Journal of Neuro-Oncology最新文献

{"title":"Financial toxicity in pediatric and adolescent neurosurgical oncology.","authors":"Alexandra M Giantini-Larsen, Samantha Brown, Anne S Reiner, Stephanie Doyle Giandalone, Kyle Zappi, Zaki Abou-Mrad, Yasmin Khakoo, Ira J Dunkel, Matthias A Karajannis, Sameer F Sait, Caitlin E Hoffman, Jeffrey P Greenfield, Mark M Souweidane, W Christopher Newman","doi":"10.1007/s11060-025-05056-3","DOIUrl":"10.1007/s11060-025-05056-3","url":null,"abstract":"<p><strong>Background: </strong>Financial toxicity (FT) encompasses the negative impact of medical costs on patients. In-depth analysis of FT in pediatric and adolescent neurosurgical oncology has not been performed. The aim of this study was to determine the incidence of FT in this population.</p><p><strong>Design: </strong>A retrospective review of medical and financial services data was conducted at Memorial Sloan Kettering Cancer Center of patients under 21 years of age who underwent neurosurgery for a cancer-related diagnosis from 2016 to 2020.</p><p><strong>Results: </strong>294 surgical procedures across 202 patients were analyzed. 16% (33/202) of patients experienced FT in the two years prior to the first neurosurgical procedure, and the most common toxicity identifier was utilization of the financial assistance program (45%). For all 202 patients, the 2-year cumulative incidence of FT following first neurosurgical procedure was 19% (CI:14%,24%). Among patients who survived for at least 2 years after surgery, 34% (29/86) experienced FT with the most common toxicity being having bills sent to collections (34%). Most patients who experienced FT had at least one commercial insurance policy. Presence of pre-operative FT was associated with a significantly higher cumulative incidence of post-operative FT (2-year estimates: pre-operative FT 61% (95%CI: [41%,75%]) vs. no pre-operative FT 11% (95%CI: [7%,16%]), p < 0.001).</p><p><strong>Conclusion: </strong>FT poses challenges in the pediatric neurosurgical oncology population. Pre-operative FT significantly influences post-operative FT. Most patients who experienced FT had at least one commercial insurance plan, providing evidence that even patients with insurance are not immune to FT.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"349-356"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030250","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":"Multimodal MRI radiomics enhances epilepsy prediction in pediatric low-grade glioma patients.","authors":"Tianyou Tang, Yuxin Wu, Xinyu Dong, Xuan Zhai","doi":"10.1007/s11060-025-05073-2","DOIUrl":"10.1007/s11060-025-05073-2","url":null,"abstract":"<p><strong>Background: </strong>Determining whether pediatric patients with low-grade gliomas (pLGGs) have tumor-related epilepsy (GAE) is a crucial aspect of preoperative evaluation. Therefore, we aim to propose an innovative, machine learning- and deep learning-based framework for the rapid and non-invasive preoperative assessment of GAE in pediatric patients using magnetic resonance imaging (MRI).</p><p><strong>Methods: </strong>In this study, we propose a novel radiomics-based approach that integrates tumor and peritumoral features extracted from preoperative multiparametric MRI scans to accurately and non-invasively predict the occurrence of tumor-related epilepsy in pediatric patients.</p><p><strong>Results: </strong>Our study developed a multimodal MRI radiomics model to predict epilepsy in pLGGs patients, achieving an AUC of 0.969. The integration of multi-sequence MRI data significantly improved predictive performance, with Stochastic Gradient Descent (SGD) classifier showing robust results (sensitivity: 0.882, specificity: 0.956).</p><p><strong>Conclusion: </strong>Our model can accurately predict whether pLGGs patients have tumor-related epilepsy, which could guide surgical decision-making. Future studies should focus on similarly standardized preoperative evaluations in pediatric epilepsy centers to increase training data and enhance the generalizability of the model.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"431-437"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120030","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":"Engineering overexpressing SYNGR1 inhibited the progression of GBM cells by suppressing the intracellular FGF1-mediated LDs accumulation and cytoskeleton remodeling.","authors":"Juncheng Wang, Qiang Yang, Xinlong Li, Qiao Li, Yufeng Zhu, Liang Niu, Pengyu Yang, Guopeng Tian, Dongming Ma, Guoqiang Yuan, Yawen Pan","doi":"10.1007/s11060-025-05095-w","DOIUrl":"10.1007/s11060-025-05095-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Glioblastoma (GBM) is the most common and aggressive glioma subtype in adults, characterized by disrupted lipid homeostasis. The accumulation of lipid droplets (LDs) is involved in the actin cytoskeleton remodeling in different types of cells, the intracellular fibroblast growth factor 1 (FGF1) plays an important role in this process. The stability of cytoskeleton is crucial for the proliferation, invasion and other malignant behavior of GBM. The synaptic gyrus protein 1 (synaptogyrin 1, SYNGR1) is closely correlated with the progression of various tumours, but there have been no reports of research in the field of glioma. This research was conducted to investigate whether the overexpression of SYNGR1 was involved in regulating the malignant biological behaviour of GBM cells and its potential regulatory mechanism, especially whether the LDs accumulation is involved in the remodeling of the actin cytoskeleton in GBM cells.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The UCSC Xena database and GEPIA database were used to analyze the correlation between the expression level of SYNGR1 and the survival time of glioma patients. Engineering Lentiviruses were used to establish cells with stable overexpression of SYNGR1, FGF1, or both. The proliferation, invasion, and cytoskeleton of glioma cells (U251, LN229, U118) were detected by cell counting kit-8 (CCK8), 5-ethynyl-2'-deoxyuridine (EdU), immunofluorescence(IF), colony formation, adhesion, and transwell assays. Intracellular LDs were detected by the lipid droplet red fluorescence assay with Nile red. The cell cycle distribution and apoptosis rate of the cells were assessed using flow cytometry analysis. Bioinformatics analysis, IF, RNA sequencing, and western blot analysis were used to measure the expression levels of target proteins. The protein from HA and HT22 cell lines served as control was detected by western blot analysis. The Gl261 cell line and C57BL/6 mouse were used to construct C57BL/6 mouse glioblastoma model. Animal MRI was used to examine tumor size.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;SYNGR1 expression was significantly reduced in GBM. Overexpression of SYNGR1 significantly inhibited the LDs accumulation, proliferation, invasion, adhesion, and other malignant processes in GBM cells in vitro. Moreover, SYNGRI overexpression inhibited the growth of intracranial gliomas in vivo and prolonged survival of C57BL/6 model mice. Mechanistic exploration revealed that the overexpression of SYNGR1 had an antiglioma effect by inhibiting the LDs accumulation and remodeling the cytoskeleton via the downregulation of the intracellular FGF1, while FGF1 overexpression could reverse the antiglioma effect of SYNGR1.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The intracellular FGF1 played an important role in maintaining the homeostasis of LDs and the actin cytoskeleton, which promoted the malignant progression of GBM cells. Engineering overexpressing SYNGR1 could effectively inhibit the malignant","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"667-687"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234366","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 comparison of outcomes after radiosurgery in non-small cell lung cancer patients with one versus more than twenty brain metastases: an international multi-center study.","authors":"Chris Z Wei, Regan Shanahan, David Puccio, Hansen Deng, Cheng-Chia Lee, Huai-Che Yang, Christopher P Cifarelli, Joshua D Hack, Daniel T Cifarelli, Selcuk Peker, Yavuz Samanci, David Mathieu, Jocelyn Blanchard, Haley K Perlow, Joshua D Palmer, Manjul Tripathi, Nuria Martínez Moreno, Roberto Martínez Álvarez, Herwin Speckter, Wenceslao Hernandez, Roman Liščák, Jaromir May, Shahed Elhamdani, Matthew J Shepard, Rodney Wegner, Constantinos G Hadjipanayis, L Dade Lunsford, Ajay Niranjan","doi":"10.1007/s11060-025-05093-y","DOIUrl":"10.1007/s11060-025-05093-y","url":null,"abstract":"<p><strong>Background: </strong>Whether the number or cumulative volume of brain metastases affects survival in patients with metastatic non-small cell lung cancer (NSCLC) remains controversial. We conducted a volume matched multi-center study to determine whether patients with a single metastasis had better outcomes than patients with > 20 brain metastases.</p><p><strong>Methods: </strong>Between 2014 and 2022, 317 NSCLC patients (21.14% female; single tumor: 278 patients; >20 tumors, 39 patients) underwent stereotactic radiosurgery (SRS). The prescribed margin dose, cumulative tumor volume, 12 Gy volume, and concurrent systematic disease managements were recorded. The overall survival (OS), local tumor control (LTC), adverse radiation effect (ARE) risk, and new tumor development were compared.</p><p><strong>Results: </strong>No difference in OS was found between patients with > 20 brain metastases and patients with a single metastasis (p = 0.61). Compared to the single tumor cohort, where 217 of 278 (78.06%) patients had no recorded local tumor progression, patients with > 20 brain metastases had a local tumor control rate of 76.92% (p = 0.25). Patients with > 20 tumors had a significantly higher rate of distant tumor development (69.2%) after SRS compared to patients with single tumors (35.3%; **p = 0.024). No significant difference of ARE rate was found.</p><p><strong>Conclusion: </strong>In this volume matched multi-center study, patients with > 20 tumors showed comparable OS and LTC outcomes compared to patients with single tumors. The number of brain metastases should not be used as a criteria to exclude patients from receiving SRS.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"645-652"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208754","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":"CDKN2A/B status versus morphology in diagnosing WHO grade 4 IDH-mutated astrocytomas: what is the clinical relevance?","authors":"Anna Lipatnikova, Teresia Kling, Anna Dénes, Louise Carstam, Alba Corell, Malin Blomstrand, Sandra Ferreyra Vega, Dima Harba, Thomas Olsson Bontell, Helena Carén, Asgeir S Jakola","doi":"10.1007/s11060-025-05078-x","DOIUrl":"10.1007/s11060-025-05078-x","url":null,"abstract":"<p><strong>Purpose: </strong>In the 2021 WHO classification system for central nervous system tumors, the diffuse glioma subgroup IDH-mutated (IDHm) astrocytomas WHO grade 4 was introduced. The diagnosis can be based upon molecular or histopathological morphological criteria. Here we explore whether phenotype and survival of IDHm astrocytomas WHO grade 4 differed across the criteria used for diagnosis.</p><p><strong>Methods: </strong>Patients with IDHm astrocytoma, WHO grade 4, were included from Sahlgrenska University Hospital and TCGA database. We created three subgroups based upon the criteria for diagnosis of WHO grade 4; (1) homozygous CDKN2A/B deletion; (2) morphological (necrosis and/or microvascular proliferation); (3) combined subgroup with both homozygous CDKN2A/B deletion and morphological grade 4 criteria.</p><p><strong>Results: </strong>We included 90 patients (local cohort, n = 35, TCGA cohort, n = 55) with IDHm astrocytoma, WHO grade 4. The median survival was 4.1 years (95% CI 3.0-5.3). Survival was comparable when the diagnosis was based on homozygous CDKN2A/B deletion and on morphological WHO grade 4 criteria (5.2 vs. 5.3 years). However, in the combined subgroup, survival was significantly shorter (2.8 years, p = 0.006).</p><p><strong>Conclusion: </strong>The different subgroups of IDHm astrocytoma WHO grade 4 share similar characteristics. Patients whose tumors exhibit combined criteria have worse prognosis.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"449-458"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110992","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":"Local cranial radiation combined with third-generation tyrosine kinase inhibitors improve leptomeningeal metastasis disease-free survival in patients with EGFR-mutated non-small cell lung cancer and brain metastasis.","authors":"Qian Wang, Hui Wang, Weiping Hong, Shoaib Bashir, Xiaoyu Hua, Yanying Yang, Junjie Zhen, Juan Li, Mingyao Lai, Linbo Cai","doi":"10.1007/s11060-025-05045-6","DOIUrl":"10.1007/s11060-025-05045-6","url":null,"abstract":"<p><strong>Purpose: </strong>The role of local cranial radiation (LCR) combined with third-generation tyrosine kinase inhibitors (TKIs) in the following the progression to leptomeningeal metastasis (LM) in epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC) with brain metastasis (BM) remains unclear. This study investigates whether LCR combined with third-generation TKIs can influence the occurrence LM in EGFR-mutated NSCLC with BM.</p><p><strong>Methods: </strong>Patients diagnosed with EGFR exon 19del or exon 21 L858R mutant NSCLC with LM in Guangdong Sanjiu Brain Hospital were recruited into the study between January 1, 2018 and December 31, 2023. They were separated into two groups according to whether they received LCR during the period from BM to LM on not. The primary endpoints were the LM disease-free survival (LM-DFS) and LM rate.</p><p><strong>Results: </strong>A total of 93 patients were enrolled, 60 in the TKIs group and 33 in the LCR + TKIs group. The median LM-DFS of the TKIs group and the LCR + TKIs group were 14.1 months (95% CI 12.3-19.8 months) and 27.0 months (95% CI 19.4-35.1 months), respectively (p < 0.01). After propensity score matching, the median LM-DFS were 13.2 months (95% CI 9.5-21.6 months) and 24.6 months (95% CI 18.1-35.1 months), respectively (p = 0.01). 2-year LM rates in TKIs group and LCR + TKIs group were 78.3% and 45.5% in all patients (p < 0.01); 76.9% and 50.0% in matched cohort (p = 0.02), respectively.</p><p><strong>Conclusion: </strong>LCR combined with third-generation TKIs could improve LM-DFS and decrease 2-year LM rate compared with third-generation TKIs alone. Further studies are required to ascertain this effect.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"471-482"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326064","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":"Temporospatial tumor dynamic changes in glioblastoma during radiotherapy.","authors":"Alonso La Rosa, Kathryn E Mittauer, Amy E Rzepczynski, Michael D Chuong, Nema Bassiri-Gharb, Nicole C McAllister, Matthew D Hall, Robert H Press, Alonso N Gutierrez, Ranjini Tolakanahalli, Minesh P Mehta, Rupesh Kotecha","doi":"10.1007/s11060-025-05060-7","DOIUrl":"10.1007/s11060-025-05060-7","url":null,"abstract":"<p><strong>Introduction: </strong>Glioblastoma (GBM) management post maximal-safe resection consists of concurrent chemoradiation (CRT) and adjuvant chemotherapy. MRIs are historically performed post-operatively and/or at treatment planning. Continuous interfractional changes during CRT have not been adequately characterized. MR-guided radiation therapy (MRgRT) allows for detailed imaging of tumor volumes during the course of treatment. This is a preliminary initial report evaluating temporal and spatial changes that occur in GBM, in order to model tumor dynamics.</p><p><strong>Methods: </strong>Five GBM patients enrolled onto an institutional biorepository registry underwent treatment with our 0.35T MRgRT workflow. Target volumes were delineated based on T2/FLAIR (GTV_46Gy) and T1 gadolinium-enhanced MR (GTV_14Gy) sequences. Weekly post-contrast MRIs were performed during CRT with the 0.35T magnet to monitor target volume dynamics.</p><p><strong>Results: </strong>Thirty-five MR scans were evaluated. The median time from surgery to CRT was 32 days (range: 28-40), with a median of 13 days (range: 12-14) from simulation to CRT. We found median volume reductions of 40.0% (range: 8.3-86.5%), and 37.1% (range: 15.0-67.5%) for GTV_46Gy and GTV_14Gy, respectively. The bulk of these changes occurred early, within the first 3 weeks of the 6-week treatment, with significant reductions observed between baseline and week 1 -32.6% for GTV_46Gy and 17.9% for GTV_14Gy. Separately, statistically significant volume reductions for the cavity volume (F = 59.43, p < 0.05) were observed. Compared to baseline, centroid migrations of the target volumes were also noted: the median GTV_46Gy centroid migration was 7.4 mm (range: 2.0-10.8 mm) and the median GTV_14Gy centroid migration was 3.6 mm (range: 1.3-8.8 mm).</p><p><strong>Conclusions: </strong>Our pilot study suggests that weekly MRgRT imaging for GBM patients undergoing long course CRT reveals significant GTV reductions and centroid migrations, especially during the first 3 weeks of treatment. A more detailed understanding of which patients are at highest risk for tumor change and migration is needed to best apply these imaging parameters to clinical practice.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"493-501"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030421","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":"Current trends in reoperation for recurrent glioblastoma: a meta-analysis (2007-2023).","authors":"Pavel S Pichardo-Rojas, Fabricio Garcia-Torrico, César B Espinosa-Cantú, Francisco A Rodriguez-Elvir, Andrea C Beltran-De la Fuente, Myriam S Hernandez-Garcia, James S Trippett, Alexis Morell, Ashish H Shah, Ricardo J Komotar, Yoshua Esquenazi","doi":"10.1007/s11060-025-05058-1","DOIUrl":"10.1007/s11060-025-05058-1","url":null,"abstract":"<p><strong>Purpose: </strong>Despite conflicting evidence, reoperation for recurrent glioblastoma (rGBM) achieving complete resection of enhancing-tumor (CRET) may offer benefits over partial resection or salvage therapy alone. However, pooled analyses remain limited.</p><p><strong>Methods: </strong>A systematic search identified rGBM studies comparing reoperation and non-reoperation, including chemotherapy with/without radiotherapy, radiation-based therapies (RBT), and best supportive care (BSC).</p><p><strong>Results: </strong>Thirty-six studies, comprising 10,738 patients, were included, with 2,806 undergoing reoperation. Nine propensity-score-matched studies and one clinical trial were identified. Mean overall survival (OS) favored reoperation (19.66 months) over chemotherapy with/without radiotherapy (12.56 months, p < 0.00001) and BSC (4.04 months, p < 0.00001), but not over chemotherapy alone (14.60 months) or RBT (14.26 months)(p > 0.05). Multivariate OS favored reoperation over chemotherapy with/without radiation(HR = 0.62,95%CI:0.50-0.76,p < 0.00001), but not to stereotactic radiosurgery (SRS) (HR = 0.52,95%CI:0.25-1.08,p = 0.08) or chemotherapy alone (HR = 0.80,95%CI:0.63-1.00,p = 0.05). Progression-free survival after recurrence (PFS2) was only compared between reoperation and chemotherapy with/without radiotherapy, favoring reoperation (8.36 vs. 4.97 months, p < 0.00001). Multivariate analysis also favored reoperation (HR = 0.56, 95% CI:0.41-0.76,p = 0.0002).The mean post-recurrence survival (PRS) was 12.18 months in the reoperation group, 9.19 months in the chemotherapy with/without radiotherapy, and 9.64 months in SRS. Multivariate PRS favored reoperation over chemotherapy with/without radiotherapy (HR = 0.78, 95%CI: 0.62-0.98,p = 0.04). CRET with < 1 cm³ residual tumor correlated with improved PRS over incomplete resection (HR: 0.54, 95%CI:0.39-0.73, p = 0.04).</p><p><strong>Conclusion: </strong>The role of reoperation in rGBM remains uncertain. While it may improve survival in selected cases, limited high-quality data hinder definitive conclusions. Achieving CRET may correlate with improved PRS over partial resection. Further prospective trials are necessary to guide optimal management of rGBM.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"271-301"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025715","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":"Patterns, clinical presentations, and time to diagnosis in pediatric central nervous system tumors: insights from a pediatric neuro-oncology tumor board team at a tertiary referral hospital in Ethiopia.","authors":"Gashaw Arega, Daniel Hailu, Getasew Fikad, Mulualem Nigusie, Haileyesus Adam, Abenezer Tirist, Adungha Fekdau, David N Korones, Abdulkadir Mohammedsaid","doi":"10.1007/s11060-025-05040-x","DOIUrl":"10.1007/s11060-025-05040-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pediatric central nervous system (CNS) tumors are the most common solid cancers and the leading cause of cancer-related morbidity and mortality in children. The global demographic and epidemiological trends indicate a significant increase in childhood and adolescent cancers, including pediatric brain tumors, in low- and middle-income countries, particularly in Sub-Saharan African countries necessitating the dire need of multidisciplinary Pediatric Neuro-Oncology (PNO) teams to improve outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The primary objective of the study was to evaluate the patterns, clinical presentations, time to diagnosis (TD), and treatment provided to pediatric and adolescent patients with central nervous system tumors who were discussed at the pediatric neuro-oncology tumor board and treated by the neuro-oncology team at Tikur Anbessa Specialized Hospital in Ethiopia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods and materials: &lt;/strong&gt;This retrospective cross-sectional study was conducted in the Pediatric Hematology and Oncology (PHO) unit at Tikur Anbessa Specialized Hospital in Ethiopia. It included all pediatric patients under 15 years old with primary central nervous system (CNS) tumors from December 2021 to May 2024. The study aimed to provide an overview of the sociodemographic characteristics of the children, clinical presentation, time to diagnosis, histopathology of the tumors, and treatment modalities recommended by the PNO tumor board.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of two hundred ten patients with pediatric CNS tumors were discussed and reviewed at the Pediatric Neuro-Oncology (PNO) Tumor Board during the study period. More than half of the patients (54.8%, n = 114) were males. The median age at diagnosis was 7 years, and nearly half of the patients (48.6%) were between 5 and 10 years old. The most common clinical presentations were headache (66.2%), vomiting (64.3%), visual symptoms (44.8%), and cerebellar symptoms (43.8%). The median time to diagnosis was 90 days (IQR 60-210), and 60% of the patients presented after three months of symptom onset of the disease. The most common pediatric CNS tumors were medulloblastoma and embryonal CNS tumors, accounting for 32.9% (n = 69), followed by astrocytic tumors; 30.0% (n = 63), craniopharyngiomas (14.0%), and ependymal tumors (11.4%). The main treatments offered by the PNO Tumor Board were a combination of surgery, radiotherapy, and systemic chemotherapy (33.8%), surgery alone (23.8%), and surgery with radiotherapy (21.4%). The PNO Tumor Board was primarily attended by pediatric hematology-oncology fellows, pediatric oncologists (90%), and neurosurgeons (86%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study focused on analyzing the age distribution, clinical presentation, time to diagnosis, burden, and patterns of pediatric primary CNS tumors at the largest tertiary referral center in Ethiopia. It is imperative to prioritize educating healthcare professionals ","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"587-598"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144285016","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 neurocognitive sequelae in pediatric medulloblastoma survivors treated according to the HIT protocol.","authors":"Iuliia A Aldeeva, Elena V Glebova, Roza A Sarkisyan, Elizaveta N Romanova, Nadezhda M Karpova, Valeriia G Shapovalova, Alexander F Karelin","doi":"10.1007/s11060-025-05070-5","DOIUrl":"10.1007/s11060-025-05070-5","url":null,"abstract":"<p><strong>Objective: </strong>Medulloblastoma is the most prevalent malignant brain tumour in children. Although contemporary comprehensive anticancer therapy has been shown to result in favourable survival and relapse outcomes, the long-term toxic effects on cognitive and motor function remain a concern. This study aims to investigate the long-term neurotoxic effects on cognitive function in paediatric medulloblastoma survivors.</p><p><strong>Method: </strong>Data from 70 patients (M_age = 12.7 ± 2.94 years, 40% female) in remission treated according to the HIT protocol who underwent comprehensive neuropsychological assessment were analyzed. General linear models (GLMs) were constructed to assess the contribution of remission duration, chemotherapy type, and radiation dose to variability in cognitive performance on the CANTAB and DTKI tests.</p><p><strong>Results: </strong>GLM revealed that remission > 4 years was associated with poorer processing speed, attention, and executive functions: cognitive flexibility, inhibitory control, planning, and working memory compared to participants with shorter remission. Induction therapy with methotrexate had more pronounced long-term negative effects on processing speed. However, no significant effects were observed across different radiation doses.</p><p><strong>Conclusions: </strong>Remission duration emerged as a more significant predictor of a poor neurocognitive outcome than chemotherapy type or radiation dose, that is, the longer the remission, the more pronounced the neurocognitive impairment becomes. This highlights the need for continued monitoring and the development of targeted rehabilitation interventions for paediatric medulloblastoma survivors.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"401-409"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078527","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}