Journal of Neuro-Oncology最新文献

{"title":"Takeaways from meta-analysis: indications of combinational treatments for glioblastoma.","authors":"Chin-Hsing Annie Lin, Chenwei Lin, Christopher T Rhodes, Madeleine C Moseley, Yufeng Wang, Mitchel S Berger","doi":"10.1007/s11060-025-05205-8","DOIUrl":"10.1007/s11060-025-05205-8","url":null,"abstract":"<p><strong>Background: </strong>Patients with brain cancers are diagnosed based on MRI in the clinical setting while molecular signatures offer potential therapeutic targets. The necessity to re-form molecular and imaging information motivated our meta-analysis to decipher the correlation between the MRI-classified tumor locations, gene expression, and protein signatures in GBM.</p><p><strong>Methods: </strong>We analyzed spatial and omics data alongside the assessment of post-translational modifications. We first utilized MRI data to classify GBM into 4 groups. We then integrated imaging groups with RNA-Seq and proteomic data to determine the association between tumor locations, gene signatures, and protein abundance. Furthermore, we scrutinized independent measurements of post-translational modifications in each group of MRI-classified GBM.</p><p><strong>Results: </strong>The coherent layer of imaging and molecular data collectively showed the dysregulation of cell cycle, ECM organization, immune infiltration or surveillance in all GBM cases regardless of tumor locations. Several neuronal and synaptic-specific genes were differentially altered, indicative of aberrant neuroactivity in GBM. These dysregulated genes and networks provided druggable targets that led to small compounds identification, possessing cytotoxicity against primary GBM and spanning histological boundaries. Our analysis also revealed lesion-specific molecular signatures in each group of GBM, suggesting pathological features uniquely in subgroups of GBM with prognostic or therapeutic potential. Moreover, alterations in post-translational modifications would be noteworthy to explore clinical applications.</p><p><strong>Conclusions: </strong>Deliverables from our meta-analysis hold the potential to inform therapeutic intervention. Despite heterogeneity in GBM, our findings implicate new directions of emerging treatments that may be used as concomitants to chemo-, radio- or immunological therapies.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"1199-1209"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957724","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":"Stereotactic radiosurgery for lung cancer spinal metastases.","authors":"Michael R Kann, Samuel Adida, Suchet Taori, Shovan Bhatia, Akshath Rajan, James C Bayley, Pascal O Zinn, Steven A Burton, John C Flickinger, Roberta K Sefcik, Peter C Gerszten","doi":"10.1007/s11060-025-05221-8","DOIUrl":"10.1007/s11060-025-05221-8","url":null,"abstract":"<p><strong>Purpose: </strong>Lung cancer spinal metastases may present with intractable pain and neurological deficits. This study is one of the largest to examine outcomes following stereotactic radiosurgery (SRS) in this patient population.</p><p><strong>Methods: </strong>A single institution retrospectively collected database of patients with lung cancer spinal metastases treated with SRS between 2003-2023 was analyzed. The primary outcome was local control (LC). Secondary outcomes included pain response, overall survival (OS), and radiation-induced toxicity. The median single-fraction dose was 16 Gy (range: 12-20). Multi-fractionated treatments utilized doses of 18-30 Gy in 2-5 fractions.</p><p><strong>Results: </strong>One hundred twenty-two patients with 167 lesions met inclusion criteria. Prior to radiosurgery, 21 lesions (13%) underwent open resection and 131 lesions (78%) received external beam radiation therapy. Median follow-up was 4 months (range: 1-133). Fifteen lesions (9%) locally recurred 5 months (range: 1-10) after treatment. Six-month and 1-year LC rates were 88% and 75%, respectively. Patient-reported pain predominantly improved or remained stable (67%) after treatment; worsened pain was associated with inferior LC (p < 0.01, HR: 22.7, 95% CI: 2.5-207.1) and development of radiation-induced vertebral compression fractures (VCFs) (p < 0.01, OR: 34.2, 95% CI: 3.0-392.4). Six-month and 1-year OS rates were 45% and 23%, respectively. Low functional status (Karnofsky Performance Score ≤ 70) was associated with inferior LC (p = 0.03, HR: 3.7, 95% CI: 1.1-12.1) and OS (p = 0.03, HR: 1.8, 95% CI: 1.1-2.9). Thirty-one radiation-induced toxicities (19%), including 13 VCFs (8%), were observed.</p><p><strong>Conclusions: </strong>Radiosurgery provides LC and pain palliation with minimal rates of toxicity in a challenging patient population with lung cancer spinal metastases.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"1117-1130"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033573","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":"Sacituzumab govitecan and stereotactic radiosurgery in the management of HER2 negative breast cancer brain metastases: a multi-institutional report.","authors":"Vaseem M Khatri, Mariella A Mestres-Villanueva, Sierra Daniel, Sreenija Yarlagadda, Ajay Doniparthi, Rituraj Upadhyay, Matthew N Mills, Daniel E Oliver, Hsiang-Hsuan Michael Yu, Joshua D Palmer, Daniel G Stover, Nicole O Williams, Reshma L Mahtani, Manmeet S Ahluwalia, Aixa E Soyano, Hatem H Soliman, Hyo S Han, Rupesh Kotecha, Sasha J Beyer, Kamran A Ahmed","doi":"10.1007/s11060-025-05230-7","DOIUrl":"10.1007/s11060-025-05230-7","url":null,"abstract":"<p><strong>Purpose: </strong>Improved treatment strategies are needed for HER2 negative breast cancer brain metastases (BCBM). Stereotactic radiosurgery (SRS) is the standard of care for limited brain metastases. Sacituzumab govitecan (SG) may have intracranial efficacy for BCBM; however, safety and efficacy data remain limited when combined with SRS.</p><p><strong>Methods: </strong>A multi-institutional retrospective review was performed of patients with HR+/HER2- and triple negative (TNBC) BCBM treated with SG and SRS for active BMs at three institutions. Concurrent SG and SRS was defined as SRS after the date of first SG infusion and before or on the date of last SG infusion. Safety was assessed as well as distant intracranial control (DIC), systemic and central nervous systemic (CNS) progression-free survival (PFS), local control (LC), and overall survival (OS).</p><p><strong>Results: </strong>A total of 277 lesions were treated over 36 SRS courses in 26 patients. Median follow up from SG initiation was 23.3 months. One hundred sixty-eight (61%) lesions were treated with single fraction SRS and 109 (39%) lesions were treated with fractionated SRS (fSRS). One hundred thirty-five (47%) lesions received concurrent SRS and SG. No cases of symptomatic radiation necrosis (SRN) were noted. LC rates at 12- and 24-months were 94% and 84%, respectively. Median CNS-PFS was 5.4 months (95% CI 2.8-7.3). Median systemic PFS was 4.4 months (95% CI 2.2-7.3 months). Median overall survival was 8.4 months with a 24-month rate of 16%.</p><p><strong>Conclusion: </strong>In our series, concurrent SRS and SG was associated with excellent local control, without an increased risk of SRN. Prospective investigation into potential synergy is warranted.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"1435-1441"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199740","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":"Timing matters: overall treatment time, radiotherapy interruptions, and outcomes in glioblastomas-prognostic significance in different biological sub-groups.","authors":"Paolo Tini, Flavio Donnini, Francesco Marampon, Pierpaolo Pastina, Giovanni Rubino, Giuseppe Battaglia, Salvatore Chibbaro, Alfonso Cerase, Maria Antonietta Mazzei, Isacco Desideri, Giuseppe Minniti","doi":"10.1007/s11060-025-05215-6","DOIUrl":"10.1007/s11060-025-05215-6","url":null,"abstract":"<p><strong>Background: </strong>Glioblastoma (GBM) is the most common and aggressive primary malignant brain tumor in adults, with a median overall survival (OS) rarely exceeding 15 months despite multimodal therapy. While established prognostic factors include age, Karnofsky Performance Status (KPS), and molecular features such as MGMT promoter methylation and IDH mutation status, increasing attention has focused on the role of treatment timing as a potentially modifiable prognostic determinant. In particular, Overall Treatment Time (OTT)-the number of calendar days from the first to the last radiotherapy fraction-may impact survival by enabling tumor repopulation when extended or interrupted.</p><p><strong>Methods: </strong>We conducted a retrospective monocentric cohort study of 166 consecutive adult patients with histologically confirmed IDH-wild-type glioblastoma treated with standard concurrent chemoradiotherapy and adjuvant temozolomide between January 2016 and January 2024. OTT was defined as the total number of days from radiotherapy start to end, including all interruptions. A cutoff of 48 days was adopted based on prior evidence. Patients were stratified according to OTT, number and cause of radiotherapy interruptions, and molecular status (MGMT promoter methylation and EGFR amplification). The primary endpoints were OS and progression-free survival (PFS), analyzed with Kaplan-Meier and Cox regression models.</p><p><strong>Results: </strong>Median OTT was 43 days (range: 40-65). Patients with OTT ≤ 48 days had a significantly longer median OS than those with OTT > 48 days (20 vs. 10 months, p = 0.003). Multivariable Cox regression confirmed OTT > 48 days as an independent negative prognostic factor (HR = 1.41, p = 0.009). Multiple interruptions, regardless of cause, further reduced OS, particularly in patients with MGMT-methylated tumors and low EGFR expression. Clinical interruptions-often due to toxicity-were associated with significantly worse outcomes than single technical interruptions. Notably, the negative impact of prolonged OTT was significantly more pronounced in the MGMT-methylated subgroup (p for interaction = 0.018), suggesting a biologically distinct vulnerability to treatment delays.</p><p><strong>Conclusions: </strong>This study demonstrates that prolonged OTT and radiotherapy interruptions are independently associated with inferior survival in patients with IDH-wild-type glioblastoma, particularly in biologically favorable subgroups such as MGMT-methylated tumors. These findings underscore the importance of strict adherence to treatment schedules and minimizing avoidable delays. Molecular profiling may aid in identifying patients most vulnerable to the adverse effects of treatment prolongation, supporting a more personalized and time-sensitive approach to GBM management. Further prospective validation is warranted.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"1261-1269"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12511268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137844","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":"Pattern of recurrence with 1.0 cm CTV in brain glioblastoma treated with radiotherapy.","authors":"Erica L Braschi, Olivia Trumble, Anthony Casper, Robert J Amdur, Christopher G Morris, Alexandra N De Leo","doi":"10.1007/s11060-025-05195-7","DOIUrl":"10.1007/s11060-025-05195-7","url":null,"abstract":"<p><strong>Purpose: </strong>Historically, clinical target volume (CTV) expansions for glioblastoma (GBM) have ranged from 2 to 3 cm. Since 2017, our institution has adopted a 1 cm CTV expansion beyond the gross tumor volume (GTV) and postoperative cavity on contrast-enhanced T1 Magnetic Resonance (MR) scan. Our study evaluates recurrence patterns using this approach.</p><p><strong>Methods: </strong>We identified 50 patients who developed tumor recurrence following treatment between 01/01/2017-01/31/2024 at our institution. All patients underwent maximal safe resection followed by standard chemoradiation with 60 Gy in 30 fractions, though dose reductions to 59.4 Gy-54 Gy were permitted to meet organ-at-risk constraints. All but three patients received concurrent temozolomide. Radiotherapy target volumes were defined as follows: GTV included gross tumor and postoperative cavity on contrast-enhanced T1 MR, CTV included GTV plus a 1 cm expansion (edited for anatomical barriers), and the planning target volume included a 2 mm expansion beyond the CTV. Recurrences were classified based on the recurrence volume within the 100% isodose: in-field (> 80%), marginal (20-80%), and distant (< 20%).</p><p><strong>Results: </strong>Recurrence patterns were as follows: 80% (40/50) in-field alone, 10% (5/50) in-field and distant, 8% (4/50) distant alone, and 2% (1/50) marginal alone. The single marginal recurrence had 52% of its volume within the 100% isodose.</p><p><strong>Conclusions: </strong>In GBM patients treated with a 1 cm CTV margin on the gross tumor and postoperative cavity on contrast-enhanced T1 MR, we observed a very low marginal recurrence (2%). These findings support the continued use of a 1 cm CTV expansion at our institution.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"1321-1329"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816901","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":"NOTCH3 drives fatty acid oxidation and ferroptosis resistance in aggressive meningiomas.","authors":"Nishanth S Sadagopan, Mateo Gomez, Shashwat Tripathi, Leah K Billingham, Susan L DeLay, Martha A Cady, Harrshavasan T S Congivaram, Tzu-Yi Chia, Hanxiao Wan, Si Wang, David R Raleigh, Faith C Kaluba, Evan C Lien, Amy B Heimberger, Catalina Lee-Chang, Mark W Youngblood, Stephen T Magill, Jason M Miska","doi":"10.1007/s11060-025-05208-5","DOIUrl":"10.1007/s11060-025-05208-5","url":null,"abstract":"<p><strong>Purpose: </strong>NOTCH3 is increasingly implicated for its oncogenic role in many malignancies, including meningiomas. While prior work has linked NOTCH3 expression to higher-grade meningiomas and treatment resistance, the metabolic phenotype of NOTCH3 activation remains unexplored in meningioma.</p><p><strong>Methods: </strong>We performed single-cell RNA sequencing on NOTCH3 + human meningioma cell lines. Using the CH157-MN meningioma cell model, we overexpressed NOTCH3 intracellular domain (ICD) and performed untargeted metabolomic, lipidomic, and bulk RNA sequencing analyses as well as functional metabolic assays.</p><p><strong>Results: </strong>We show that NOTCH3 mediates a metabolic shift towards fatty acid oxidation (FAO), depleting lipid availability and conferring resistance to ferroptosis. Single-cell RNA sequencing revealed a correlation with CD36, a key fatty acid transporter. Furthermore, patient-derived primary meningioma lines stratified by NOTCH3 expression confirmed higher CD36 expression and increased maximal mitochondrial respiration in NOTCH3-high cells in the presence of palmitate, supporting enhanced FAO. NOTCH3 ICD overexpression (OE) exhibited depletion of fatty acid pools, alongside transcriptional upregulation of canonical FAO genes. Functional mitochondrial assays confirmed elevated oxidative respiration in the presence of palmitate compared with controls. Additionally, NOTCH3 OE cells exhibit increased resistance to RSL3-induced ferroptosis, a phenotype that was reversed with CPT1 inhibition.</p><p><strong>Conclusion: </strong>These data establish a link between NOTCH3 signaling, lipid metabolic reprogramming, and ferroptosis evasion in aggressive meningioma cells. This metabolic shift may contribute to the malignant behavior observed in NOTCH3 + meningiomas, offering new insight into the biochemical vulnerabilities of these tumors.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"979-991"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12511256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023501","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":"Complete resection of brain metastases - when does it matter?","authors":"Tommaso Araceli, Amer Haj, Christian Doenitz, Eva-Maria Stoerr, Katharina Rosengarth, Nils Ole Schmidt, Martin Proescholdt","doi":"10.1007/s11060-025-05193-9","DOIUrl":"10.1007/s11060-025-05193-9","url":null,"abstract":"<p><strong>Purpose: </strong>The value of gross total resection (GTR) in patients with brain metastases (BM) is controversial. Therefore, we analyzed the circumstances under which GTR is crucial for optimal outcome in a large population of patients with BM treated with surgical resection at our institution.</p><p><strong>Methods: </strong>The analysis included 539 patients. The extent of resection was rated as complete if no residual contrast-enhancing tumor was detectable on the early postoperative magnet-resonance image (MRI); the tumor size was determined by measuring the volume of the contrast-enhancing areas on the presurgical MRI. Outcome included overall survival (OS) and progression-free survival (PFS).</p><p><strong>Results: </strong>GTR was achieved in most patients (82.8%) but was not associated with longer OS and PFS in the entire population (HR: 0.88; p = 0.162 and HR: 0.84; p = 0.319). However, a significant survival benefit of GTR was observed in patients with solitary BM (HR: 0.39; p = 0.0006). Age younger than 65 years (HR: 0.75; p = 0.047), controlled disease status (HR: 0.68; p = 0.033), focal radiotherapy (HR: 0.64, p = 0.044), postsurgical systemic treatment (HR: 0.67; p = 0.038), and no target therapy (HR: 0.75, p = 0.039) were also associated with significant benefit of GTR. Multivariate interaction analysis showed that solitary BM and controlled disease status significantly influenced the impact of GTR in our patient population (p = 0.0001).</p><p><strong>Conclusion: </strong>Achieving GTR is highly relevant in patients with solitary BM status, controlled systemic disease, specific postsurgical systemic treatment options, postsurgical focal radiation strategies, and in the population younger than 65 years of age.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"1299-1309"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12511165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957663","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":"Thromboembolism in gliomas: an under-recognized danger.","authors":"Alexander Ho, Craig Horbinski, Sean Sachdev","doi":"10.1007/s11060-025-05204-9","DOIUrl":"10.1007/s11060-025-05204-9","url":null,"abstract":"","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"1465-1466"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006269","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":"Prediction of double expression status of primary CNS lymphoma using multiparametric MRI radiomics combined with habitat radiomics: a double-center study.","authors":"Jianxin Zhao, Lijun Liang, Jixian Li, Qi Li, Fei Li, Lei Niu, Caiqiang Xue, Weiwei Fu, Yingchao Liu, Shuangshuang Song, Xuejun Liu","doi":"10.1007/s11060-025-05225-4","DOIUrl":"10.1007/s11060-025-05225-4","url":null,"abstract":"<p><strong>Rationale and objectives: </strong>Double expression lymphoma (DEL) is an independent high-risk prognostic factor for primary CNS lymphoma (PCNSL), and its diagnosis currently relies on invasive methods. This study first integrates radiomics and habitat radiomics features to enhance preoperative DEL status prediction models via intratumoral heterogeneity analysis.</p><p><strong>Materials and methods: </strong>Clinical, pathological, and MRI imaging data of 139 PCNSL patients from two independent centers were collected. Radiomics, habitat radiomics, and combined models were constructed using machine learning classifiers, including KNN, DT, LR, and SVM. The AUC in the test set was used to evaluate the optimal predictive model. DCA curve and calibration curve were employed to evaluate the predictive performance of the models. SHAP analysis was utilized to visualize the contribution of each feature in the optimal model.</p><p><strong>Results: </strong>For the radiomics-based models, the Combined radiomics model constructed by LR demonstrated better performance, with the AUC of 0.8779 (95% CI: 0.8171-0.9386) in the training set and 0.7166 (95% CI: 0.497-0.9361) in the test set. The Habitat radiomics model (SVM) based on T1-CE showed an AUC of 0.7446 (95% CI: 0.6503- 0.8388) in the training set and 0.7433 (95% CI: 0.5322-0.9545) in the test set. Finally, the Combined all model exhibited the highest predictive performance: LR achieved AUC values of 0.8962 (95% CI: 0.8299-0.9625) and 0.8289 (95% CI: 0.6785-0.9793) in training and test sets, respectively.</p><p><strong>Conclusion: </strong>The Combined all model developed in this study can provide effective reference value in predicting the DEL status of PCNSL, and habitat radiomics significantly enhances the predictive efficacy.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"1103-1113"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023468","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":"Utility and performance of cerebrospinal fluid cytology in discriminating central nervous system infections and brain tumors.","authors":"Miao Su, Huiqian Duan, Qian Lei, Zhimei Tan, Yuxin Shi, Jia Liu, Liqun Xu, Qiuxiang Li, Jing Li, Zhaohui Luo","doi":"10.1007/s11060-025-05214-7","DOIUrl":"10.1007/s11060-025-05214-7","url":null,"abstract":"<p><strong>Background and objective: </strong>Differentiating central nervous system infections (CNSIs) from brain tumors (BTs) is difficult due to overlapping features and the limited individual indicators, and cerebrospinal fluid (CSF) cytology remains underutilized. To improve differential diagnosis, we developed a model based on 9 early, cost-effective cerebrospinal fluid parameters, including CSF cytology.</p><p><strong>Methods: </strong>Patients diagnosed with CNSIs or BTs at Xiangya Hospital of Central South University between October 1st, 2017 and March 31st, 2024 were enrolled and divided into the training set and the test set. Lasso analysis, random forest, and multivariable logistic regression were used to construct a diagnostic model to distinguish CNSIs from BTs by utilizing differences in basic CSF parameters and CSF cytology results. And its diagnostic efficacy was evaluated using the receiver operating characteristic (ROC) curve. A nomogram was used for model visualization.</p><p><strong>Results: </strong>A total of 783 patients were included in this study. 9 important CSF parameters significantly contribute to the differentiation between CNSIs and BTs, including CSF pressure, protein, glucose, adenosine deaminase, chloride, and the counts of lymphocytes, monocytes, plasma cells and phagocytes. CSF phagocytes and monocytes were elevated in BTs, whereas lymphocytes and plasma cells were higher in CNSIs. The model demonstrated strong diagnostic performance, achieving an area under the ROC curve (AUC) of 0.889 in the training set and 0.900 in the test set.</p><p><strong>Conclusions: </strong>We developed a diagnostic model based on 9 CSF indicators. In our study, CSF phagocytes and monocytes were associated with BTs, while lymphocytes and plasma cells indicated CNSIs.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"1343-1353"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029695","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}