Journal of Neuro-Oncology最新文献

{"title":"Education paths in neuro-oncology: combining technical skills with multidisciplinary care. A survey from the AINO (Italian Association for Neuro-Oncology) Youngster Committee.","authors":"Rina Di Bonaventura, Denis Aiudi, Silvia Chiesa, Alessia Pellerino, Francesco Bruno, Valeria Internò, Ciro Mazzarella, Edoardo Pronello, Roberto Colasanti, Teresa Somma, Tamara Ius, Giuseppe Maria Della Pepa, Valeria Barresi, Quintino Giorgio D'Alessandris, Roberta Rudà, Antonio Silvani","doi":"10.1007/s11060-025-05003-2","DOIUrl":"https://doi.org/10.1007/s11060-025-05003-2","url":null,"abstract":"<p><strong>Purpose: </strong>Neuro-oncology is a multidisciplinary subspecialty that has evolved and expanded tremendously over the last 20 years. In Europe, notwithstanding a number of commendable initiatives, neither a specific neuro-oncology training curriculum nor a consensus on the ideal training tools have been set. In this context, the Youngster Committee of the Italian Association for Neuro-Oncology (AINO) has run a nationwide survey to take a snapshot of the current situation of neuro-oncology education in Italy.</p><p><strong>Methods: </strong>Between July and November 2023, we distributed through AINO a 34-question survey addressed to all Italian care providers dealing with neuro-oncology, irrespective of specialty and level of experience, as per AINO mission. The questionnaire was disseminated using an open link. We analyzed and stratified answers according to epidemiological characteristics of the respondents, i.e. age, gender, role, years of experience, type and case load of their work Institutions, geographical region.</p><p><strong>Results: </strong>We collected 254 valid questionnaires. The majority of respondents were under 40 years old (62.6%); neurosurgeons formed the largest specialty group (48%). Residency was a key step for neuro-oncology education according to 33% of participants; notably, younger respondents gave a significantly more positive assessment of residency programs compared to older ones (72% vs. 56%, p = 0.0193). PhD programs in Italy are focused only on research, according to 30% of respondents. Regarding the tools for continuing medical education in neuro-oncology, a striking contrast between the ideal ones, which should be the frequent participation in dedicated courses (59% responses), and the actual one, which is scientific literature (55%), was recorded. Mentorship programs are rare and inconsistent and should be strengthened. More than 90% of participants declared multidisciplinary collaboration as fundamental. Multispecialty societies like AINO have a key role in strengthening education in neuro-oncology through the organization of structured post-graduate programs.</p><p><strong>Conclusion: </strong>The results of this survey, by describing the status of the neuro-oncology training paths in Italy, can lay the foundation for initiatives aimed at harmonizing neuro-oncology education in Italy and Europe. The creation of a shared neuro-oncology curriculum and of a network of mentors is suggested.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657500","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":"Survival prediction with radiomics for patients with IDH mutated lower-grade glioma.","authors":"Alice Neimantaite, Louise Carstam, Tomás Gómez Vecchio, Ida Häggström, Tora Dunås, Francesco Latini, Maria Zetterling, Malin Blomstrand, Jiri Bartek, Margret Jensdottir, Erik Thurin, Anja Smits, Asgeir S Jakola","doi":"10.1007/s11060-025-05006-z","DOIUrl":"https://doi.org/10.1007/s11060-025-05006-z","url":null,"abstract":"<p><strong>Purpose: </strong>Adult patients with diffuse lower-grade gliomas (dLGG) show heterogeneous survival outcomes, complicating postoperative treatment planning. Treating all patients early increases the risk of long-term side effects, while delayed treatment may lead to impaired survival. Refinement of prognostic models could optimize timing of treatment. Conventional radiological features are prognostic in dLGG, but MRI could carry more prognostic information. This study aimed to investigate MRI-based radiomics survival models and compare them with clinical models.</p><p><strong>Methods: </strong>Two clinical survival models were created: a preoperative model (tumor volume) and a full clinical model (tumor volume, extent of resection, tumor subtype). Radiomics features were extracted from preoperative MRI. The dataset was divided into training set and unseen test set (70:30). Model performance was evaluated on test set with Uno's concordance index (c-index). Risk groups were created by the best performing model's predictions.</p><p><strong>Results: </strong>207 patients with mutated IDH (mIDH) dLGG were included. The preoperative clinical, full clinical and radiomics models showed c-indexes of 0.70, 0.71 and 0.75 respectively on test set for overall survival. The radiomics model included four features of tumor diameter and tumor heterogeneity. The combined full clinical and radiomics model showed best performance with c-index = 0.79. The survival difference between high- and low-risk patients according to the combined model was both statistically significant and clinically relevant.</p><p><strong>Conclusion: </strong>Radiomics can capture quantitative prognostic information in patients with dLGG. Combined models show promise of synergetic effects and should be studied further in astrocytoma and oligodendroglioma patients separately for optimal modelling of individual risks.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657512","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 quality of life and hypothalamic dysfunction after craniopharyngioma.","authors":"Hermann L Müller","doi":"10.1007/s11060-025-04987-1","DOIUrl":"https://doi.org/10.1007/s11060-025-04987-1","url":null,"abstract":"<p><strong>Background: </strong>After diagnosis and management of childhood-onset craniopharyngioma, patients frequently develop a rapid weight gain starting in the first 6-12 months after diagnosis and leading to morbid hypothalamic obesity due to disease- and/or treatment-associated hypothalamic lesions.</p><p><strong>Methods: </strong>A scoping review was performed after search of the MEDLINE/PubMed, Embase, and Web of Science databases for initial identification of articles. The search terms craniopharyngioma, hypothalamic obesity, and quality of life were used.</p><p><strong>Results: </strong>Hypothalamic obesity should be diagnosed and treated in the context of hypothalamic syndrome. Hypothalamic nuclei are the key-regulators of our body homeostasis. Hypothalamic syndrome includes endocrine deficiencies of hypothalamic-pituitary axes, disruption of circadian rhythm, disturbed hunger-satiety and thirst feelings, temperature dysregulation, and neurocognitive, sleep and psychosocial behavioral problems. Consequently, patients with hypothalamic syndrome develop hypothalamic obesity, chronic fatigue, increased daytime sleepiness and mood disorders resulting in isolation, school drop-out and inability to participate in daily life. Long-term follow-up is frequently impaired by increased risk for metabolic syndrome, cardiovascular health problems, severe impairments of health-related quality of life, and premature mortality. Treatment of hypothalamic syndrome is challenging. Hypothalamic syndrome is not a ,one-size-fits-all- disease, which may not require a ,one-size-fits-all- management. Recently, an algorithm for personalized, risk-specific treatment of hypothalamic syndrome after CP has been published. Dextro-amphetamines and other central stimulating agents (modafinil, methylphenidate) may cause weight loss, especially in children with hyperphagia or decreased resting-energy expenditure. Reports on the use of glucagon-like peptide-1 receptor (GLP-1R) agonists for acquired hypothalamic obesity have been contradictory, with successful reports but also series with limited results. Bariatric surgery is effective. However, non-reversible procedures are controversial due to ethical and legal considerations in minors.</p><p><strong>Conclusions: </strong>Hypothalamus-sparing treatment strategies and further research on novel therapeutic agents for hypothalamic syndrome are warranted.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649292","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":"Serum exosomal miRNA contributes to the diagnosis of leptomeningeal carcinomatosis.","authors":"Jie Jin, Junjuan Qin, Xuejiao Qi, Jiasi Zhang, YingLu Zhang","doi":"10.1007/s11060-025-04999-x","DOIUrl":"https://doi.org/10.1007/s11060-025-04999-x","url":null,"abstract":"<p><strong>Purpose: </strong>Leptomeningeal carcinomatosis (LC) is a severe complication in the advanced stage of lung adenocarcinoma, with an extremely poor prognosis. Currently, the diagnosis of LC poses challenges. Serum exosomal miRNAs (microRNAs) have been demonstrated to possess potential as viable biomarkers. However, their value in the diagnosis of LC remains unclear.</p><p><strong>Methods: </strong>In this study, serum samples were collected from lung adenocarcinoma patients with LC. The control groups consisted of patients with early-stage and advanced-stage lung adenocarcinoma without LC. Serum exosomes were isolated for high - throughput RNA sequencing to screen for differential miRNAs, and the results were validated in 123 samples. Subsequently, the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic ability of exosomal miRNAs for LC.</p><p><strong>Results: </strong>The results of miRNA sequencing revealed seven differentially enriched miRNAs (miRNA-1296-5p, miR-503-5p, miR-499a-5p, miR-374a-5p, miR-3173-5p, miR-370-3p and miR-885-3p). The ddPCR confirmed that the expression levels of miRNA-1296-5p, miR-499a-5p and miR-374a-5p were significantly elevated in LC, while miR-370-3p was significantly decreased (P < 0.05). ROC curve analysis showed that the AUC of the combination of miRNA-1296-5p, miR-499a-5p and miR-370-3p with CEA was 0.803 (P < 0.0001), displaying higher diagnostic power for LC.</p><p><strong>Conclusion: </strong>This study suggests that the specific expression of miRNA-1296-5p, miR-499a-5p, miR-374a-5p and miR-370-3p in the serum exosomes of LC, which has diagnostic potential. And the combination of miRNA-1296-5p, miR-499a-5p and miR-370-3p with CEA can further enhance this potential.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624964","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 morphological features-based nomogram for predicting facial nerve function in the immediate postoperative period after vestibular schwannoma surgery.","authors":"Yuichi Fujita, Yoichi Uozumi, Yosuke Fujimoto, Hiroaki Nagashima, Masaaki Kohta, Kazuhiro Tanaka, Hidehito Kimura, Atsushi Fujita, Eiji Kohmura, Takashi Sasayama","doi":"10.1007/s11060-025-04984-4","DOIUrl":"https://doi.org/10.1007/s11060-025-04984-4","url":null,"abstract":"<p><strong>Purpose: </strong>Tumor morphology critically influences facial nerve (FN) outcomes following vestibular schwannoma (VS) surgery. This study aimed to develop a nomogram based on preoperative features for preoperative prediction of FN outcomes after VS surgery.</p><p><strong>Methods: </strong>A retrospective analysis included patients with sporadic VS who underwent surgical resection via the retrosigmoid approach. Tumor size was assessed using the Koos grade, the intrameatal components using the fundal fluid cap (FFC) sign, and the cerebellopontine angle cisternal components using our modified morphological subclassification. Logistic regression analysis was performed to construct a nomogram for predicting immediate postoperative FN function.</p><p><strong>Results: </strong>A total of 265 patients with VS met the inclusion criteria. Of these patients, 62 (23.4%) had poor FN function (House-Brackmann grade ≥ III) immediately after surgery. Univariate logistic regression analysis identified the Koos grade (p = 0.001), FFC sign (p = 0.023), and morphological subtype (p < 0.001) as significant predictors of poor FN function immediately after surgery. In multivariate logistic regression analysis, the FFC sign (OR 2.07, p = 0.042) and morphological subtype (OR 8.21, p < 0.001) remained statistically significant independent predictors of poor FN function. A nomogram constructed based on these indicators demonstrated good discrimination in the training cohort (area under the curve [AUC] 0.80), internal validation cohort (AUC 0.79), and external validation cohort (AUC 0.97).</p><p><strong>Conclusions: </strong>A simple and reliable nomogram incorporating the Koos grade, FFC sign, and morphological subtype accurately predicts the risk of FN injury during surgery aimed at total resection of VS. This clinically straightforward tool can assist in patient counseling and development of more individualized surgical strategies to improve FN outcomes in patients with VS.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624963","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 impact of bevacizumab for the treatment of brain radiation necrosis.","authors":"Hila Nobel, Jonathan Ofer, Sara Faye Borenstein, Dror Limon, Omer Gal, Yosef Laviv, Andrew A Kanner, Tali Siegal, Shlomit Yust-Katz, Alexandra Benouaich-Amiel","doi":"10.1007/s11060-025-04979-1","DOIUrl":"https://doi.org/10.1007/s11060-025-04979-1","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate short and long-term efficacy of bevacizumab (Bev), for the treatment of radiation necrosis (RN) in patients with brain metastasis after stereotactic radiosurgery (SRS).</p><p><strong>Methods: </strong>The database of a tertiary medical center was reviewed for all adult patients treated by Bev (from January 2018 to January 2023) for RN after having received SRS for BM. Clinical and MRI data were systematically collected at baseline, immediately after the completion of Bev treatment, and at 6, 12, and, when available, 24 months post-treatment.</p><p><strong>Results: </strong>The cohort included 23 patients with a total of 31 RN lesions (defined as target lesion) which have been previously treated by SRS, either as single-session SRS (27/31) or as fractionated stereotactic radiotherapy (4/31). Median follow-up time was 15 months (range: 8-28.5). Immediately after completion of Bev, 15 patients (65.2%) exhibited a complete/partial response, 6 (26.1%) had stable disease, and 2 had progressive disease (8.7%). thirteen patients (56%) improved clinically. Greater than 50% reduction in volume was observed in 84% of target lesions. At 12 months, among the 13 patients still evaluable (9 other being deceased, 1 loss to follow up), three continued to improve, and four remained stable. Median volume of target lesion was then 1.4 cm³ (range 0.7-2.9) demonstrating a reduction of 67.4% compared to the initial target volume, which was 4.35 cm³ (range 2.14-10.37). During the entire follow-up period, 11 patients experienced regrowth of the target lesion; median time to progression was 7 months. Five underwent Bev re-challenge, but only 2 responded.</p><p><strong>Conclusion: </strong>Bev for the treatment of SRS-induced RN was associated with a high initial response rate, significant lesion reduction, and prolonged clinical improvement. However, the high rate of lesion regrowth (50%) and poor response to Bev re-challenge highlight the complexity of diagnosis and treatment of RN.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615761","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":"Gamma Knife Radiosurgery for optic nerve sheath meningioma: comparison of efficacy and costs with radiotherapy under Korean health insurance system.","authors":"Shang-Te Ma, Yong Chan Ahn, Do Hoon Lim, Jung-Il Lee, Ho Jun Seol, Won-Jae Lee, Yong Seok Im, Kyung-Ah Park, Yoon-Duck Kim, Kyung In Woo","doi":"10.1007/s11060-025-04986-2","DOIUrl":"https://doi.org/10.1007/s11060-025-04986-2","url":null,"abstract":"<p><strong>Purpose: </strong>To survey the real-world effectiveness and cost of optic nerve sheath meningioma (ONSM) treating with Gamma Knife Radiosurgery (GKRS), and compare with the external beam radiation therapy (EBRT).</p><p><strong>Methods: </strong>Retrospective, comparative study that included patients with primary ONSM treated with either GKRS or EBRT in Samsung Medical Center, Korea. The treatment response, and treatment costs were compared between GKRS and EBRT groups.</p><p><strong>Results: </strong>There were 34 adult patients with primary ONSM treated with either GKRS (n = 25) or EBRT (n = 9) (follow-up period: 6-207 months). The local tumor control rates (GKRS: 92%; EBRT: 100%; P = 1) and vision preservation rates (GKRS: 64%; EBRT: 67%; P = 1) were similar in both groups. The mean gross tumor volume (GTV) decreased by 21.4 ± 19.7% after GKRS and 26.4 ± 18.7% after EBRT (P = 0.4803). The complication rates did not differ between two modalities. Factors associated with better visual outcomes were pretreatment BCVA > 20/50 (odds ratio: 6.000, P = 0.0234) and the absence of intracranial tumor extension (odds ratio: 30.00, P = 0.0001). GKRS reduced the total costs of care by 43% under Korean National Health Insurance System (NHIS).</p><p><strong>Conclusion: </strong>This study revealed that GKRS and EBRT had similar treatment efficacy and safety profile in treating ONSMs. Instant management is advantageous when the BCVA deteriorates to 20/50 and tumors involve intracranially. Under the framework of Korean NHIS, GKRS contributed to less indirect cost estimates and was preferred by patients under shared decision-making process.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605208","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 Mickey Mouse's hand sign in brain MRI points out multinodular and vacuolating neuronal tumors in mesial temporal lobe structures.","authors":"Valerio Frazzini, Bertrand Mathon, Natalia Shor, Lucia Nichelli, Franck Bielle, Vincent Navarro","doi":"10.1007/s11060-025-04962-w","DOIUrl":"https://doi.org/10.1007/s11060-025-04962-w","url":null,"abstract":"<p><strong>Purpose: </strong>Multinodular and vacuolating neuronal tumor (MVNT) is a rarely diagnosed neoplastic lesion often associated with adult-onset focal seizures. In some situations, atypical MRI features of MVNT may mimic other long-term epilepsy associated tumors (LEATs) or diffuse low-grade gliomas. In such a context, the identification of distinct clinical markers is recommended.</p><p><strong>Methods: </strong>We retrospectively analyzed the neuroimaging features of histologically confirmed MVNT lesions of our epilepsy surgery cohort. All the identified MVNT patients had a mesial temporal lobe location. The MRI features from the MVNT population were compared to those from non-MVNT lesions randomly selected in our cohort. Non-MVNT lesions consisted of (i) other tumoral lesions belonging to LEATs group, (ii) infiltrative tumoral lesions such as grade 2, IDH-mutant Gliomas, and (iii) non-tumoral, highly epileptogenic lesions, such as hippocampal sclerosis.</p><p><strong>Results: </strong>MRI analysis of patients with MVNT noticed an unusual FLAIR hyperintense signal extending from the uncus to the anterior white commissure through the sublenticular region. This neuroimaging abnormality visually mimicked \"Mickey Mouse's hand\" on coronal plane. The \"Mickey Mouse's hand\" sign was identified in 6 patients out of 9 (66.7%) MVNT patients. We did not identify the Mickey Mouse's hand sign in other control lesions (0/11 ganglioglioma, 0/11 glioma, 0/150 hippocampal sclerosis), except in one patient with dysembryoplastic neuroepithelial tumors (DNET) (1/15; 6.7%). All patients showing the \"Mickey Mouse's hand\" sign were seizure-free after surgery.</p><p><strong>Conclusions: </strong>The Mickey Mouse's hand sign represents a straightforward and easy-to-remember neuroimaging feature, that does not require advanced MRI sequences and that could help clinicians facing mesial temporal lesions to rapidly raise the suspicion of MVNT diagnosis.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597236","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 alternating electric fields therapy for newly diagnosed WHO grade 4 astrocytoma on patient survival: a real-world propensity-score adjusted prospective multicenter study.","authors":"Peter Y M Woo, Jenny K S Pu, Lai-Fung Li, Desiree K K Wong, Victor K H Hui, Danny T M Chan, Michael W Y Lee, Tony K T Chan, Jason M K Ho, Ka-Man Cheung, Teresa P K Tse, Sarah S N Lau, Joyce S W Chow, Natalie M W Ko, Herbert H F Loong, Aya El-Helali, Tai-Chung Lam, Fung-Ching Cheung, Wai-Sang Poon","doi":"10.1007/s11060-025-04985-3","DOIUrl":"https://doi.org/10.1007/s11060-025-04985-3","url":null,"abstract":"<p><strong>Purpose: </strong>Alternating electric fields (AEF) therapy in addition to temozolomide chemoradiotherapy (TMZ CRT) is increasingly being recommended as first-line treatment for patients with newly-diagnosed WHO grade 4 astrocytoma. However, few have validated this treatment with real-world evidence.</p><p><strong>Methods: </strong>Consecutive adult patients with newly-diagnosed WHO grade 4 astrocytoma treated with adjuvant TMZ CRT across all neuro-oncology centers in Hong Kong were reviewed. Identified from a territory-wide prospective glioma registry, propensity-score matching (1:2) was performed to match patients that either received TMZ CRT with AEF or TMZ CRT alone. Matching was according to age, Karnofsky performance status, IDH-1 mutation, pMGMT methylation and extent of resection. The primary endpoint was overall survival (OS). Secondary endpoints were the incidence of AEF-associated adverse effects and mean monthly treatment compliance.</p><p><strong>Results: </strong>141 patients were reviewed, of whom 47 patients received AEF with TMZ CRT and 94 had CRT alone. Multivariate Cox proportional hazards analysis revealed that patients with pMGMT-methylated tumors (mOS: 30.8 months vs. 16.7 months [95% CI: 1.9-4.7] and those that received AEF (mOS: 22.8 vs. 14.3 months [95% CI: 1.9-4.7]) had longer OS. AEF therapy patients had a mOS benefit of 8.5 months. The mean monthly treatment compliance was 74 ± 12%. A compliance threshold of 60% conferred a survival benefit of 4.1 months (mOS: 21.5 months vs. 17.4 months [95% CI: 0.10-0.96]). The only identified AEF-associated adverse reaction was scalp dermatitis that occured in 77% (36/47) of patients.</p><p><strong>Conclusion: </strong>This post-approval study offers real-world evidence in support of the use of AEF therapy as first-line treatment.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605210","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":"Bevacizumab in recurrent glioblastoma: does dose matter? Our monocentric and comparative experience.","authors":"Giulia Cerretti, Alberto Bosio, Giovanni Librizzi, Giovanna Pintacuda, Mario Caccese, Alessandro Salvalaggio, Marco Zoccarato, Alessandro Parisi, Marta Padovan, Marta Maccari, Francesco Cavallin, Luisa Bellu, Francesco Pasqualetti, Tamara Ius, Luca Denaro, Francesco Volpin, Marina Coppola, Sara Lonardi, Giuseppe Lombardi","doi":"10.1007/s11060-025-04992-4","DOIUrl":"https://doi.org/10.1007/s11060-025-04992-4","url":null,"abstract":"<p><strong>Purpose: </strong>Bevacizumab is an anti-angiogenetic treatment that can be used in patients with recurrent glioblastoma, but there are limited and controversial data on the optimal dose and schedule, associated toxicities and survival benefits of different doses.</p><p><strong>Methods: </strong>A retrospective analysis of patients with recurrent IDHwt glioblastoma treated with bevacizumab at the Veneto Institute of Oncology was performed. Patients received bevacizumab in 2 different schedules (5 mg/kg or 10 mg/kg q2w), as monotherapy or in combination with chemotherapy.</p><p><strong>Results: </strong>81 patients were analyzed, 33 received bevacizumab 5 mg/Kg, 48 received bevacizumab 10 mg/Kg. Median PFS was 4 months in both patients treated with 5 mg/kg and those treated with 10 mg/kg (p-value=0.08), median OS was 5 months in patients treated with 5 mg/kg and 7 months in those treated with 10 mg/kg (p-value=0.10). There was no difference in the use of steroid therapy between the two groups. The incidence of adverse events was not statistically different.</p><p><strong>Conclusions: </strong>There was no statistically significant difference in survival, PFS, response, toxicity and steroid reduction between the two different doses. These results may support the use of lower doses of the drug with comparable benefit for patients and with additional advantage in terms of health care costs.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597234","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}