Alain C. J. de Lotbinière, M.D.
Mission
The mission of the neuro-oncology program is to provide multidisciplinary management for patients with brain tumors. The program originated in 1986 in collaboration with the Yale Comprehensive Cancer Center and has grown to include representation from Neurosurgery, Neurology, Radiation Oncology, Neuropathology, Medical Oncology and Neuroradiology. The goals of the program are to identify and implement appropriate therapy for tumor patients that will improve the length and quality of their lives. Clinical care is complemented by research and teaching activities devoted to identifying better therapy and efficient patient management.
Clinical Programs
Under Dr. Piepmeier's leadership, the Neuro-oncology Unit in the Yale Comprehensive Cancer Center provides comprehensive multidisciplinary evaluation and treatment for patients with brain tumors. The Yale program is the only multidisciplinary consortium dedicated to neuro-oncology in southern New England. Our program has gained regional and national recognition for the clinical expertise of its members.
The organizational structure of the Unit improves the efficient management of complex clinical problems by bringing all the relevant disciplines together for patient evaluation and treatment. Surgical treatment of brain tumors is facilitated by the use of neurophysiological monitoring, advanced high resolution imaging, image-guided stereotactic techniques, and highly skilled operating room personnel. Radiation Oncology offers a broad range of radiation therapy options including standard radiotherapy, brachytherapy and stereotactic radiosurgery. Medical Oncology works closely within the Unit to deliver appropriate chemotherapy for patients with chemosensitive tumors. The Neuro-oncology Service includes a dedicated Clinical Coordinator whose role it is to facilitate efficient patient management as well as to lead a support group for patients and their families.
In collaboration with Dr. John Kveton in the Section of Otolaryngology, Dr. Piepmeier also has established a nationally recognized practice in the surgical treatment of skull base tumors and acoustic neuromas. The skull base surgery service is integrated with the Neuro-oncology Unit to optimize case management in a multidisciplinary manner.
Dr. Piepmeier also is the Program Director of the internationally recognized Yale Spinal Cord Injury Unit. This unit has been directly responsible for identifying more effective treatments for patients with traumatic spinal cord lesions that have become the standard of care.
Research Programs
Dr. Piepmeier has established a neuro-oncology laboratory that serves as a coordinating center for brain tumor related research throughout the university. Dr. Piepmeier's work has focused on the cytoskeleton of malignant glioma cells as a target for selective therapy. His laboratory is funded by NCI and, in collaboration with Hoechst Marion Roussel, Inc., and with support from the Stein Foundation, the laboratory is investigating new compounds (estrogen carbamate conjugates) for use as antimicrotubule agents for the treatment of brain tumors. Laboratory projects in neuro-oncology are performed in collaboration with the Yale Comprehensive Cancer Center and other departments at Yale (Ob/Gyn, Boyer Center for Molecular Medicine, Pathology, Neurobiology) as well as through collaborative laboratory research arrangements with scientists in Japan (Nippon School of Medicine) and Sweden (University of Lund). The goal of laboratory research is to identify promising new forms of therapy that can be brought to the clinic for use. Recent discoveries include a novel ribonucleoside reductase inhibitor with potent in vitro and in vivo activity against glioblastoma. Additional research projects are in progress in collaboration with Neurobiology and the Boyer Center for Molecular Medicine.
Dr. Piepmeier is the Director for Yale's participation in the National Acute Spinal Cord Injury Study III. This study investigated the potential benefit of high dose methylprednisolone and tirilazad in a randomized clinical trial and was completed in 1995.
Dr. Piepmeier has established a Brain Tumor Data Bank to prospectively study the effects of therapy in the treatment of low-grade astrocytomas.
Teaching Programs
Dr. Joseph Piepmeier is directly involved in resident and medical student education in neurosurgery. In addition to clinical education responsibilities as an Associate Professor, he provides an annual lecture series to 3rd and 4th year medical students in neuro-oncology and to 1st year students in traumatic spinal cord injury. Dr. Piepmeier's laboratory has served to train one postdoctoral fellow and for each of the past 4 years he has served as faculty advisor for medical student thesis work. Dr. Piepmeier has been a visiting professor at several medical schools in the United States and Canada as well as in Europe and Japan. He has provided numerous invited lectures for national and international neurosurgical societies. The weekly Neuro-oncology Tumor Board meeting serves as the major teaching conference for neurosurgical residents, medical students and medical oncology fellows.
The Yale Neuro-oncology Program can be reached at 203-737-2791
or email to joseph.piepmeier@yale.edu
Neurosurgery Faculty/Program Menu
Department of Neurosurgery address and phone number
http://info.yale.med.edu/surgery/neurosur/neuroonco.html
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