Journal of Neuro-Oncology最新文献

{"title":"Single-cell RNA-seq reveals diverse molecular signatures associated with Methotrexate resistance in primary central nervous system lymphoma cells.","authors":"Ryosuke Osako, Azusa Hayano, Atsushi Kawaguchi, Ryuya Yamanaka","doi":"10.1007/s11060-024-04893-y","DOIUrl":"10.1007/s11060-024-04893-y","url":null,"abstract":"<p><strong>Purpose: </strong>Methotrexate is one of the most essential single agents in patients with primary central nervous system lymphoma (PCNSL). However, 25-50% result in relapse with a poor prognosis. Therefore, studies on methotrexate resistance are warranted to explore salvage chemotherapy for recurrent PCNSL. Single-cell sequence analysis enables the characterization of novel cell types and provides a precise understanding of cancer biology.</p><p><strong>Methods: </strong>Single-cell sequence analysis of parental and methotrexate-resistant PCNSL cells was performed. We used a Weighted Gene Co-expression Network Analysis to identify groups of significantly connected genes.</p><p><strong>Results: </strong>We identified consensus modules in both the HKBML and TK datasets. HLA-DRβ1, HLA-DQβ1,and SNRPG were hub genes those detected in both datasets revealed by network analysis. Cyclosporine A was selected as the candidate drug for treating methotrexate-resistant cells.</p><p><strong>Conclusion: </strong>The results of the present study characterized the methotrexate resistance-related signaling pathways in cultured PCNSL cells. Overall, these results may account for variations in treatment responses and lead potential novel therapeutic strategies for patients with PCNSL.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"163-173"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785997","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 of failure after stereotactic radiosurgery for brain metastases from small cell lung cancer: outcomes in the immunotherapy era.","authors":"Alexander S Marwaha, Yun Liang, Matthew J Shepard, Alexander Yu, Stephen M Karlovits, Rodney E Wegner","doi":"10.1007/s11060-024-04895-w","DOIUrl":"10.1007/s11060-024-04895-w","url":null,"abstract":"<p><strong>Purpose/objective(s): </strong>Small cell lung cancer (SCLC) is known to have high rates of development of brain metastases. Standard treatment has been whole brain radiation therapy (WBRT) but the role for more focused treatment and hippocampal avoidance has arisen in the past decade. In addition, with possible penetration of the central nervous system by more modern immunotherapies, the risk of distant failure may be lower. As such, we reviewed patients at our institution treated with stereotactic radiosurgery (SRS) to look at patterns, locations, and predictors of failure in the brain.</p><p><strong>Materials/methods: </strong>A retrospective review and analysis of charts was done on 46 patients treated with SRS (no history of prior WBRT) for their brain metastases from SCLC. Multivariate analysis was used to determine significant prognostic factors influencing survival and local/distant failure. We tracked timing and type of immunotherapy, if any, as well as if patients failed in the hippocampus or required WBRT.</p><p><strong>Results: </strong>There were 46 patients with 97 total brain metastases treated with SRS in this study. Median number of metastases was 2 (1-5). The median dose of radiation was 20 Gy (20-30) in 3 fractions (1-5) for all 97 tumors. 11 patients did not receive immunotherapy, whereas 35 patients had immunotherapy of some sort. Median overall survival (OS) for the entire cohort was 13 months, with a 12 month OS of 59% and 2 year OS of 30%. Cox regression did not reveal any significant predictors of OS, including age, sex, total volume, extracranial disease, KPS, immunotherapy, or number of metastases. 12 month and 24 month local control of disease was 95% and 80%, respectively. There were no significant predictors of local failure including volume, dose, or immunotherapy. 25 of the patients had distant brain failure, with a rate of distant failure of 38% and 64% for 6 and 12 months, respectively. Immunotherapy, number of metastases, total target volume, nor presence of extracranial disease was predictive of distant brain failure. WBRT free survival was also measured and found to be 73% at 1 year. There were no significant predictors for this measure. Lastly, five patients in this cohort showed failure in the hippocampus, where the rate of failure at 6 and 12 months was 16%.</p><p><strong>Conclusion: </strong>Rates of distant brain failure in SCLC patients after SRS remain similar to those of NSCLC patients in the immunotherapy era. We did not show a decrease in distant failure rate based on immunotherapy use. The rate of hippocampal failure was quite low and should provide reassurance that SRS and techniques such as HA-IMRT can be reasonably used in these patients. Ongoing clinical trials will help provide more definitive answers in this arena.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"177-183"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791854","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":"MR perfusion characteristics of pseudoprogression in brain tumors treated with immunotherapy - a comparative study with chemo-radiation induced pseudoprogression and radiation necrosis.","authors":"Hongyan Chen, Guirong Tan, Lijuan Zhong, Yichuan Hu, Wenjing Han, Yi Huang, Qiong Liang, Denes Szekeres, Haihui Jiang, Rajnish Bharadwaj, Stephen M Smith, Henry Z Wang, Xiang Liu","doi":"10.1007/s11060-024-04910-0","DOIUrl":"10.1007/s11060-024-04910-0","url":null,"abstract":"<p><strong>Purpose: </strong>Pseudoprogression is an atypical imaging pattern of response to immunotherapy in patients with brain tumors. MR perfusion studies in this field are limited. The purpose of our study is to compare the perfusion features between pseudoprogression lesions in malignant gliomas and brain metastases treated with immunotherapy (iPsP) and the pseudoprogression after chemo-radiation therapy and radiation necrosis after radiation treatment (ChR-PsP & RN).</p><p><strong>Methods: </strong>We retrospectively reviewed 25 iPsP lesions in 16 brain tumor patients and 48 ChR-PsP & RN lesions in 35 patients. The cerebral blood volume (CBV) of MR dynamic susceptibility contrast (DSC) perfusion weighted imaging (PWI) was analyzed, and the mean and maximal values of the ratio of CBV (rCBV_mean and rCBV_max) of iPsPs and ChR-PsP & RNs were calculated and compared between these two groups using the Mann-Whitney U test. A receiver operating characteristic curve analysis was conducted, and the optimal cutoff of perfusion parameters were determined using the area under the curve, sensitivity, and specificity.</p><p><strong>Results: </strong>The medians of rCBV_mean and rCBV_max in iPsP group were significantly higher (0.94 and 1.39 respectively) than ChR-PsP & RN group (0.67, p < 0.01 and 1.1, p = 0.01 respectively). The rCBV_mean value of 0.69 can differentiate the iPsP from ChR-PsP & RN with the area under the curve of 0.71, sensitivity of 0.72, and specificity of 0.56.</p><p><strong>Conclusion: </strong>These findings may suggest immunotherapy-induced higher perfusion in the iPsP lesions compared to ChR-PsP & RN lesions in primary and metastatic brain tumors.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"239-247"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142836949","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":"Congress of Neurological Surgeons systematic review and evidence-based guidelines for the role of surgery in the management of patients with diffuse low grade glioma: update.","authors":"Navid Redjal, Mateo Ziu, Serah Choi, Patrick R Ng, Brain V Nahed, Jeffrey J Olson","doi":"10.1007/s11060-024-04871-4","DOIUrl":"10.1007/s11060-024-04871-4","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Target populationAdults with imaging suggestive of a WHO grade II diffuse gliomas (oligodendrogliomas or astrocytomas)QuestionIn adults with imaging suggestive of a WHO grade II diffuse gliomas (oligodendrogliomas or astrocytomas), does surgical resection improve overall survival compared to observation or biopsy?Updated Recommendation from the Prior Version of These Guidelines:Level III: In adults with imaging suggestive of a WHO grade II diffuse gliomas (oligodendrogliomas or astrocytomas), surgical resection is suggested over observation or biopsy to improve overall survival.Question Q2In adults with imaging suggestive of a WHO grade II diffuse gliomas (oligodendrogliomas or astrocytomas), does maximal surgical resection improve progression free survival (PFS) and overall survival (OS) compared to subtotal resection/biopsy?Unchanged Recommendations from the Prior Version of These GuidelinesLevel II It is recommended that GTR or STR be accomplished instead of biopsy alone when safe and feasible so as to decrease the frequency of tumor progression recognizing that the rate of progression after GTR is fairly high.Level III Greater extent of resection can improve OS in WHO grade II diffuse gliomas patients. New RecommendationsLevel III: It is suggested that extent of resection be maximized as is safely possible for IDH mutant and IDHwt WHO grade II diffuse gliomas. to improve PFS and OS. Level III: There is insufficient evidence that greater extent of resection of 1p19q codeleted oligodendrogliomas (WHO grade II diffuse gliomas) improves OS Question Q3In adults with imaging suggestive of a WHO grade II diffuse gliomas (oligodendrogliomas or astrocytomas), does the addition of intraoperative MRI and/or intraoperative ultrasound during surgery improve extent of resection?Unchanged Recommendation from the Prior Version of These GuidelinesLevel III: The use of intraoperative MRI is suggested to increase the extent of resection for adults with WHO grade II diffuse glioma.New RecommendationLevel III: The use of intraoperative ultrasound is suggested to increase the extent of resection compared to conventional surgery for adults with WHO grade II diffuse glioma.Question 4In adults with imaging suggestive of a WHO grade II diffuse glioma (oligodendrogliomas or astrocytomas) with seizures, does maximal surgical resection improve seizure control compared to observation or subtotal resection/biopsy?Updated Recommendation from the Prior Version of These GuidelinesLevel III: In adults with imaging consistent with a WHO Grade II diffuse glioma who present with seizure activity, surgical resection of greater than 90% of the lesion, when it can be accomplished safely, is suggested over observation or lesser extent of resection/biopsy to improve seizure control.New Questions and RecommendationsQuestion 5In adults with imaging suggestive of a WHO grade II diffuse glioma (oligodendrogliomas or astrocytomas), does use of intraoperative fluorescent guided surger","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"99-152"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978791","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":"Radiation therapy for childhood-onset craniopharyngioma: systematic review and meta-analysis.","authors":"Yuqi Miao, Di Wu, Yu Li, Yangmingyue Ji, Yanmei Sang","doi":"10.1007/s11060-024-04914-w","DOIUrl":"10.1007/s11060-024-04914-w","url":null,"abstract":"<p><strong>Background: </strong>Craniopharyngioma (CP), a benign tumor originating from remnants of Rathke's pouch in the sellar region, accounts for approximately 30% of all cases of craniopharyngioma. Radiation therapy has been used to treat CP patients for decades; however, there is still a lack of systematic reviews on the long-term tumor control outcomes in pediatric CP patients treated with external radiation therapy.</p><p><strong>Methods: </strong>We conducted a comprehensive search of multiple databases for studies on the tumor progression rates of childhood-onset CP(COCP) patients who received external radiotherapy. We also recorded morbidities related to hypopituitarism and vasculopathy. A meta-analysis was performed to calculate the pooled incidence rates. Meta-regression was applied to explore potential sources of heterogeneity in the tumor progression rates.</p><p><strong>Results: </strong>A total of 22 studies were included after screening and eligibility assessment in accordance with PRISMA guidelines. The median (mean) follow-up period ranged from 2 to 14.9 years. The pooled overall tumor progression rate was 0.10 (95% CI 0.07-0.15). The recurrence rates were 0.14 (95% CI 0.09-0.19) for photon therapy and 0.04 (95% CI 0.01-0.07) for proton therapy. Meta-regression indicated that none of the following underlying risk factors significantly affected the heterogeneity of the recurrence rate: radiation modality (photon vs. proton), median (mean) follow-up duration, or the proportion of patients who did not undergo surgical resection. The pooled incidence of growth hormone deficiency (GHD), thyroid hormone deficiency (THD), adrenocorticotropic hormone deficiency (ACTHD), gonadotropin-releasing hormone deficiency (GnRHD), and diabetes insipidus (DI) were 0.81 (95% CI 0.70-0.90), 0.88 (95% CI 0.79-0.95), 0.69 (95% CI 0.52-0.85), 0.43 (95% CI 0.38-0.49), and 0.56 (95% CI 0.33-0.78), respectively. The pooled morbidity rate for vasculopathy was 0.06 (95% CI 0.04-0.09), with similar rates observed for both photon and proton therapy.</p><p><strong>Conclusion: </strong>Radiotherapy is a suitable adjuvant or alternative treatment method for childhood CP patients. However, patients inevitably face significant long-term treatment-related complications.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"89-98"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921619","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":"Primary diffuse leptomeningeal glioblastoma: a case report and literature review.","authors":"Mark Willy L Mondia, Rebekka E Hooks, Georgios A Maragkos, Vanessa L Smith, Matthew R McCord, Joseph H Donahue, Eli S Williams, M Beatriz Lopes, David Schiff, Ashok R Asthagiri","doi":"10.1007/s11060-024-04908-8","DOIUrl":"10.1007/s11060-024-04908-8","url":null,"abstract":"<p><strong>Purpose: </strong>Glioblastoma (GBM) that presents as leptomeningeal disease (LMD) is extremely rare and fatal. Limited data are available regarding incidence, clinical presentation, and management. Prognosis is poor and no treatment is known to improve survival.</p><p><strong>Methods and results: </strong>We present a case report of a 72-year-old female who presented with depressed sensorium, ataxia, and myelopathy. Magnetic resonance imaging (MRI) showed diffuse supratentorial and spinal LMD. There was an absence of any detectable and distinct intraparenchymal lesion on neuroaxis imaging. Biopsy of the Sylvian fissure nodule revealed GBM. Steroid therapy was ineffective for symptom relief. She opted for palliative care and expired shortly after diagnosis.</p><p><strong>Conclusion: </strong>To our knowledge, this is the first reported case of GBM presenting exclusively as LMD without a primary lesion. If systemic imaging techniques do not provide a biopsy target and cerebrospinal fluid (CSF) studies are non-diagnostic, tissue diagnosis from leptomeningeal biopsy is recommended. Palliative chemoradiation or best supportive care are reasonable treatment options.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"265-272"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813348","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":"Congress of Neurological Surgeons systematic review and evidence based guideline on neuropathology for WHO grade II diffuse glioma: update.","authors":"Nataniel Mandelberg, Tiffany R Hodges, Tony J C Wang, Tresa McGranahan, Jeffrey J Olson, Daniel A Orringer","doi":"10.1007/s11060-024-04898-7","DOIUrl":"10.1007/s11060-024-04898-7","url":null,"abstract":"&lt;p&gt;&lt;p&gt;QUESTIONS AND RECOMMENDATIONS FROM THE PRIOR VERSION OF THESE GUIDELINES WITHOUT CHANGE: TARGET POPULATION: Adult patients (age ≥ 18 years) who have suspected low-grade diffuse glioma.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Question: &lt;/strong&gt;What are the optimal neuropathological techniques to diagnose low-grade diffuse glioma in the adult?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Recommendation: &lt;/strong&gt;Level I Histopathological analysis of a representative surgical sample of the lesion should be used to provide the diagnosis of low-grade diffuse glioma. Level III Both frozen section and cytopathologic/smear evaluation should be used to aid the intra-operative assessment of low-grade diffuse glioma diagnosis. A resection specimen is preferred over a biopsy specimen, to minimize the potential for sampling error issues.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Target population: &lt;/strong&gt;Patients with histologically-proven WHO grade II diffuse glioma.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Question: &lt;/strong&gt;In adult patients (age ≥ 18 years) with histologically-proven WHO grade II diffuse glioma, is testing for IDH1 mutation (R132H and/or others) warranted? If so, is there a preferred method?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Recommendation: &lt;/strong&gt;Level II IDH gene mutation assessment, via IDH1 R132H antibody and/or IDH1/2 mutation hotspot sequencing, is highly-specific for low-grade diffuse glioma, and is recommended as an additional test for classification and prognosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Target population: &lt;/strong&gt;Patients with histologically-proven WHO grade II diffuse glioma.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Question: &lt;/strong&gt;In adult patients (age ≥ 18 years) with histologically-proven WHO grade II diffuse glioma, is testing for 1p/19q loss warranted? If so, is there a preferred method?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Recommendation: &lt;/strong&gt;Level III 1p/19q loss-of-heterozygosity testing, by FISH, array-CGH or PCR, is recommended as an additional test in oligodendroglial cases for prognosis and potential treatment planning.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Target population: &lt;/strong&gt;Patients with histologically proven WHO grade II diffuse glioma.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Question: &lt;/strong&gt;In adult patients (age &gt; 18 years) with histologically-proven WHO grade II diffuse glioma, is methyl-guanine methyl-transferase (MGMT) promoter methylation testing warranted? If so, is there a preferred method?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Recommendation: &lt;/strong&gt;There is insufficient evidence to recommend MGMT promoter methylation testing as a routine for low-grade diffuse gliomas. It is recommended that patients be enrolled in properly designed clinical trials to assess the value of this and related markers for this target population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Target population: &lt;/strong&gt;Patients with histologically-proven WHO grade II diffuse glioma.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Question: &lt;/strong&gt;In adult patients (age ≥ 18 years) with histologically proven WHO grade II diffuse glioma, is Ki-67/MIB1 immunohistochemistry warranted? If so, is there a preferred method to quantitate results?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Recommendation: &lt;/strong&gt;Level III Ki67/MIB1 immunohistochemistry ","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"195-218"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921227","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":"Establishment and transcriptomic characteristics of radio-resistant meningioma cell lines.","authors":"Jinxiu Yu, Leihao Ren, Tianqi Wu, Lingyang Hua, Daijun Wang, Yang Wang, Qing Xie, Jiaojiao Deng, Ye Gong","doi":"10.1007/s11060-025-04966-6","DOIUrl":"https://doi.org/10.1007/s11060-025-04966-6","url":null,"abstract":"<p><strong>Purpose: </strong>Radio-resistance poses a significant challenge in meningioma treatment. This study aimed to establish radio-resistant meningioma cell lines and uncover molecular mechanisms driving radio-resistance to identify potential biomarkers and therapeutic targets.</p><p><strong>Methods: </strong>Radio-resistant meningioma cell lines (IOMM-Lee-RR, CH157-RR) were developed using a progressive radiation dose (cumulative 90 Gy). Cell morphology, radiosensitivity, apoptosis, viability, migration, invasion, cell cycle, and DNA damage repair were analyzed via clonogenic assays, flow cytometry, and Western blotting. Transcriptome sequencing was performed to identify differentially expressed genes (DEGs), followed by KEGG and GO enrichment analyses. Protein-protein interaction (PPI) analysis was conducted to identify hub genes. TK1 expression was further validated in a cohort of 350 meningiomas and the GSE189672 dataset.</p><p><strong>Results: </strong>Radio-resistant meningioma cell lines exhibited enhanced survival, reduced apoptosis, increased cell viability, and superior migratory and invasive abilities compared to parental cells. Under radiation, these cells showed G0/G1 phase accumulation and reduced G2/M phase arrest, along with enhanced DNA repair capacity, as evidenced by lower γ-H2AX expression and fewer DNA damage foci. Transcriptome analysis revealed significant enrichment in metabolic pathways, DNA repair, and cell cycle regulation. Among 34 hub genes identified, TK1 emerged as a key gene, being highly expressed in recurrent and high-grade meningiomas and positively correlated with Ki67. Analysis of the GSE189672 dataset confirmed TK1 as a poor prognostic factor associated with tumor recurrence.</p><p><strong>Conclusion: </strong>Radio-resistant meningioma cells exhibit enhanced DNA repair, migration, invasion, and altered cell cycle dynamics. TK1 was identified as a promising biomarker and therapeutic target for overcoming radio-resistance in meningiomas.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523661","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":"Clinical predictors of overall survival in very elderly meningioma patients: a surveillance, epidemiology, and end results (SEER) database analysis.","authors":"Sai Chandan Reddy, Yuncong Mao, Julian Gendreau, A Karim Ahmed, Debraj Mukherjee","doi":"10.1007/s11060-025-04982-6","DOIUrl":"https://doi.org/10.1007/s11060-025-04982-6","url":null,"abstract":"<p><strong>Objective: </strong>Surgical resection is the gold standard of management for symptomatic intracranial meningiomas. However, surgical intervention may be contraindicated in very elderly patients. In this study, we assessed the survival outcomes for elderly and very elderly patients and the impact of surgical intervention [e.g., subtotal resection (STR) and gross total resection (GTR)] and radiotherapy (RT).</p><p><strong>Methods: </strong>The Surveillance, Epidemiology, and End Results (SEER) database was queried to identify all patients ≥ 65 years of age diagnosed with intracranial meningiomas between 2000 and 2020. Baseline demographics, clinical characteristics, and survival outcomes were compared between elderly (65-79 years) and very elderly (80 + years) patients.</p><p><strong>Results: </strong>4,052 intracranial meningioma patients were identified- 3,462 elderly patients and 590 very elderly patients. Very elderly patients were less likely to undergo GTR compared to elderly patients (OR: 0.756, 95% CI: 0.631-0.905, p = 0.002) and less likely to receive RT (OR: 0.441, 95% CI: 0.294-0.642, p < 0.001). Achievement of GTR in very elderly patients did not decrease the risk of death (HR: 1.003, 95% CI: 0.682-1.475, p = 0.987). However, RT was associated with decreased risk of death in very elderly patients (HR: 0.212, 95% CI: 0.052-0.860, p = 0.030).</p><p><strong>Conclusion: </strong>In this retrospective study, we found pursual of aggressive surgical intervention in very elderly patients was not associated with increased mortality. Despite very elderly patients being much less likely to be prescribed radiotherapy, the administration of RT significantly increased overall survival, suggesting a greater role for radiotherapy in managing intracranial meningiomas in the very elderly population.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523660","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":"Comparison of adjuvant radiation versus observation and salvage radiation after subtotal resection of a WHO grade I skull base meningioma: a propensity score-adjusted analysis.","authors":"Anish R Kosanam, Jun Ma, Alexandra J White, Roger Murayi, Pranay Soni, Pablo F Recinos, Varun R Kshettry","doi":"10.1007/s11060-025-04980-8","DOIUrl":"https://doi.org/10.1007/s11060-025-04980-8","url":null,"abstract":"<p><strong>Purpose: </strong>In patients with subtotal resection (STR) of WHO grade I skull base meningiomas, treatment strategies of adjuvant radiation versus observation with salvage radiation, if necessary, were compared using progression-free survival (PFS) and radiation failure-free survival (RFFS).</p><p><strong>Methods: </strong>Patients with newly diagnosed WHO grade I skull base meningioma who underwent radiographically confirmed STR between 1995 and 2021 were included. PFS was measured from last treatment date. RFFS was measured from surgery date to first radiation failure. Multivariable Cox regression, adjusted for propensity score (PS) and inverse probability treatment weighted (IPTW), was performed.</p><p><strong>Results: </strong>Of 179 patients, 25 (14.0%) received adjuvant radiation. Among 154 observed patients, 90 (58.4%) experienced tumor progression and 64 (71.1%) received salvage radiation. Observation after STR had PFS at 3, 5, and 10 years of 60.6%, 47.5%, and 26.8%, respectively. Adjuvant radiation had PFS/RFFS at 3, 5, and 10 years of 84.2%, 77.2%, and 77.2%. Salvage radiation had PFS at 3, 5, and 10 years of 96.0%, 85.0%, and 80.0%. RFFS after observation with salvage radiation, if needed, at 3, 5, and 10 years was 100%, 97.7%, and 92.8%. PS and IPTW Cox regression models, controlling for residual tumor volume, demonstrated that observation with salvage radiation significantly prolonged RFFS (HR = 0.06, p = 0.013; HR 0.08, p = 0.026, respectively) compared to adjuvant radiation. Median follow-up was 77.5 months.</p><p><strong>Conclusion: </strong>Most patients will have tumor progression within 10 years of STR. Our data suggests that appropriately selected patients can be observed with close follow-up, reserving radiation for progression.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492323","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}