Journal of Neuro-Oncology最新文献

{"title":"Days at home after treatment of spinal metastases: measurement and validation of a novel patient centered outcome.","authors":"Husain Shakil, Armaan K Malhotra, Ahmad Essa, Vishwathsen Karthikeyan, Christopher S Lozano, Yingshi He, Jetan H Badhiwala, Arjun Sahgal, Nicolas Dea, Michael G Fehlings, Alexander Kiss, Christopher D Witiw, Jefferson R Wilson, Donald A Redelmeier","doi":"10.1007/s11060-025-05014-z","DOIUrl":"https://doi.org/10.1007/s11060-025-05014-z","url":null,"abstract":"<p><strong>Purpose: </strong>Clinically meaningful population health outcomes for patients with spinal metastases are lacking. This study quantifies and validates days at home (DAH) after treatment of spinal metastases, and investigates factors associated with this patient-centered outcome.</p><p><strong>Methods: </strong>A population-based cohort study was conducted with the 2007-2019 Ontario Cancer Registry. Patients aged over 18 years undergoing surgery and/or radiation for a spinal metastasis were included. DAH was assessed at 3 months, 6 months (DAH-180), 1 year (DAH-365), and 2 years (DAH-730) after first treatment. Associations between DAH and primary cancer type, age, and frailty were assessed using multivariable quantile regression to estimate adjusted medians differences (aMD) in DAH. Predictive validity was determined with Spearman correlations between DAH-180 and longer-term DAH measures.</p><p><strong>Results: </strong>We identified 36,233 treated patients. Median DAH for patients after 3 months, 6 months, 1 year, and 2 years from treatment were 79 days, 114 days, 120 days, and 121 days, respectively. Lower home time was associated with older age (aMD: -16 days per decade increase in age), and frailty (aMD: -36). Primary cancers associated with the least DAH included gastrointestinal cancer (aMD: -162 days), lung cancer (aMD: -165 days), and melanoma (aMD: -167 days). DAH-180 demonstrated predictive validity with longer term DAH-365 (p < 0.001), and DAH-730 (p < 0.001).</p><p><strong>Conclusion: </strong>These data help validate DAH as a reliable metric for patients treated for spinal metastases. Patients with older age, frailty, high health resource utilization, and primary melanoma, gastrointestinal or lung cancer were found to have the fewest DAH after treatment.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast cancer spine metastases treated with stereotactic body radiation therapy: patient outcomes and predictors.","authors":"Bryce Thomsen, Danny Vesprini, Eshetu Atenafu, Jay Detsky, Jeremie Larouche, Pejman Maralani, Sten Myrehaug, Hany Soliman, Chai-Lin Tseng, Kang Liang Zeng, Beibei Zhang, Arjun Sahgal, Hanbo Chen","doi":"10.1007/s11060-025-04998-y","DOIUrl":"https://doi.org/10.1007/s11060-025-04998-y","url":null,"abstract":"<p><strong>Background/purpose: </strong>Spine stereotactic body radiation therapy (SBRT) is increasingly utilized for oligometastatic and symptomatic breast cancer spinal metastases (BCSM), yet primary site-specific outcomes remain lacking. This study evaluates outcomes of SBRT for BCSM, focusing on predictors of local failure (LF), vertebral compression fraction (VCF) and overall survival (OS).</p><p><strong>Materials/methods: </strong>We retrospectively analyzed 409 BCSM in 168 patients treated with SBRT between 2008 and 2022. Receptor status was grouped based on ER+/Her2-, HER2+, and ER-/HER2-. Follow-up included full-spine magnetic resonance imaging (MRI) and clinical assessment every 3-6 months post-SBRT. The primary endpoint was radiological LF, and secondary endpoints were OS and VCF.</p><p><strong>Results: </strong>Median follow-up was 33 months (range, 3.3-123 months), most were ECOG 0-1 (95%), neurologically intact (94%), polymetastatic (> 5 metastases, 45%), and ER+/HER2- (79%). Of 409 segments, most had no prior radiation or surgery (76%), were SINS stable (60%) and treated with 24-28 Gy/2 fractions (73%). Five-year LF, OS and VCF rates were 14%, 45% and 11%, respectively. On multivariable analyses, lower LF rates were associated with < 2 lines of prior systemic therapy, low/no grade epidural disease, and greater equivalent dose in 2 Gy fractions (α/β = 2) to the spinal cord/thecal sac (HR = 0.97 per 1 Gy increase, 95% CI: 0.949-0.995, p = 0.019). ER-/HER2-, liver and lung metastases, and > 2 systemic therapy lines predicted worse OS. Baseline VCF and deformity were associated with a higher VCF risk.</p><p><strong>Conclusion: </strong>Treatment intensification in those heavily systemically pretreated or with high-grade epidural disease may optimize long-term LF rates independent of molecular status.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulation tools in neuro-oncological surgery: a scoping review of perioperative and training applications.","authors":"Grazia Menna, Dora Riva, Salvatore Marino, Jocelyn Garber, Jasper Kees Wim Gerritsen, Pier Paolo Mattogno, Jacob Stewart Young, Alessandro Olivi, Francesco Doglietto, Mitchel Stuart Berger, Giuseppe Maria Della Pepa","doi":"10.1007/s11060-025-04972-8","DOIUrl":"https://doi.org/10.1007/s11060-025-04972-8","url":null,"abstract":"<p><strong>Background: </strong>Neuro-oncological surgery has lagged other neurosurgical subspecialties in integrating simulation technologies for training and surgical planning. This study provides a comprehensive scoping review of the current landscape of simulation tools in neuro-oncological surgery, mapping existing research, identifying technological advancements, and highlighting gaps in surgical training and perioperative planning.</p><p><strong>Methods: </strong>We formulated the research question: \"What is the effect of perioperative simulation and neuro-oncological training on surgical skill acquisition, patient outcomes, and safety among neurosurgeons, compared to traditional or no training methods?\" A comprehensive search was conducted on PubMed, Scopus and ClinicalTrials.gov, with the final search completed in May 2024. The quality of training studies was assessed using the Medical Education Research Study Quality Instrument (MERSQI), and the Cochrane ROBINS-I tool was used to evaluate bias in simulation studies.</p><p><strong>Results: </strong>The search yielded 5,518 records, with 51 studies meeting the inclusion criteria. These were categorized into six groups: (1) 3D Models in Presurgical Planning and Intraoperative Navigation: 5 articles; (2) Augmented Reality (AR) in Presurgical Planning and Intraoperative Navigation: 25 articles; (3) Mixed Reality (MR) in Presurgical Planning and Intraoperative Navigation: 6 articles; (4) Virtual Reality (VR) in Presurgical Planning and Intraoperative Navigation: 4 articles; (5) AR in Surgical Training: 5 articles; (6) VR in Surgical Training: 6 articles.</p><p><strong>Conclusion: </strong>While the number of studies on simulation in neuro-oncological surgery is increasing, their analytical depth remains limited. Simulation holds promise for advancing the field, but a significant journey lies ahead before achieving universal academic validation.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Education paths in neuro-oncology: combining technical skills with multidisciplinary care. A survey from the AINO (Italian Association for Neuro-Oncology) Youngster Committee.","authors":"Rina Di Bonaventura, Denis Aiudi, Silvia Chiesa, Alessia Pellerino, Francesco Bruno, Valeria Internò, Ciro Mazzarella, Edoardo Pronello, Roberto Colasanti, Teresa Somma, Tamara Ius, Giuseppe Maria Della Pepa, Valeria Barresi, Quintino Giorgio D'Alessandris, Roberta Rudà, Antonio Silvani","doi":"10.1007/s11060-025-05003-2","DOIUrl":"https://doi.org/10.1007/s11060-025-05003-2","url":null,"abstract":"<p><strong>Purpose: </strong>Neuro-oncology is a multidisciplinary subspecialty that has evolved and expanded tremendously over the last 20 years. In Europe, notwithstanding a number of commendable initiatives, neither a specific neuro-oncology training curriculum nor a consensus on the ideal training tools have been set. In this context, the Youngster Committee of the Italian Association for Neuro-Oncology (AINO) has run a nationwide survey to take a snapshot of the current situation of neuro-oncology education in Italy.</p><p><strong>Methods: </strong>Between July and November 2023, we distributed through AINO a 34-question survey addressed to all Italian care providers dealing with neuro-oncology, irrespective of specialty and level of experience, as per AINO mission. The questionnaire was disseminated using an open link. We analyzed and stratified answers according to epidemiological characteristics of the respondents, i.e. age, gender, role, years of experience, type and case load of their work Institutions, geographical region.</p><p><strong>Results: </strong>We collected 254 valid questionnaires. The majority of respondents were under 40 years old (62.6%); neurosurgeons formed the largest specialty group (48%). Residency was a key step for neuro-oncology education according to 33% of participants; notably, younger respondents gave a significantly more positive assessment of residency programs compared to older ones (72% vs. 56%, p = 0.0193). PhD programs in Italy are focused only on research, according to 30% of respondents. Regarding the tools for continuing medical education in neuro-oncology, a striking contrast between the ideal ones, which should be the frequent participation in dedicated courses (59% responses), and the actual one, which is scientific literature (55%), was recorded. Mentorship programs are rare and inconsistent and should be strengthened. More than 90% of participants declared multidisciplinary collaboration as fundamental. Multispecialty societies like AINO have a key role in strengthening education in neuro-oncology through the organization of structured post-graduate programs.</p><p><strong>Conclusion: </strong>The results of this survey, by describing the status of the neuro-oncology training paths in Italy, can lay the foundation for initiatives aimed at harmonizing neuro-oncology education in Italy and Europe. The creation of a shared neuro-oncology curriculum and of a network of mentors is suggested.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival prediction with radiomics for patients with IDH mutated lower-grade glioma.","authors":"Alice Neimantaite, Louise Carstam, Tomás Gómez Vecchio, Ida Häggström, Tora Dunås, Francesco Latini, Maria Zetterling, Malin Blomstrand, Jiri Bartek, Margret Jensdottir, Erik Thurin, Anja Smits, Asgeir S Jakola","doi":"10.1007/s11060-025-05006-z","DOIUrl":"https://doi.org/10.1007/s11060-025-05006-z","url":null,"abstract":"<p><strong>Purpose: </strong>Adult patients with diffuse lower-grade gliomas (dLGG) show heterogeneous survival outcomes, complicating postoperative treatment planning. Treating all patients early increases the risk of long-term side effects, while delayed treatment may lead to impaired survival. Refinement of prognostic models could optimize timing of treatment. Conventional radiological features are prognostic in dLGG, but MRI could carry more prognostic information. This study aimed to investigate MRI-based radiomics survival models and compare them with clinical models.</p><p><strong>Methods: </strong>Two clinical survival models were created: a preoperative model (tumor volume) and a full clinical model (tumor volume, extent of resection, tumor subtype). Radiomics features were extracted from preoperative MRI. The dataset was divided into training set and unseen test set (70:30). Model performance was evaluated on test set with Uno's concordance index (c-index). Risk groups were created by the best performing model's predictions.</p><p><strong>Results: </strong>207 patients with mutated IDH (mIDH) dLGG were included. The preoperative clinical, full clinical and radiomics models showed c-indexes of 0.70, 0.71 and 0.75 respectively on test set for overall survival. The radiomics model included four features of tumor diameter and tumor heterogeneity. The combined full clinical and radiomics model showed best performance with c-index = 0.79. The survival difference between high- and low-risk patients according to the combined model was both statistically significant and clinically relevant.</p><p><strong>Conclusion: </strong>Radiomics can capture quantitative prognostic information in patients with dLGG. Combined models show promise of synergetic effects and should be studied further in astrocytoma and oligodendroglioma patients separately for optimal modelling of individual risks.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term quality of life and hypothalamic dysfunction after craniopharyngioma.","authors":"Hermann L Müller","doi":"10.1007/s11060-025-04987-1","DOIUrl":"https://doi.org/10.1007/s11060-025-04987-1","url":null,"abstract":"<p><strong>Background: </strong>After diagnosis and management of childhood-onset craniopharyngioma, patients frequently develop a rapid weight gain starting in the first 6-12 months after diagnosis and leading to morbid hypothalamic obesity due to disease- and/or treatment-associated hypothalamic lesions.</p><p><strong>Methods: </strong>A scoping review was performed after search of the MEDLINE/PubMed, Embase, and Web of Science databases for initial identification of articles. The search terms craniopharyngioma, hypothalamic obesity, and quality of life were used.</p><p><strong>Results: </strong>Hypothalamic obesity should be diagnosed and treated in the context of hypothalamic syndrome. Hypothalamic nuclei are the key-regulators of our body homeostasis. Hypothalamic syndrome includes endocrine deficiencies of hypothalamic-pituitary axes, disruption of circadian rhythm, disturbed hunger-satiety and thirst feelings, temperature dysregulation, and neurocognitive, sleep and psychosocial behavioral problems. Consequently, patients with hypothalamic syndrome develop hypothalamic obesity, chronic fatigue, increased daytime sleepiness and mood disorders resulting in isolation, school drop-out and inability to participate in daily life. Long-term follow-up is frequently impaired by increased risk for metabolic syndrome, cardiovascular health problems, severe impairments of health-related quality of life, and premature mortality. Treatment of hypothalamic syndrome is challenging. Hypothalamic syndrome is not a ,one-size-fits-all- disease, which may not require a ,one-size-fits-all- management. Recently, an algorithm for personalized, risk-specific treatment of hypothalamic syndrome after CP has been published. Dextro-amphetamines and other central stimulating agents (modafinil, methylphenidate) may cause weight loss, especially in children with hyperphagia or decreased resting-energy expenditure. Reports on the use of glucagon-like peptide-1 receptor (GLP-1R) agonists for acquired hypothalamic obesity have been contradictory, with successful reports but also series with limited results. Bariatric surgery is effective. However, non-reversible procedures are controversial due to ethical and legal considerations in minors.</p><p><strong>Conclusions: </strong>Hypothalamus-sparing treatment strategies and further research on novel therapeutic agents for hypothalamic syndrome are warranted.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum exosomal miRNA contributes to the diagnosis of leptomeningeal carcinomatosis.","authors":"Jie Jin, Junjuan Qin, Xuejiao Qi, Jiasi Zhang, YingLu Zhang","doi":"10.1007/s11060-025-04999-x","DOIUrl":"https://doi.org/10.1007/s11060-025-04999-x","url":null,"abstract":"<p><strong>Purpose: </strong>Leptomeningeal carcinomatosis (LC) is a severe complication in the advanced stage of lung adenocarcinoma, with an extremely poor prognosis. Currently, the diagnosis of LC poses challenges. Serum exosomal miRNAs (microRNAs) have been demonstrated to possess potential as viable biomarkers. However, their value in the diagnosis of LC remains unclear.</p><p><strong>Methods: </strong>In this study, serum samples were collected from lung adenocarcinoma patients with LC. The control groups consisted of patients with early-stage and advanced-stage lung adenocarcinoma without LC. Serum exosomes were isolated for high - throughput RNA sequencing to screen for differential miRNAs, and the results were validated in 123 samples. Subsequently, the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic ability of exosomal miRNAs for LC.</p><p><strong>Results: </strong>The results of miRNA sequencing revealed seven differentially enriched miRNAs (miRNA-1296-5p, miR-503-5p, miR-499a-5p, miR-374a-5p, miR-3173-5p, miR-370-3p and miR-885-3p). The ddPCR confirmed that the expression levels of miRNA-1296-5p, miR-499a-5p and miR-374a-5p were significantly elevated in LC, while miR-370-3p was significantly decreased (P < 0.05). ROC curve analysis showed that the AUC of the combination of miRNA-1296-5p, miR-499a-5p and miR-370-3p with CEA was 0.803 (P < 0.0001), displaying higher diagnostic power for LC.</p><p><strong>Conclusion: </strong>This study suggests that the specific expression of miRNA-1296-5p, miR-499a-5p, miR-374a-5p and miR-370-3p in the serum exosomes of LC, which has diagnostic potential. And the combination of miRNA-1296-5p, miR-499a-5p and miR-370-3p with CEA can further enhance this potential.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor-infiltrating and circulating B cells mediate local and systemic immunomodulatory mechanisms in Glioblastoma.","authors":"Pierfrancesco De Domenico, Filippo Gagliardi, Francesca Roncelli, Silvia Snider, Pietro Mortini","doi":"10.1007/s11060-025-04989-z","DOIUrl":"https://doi.org/10.1007/s11060-025-04989-z","url":null,"abstract":"<p><strong>Background: </strong>Glioblastoma (GBM) demonstrates extensive immunomodulatory mechanisms that challenge effective therapeutic interventions. These phenomena extend well beyond the tumor microenvironment (TME) and are reflected in the circulating immunophenotype. B lymphocytes (B cells) have received limited attention in GBM studies despite their emerging importance in mediating both local and systemic immune responses. Recent findings highlight the complex regulatory interactions between B cells and other immune cell populations, including tumor-infiltrating macrophages (TAMs), myeloid-derived suppressor cells (MDSCs), and other infiltrating lymphocytes (TILs). B cells are believed to hinder the efficacy of modern immunotherapy strategies focusing on T cells.</p><p><strong>Methods: </strong>This is a focused review of available evidence regarding B cells in GBM through January 2025.</p><p><strong>Results: </strong>Peripheral blood reflects a systemically dampened immune response, with sustained lymphopenia, increased plasma cells, and dysfunctional memory B cells. The tumor immune landscape is enriched in cells of B-lineage. Subsets of poorly characterized B regulatory cells (Bregs) populate the TME, developing their phenotype due to their proximity to MDSCs, TAMs, and tumoral cells. The Bregs inhibit CD8⁺ T activity and may have potential prognostic significance.</p><p><strong>Conclusion: </strong>Understanding the role of B cells, how they are recruited, and their differentiation shifted towards an immunomodulatory role could inform better therapeutic strategies and unleash their full antitumoral potential in GBM.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A morphological features-based nomogram for predicting facial nerve function in the immediate postoperative period after vestibular schwannoma surgery.","authors":"Yuichi Fujita, Yoichi Uozumi, Yosuke Fujimoto, Hiroaki Nagashima, Masaaki Kohta, Kazuhiro Tanaka, Hidehito Kimura, Atsushi Fujita, Eiji Kohmura, Takashi Sasayama","doi":"10.1007/s11060-025-04984-4","DOIUrl":"https://doi.org/10.1007/s11060-025-04984-4","url":null,"abstract":"<p><strong>Purpose: </strong>Tumor morphology critically influences facial nerve (FN) outcomes following vestibular schwannoma (VS) surgery. This study aimed to develop a nomogram based on preoperative features for preoperative prediction of FN outcomes after VS surgery.</p><p><strong>Methods: </strong>A retrospective analysis included patients with sporadic VS who underwent surgical resection via the retrosigmoid approach. Tumor size was assessed using the Koos grade, the intrameatal components using the fundal fluid cap (FFC) sign, and the cerebellopontine angle cisternal components using our modified morphological subclassification. Logistic regression analysis was performed to construct a nomogram for predicting immediate postoperative FN function.</p><p><strong>Results: </strong>A total of 265 patients with VS met the inclusion criteria. Of these patients, 62 (23.4%) had poor FN function (House-Brackmann grade ≥ III) immediately after surgery. Univariate logistic regression analysis identified the Koos grade (p = 0.001), FFC sign (p = 0.023), and morphological subtype (p < 0.001) as significant predictors of poor FN function immediately after surgery. In multivariate logistic regression analysis, the FFC sign (OR 2.07, p = 0.042) and morphological subtype (OR 8.21, p < 0.001) remained statistically significant independent predictors of poor FN function. A nomogram constructed based on these indicators demonstrated good discrimination in the training cohort (area under the curve [AUC] 0.80), internal validation cohort (AUC 0.79), and external validation cohort (AUC 0.97).</p><p><strong>Conclusions: </strong>A simple and reliable nomogram incorporating the Koos grade, FFC sign, and morphological subtype accurately predicts the risk of FN injury during surgery aimed at total resection of VS. This clinically straightforward tool can assist in patient counseling and development of more individualized surgical strategies to improve FN outcomes in patients with VS.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term impact of bevacizumab for the treatment of brain radiation necrosis.","authors":"Hila Nobel, Jonathan Ofer, Sara Faye Borenstein, Dror Limon, Omer Gal, Yosef Laviv, Andrew A Kanner, Tali Siegal, Shlomit Yust-Katz, Alexandra Benouaich-Amiel","doi":"10.1007/s11060-025-04979-1","DOIUrl":"https://doi.org/10.1007/s11060-025-04979-1","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate short and long-term efficacy of bevacizumab (Bev), for the treatment of radiation necrosis (RN) in patients with brain metastasis after stereotactic radiosurgery (SRS).</p><p><strong>Methods: </strong>The database of a tertiary medical center was reviewed for all adult patients treated by Bev (from January 2018 to January 2023) for RN after having received SRS for BM. Clinical and MRI data were systematically collected at baseline, immediately after the completion of Bev treatment, and at 6, 12, and, when available, 24 months post-treatment.</p><p><strong>Results: </strong>The cohort included 23 patients with a total of 31 RN lesions (defined as target lesion) which have been previously treated by SRS, either as single-session SRS (27/31) or as fractionated stereotactic radiotherapy (4/31). Median follow-up time was 15 months (range: 8-28.5). Immediately after completion of Bev, 15 patients (65.2%) exhibited a complete/partial response, 6 (26.1%) had stable disease, and 2 had progressive disease (8.7%). thirteen patients (56%) improved clinically. Greater than 50% reduction in volume was observed in 84% of target lesions. At 12 months, among the 13 patients still evaluable (9 other being deceased, 1 loss to follow up), three continued to improve, and four remained stable. Median volume of target lesion was then 1.4 cm³ (range 0.7-2.9) demonstrating a reduction of 67.4% compared to the initial target volume, which was 4.35 cm³ (range 2.14-10.37). During the entire follow-up period, 11 patients experienced regrowth of the target lesion; median time to progression was 7 months. Five underwent Bev re-challenge, but only 2 responded.</p><p><strong>Conclusion: </strong>Bev for the treatment of SRS-induced RN was associated with a high initial response rate, significant lesion reduction, and prolonged clinical improvement. However, the high rate of lesion regrowth (50%) and poor response to Bev re-challenge highlight the complexity of diagnosis and treatment of RN.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}