Journal of Neuro-Oncology最新文献

{"title":"Unscheduled hospitalization as a potential trigger for specialist palliative care referral in patients with high grade glioma: a retrospective analysis in a tertiary hospital.","authors":"Juan Luis Torres-Tenor, Andrea García-Leal, David Hui, Eduardo Bruera, Virginia Martínez-Marín, Ana Castaño-Cantos, Alberto Alonso-Babarro","doi":"10.1007/s11060-025-04993-3","DOIUrl":"https://doi.org/10.1007/s11060-025-04993-3","url":null,"abstract":"<p><strong>Purpose: </strong>Guidelines recommend early palliative care for patients with cancer, including high grade glioma (HGG), but referrals to palliative care are often delayed. Our study aimed to describe characteristics and outcomes of patients with HGG with a first unscheduled hospitalization, and assess if it should trigger palliative care referral.</p><p><strong>Methods: </strong>Retrospective study of medical oncology outpatients with HGG at a tertiary hospital, analyzing first unscheduled hospitalizations. Primary variable: Overall Survival (OS) after admission.</p><p><strong>Results: </strong>133 HGG consecutive patients were referred to the medical oncology outpatient clinic. By the study's end, 90% (N = 119) had died, with a median OS from diagnosis of 11 months (95% CI 10-14). Unscheduled hospitalizations occurred in 53% of patients (N = 71) and were associated to reduced median OS from diagnosis: 10.5 months vs. 14 months, HR (95% CI) = 1.9 (1.3-2.7), p = 0.0012. Mortality during hospitalization was 24% (N = 17). Median OS after admission was 2.5 months (95% CI 2-4). Poor ECOG performance status (p = 0.059), no prior cancer treatment (p = 0.0003), longer diagnosis-to-admission time (p = 0.0147), admission to acute palliative care unit (p = 0.0012), and discharge to Hospice (p < 0.0001) associated with lower survival. Of admitted patients, palliative care assessed 39% (N = 28) during hospitalization, 28% (N = 20) before, and 24% (N = 17) after. Median OS after admission was shorter for those referred before/during hospitalization: 2 months vs. 7 months, HR (95% CI) = 0.4 (0.2-0.7), p = 0.0012.</p><p><strong>Conclusion: </strong>The first unscheduled hospitalization in HGG patients could signal poor prognosis, yet palliative care referrals often occur late, highlighting missed opportunities for earlier intervention and suggesting unscheduled hospitalization as a potential trigger for referral.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567371","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":"Characterizing the molecular and spatial heterogeneity of midline gliomas in adults: a single institution analysis.","authors":"Bryan J Neth, Robert M Kraft, Kathryn L Eschbacher, Derek R Johnson, Paul A Decker, Ugur T Sener, Joon H Uhm, Michael W Ruff, Jonathan D Schwartz, William G Breen, Muhammad Asad Maqbool, David J Daniels, Terry C Burns, Ian F Parney, Aditya Raghunathan, Sani H Kizilbash","doi":"10.1007/s11060-025-04994-2","DOIUrl":"https://doi.org/10.1007/s11060-025-04994-2","url":null,"abstract":"<p><strong>Purpose: </strong>Primary gliomas arising within midline structures of the central nervous system are associated with a worse prognosis compared with hemispheric gliomas. In adults, compared to their pediatric counterparts, adult midline gliomas are not as clearly characterized on the clinical behavior, prognostic factors, and treatment approaches for these diseases.</p><p><strong>Methods: </strong>This retrospective cohort assessed all adult (≥ 18 years) patients from our institution with diffuse gliomas arising from midline structures at time of diagnosis (2014-2020). Molecular features characterized using immunohistochemistry, targeted next-generation sequencing, and chromosomal microarray analysis were collected. Patient characteristics were compared across groups using analysis of variance, Kruskal-Wallis, and the chi-square test as appropriate. Cumulative progression-free survival (PFS) and overall survival (OS) probabilities were estimated using the Kaplan-Meier method. Comparisons across groups were made using the log rank test.</p><p><strong>Results: </strong>79 patients were included in analysis, with a median follow-up of 22.5 months (range, 0.6-123). The mean age at diagnosis was 44.5 years (range, 19.4-76.4), and 51% (n = 40) were female. Thalamus/basal ganglia was the most common primary tumor location (47%), followed by the brainstem (30%), and cerebellum (23%). For the entire cohort, median PFS was 11.5 months (95% CI 9.4-20.1), and median OS was 25.5 months (95% CI 22.0-38.2). We grouped primary tumor types into four distinct diagnostic entities based on integrated histological and molecular features, which had survival differences (log-rank p = 0.007)-diffuse midline glioma, H3 K27-altered (17% with median OS 19.4 months); astrocytoma, IDH-wild type, not otherwise specified (42% with median OS 25.5 months); glioblastoma, IDH-wild type (24% with median OS 11.0 months); and astrocytoma, IDH-mutant (18% with OS 63.3 months). There were no cases of IDH-mutant tumors in the thalamus/basal ganglia. IDH-mutant tumors had better prognosis (OS: IDH-mutant 63.3 months, IDH-wild type 22.5 months, log-rank p = 0.003). Tumor enhancement and diffusion restriction at initial diagnosis was associated with worse prognosis (OS: enhancing 22.0 months, non-enhancing 64.5 months, log-rank p < 0.001; OS: restriction 20.3 months, no restriction 30.6 months, log-rank p = 0.028).</p><p><strong>Conclusion: </strong>There is significant molecular heterogeneity between midline gliomas which has prognostic implications. These findings emphasize the need to molecularly characterize these tumors to facilitate personalized treatment approaches.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567326","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 clinical trials for craniopharyngiomas: what's on the horizon?","authors":"Nikhil Joshi, Sabine Mueller, Cassie Kline","doi":"10.1007/s11060-024-04899-6","DOIUrl":"https://doi.org/10.1007/s11060-024-04899-6","url":null,"abstract":"<p><p>Craniopharyngiomas are histologically low-grade tumors in the sellar/suprasellar region that grow close to critical structures including the hypothalamus, pituitary gland, and optic chiasm. Due to this challenging location, many patients face long-term complications including neuroendocrine, neurologic, and visual deficits. As a result, there is interest in developing risk-optimized treatments that minimize damage to adjacent normal tissue and limit chronic complications patients face. In recent years, numerous multi-omic characterizations of craniopharyngioma have identified potential targetable markers of craniopharyngioma. In adamantinomatous craniopharyngioma, numerous clinical trials to explore MEK, PD-1, WNT, and IL-6 inhibition are currently active. In papillary craniopharyngioma, targeting BRAF-V600E and MEK with monotherapy and combined therapies are currently being investigated. Further combining of these therapies with radiation and surgical techniques have potential to change existing treatment paradigms and improve the long-term outcome for patients with craniopharyngioma. With our advanced understanding, clinical investigations that target identified oncogenic drivers of craniopharyngioma should continue to center on therapy options that minimize complications faced by patients with this chronic, high morbidity disease.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557187","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 pregnancy on the treatment and outcomes of glioma: a cohort study.","authors":"Jack M Shireman, Emily Distler, Cheyenne Schepp, Yilong Tao, Liam McCarthy, Varshitha Kasulabada, Mahua Dey","doi":"10.1007/s11060-025-04961-x","DOIUrl":"https://doi.org/10.1007/s11060-025-04961-x","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy's impact on cancer has been understudied throughout the literature. The current authoritative cancer database in the US, NCI's SEER database, tracks nearly all aspects of cancer care however has no provision to track pregnancy. Consequently, there are no systematic evidence based clinical guidelines available for this vulnerable population.</p><p><strong>Objective: </strong>This retrospective cohort study outlines reported clinical presentation, obstetric outcomes, and treatment regimens for pregnant patients diagnosed with glioma to better understand current practice pattern for glioma during pregnancy.</p><p><strong>Evidence review: </strong>An exhaustive PubMed and Cochrane based literature search was performed for pregnancy and glioma. Individual patient data was extracted primarily from case reports and case series, since pregnancy is an exclusion criterion for most clinical trials.</p><p><strong>Findings: </strong>We identified a cohort of 94 patients, 54% of whom (n = 51/94) were diagnosed prior to their pregnancy. Of the patients who were diagnosed during their pregnancy, diagnosis was most common in the second trimester (27%, n = 25/94). Seizure was the most common presenting symptom and maternal survival varied significantly by glioma grade. Treatment delays were common and were most detrimental to maternal survival in glioblastoma (GBM) (22 months (no delay) vs 8 months (delay) p < 0.10). Most patients regardless of tumor grade delivered healthy babies (80%, n = 75/94) while GBM carried the highest rate of birth complications or defects (15% n = 3/20). Fetal exposure to chemotherapy and/or radiotherapy increased the rate of birth defects or complications from 5% (n = 2/47) to 16% (n = 6/37).</p><p><strong>Conclusions and relevance: </strong>In summary, we found wide practice variation in management of glioma during pregnancy. Systematic reporting on this vulnerable population is needed to better serve mothers and fetuses during this incredibly challenging life event.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557189","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":"Spatial invasion patterns of temporal lobe glioblastoma after complete resection of contrast-enhancing tumor.","authors":"Jawad Fares, Yizhou Wan, Binay Gurung, Thaaqib Nazar, Richard Mair, Alexis Joannides, Thomas Santarius, Tomasz Matys, Stephen J Price","doi":"10.1007/s11060-025-04991-5","DOIUrl":"https://doi.org/10.1007/s11060-025-04991-5","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated invasion patterns of temporal lobe glioblastoma following complete resection of contrast-enhancing tumor and evaluated whether non-enhancing tumor presence in the anterior temporal tip predicts the site of progression.</p><p><strong>Methods: </strong>We retrospectively analyzed patients from a single-institution database who were diagnosed with IDH-wildtype temporal lobe glioblastoma and underwent complete resection of the contrast-enhancing region. Eligible patients had preoperative, immediate postoperative, and progression MRIs to assess tumor progression patterns. FLAIR imaging was examined for its predictive value in identifying progression sites. Surgical outcomes, progression-free survival (PFS), and overall survival were analyzed.</p><p><strong>Results: </strong>A total of 48 patients were identified, of whom 14 (29%) underwent anterior temporal lobectomy and were excluded from further analysis. Among the remaining 34 patients, 21 (62%) exhibited anterior progression. Expert assessment suggested that in 12 of these 21 patients (57%), an anterior temporal lobectomy might have encompassed the region of tumor progression. Superior, inferior, and lateral progression patterns were associated with longer median PFS (~ 11 months), whereas medial progression correlated with the shortest PFS (5.9 months). FLAIR signal at the temporal tip had moderate sensitivity (71.43%) but low specificity (18.52%) for predicting anterior progression, resulting in a high false-positive rate.</p><p><strong>Conclusions: </strong>Temporal lobe glioblastomas often progress anteriorly, suggesting that anterior temporal lobectomy may help reduce progression in select cases. FLAIR imaging had limited predictive value for anterior progression, emphasizing the need for advanced imaging techniques. Future research should identify reliable biomarkers and evaluate the role of anterior temporal lobectomy through well-designed prospective studies.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567370","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":"Improving IL12 immunotherapy in glioblastoma by targeting the long noncoding RNA INCR1.","authors":"Shikha Saini, Josephina A M A Gadet, Gordon J Freeman, E Antonio Chiocca, Marco Mineo","doi":"10.1007/s11060-025-04978-2","DOIUrl":"https://doi.org/10.1007/s11060-025-04978-2","url":null,"abstract":"<p><strong>Purpose: </strong>The potent antitumor effects of interleukin 12 (IL12) gene therapy in glioblastoma (GBM) are significantly attenuated by the highly immunosuppressive microenvironment and the upregulation of the PD-1/PD-L1 immune checkpoint. However, combining IL12 gene therapy with PD-1/PD-L1 inhibitors failed to improve efficacy. This study aims to assess the effects of silencing the immunosuppressive long noncoding RNA INCR1 when combined with IL12 therapy.</p><p><strong>Methods: </strong>RNAscope in situ hybridization was performed to analyze INCR1 and PD-L1 expression in tumor tissues from GBM patients pre- and post-IL12 gene therapy. Quantitative PCR was used to analyze immunosuppressive gene expression in patient-derived GBM cells co-cultured with immune cells stimulated with IL12. The effects of INCR1 and PD-L1 silencing on the expression of immunosuppressive genes were evaluated by RNA sequencing. 3D-cytotoxicity assays were performed to assess the activity of immune cells against GBM tumor cells.</p><p><strong>Results: </strong>INCR1 and PD-L1 expression was upregulated in tumor tissue from GBM patients treated with IL12 gene therapy compared to the tumor tissue of the same patients before the IL12 treatment. Co-culture of patient-derived GBM cells with IL12-stimulated immune cells increased the expression of several immunosuppressive genes. Knocking down INCR1 was more effective than silencing PD-L1 in reducing the expression of multiple immunosuppressive genes. INCR1 silencing improved IL12-mediated immune cell antitumor activity compared to monoclonal antibodies targeting the PD-1/PD-L1 immune checkpoint signaling.</p><p><strong>Conclusion: </strong>INCR1 silencing affects more immune evasive pathways than PD-L1. Targeting INCR1 may represent a valid approach to improve the efficacy of IL12 therapy in GBM.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542364","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":"Comment on \"The 5-factor modified frailty index as a prognostic factor for stereotactic radiosurgery in meningioma management\".","authors":"Samuel Adida, Roberta K Sefcik, Peter C Gerszten","doi":"10.1007/s11060-025-04983-5","DOIUrl":"https://doi.org/10.1007/s11060-025-04983-5","url":null,"abstract":"","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542362","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 LITT Fit in neuro-oncology: indications, imaging, and adjunctive therapies.","authors":"Aden P Haskell-Mendoza, Ariel T Gonzalez, Ellery H Reason, Ann Marie Flusche, Pakawat Chongsathidkiet, Lucas P Wachsmuth, C Rory Goodwin, Peter E Fecci","doi":"10.1007/s11060-024-04894-x","DOIUrl":"10.1007/s11060-024-04894-x","url":null,"abstract":"<p><strong>Purpose: </strong>There is an unmet need for new treatments for many central nervous system tumors. An expanding body of research supports the use of laser interstitial thermal therapy (LITT) in the treatment of gliomas, recurrent brain metastases, and radiation necrosis.</p><p><strong>Methods: </strong>In this review, we highlight emerging indications for LITT, including its use adjacent to eloquent structures, in the posterior fossa, and for meningioma and tumors of the vertebral column. We conclude by providing an overview of current research into post-LITT response assessment and adjunctive therapies.</p><p><strong>Results: </strong>Evidence has continued to accumulate regarding the safety of LITT in locations as varied as the motor cortex, posterior fossa, and vertebral column, as well as for novel pathologies such as meningioma. Regardless of disease histology, most patients leave the hospital within 12-48 h of LITT and can rapidly return to systemic and radiation therapies. Emerging data has allowed for a characterization of post-LITT imaging findings, and receipt of LITT should not preclude subsequent clinical trial enrollment, especially as hyperthermia modulates blood-brain barrier permeability and may synergize with immunotherapies.</p><p><strong>Conclusion: </strong>As LITT is incorporated into neurosurgical oncology practice, novel use cases will continue to emerge. Given that laser ablation is associated with shortened length of stay and decreased debility relative to open resection, development of radiographic response assessment criteria for LITT-treated lesions is urgently needed so that patients may more rapidly receive definitive management or proceed to clinical trial enrollment. Prospective evaluation of LITT and adjunctive combination therapies is ongoing.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"1-11"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710476","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 stereotactic radiosurgery for intracranial epidermoid tumors: a systematic review to assess its safety, efficacy, and complication profile.","authors":"Onam Verma, Sandeep Mishra, Manjul Tripathi, Jason P Sheehan","doi":"10.1007/s11060-024-04901-1","DOIUrl":"10.1007/s11060-024-04901-1","url":null,"abstract":"<p><strong>Background: </strong>Even a gross total resection of a benign epidermoid tumor (ET) carries a high risk of recurrence. The management strategy mostly involves redo surgical excision but at a significant cost of morbidity and mortality. The role of adjuvant radiation therapies in this scenario is still undefined.</p><p><strong>Objective: </strong>To evaluate the feasibility, safety, efficacy, and complication profile of radiosurgery as a standalone or adjuvant therapy for intracranial epidermoid in the published literature.</p><p><strong>Methodology: </strong>Following PRISMA guidelines, a comprehensive search of the databases PubMed, Embase, Scopus, and Web of Science in published English language was conducted. We included studies with radiosurgery for benign ET and in patients with malignant transformation of ET (MTET). All studies were evaluated for tumor characteristics, pattern of treatment, dosimetric profile, outcome, and complications. We included all studies with at least one outcome of interest i.e. local control (LC); progression-free survival (PFS); symptomatic toxicity; disease progression; retreatment; and overall survival (OS); and cause-specific mortality.</p><p><strong>Results: </strong>The search revealed 403 articles, of which 6 and 8 studies with patients of benign ET and MTET respectively were included. 25 (65.7%) patients received primary SRS. 27 patients presented with hyperactive cranial nerve syndromes; 77.7% gained complete improvement. The overall median age was 46.7 years (22-67) and the median tumor volume ranged from 0.38 to 6.2cc in benign ET. Volumetric reduction was seen in 6 cases; progression was seen in 2 cases while ET remained stable in the rest. Mean follow-up duration ranged from 33.7 to 60 months, and no recurrence was reported at the latest follow-up in any case of benign ET. 9.5% of patients suffered from transient cranial nerve deficits with no prolonged adverse radiation effect. OS in the MTET group was 6 to 60 months following GKRS with 50% of patients alive at the latest follow-up.</p><p><strong>Conclusion: </strong>SRS may be a promising treatment option for a conventionally benign and radioresistant ET making a meaningful change in the natural history of the disease. It is a valuable adjuvant technique in patients with MTET.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"13-30"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006877","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 METACER national cohort study of brain metastases in gastrointestinal cancers prospectively establishes prognostic factors.","authors":"Violaine Randrian, Fabienne Portales, Olivier Bouché, Simon Thezenas, Benoist Chibaudel, May Mabro, Eric Terrebonne, Claire Garnier-Tixidre, Christophe Louvet, Thierry André, Thomas Aparicio, Olivier Dubreuil, Gregoire Bouché, Marc Ychou, David Tougeron","doi":"10.1007/s11060-024-04905-x","DOIUrl":"10.1007/s11060-024-04905-x","url":null,"abstract":"<p><strong>Purpose: </strong>Availability data are scarce and primarily retrospective in patients with brain metastasis (BM) from gastrointestinal (GI) cancers. The objective of this cohort was to determine prognostic factors for survival outcomes in patients with BM from GI cancers.</p><p><strong>Methods: </strong>METACER is a national multicentric prospective cohort study which included patients with BM diagnosis during a histologically proven digestive cancer follow-up between 2010 and 2014. The primary endpoint was overall survival (OS). The secondary endpoints were Progression-Free survival (PFS), prognostic factors, and BM-free survival as time from disease diagnosis to BM diagnosis.</p><p><strong>Results: </strong>METACER included 130 patients, with colorectal cancer (CRC) (N = 105) and eso-gastric (N = 25) cancer (EGC). The median OS was 6.6 months: 7.1 months (95%CI: 4.7-9.7) in CRC patients and 5.2 months, (95%CI: 1.9-7.6) in EG patients (p = 0.827). In multivariate analysis, cerebral BM location (versus cerebellar), BM surgery, performance status (0-1 versus 2), and a unique BM were significantly associated with prolonged OS. BM-free survival were 30.8 months (95%CI:25.2-36.9) in CRC patients and 7.8 months (95%CI:3.8-13.6) in EGC patients (p < 0.001). In synchronous metastatic disease, BM-free survival were 18.6 months (95%CI:13.1-25.2) in CRC patients and 3.7 months (95%CI:0.03-7.8) in EGC patients (p < 0.001).</p><p><strong>Conclusion: </strong>BM in GI cancers are of poor prognosis. BM surgery should be considered in case of unique brain lesion. In metastatic settings, EGC patients have shorter BM-free survival than CRC patients.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"229-238"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921664","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}