Journal of Neuro-Oncology最新文献

{"title":"Preoperative assessment of tumor eloquence and resectability: an international survey.","authors":"Emma Rammeloo, Jacob S Young, Joost W Schouten, Eelke M Bos, Shawn L Hervey-Jumper, Christine Jungk, Sandro M Krieg, Timothy Smith, Jordina Rincon-Torroella, Chetan Bettegowda, Takashi Maruyama, Arthur Wagner, Philippe Schucht, Marike L D Broekman, Steven De Vleeschouwer, Brian V Nahed, Mitchel S Berger, Arnaud J P E Vincent, Jasper K W Gerritsen","doi":"10.1007/s11060-025-05067-0","DOIUrl":"https://doi.org/10.1007/s11060-025-05067-0","url":null,"abstract":"<p><strong>Background and objectives: </strong>Tumor location and its proximity to eloquent brain areas are key factors in glioma surgery decision-making. However, the absence of a consensus definition for eloquent brain areas leads to variability in surgical decision-making. This survey aimed to assess this heterogeneity in defining eloquent brain regions.</p><p><strong>Methods: </strong>A survey was distributed among neurosurgeons in the United States, Europe, Latin America, and Australasia between February and November 2023. Respondents rated the eloquence of various brain structures on a Likert scale and reported their use of preoperative techniques. Twelve glioma and glioblastoma cases were presented to assess opinions on tumor location eloquence and preferred surgical approaches.</p><p><strong>Results: </strong>157 neurosurgeons from 25 countries responded to the survey. Two-thirds (68%) agreed on the need for a standardized definition of eloquence, while only 23% applied existing eloquence grading scales. Eloquence ratings varied, with the highest variation reported for the corona radiata, uncinate fasciculus and superior longitudinal fasciculus. In patient cases, variability was observed at four levels of decision-making: (1) degree of eloquence; (2) preferred surgical modality; (3) use of intraoperative mapping; (4) the preferred mapping modality (asleep or awake).</p><p><strong>Conclusions: </strong>This survey highlights the variability in defining eloquence and its impact on glioma surgery decision-making. This lack of consensus limits the reliability of eloquence as a descriptor of tumor location, affecting patient care and comparability across studies. Future research should focus on the development of an easy-to-use, objective method (based on intraoperative data) for identifying eloquent brain regions preoperatively.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110980","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":"Knockdown of STK39 inhibits lung cancer brain metastasis by suppressing the CPSF4/NFκB/COX2 pathway.","authors":"Yue Shu, Yunzhu Dong, Bo Li, Yutong Wang, Quanyang Liao, Ziqin Su, Jun Wang, Pin Zuo, Hongpin Yuan, Chun Wang, Shujuan Li, Yaodong Fan, Xiaosan Su","doi":"10.1007/s11060-025-05072-3","DOIUrl":"https://doi.org/10.1007/s11060-025-05072-3","url":null,"abstract":"<p><strong>Purpose: </strong>Lung cancer is the most common cancer worldwide, and approximately 30% of lung cancer patients will develop brain metastases. Serine/threonine kinase 39 (STK39) plays a significant role in various malignancies. However, the role and mechanism of STK39 in lung cancer brain metastasis have not been reported.</p><p><strong>Methods: </strong>The expression levels of STK39 in lung cancer cells were detected using quantitative reverse transcription PCR (RT-qPCR) and Western blotting. STK39 expression was knocked down in lung cancer cell lines PC9 and H1299 using RNA interference. Cell proliferation, apoptosis, cell cycle, migration, and invasion abilities were assessed using the CCK-8 assay, colony formation assay, flow cytometry, and Transwell chamber assay, respectively. Phosphoproteomics analysis was performed to identify phosphorylated target proteins of STK39 and associated signaling pathways. PC9 and H1299 cells with knocked-down STK39 were injected into nude mice via the common carotid artery to observe the formation of brain metastases. Finally, RT-qPCR and Western blotting were used to detect the expression of STK39, CPSF4/NFκB/COX2, and epithelial-mesenchymal transition (EMT) markers in lung cancer and brain metastasis tissues, and to analyze the correlation between STK39 expression and the size of metastatic tumors.</p><p><strong>Results: </strong>STK39 was highly expressed in lung cancer cell lines PC9 and H1299. Knockdown of STK39 inhibited proliferation, migration, and invasion of lung cancer cells, induced apoptosis, and caused cell cycle arrest. Phosphoproteomics and Phos-tag analyses showed that knockdown of STK39 significantly downregulated the expression of phosphorylated CPSF4 protein in PC9 and H1299 cells, along with significant downregulation of NFκB, COX2, and EMT markers. Knockdown of STK39 inhibited the formation of brain metastases by PC9 and H1299 cells in nude mice. Lung cancer brain metastasis tissues exhibited high expression of STK39, CPSF4, NFκB, and COX2, with their expression levels showing a significant positive correlation with the size of metastatic tumors.</p><p><strong>Conclusion: </strong>STK39 is highly expressed in lung cancer brain metastasis tissues, and knockdown of STK39 significantly inhibits brain metastasis in experimental models, accompanied by the suppression of the CPSF4/NFκB/COX2 signaling pathway and EMT process. Therefore, STK39 may be a key factor promoting lung cancer brain metastasis and a potential therapeutic target.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120029","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":"Radiosurgery for central nervous system ependymomas: a systematic review and meta-analysis.","authors":"Amirhossein Zare, Amirhessam Zare, Bardia Hajikarimloo, Barbod Mohammadi, Jason P Sheehan, Arad Iranmehr","doi":"10.1007/s11060-025-05076-z","DOIUrl":"https://doi.org/10.1007/s11060-025-05076-z","url":null,"abstract":"<p><strong>Background: </strong>Ependymomas, rare malignant central nervous system (CNS) lesions (2-6% of primary CNS tumors), are typically treated with maximal safe resection followed by fractionated radiation therapy. Stereotactic radiosurgery (SRS) has emerged as an alternative, particularly in recurrent or residual cases. This study evaluates the safety and efficacy of SRS for CNS ependymomas, while also identifying key prognostic factors.</p><p><strong>Method: </strong>A systematic search was conducted to identify studies that evaluated the efficacy and safety of SRS in WHO Grade 2/3 CNS ependymoma patients. Random-effect meta-analysis was employed.</p><p><strong>Results: </strong>Fourteen studies with 298 patients and 496 lesions were included. Our meta-analysis demonstrated an overall local tumor control (LTC) rate of 72% (95% CI: 65-79%). LTC rates at 1, 3, and 5 years were 83% (95% CI: 76-88%), 72% (95% CI: 64-78%), and 69% (95% CI: 61-76%), respectively. Progression-free survival (PFS) rates at 1, 3, and 5 years were estimated at 67% (95% CI: 50-80%), 56% (95% CI: 48-64%), and 51% (95% CI: 39-63%), respectively. Additionally, the 5-year overall survival (OS) rate was 58% (95% CI: 48-67%). The incidence of adverse radiation events (ARE) was 20% (95% CI: 12-31%). Meta-regression showed older age correlated with improved tumor control (P = 0.02) and lower ARE (P = 0.06) and radionecrosis rates (P < 0.01), while larger tumor volumes (P = 0.03) and anaplastic histology (P = 0.01) were associated with poorer PFS.</p><p><strong>Conclusions: </strong>SRS is a reasonably valuable therapeutic option in the multimodal management of WHO Grade 2/3 CNS ependymomas, especially for individuals with inoperable, recurrent, or residual lesions. Key patient and tumor characteristics have been analyzed to determine factors potentially impacting treatment outcomes.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110984","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":"Retrospective study of leptomeningeal metastasis: unveiling the indolent and rapid progression phases.","authors":"Qiang Xie, Jiamin Hu, Yi Liu, George Takura Tabengwa, Jinlong Huang, Shuang Liu, Pin Chen, Qin Hu, Xiaobiao Zhang, Tao Xie","doi":"10.1007/s11060-025-05059-0","DOIUrl":"https://doi.org/10.1007/s11060-025-05059-0","url":null,"abstract":"<p><strong>Purpose: </strong>Leptomeningeal metastasis (LM) is a severe cancer complication with poor prognosis and inconsistent treatment. Most studies are from Western countries, limiting understanding of LM in the Chinese population. This study aims to explore LM characteristics in Chinese patients and develop tailored treatment strategies.</p><p><strong>Methods: </strong>We retrospectively studied 103 Chinese LM patients, all confirmed by CSF cytology, from 2015 to 2024. Data on demographics, medical history, imaging, and follow-up were gathered. Survival analysis was conducted using the Kaplan - Meier method, and univariate and multivariate analyses were performed to identify prognostic factors. A nomogram was developed, and patients were stratified into risk groups based on these factors.</p><p><strong>Results: </strong>The median age was 54.99 ± 11.18 years, with 53.4% being female. Lung cancer was the primary tumor in 76.7% of patients. Headache was the most common symptom. The median survival was 441 days. Primary tumor site, CSF tumor cell proportion, and asymptomatic status at diagnosis were independent prognostic factors. The nomogram's C - index was 0.81. We identified two distinct groups of LM patients with markedly different characteristics, which we designated as the indolent and rapid progression phases of LM.</p><p><strong>Conclusions: </strong>The clinical characteristics of LM patients with positive CSF cytology at the center were described, with a longer median survival than previously reported. The developed nomogram demonstrated potential clinical predictive value. Two distinct LM patient groups were identified: the indolent and rapid progression phases, which hold significant clinical relevance.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110995","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":"https://doi.org/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":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The hormonal nexus in PIK3CA-mutated meningiomas: implications for targeted therapy and clinical trial design.","authors":"Matthew Abikenari, Amit Regev, Vratko Himic, John Choi, Sanjeeva Jeyaretna, Daniel M Fountain, Michael Lim","doi":"10.1007/s11060-025-05082-1","DOIUrl":"https://doi.org/10.1007/s11060-025-05082-1","url":null,"abstract":"<p><p>The presence of hormonal receptors in meningiomas has been known for decades. More recently, evidence has shown increased prevalence of meningiomas in patients taking certain types of hormonal treatments, such as oral contraceptives, progestins or hormone replacement therapy. Epidemiological evidence suggests that patients undergoing hormonal therapy harbor higher mutational rates of the oncogene PIK3CA. Due to the relative paucity of literature describing the intersection of hormone therapy and mutated PIK3CA pathways in meningioma, we have conducted a narrative review on this topic. Similarly, the clinical trial landscape for hormonal therapies for meningioma currently focuses on somatostatin receptor-targeted therapies and peptide receptor radionucleotide therapy, and the PIK3CA-hormonal signaling axis has not been explicitly targeted. Given the role of PIK3CA mutations in promoting cancer progression in other hormone-sensitive tumors, such as breast and prostate cancer, exploring this axis could inform drug repurposing including hormonal therapy specifically for these tumors.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110997","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":"https://doi.org/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":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-16","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}

{"title":"Tips and tricks of spinal cord biopsy: insights from a multicenter series of 61 patients.","authors":"Charles-Henry Mallereau, Guillaume Dannhoff, Julien Todeschi, François Severac, Nozar Aghakhani, Fabrice Parker, Aymen Benali, Mario Ganau, Noor Hamdan, Tuan Le Van, Helene Cebula, François Proust, Dominique Chaussemy, Franco Moruzzi, Biagio Roberto Carangelo, Alessandro Zalaffi, Andrea Cardia, Ismail Zaed, Giorgio Spatola, Carmen Bruno, Paolo Tini, Anna Maria Di Giacomo, Alfonso Cerase, Giacomo Gualtieri, Steven Knafo, Salvatore Chibbaro","doi":"10.1007/s11060-025-05009-w","DOIUrl":"https://doi.org/10.1007/s11060-025-05009-w","url":null,"abstract":"<p><strong>Purpose: </strong>Whenever the radiological and clinical presentation of diffuse spinal cord lesions pose diagnostic and therapeutic dilemmas, the role of primary spinal cord biopsies (SCB) can represent a crucial surgical step to guide further management. However, the benefits of SCB comes with the risks of significant neurological worsening and potentially non-diagnostic findings. An evidence-based algorithm to assess the appropriateness of SCB and its chances of successful diagnosis is currently lacking.</p><p><strong>Method: </strong>A multicenter retrospective study was conducted across 8 tertiary neurosurgery European centers and included all patients undergoing primary SCB between January 2005 and December 2020. The main objective of this study was to assess the positive diagnostic rate, while the secondary objective was to evaluate the rate of neurological deterioration.</p><p><strong>Results: </strong>Histological diagnoses were obtained in 91.8% (56/61) of cases. Lesions spanning more than three spinal levels were significantly associated with non-diagnostic biopsies (p = 0.03). Neurological deterioration occurred in 47.5% (29/61) of patients, with 48,3% recovering within three weeks. Independent risk factors for postoperative deterioration included low-grade glioma (LGG) (p = 0.005) and lymphoma (p = 0.007). Intraoperative Ultrasound (IoUS) was significantly associated with reduced postoperative deficits (p = 0.030). Surprisingly, preoperative clinical and radiological diagnoses differed from histopathological findings in 47.5% of cases.</p><p><strong>Conclusion: </strong>SCB are relatively safe and effective diagnostic procedures despite their inherent risk of significant perioperative neurological worsening. The decision to undertake a primary SCB should always be made in a multidisciplinary setting after careful review of clinical and diagnostic findings.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012041","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":"Predictors of return to work following surgery in patients with glioblastoma: a retrospective multicenter study.","authors":"Harshvardhan G Iyer, Ogechukwu K Ariwodo, Chase Mckevitt, Paola Suarez Meade, Lina Marenco-Hillembrand, Andrea Otamendi-Lopez, Leonardo José Monteiro de Macêdo Filho, Steven S Rosenfeld, Christine Cordova, Jennifer L Peterson, Daniel M Trifiletti, David S Sabsevitz, Ian F Parney, Terry C Burns, Fredric B Meyer, Bernard R Bendok, Krishna Chandan, Rich Byrne, Victoria Clark, Alfredo Quinones-Hinojosa, Wendy J Sherman, Kaisorn L Chaichana","doi":"10.1007/s11060-025-05066-1","DOIUrl":"https://doi.org/10.1007/s11060-025-05066-1","url":null,"abstract":"<p><strong>Purpose: </strong>While clinical outcomes of glioblastoma (GBM) are well-documented, its socio-economic impact, particularly on return to work (RTW) remains unexplored. In this study we aimed to identify the predictors of RTW at 6 months postoperatively in patients undergoing GBM treatment and to assess its association with post-operative neurological deficits and median overall survival (mOS).</p><p><strong>Methods: </strong>We retrospectively studied 106 adults with pre-operative employment, undergoing primary GBM resection or biopsy at three tertiary centers. RTW at 3 and 6 months postoperatively were assessed using univariate and multivariate analyses.</p><p><strong>Results: </strong>After 6 months 33 patients (33.1%) were able to RTW. Factors associated with lower odds of RTW included female sex (p = 0.039), Karnofsky Performance Scale (KPS) < 80 at 2 weeks (p = 0.034), and 3 months post-operatively (p = 0.0001), right handedness (p = 0.038), and subtotal resection (p = 0.042). On multivariate analysis female sex (OR 0.238, 95% CI 0.077-0.733, p = 0.012) and three-month postoperative KPS < 80 (OR 0.019, 95% CI 0.001-0.0293, p = 0.004) were the least likely to RTW at six months. Acute postoperative motor (p = 0.047), gait (p = 0.008) and cognitive deficits (p = 0.048) and persistent motor (p = 0.017), gait (p = 0.033) and language (p = 0.026) deficits were all associated with lesser RTW. Patients who returned to work had significantly longer mOS (21.44, p < 0.001).</p><p><strong>Conclusions: </strong>RTW at 6 months post GBM Surgery corelates with improved mOS. Female sex and lower post-operative KPS scores were the strongest predictors of reduced RTW.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001767","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":"Outcomes following radiation therapy for embryonal tumor with multilayered rosettes (ETMR): results from the Pediatric Proton/Photon Consortium Registry (PPCR).","authors":"Jacquelyn M Krisch, Ralph P Ermoian, Daniel J Indelicato, Jae Y Lee, John P Perentesis, Stephanie M Perkins, Nadia N Laack, John H Chang, Iain J MacEwan, Suzanne L Wolden, Dongliang Wang, Torunn I Yock, Paul D Aridgides","doi":"10.1007/s11060-025-05065-2","DOIUrl":"https://doi.org/10.1007/s11060-025-05065-2","url":null,"abstract":"<p><strong>Purpose: </strong>Embryonal tumor with multilayered rosettes (ETMR) is a rare pediatric CNS embryonal tumor with poor survival. The Pediatric Proton/Photon Consortium Registry (PPCR) was queried for outcomes data from prospectively consenting pediatric patients with ETMR treated with proton radiation therapy (RT).</p><p><strong>Methods: </strong>20 patients (2013-2021) at 9 institutions had ETMR; 2 with prior RT were excluded from statistical analyses (PPCR ETMR, N = 18). Overall Survival (OS) and Event Free Survival (EFS) analyses were performed using the Kaplan-Meier method and log-rank values. Median follow-up was calculated using the reverse Kaplan-Meier method.</p><p><strong>Results: </strong>Median age at RT was 3.0 years (1.7-12.2); median follow-up was 55.5 months (2.6-119.4). 8 patients (44%) expired and 6 patients (33%) are surviving ≥ 55 months. 11 (61%) patients received systemic therapy with stem cell support. The majority (89%) had focal RT (median dose 54 Gy), while 2 patients received craniospinal irradiation (CSI, 30.6-36 Gy). 4-year OS and EFS were 59.6% and 54.2%, respectively. Local control (LC) at 4 years was 81%. No differences in OS or EFS were observed for receipt of systemic therapy with stem cell support (p = 0.361, p = 0.57), progression prior to RT (p = 0.127, p = 0.18), or surgery to RT ≥ 200 days (p = 0.35, p = 0.254). Symptomatic radionecrosis was not reported.</p><p><strong>Conclusion: </strong>Focal proton RT provided effective local control as part of multimodality therapy for ETMR, with encouraging survival for this rare and often infant age tumor. Outcomes for CSI were limited to 2 patients treated upfront, and 1 patient receiving salvage CSI for disseminated relapse after focal RT who is surviving > 1 year.</p><p><strong>Trial registration: </strong>DFCI protocol 12-103, clinicaltrials.gov NCT01696721, date of registration 9/27/2012.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970566","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}