Journal of Neuro-Oncology最新文献

{"title":"Novel predictors of tumor growth by exploratory quantitative analysis of radiomics features from MRI data for incidentally discovered meningioma.","authors":"Yuta Oi, Haruki Minamoto, Ichita Taniyama, Masayuki Fukuzawa, Koji Sakai, Takahiro Ogawa, Takumi Yamanaka, Yoshinobu Takahashi, Naoya Hashimoto","doi":"10.1007/s11060-025-05186-8","DOIUrl":"10.1007/s11060-025-05186-8","url":null,"abstract":"<p><strong>Purpose: </strong>Predicting future tumor growth from initial imaging of incidentally discovered meningioma (IDM) could inform treatment decisions. However, most factors identified in prior studies on meningioma growth are qualitative. The aim of this study is to identify factors associated with tumor growth using quantitative radiomics features from MRI data.</p><p><strong>Methods: </strong>MRI T2 features from initial imaging of 24 tumor growth cases were compared with those of 25 cases without growth. An in-house program was developed to reduce the time required for data analysis. This program is based on the open-source software 3D Slicer 5.6.2 and PyRadiomics 3.1.0. It enables semi-automatic batch t-test analyses for each feature to compare tumor growth and non-growth groups. Regions of interest (ROIs) were placed in the tumor, outer tumor edge, whole brain, and white matter contralateral to the tumor. A total of 107 features were analyzed across seven classifications: First Order, Shape, Gray Level Co-occurrence Matrix, Gray Level Run Length Matrix, Gray Level Size Zone Matrix, Gray Level Dependence Matrix, and Neighboring Gray Tone Difference Matrix. A t-test was used to identify significant predictors.</p><p><strong>Results: </strong>Ten features across five classifications showed significant differences (p < 0.05): 2 First Order statistics, 2 Shape features, 4 Gy Level Co-occurrence Matrices, 1 Gy Level Size Zone Matrix, and 1 Neighboring Gray Tone Difference Matrix.</p><p><strong>Conclusions: </strong>Potential predictors of IDM growth were identified using radiomics features. Future studies with larger cohorts and validation will be essential to confirm the clinical utility and improve the predictive accuracy of these features.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"1177-1186"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075433","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":"Role of patient frailty in resection of newly diagnosed motor eloquent glioblastomas guided by a navigated transcranial magnetic stimulation and tractography approach.","authors":"Thomas Eibl, Adrian Liebert, Leonard Ritter, Markus Neher, Karl-Michael Schebesch","doi":"10.1007/s11060-025-05206-7","DOIUrl":"10.1007/s11060-025-05206-7","url":null,"abstract":"<p><strong>Purpose: </strong>Resection of glioblastomas infiltrating the motor cortex and corticospinal tract (CST) is often linked to increased perioperative morbidity. Navigated transcranial magnetic stimulation (nTMS) motor mapping has been advocated to increase patient safety in these cases. The additional impact of patient frailty on overall outcome after resection of cases with increased risk for postoperative motor deficits as identified with nTMS needs to be investigated.</p><p><strong>Methods: </strong>Patients with newly diagnosed motor eloquent glioblastomas were retrospectively evaluated. Patients underwent nTMS- and tractography-based neuronavigation. Demographic, imaging- and nTMS-derived data and the 11-item modified frailty index (mFI-11) were collected. Primary endpoint was discharge home after tumor resection. A 4-item score comprising preoperative motor deficit, mFI-11 ≥ 2 points, distance to the CST < 12 mm and infiltration of nTMS-positive cortex was established to predict overall outcome.</p><p><strong>Results: </strong>N = 64 patients with a mean age of 64.8 ± 9.6 years (60.9% male) were included. 46 patients (71.9%) could be discharged to their homes. Risk factors for non-home discharge were greater mFI-11 (p = 0.027), surgery-related motor deficit (p < 0.001) and overall complications (p < 0.001 for non-surgical and p = 0.006 for surgical complications). In multiple regression analyses, mFI-11 and surgery-related deficit were statistically robust. The 4-item score predicted non-home discharge with an AUC = 0.745, 95%CI = 0.62-0.87, p < 0.001.</p><p><strong>Conclusion: </strong>In patients with newly diagnosed motor-eloquent glioblastomas, nTMS-based planning helps to predict postoperative surgery-related motor deficits. Patient frailty needs to be respected in decision making in addition to nTMS- and tractography-based planning in order to avoid postsurgical motor deficits and to keep overall surgical morbidity on a low level.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"1367-1375"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023483","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":"Impact of EGFR mutation subtypes and TKI generations on clinical outcomes in lung adenocarcinoma patients with brain metastases treated with gamma knife radiosurgery.","authors":"Haewon Roh, Chan Park, Won Kim, Juwhan Choi, Sung Yong Lee, Jong Hyun Kim","doi":"10.1007/s11060-025-05149-z","DOIUrl":"10.1007/s11060-025-05149-z","url":null,"abstract":"<p><strong>Background: </strong>Brain metastases are a common and severe complication in patients with lung adenocarcinoma (ADC) harboring epidermal growth factor receptor (EGFR) mutations. Gamma Knife Radiosurgery (GKRS) is a standard treatment for brain metastases, and its efficacy may be influenced by the type of EGFR mutation and the generation of tyrosine kinase inhibitors (TKIs) used. This retrospective study evaluated the impact of EGFR mutation subtypes (exon 19 deletion vs. exon 21 L858R) and TKI generations on clinical outcomes in patients with lung ADC treated with GKRS.</p><p><strong>Methods: </strong>A total of 55 patients and 136 brain metastases were analyzed from January 2017 to December 2023. Tumor response was assessed based on local failure and distant brain failure, defined as tumor progression at the treated site and new brain metastases outside the GKRS-treated regions, respectively. The Kaplan-Meier method and univariate and multivariate analyses using Cox proportional hazard regression models were used to identify prognostic factors for local failure, and distant brain failure.</p><p><strong>Results: </strong>The study found that second- and third-generation TKIs, such as afatinib and osimertinib, provided significantly better local control compared to first-generation TKIs (hazard ratio [HR] = 0.12, p = 0.017). Furthermore, tumors with exon 19 deletion demonstrated improved distant brain control compared to those with exon 21 L858R substitution (HR = 2.18, p = 0.048). These findings suggest that mutation type and TKI generation are independent prognostic factors for clinical outcomes following GKRS.</p><p><strong>Conclusion: </strong>This study suggests that both the generation of TKIs and the specific EGFR mutation subtype may influence clinical outcomes following GKRS in lung ADC patients with brain metastases. These findings may aid in stratifying patients and optimizing treatment strategies in clinical practice.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"1331-1341"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075417","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":"Unravelling genomic differences in cerebrospinal fluid: patients with lung cancer with combined brain parenchymal and meningeal metastasis versus exclusive meningeal metastasis.","authors":"Liwei Sun, Jinduo Li, Yuan Lv, Lin Li, Xiaomin Liu","doi":"10.1007/s11060-025-05224-5","DOIUrl":"10.1007/s11060-025-05224-5","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare and analyse the genomic features in cerebrospinal fluid (CSF) between patients with both brain parenchymal metastasis (BM) and meningeal metastasis (MM) of lung cancer and patients with MM only.</p><p><strong>Methods: </strong>34 patients with lung adenocarcinoma were included in this study, including 18 patients in the BM&MM group, 12 in the MM group and 4 in the BM group. The genomic characteristics were compared by circulating tumour DNA (ctDNA) detection in CSF and plasma samples.</p><p><strong>Results: </strong>The positive rate of ctDNA detection in the CSF was significantly higher than that in plasma, and the variation detected in the CSF was more abundant, especially epidermal growth factor receptor (EGFR) mutation (p < 0.05). The consistency detected between the CSF and plasma was poor. There was no significant difference in the tumour mutation burden between the BM&MM and MM groups, and no significant differential mutations were found by mutation mapping and pathway enrichment analysis (p > 0.05). In the BM&MM group, there was a significant co-mutation relationship between RB1 and ERBB4, MTOR and ATM, MLH3 and CTNNB1 and TP53 and EGFR; in the MM group, there was a strong co-exclusion of EGFR and KRAS mutations. Chromosomal copy number variation analysis showed significant amplification in the MM group at the p15.33 bands on chromosome 5 and the 7p11.2 bands on chromosome 7. In the comparative analysis of tumour markers and CSF biochemical parameters between the two groups, no significant differences were found.</p><p><strong>Conclusion: </strong>This study revealed significant differences in CSF genomic characteristics between patients with simultaneous BM and MM of lung cancer and patients with MM only. These differences provide potential biomarkers for the precise treatment of patients with brain metastases and help to distinguish patients with lung cancer brain metastases with different metastatic patterns.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"1163-1176"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12511202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of healthcare disparities on the treatment and survival of patients with high-grade gliomas in Colombia: a multicenter inverse probability-weighted cohort analysis.","authors":"Esteban Ramirez Ferrer, Juan Pablo Zuluaga-Garcia, Juan Diego Alzate, Juliana Mayorga-Corvacho, Maria Alejandra Sierra, Maria Osley Garzon-Duque, Alberto Daza-Ovalle, Humberto Madrinan-Navia, Mauricio Riveros-Castillo","doi":"10.1007/s11060-025-05198-4","DOIUrl":"10.1007/s11060-025-05198-4","url":null,"abstract":"<p><strong>Purpose: </strong>Explore the impact of healthcare disparities in patients with high-grade glioma (HGG) in the Colombia's universal healthcare model setting, aiming to assess access to adjuvant treatment and survival outcomes among HGG patients covered under contributory versus subsidized insurance schemes in Bogotá, Colombia.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted in two academic neurosurgical centers in Bogotá, Colombia, each serving patient populations with a differential distribution by insurance scheme. Adult patients with newly diagnosed high-grade glioma (HGG) who underwent surgical management between 2017 and 2021 were included. Patients with recurrent disease at presentation or lost to follow-up after surgery were excluded. Demographic, clinical, surgical, and treatment data were collected. The primary outcome was overall survival, assessed through medical records and the national death registry. A propensity score model with inverse probability of treatment weighting (IPTW) was used to adjust for confounding. Cox proportional hazards and logistic regression models were applied.</p><p><strong>Results: </strong>A total of 113 patients were included; 88 had contributory coverage and 25 had subsidized coverage. Patients in the subsidized group had significantly lower rates of postoperative medical oncology consultation (48% vs. 84%, 95% p < 0.001), chemotherapy (28% vs. 68.2%, p < 0.001), and radiotherapy (8% vs. 56.3%, p < 0.001). Median overall survival was significantly lower in the subsidized group (9.8 vs. 16.5 months, p = 0.006). After IPTW adjustment, subsidized insurance (HR 1.66, 95% CI 1.03-2.68, p = 0.035), subtotal resection (HR 1.58, 95% CI 1.01-2.49, p = 0.045), and lack of oncology consultation (HR 5.24, 95% CI 1.21-22.63, p = 0.026) were independently predicted worse survival. Female sex (OR 2.59, p = 0.045) and subsidized coverage (OR 8.21, p < 0.001) were associated with failure to complete oncology follow-up.</p><p><strong>Conclusions: </strong>In the context of a universal healthcare system such as Colombia's, differences in access to adjuvant therapy may contribute to survival disparities among patients with high-grade gliomas. While formal insurance coverage is broadly available, it does not necessarily ensure timely or equitable care delivery. Additionally, our findings suggest that gender-related factors may influence access to postoperative oncology care. Efforts to strengthen care coordination, address structural barriers, and ensure equitable access across insurance types and sexes could help improve outcomes in this population.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"1067-1077"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821611","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":"Immunotherapeutic targeting of NY-ESO-1 in malignant meningiomas with TCR-transduced T-cells.","authors":"Matthew Z Sun, Erick Contreras, Janet Treger, Marisa Imbroane, Joey Orpilla, Myungjun Ko, Jeremy Reynoso, Sara Khattab, Thomas J Lai, Jonathan E Tsang, Jeremie Vitte, Marco Giovannini, Linda M Liau, Robert Prins, Richard G Everson","doi":"10.1007/s11060-025-05200-z","DOIUrl":"10.1007/s11060-025-05200-z","url":null,"abstract":"<p><strong>Introduction: </strong>Malignant meningiomas lack effective immunotherapeutic options. NY-ESO-1 is a potential immunotherapeutic target, because it is the most frequently expressed cancer-testis-antigen in meningiomas. We investigated the efficacy of T-Cell-Receptor-Transduced T-Cells (TCR-T) targeting NY-ESO-1 in vitro and in vivo in meningiomas.</p><p><strong>Methods: </strong>Immunohistochemistry was performed on Grade I-III meningioma specimens. Primary meningioma culture LB3750(Grade I) and immortalized cultures SF1335(Grade I) and CH157-HLA-A2.1(Grade III) were established and maintained in vitro. NY-ESO-1 TCR-T (HLA-A2.1 restricted) cells were co-cultured with primary and immortalized meningioma cells and assessed for real-time tumor killing in vitro. Immunodeficient NSG mice were intracranially implanted with CH157-HLA-A2.1 and SF1335 cells, treated with systemic adoptive cell transfer (ACT) of TCR-T, and assessed for overall survival in vivo.</p><p><strong>Results: </strong>NY-ESO-1 expression correlated with tumor grade (n = 35; p < 0.01). High NY-ESO-1 nuclear expression predicted a worse progression-free-survival (p = 0.0167). CH157-HLA-A2.1 cells, with native high NY-ESO-1 expression, experienced > 60% and then nearly 100% cytolysis after co-culture with TCR-T for 10 and 24 h, respectively, compared with control T-cells (p < 0.0001). SF1335 and LB3750 cells, with low NY-ESO-1 expression, experienced 20% cytolysis after 24 h of co-culture with TCR-T compared to the control (p < 0.0001). Systemic ACT of TCR-T significantly increased the median overall survival in NSG mice bearing intracranial xenografts of CH157-HLA-A2.1 by 49% (p < 0.001).</p><p><strong>Conclusions: </strong>NY-ESO-1 TCR-T induces cytolysis in meningiomas in vitro, and its efficacy correlates with NY-ESO-1 expression. Systemic ACT results in significantly increased survival in vivo in high-grade meningioma. Therefore, targeting NY-ESO-1 may be a clinically feasible immunotherapeutic strategy for treating high-grade meningiomas.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"1079-1089"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835355","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":"The Journal of Neuro-Oncology and Journal of Neuro-Oncology: Discovery : Better meeting the needs of our global neuro-oncology community.","authors":"Jason Sheehan","doi":"10.1007/s11060-025-05222-7","DOIUrl":"10.1007/s11060-025-05222-7","url":null,"abstract":"","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"905-906"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023445","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":"Piperlongumine induces meningioma cell death via the ROS-mediated endoplasmic reticulum stress and the alteration of the ubiquitin-proteasome system.","authors":"Nopporn Naewwan, Krajang Talabnin, Thanawat Trasaktaweesakul, Phattrara Khuansonthi, Pundit Asavaritikrai, Pitchanun Jaturutthaweechot, Chutima Talabnin","doi":"10.1007/s11060-025-05219-2","DOIUrl":"10.1007/s11060-025-05219-2","url":null,"abstract":"<p><strong>Purpose: </strong>Meningiomas, the most common primary tumors of the central nervous system, are curable by surgical resection and radiotherapy. However, systemic therapeutic chemotherapy for meningiomas has not existed. Piperlongumine (PL), a natural alkaloid extracted from the long pepper (Piper longum), has emerged as a promising candidate for cancer treatment due to its multimodal anti-cancer effects. However, the effects of PL in meningiomas are limited.</p><p><strong>Methods: </strong>We examined the anti-cancer effect of PL in vitro using primary benign meningioma cells and malignant meningioma cells. The underlying mechanism of PL in meningiomas was investigated through gene expression experiments at both mRNA and protein levels.</p><p><strong>Results: </strong>PL inhibited meningioma cell growth, evidenced by inducing G2/M phase arrest via the up-regulation of cell cycle regulators including TP53 and CDKN1A/p21 and enhancing cell apoptosis via the up-regulation of cleaved caspase 3 and cleaved PARP1. PL-induced meningioma cell death was triggered via the activation of intracellular reactive oxygen species production leading to endoplasmic reticulum stress and the alteration of ubiquitin-proteasome system resulting in the accumulation of poly-ubiquitinated proteins.</p><p><strong>Conclusion: </strong>The present study indicates that PL has anti-cancer effect against meningiomas.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"1091-1102"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064938","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 prospective study of minimally invasive keyhole craniotomy and stereotactic brachytherapy for new brain oligometastases.","authors":"Smruti Mahapatra, Laurel Seltzer, Neydin Osorio, Michelle Miller, Andrew Janssen, Raj Mitra, Joseph Keen, Clayton Smith, Marcus Ware","doi":"10.1007/s11060-025-05077-y","DOIUrl":"10.1007/s11060-025-05077-y","url":null,"abstract":"<p><strong>Introduction: </strong>Metastatic brain tumors (MBTs) are the most common intracranial tumors, affecting up to 40% of cancer patients. Traditional treatments such as Whole Brain Radiotherapy (WBRT) and Stereotactic Radiosurgery (SRS) have limitations, including neurocognitive decline and potential tumor regrowth. Minimally invasive keyhole craniotomy (MIKC) and Cesium-131 (Cs-131) brachytherapy offer promising alternatives due to their precision and reduced side effects. This prospective study aims to evaluate the safety and efficacy of combining MIKC with Cs-131 brachytherapy in treating newly diagnosed brain oligometastases.</p><p><strong>Methods: </strong>Twenty-one adults with newly diagnosed brain metastases were enrolled from 2019 to 2021. Preoperative T1 MRI with gadolinium was used to calculate the gross tumor volume (GTV). Minimally invasive craniotomies were performed with resection of these tumors, followed by the implantation of Cs-131 seeds. Postoperative imaging was conducted to verify seed placement and resection. Dosimetric values (V100, V200, D90) were calculated. Patients were followed every two months for two years to monitor local progression, functional outcomes, and quality of life. The primary endpoint was freedom from local progression, with secondary endpoints including overall survival, functional outcomes, quality of life, and treatment-related complications.</p><p><strong>Results: </strong>The median preoperative tumor volume was 10.65 cm³, reducing to a resection cavity volume of 6.05 cm³ post-operatively. Dosimetric analysis showed a median V100 coverage of 93.2%, V200 of 43.9%, and D90 of 89.8 Gy. The 1-year local freedom from progression (FFP) was 91.67%, while the distant FFP was 53.91%. Five patients remained alive at the study's end, with a median survival duration of 5.9 months, a duration likely impacted by the concurrent COVID-19 pandemic. Only one patient experienced local recurrence, and no cases of radiation necrosis were observed. Significant improvements were seen in neurological, functional, and cognitive symptoms.</p><p><strong>Conclusion: </strong>Combining MIKC with Cs-131 brachytherapy is effective for local tumor control and improving functional outcomes in patients with brain oligometastases. Further studies with larger cohorts are needed to validate these findings and refine treatment protocols.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"1051-1064"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12511137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The dynamic nature of frailty in metastatic spine disease patients.","authors":"Oludotun Ogunsola, Edward S Harake, Sean Smith, Michael Albdewi, Varun Kathawate, Sebele Ogunsola, William Jackson, Joseph Evans, Vikram Chakravarthy, Nicholas Szerlip","doi":"10.1007/s11060-025-05213-8","DOIUrl":"10.1007/s11060-025-05213-8","url":null,"abstract":"<p><strong>Purpose: </strong>Frailty measures are critical for predicting outcomes in metastatic spine disease (MSD) patients. This study aimed to evaluate frailty measures throughout the disease process.</p><p><strong>Methods: </strong>This retrospective analysis measured frailty in MSD patients at multiple time points using a modified Metastatic Spinal Tumor Frailty Index (MSTFI). Scores were 0: \"not frail,\" 1: \"mild\", 2: \"moderate, and ≥ 3: \"severe.\" Measurements were taken at cancer diagnosis, spine metastasis (SM) diagnosis, and 4-month intervals up to 2-years. The change in frailty distribution was described at the general cohort and patient levels. Two-year survival was assessed from baseline frailty status at SM diagnosis.</p><p><strong>Results: </strong>This study included 465 patients with an average age of 62.3 years (± 12.7), 33.8% female. Prostate cancer was most common (20.9%), followed by renal cell carcinoma (15.3%), non-small cell lung cancer (NSCLC, 13.5%), and others. Frailty changed dynamically, most significantly early in the disease. Initially, 79.4% were not frail; this dropped to 60.1% at SM diagnosis and to 42.7% at 4 months. Patients with short-term (4 month) data showed rapid frailty progression, with 57% becoming moderately to severely frail (p = 0.01), whereas 45% with long-term (24 months) data remained non-frail (p < 0.0001). Contributing factors included anemia (32.7%), electrolyte abnormalities (16.9%), and malnutrition (11.4%). Histological classification influenced frailty. Higher frailty scores at metastatic diagnosis correlated with worse 2-year survival outcomes (p: <0.001-0.04), underscoring frailty's prognostic significance.</p><p><strong>Conclusion: </strong>Frailty is dynamic, with a potential early intervention point to maintain or reverse it. Further research is needed to assess which frailty measures are most dynamic and amenable to intervention.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"1247-1259"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12511197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}