and biopsy alone in 58 patients (26%) were done. In addition, we performed a literature review of PubMed to find out and analyze major related series. In all, we collected and analyzed the data of 33 major series including more than 11,000 patients with GBM. RESULTS There were 141 men and 82 women. The median progression free- and overall survival were 6 (95% CI=5.711-8.289) and 11 (95% CI=9.304-12.696) months respectively. In univariate analysis for overall survival, age (P=0.003), tumor size (P<0.013), performance status (P<0.001), the extent of surgical resection (P=0.009), dose of radiation (P<0.001), and adjuvant chemotherapy (P<0.001) were prognostic factors. However, in multivariate analysis, only radiation dose, extent of surgical resection, and adjuvant chemotherapy were independent prognostic factors for overall survival. CONCLUSION The prognosis of adult patients with GBM remains poor; however, complete surgical resection and adjuvant treatments improve progression-free and overall survival.
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Affiliation(s)
- Niloofar Ahmadloo
- Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
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Philip-Ephraim EE, Eyong KI, Williams UE, Ephraim RP. The role of radiotherapy and chemotherapy in the treatment of primary adult high grade gliomas: assessment of patients for these treatment approaches and the common immediate side effects. ISRN ONCOLOGY 2012; 2012:902178. [PMID: 23304556 PMCID: PMC3529903 DOI: 10.5402/2012/902178] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 11/06/2012] [Indexed: 12/16/2022]
Abstract
Gliomas are the commonest primary brain tumours in adults. They are usually classified and graded according to the criteria by the World Health Organisation. High-grade gliomas are the most malignant primary brain tumours. Conventional therapies include surgery, radiotherapy, and chemotherapy. The tumours often demonstrate high levels of resistance to these conventional therapies, and in spite of treatment advances the prognosis remains poor.
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Affiliation(s)
- E E Philip-Ephraim
- Department of Internal Medicine, College of Medical Sciences, University of Calabar, PMB 1278, Nigeria
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Grabenbauer GG, Gerber KD, Ganslandt O, Richter A, Klautke G, Birkmann J, Meyer M. Effects of Concurrent Topotecan and Radiation on 6-Month Progression-Free Survival in the Primary Treatment of Glioblastoma Multiforme. Int J Radiat Oncol Biol Phys 2009; 75:164-9. [DOI: 10.1016/j.ijrobp.2009.04.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2008] [Revised: 04/09/2009] [Accepted: 04/10/2009] [Indexed: 11/17/2022]
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Grahn AY, Bankiewicz KS, Dugich-Djordjevic M, Bringas JR, Hadaczek P, Johnson GA, Eastman S, Luz M. Non-PEGylated liposomes for convection-enhanced delivery of topotecan and gadodiamide in malignant glioma: initial experience. J Neurooncol 2009; 95:185-197. [PMID: 19466380 PMCID: PMC2759007 DOI: 10.1007/s11060-009-9917-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2009] [Accepted: 04/30/2009] [Indexed: 11/25/2022]
Abstract
Convection-enhanced delivery (CED) of highly stable PEGylated liposomes encapsulating chemotherapeutic drugs has previously been effective against malignant glioma xenografts. We have developed a novel, convectable non-PEGylated liposomal formulation that can be used to encapsulate both the topoisomerase I inhibitor topotecan (topoCED™) and paramagnetic gadodiamide (gadoCED™), providing an ideal basis for real-time monitoring of drug distribution. Tissue retention of topoCED following single CED administration was significantly improved relative to free topotecan. At a dose of 10 μg (0.5 mg/ml), topoCED had a half-life in brain of approximately 1 day and increased the area under the concentration–time curve (AUC) by 28-fold over free topotecan (153.8 vs. 5.5 μg day/g). The combination of topoCED and gadoCED was found to co-convect well in both naïve rat brain and malignant glioma xenografts (correlation coefficients 0.97–0.99). In a U87MG cell assay, the 50% inhibitory concentration (IC50) of topoCED was approximately 0.8 μM at 48 and 72 h; its concentration–time curves were similar to free topotecan and unaffected by gadoCED. In a U87MG intracranial rat xenograft model, a two-dose CED regimen of topoCED co-infused with gadoCED greatly increased median overall survival at dose levels of 0.5 mg/ml (29.5 days) and 1.0 mg/ml (33.0 days) vs. control (20.0 days; P < 0.0001 for both comparisons). TopoCED at higher concentrations (1.6 mg/ml) co-infused with gadoCED showed no evidence of histopathological changes attributable to either agent. The positive results of tissue pharmacokinetics, co-convection, cytotoxicity, efficacy, and lack of toxicity of topoCED in a clinically meaningful dose range, combined with an ideal matched-liposome paramagnetic agent, gadoCED, implicates further clinical applications of this therapy in the treatment of malignant glioma.
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Affiliation(s)
- Amy Y Grahn
- MedGenesis Therapeutix Inc, Victoria, 730-730 View St, Victoria, BC, V8W 3Y7, Canada.
| | - Krystof S Bankiewicz
- Department of Neurological Surgery, Brain Tumor Research Center, University of California San Francisco, 1855 Folsom Street, Suite 535, Box 1631, San Francisco, CA, 94143-1631, USA
| | | | - John R Bringas
- Department of Neurological Surgery, Brain Tumor Research Center, University of California San Francisco, 1855 Folsom Street, Suite 535, Box 1631, San Francisco, CA, 94143-1631, USA
| | - Piotr Hadaczek
- Department of Neurological Surgery, Brain Tumor Research Center, University of California San Francisco, 1855 Folsom Street, Suite 535, Box 1631, San Francisco, CA, 94143-1631, USA
| | - Greg A Johnson
- MedGenesis Therapeutix Inc, Victoria, 730-730 View St, Victoria, BC, V8W 3Y7, Canada
| | - Simon Eastman
- Northern Lipids Inc, 8855 Northbrook Court, Burnaby, BC, V5J 5J1, Canada
| | - Matthias Luz
- MedGenesis Therapeutix Inc, Victoria, 730-730 View St, Victoria, BC, V8W 3Y7, Canada
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Lesimple T, Riffaud L, Frappaz D, Ben Hassel M, Gédouin D, Bay JO, Linassier C, Hamlat A, Piot G, Fabbro M, Saïkali S, Carsin B, Guégan Y. Topotecan in combination with radiotherapy in unresectable glioblastoma: a phase 2 study. J Neurooncol 2009; 93:253-60. [PMID: 19139825 DOI: 10.1007/s11060-008-9774-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2008] [Accepted: 12/16/2008] [Indexed: 12/17/2022]
Abstract
Improving glioblastoma multiforme (GBM) treatment with radio-chemotherapy remains a challenge. Topotecan is an attractive option as it exhibits growth inhibition of human glioma as well as brain penetration. The present study assessed the combination of radiotherapy (60 Gy/30 fractions/40 days) and topotecan (0.9 mg/m(2)/day on days 1-5 on weeks 1, 3 and 5) in 50 adults with histologically proven and untreated GBM. The incidence of non-hematological toxicities was low and grade 3-4 hematological toxicities were reported in 20 patients (mainly lymphopenia and neutropenia). Partial response and stabilization rates were 2% and 32%, respectively, with an overall time to progression of 12 weeks. One-year overall survival (OS) rate was 42%, with a median OS of 40 weeks. Topotecan in combination with radiotherapy was well tolerated. However, while response and stabilization concerned one-third of the patients, the study did not show increased benefits in terms of survival in patients with unresectable GBM.
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Affiliation(s)
- Thierry Lesimple
- Department of Medical Oncology, Centre Eugène Marquis, Rennes, France.
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Yamashita Y, Krauze MT, Kawaguchi T, Noble CO, Drummond DC, Park JW, Bankiewicz KS. Convection-enhanced delivery of a topoisomerase I inhibitor (nanoliposomal topotecan) and a topoisomerase II inhibitor (pegylated liposomal doxorubicin) in intracranial brain tumor xenografts. Neuro Oncol 2006; 9:20-8. [PMID: 17018695 PMCID: PMC1828110 DOI: 10.1215/15228517-2006-016] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Despite multimodal treatment options, the response and survival rates for patients with malignant gliomas remain dismal. Clinical trials with convection-enhanced delivery (CED) have recently opened a new window in neuro-oncology to the direct delivery of chemotherapeutics to the CNS, circumventing the blood-brain barrier and reducing systemic side effects. Our previous CED studies with liposomal chemotherapeutics have shown promising antitumor activity in rodent brain tumor models. In this study, we evaluated a combination of nanoliposomal topotecan (nLs-TPT) and pegylated liposomal doxorubicin (PLD) to enhance efficacy in our brain tumor models, and to establish a CED treatment capable of improving survival from malignant brain tumors. Both liposomal drugs decreased key enzymes involved in tumor cell replication in vitro. Synergistic effects of nLs-TPT and PLD on U87MG cell death were found. The combination displayed excellent efficacy in a CED-based survival study 10 days after tumor cell implantation. Animals in the control group and those in singleagent groups had a median survival of less than 30 days, whereas the combination group experienced a median survival of more than 90 days. We conclude that CED of two liposomal chemotherapeutics (nLs-TPT and PLD) may be an effective treatment option for malignant gliomas.
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Affiliation(s)
| | | | | | | | | | | | - Krystof S. Bankiewicz
- Address correspondence to Krystof S. Bankiewicz, Department of Neurological Surgery, University of California, San Francisco, 1855 Folsom Street, Mission Center Building Room 226, San Francisco, CA 94103, USA (
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Saito R, Krauze MT, Noble CO, Drummond DC, Kirpotin DB, Berger MS, Park JW, Bankiewicz KS. Convection-enhanced delivery of Ls-TPT enables an effective, continuous, low-dose chemotherapy against malignant glioma xenograft model. Neuro Oncol 2006; 8:205-14. [PMID: 16723630 PMCID: PMC1871954 DOI: 10.1215/15228517-2006-001] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Treatment of malignant gliomas represents one of the most formidable challenges in oncology. The combination of surgery, radiation, and chemotherapy yields median survivals of less than one year. Here we demonstrate the use of a minimally invasive surgical technique, convection-enhanced delivery (CED), for local administration of a novel nanoparticle liposome containing topotecan. CED of this liposomal topotecan (Ls-TPT) resulted in extended brain tissue retention (t1/2 = 1.5 days), whereas free topotecan was rapidly cleared (t1/2 = 0.1 days) after CED. The favorable pharmacokinetic profile of extended topotecan release for about seven days, along with biodistribution featuring perivascular accumulation of the nanoparticles, provided, in addition to the known topoisomerase I inhibition, an effective antiangiogenic therapy. In the rat intracranial U87MG tumor model, vascular targeting of Ls-TPT with CED was associated with reductions in laminin expression and vascular density compared to free topotecan or control treatments. A single CED treatment on day 7 showed that free topotecan conferred no survival benefit versus control. However, Ls-TPT produced a significant (P = 0.0002) survival benefit, with six of seven complete cures. Larger U87MG tumors, where CED of Ls-TPT on day 12 resulted in one of six cures, indicated the necessity to cover the entire tumor with the infused therapeutic agent. CED of Ls-TPT was also efficacious in the intracranial U251MG tumor model (P = 0.0005 versus control). We conclude that the combination of a novel nanoparticle Ls-TPT and CED administration was very effective in treating experimental brain tumors.
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Affiliation(s)
| | | | | | | | | | | | | | - Krystof S. Bankiewicz
- Address correspondence to Krystof S. Bankiewicz, Department of Neurological Surgery, University of California at San Francisco, 1855 Folsom Street, Mission Center Building Room 226, San Francisco, CA 94103 (
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