Journal of Neuro-Oncology最新文献

{"title":"Stereotactic radiosurgery for lung cancer spinal metastases.","authors":"Michael R Kann, Samuel Adida, Suchet Taori, Shovan Bhatia, Akshath Rajan, James C Bayley, Pascal O Zinn, Steven A Burton, John C Flickinger, Roberta K Sefcik, Peter C Gerszten","doi":"10.1007/s11060-025-05221-8","DOIUrl":"https://doi.org/10.1007/s11060-025-05221-8","url":null,"abstract":"<p><strong>Purpose: </strong>Lung cancer spinal metastases may present with intractable pain and neurological deficits. This study is one of the largest to examine outcomes following stereotactic radiosurgery (SRS) in this patient population.</p><p><strong>Methods: </strong>A single institution retrospectively collected database of patients with lung cancer spinal metastases treated with SRS between 2003-2023 was analyzed. The primary outcome was local control (LC). Secondary outcomes included pain response, overall survival (OS), and radiation-induced toxicity. The median single-fraction dose was 16 Gy (range: 12-20). Multi-fractionated treatments utilized doses of 18-30 Gy in 2-5 fractions.</p><p><strong>Results: </strong>One hundred twenty-two patients with 167 lesions met inclusion criteria. Prior to radiosurgery, 21 lesions (13%) underwent open resection and 131 lesions (78%) received external beam radiation therapy. Median follow-up was 4 months (range: 1-133). Fifteen lesions (9%) locally recurred 5 months (range: 1-10) after treatment. Six-month and 1-year LC rates were 88% and 75%, respectively. Patient-reported pain predominantly improved or remained stable (67%) after treatment; worsened pain was associated with inferior LC (p < 0.01, HR: 22.7, 95% CI: 2.5-207.1) and development of radiation-induced vertebral compression fractures (VCFs) (p < 0.01, OR: 34.2, 95% CI: 3.0-392.4). Six-month and 1-year OS rates were 45% and 23%, respectively. Low functional status (Karnofsky Performance Score ≤ 70) was associated with inferior LC (p = 0.03, HR: 3.7, 95% CI: 1.1-12.1) and OS (p = 0.03, HR: 1.8, 95% CI: 1.1-2.9). Thirty-one radiation-induced toxicities (19%), including 13 VCFs (8%), were observed.</p><p><strong>Conclusions: </strong>Radiosurgery provides LC and pain palliation with minimal rates of toxicity in a challenging patient population with lung cancer spinal metastases.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033573","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":"Unveiling regional differences in glioblastoma patient survival with real-world data from the Norwegian brain tumor quality registry.","authors":"Cassia Bree Trewin-Nybråten, Paul Christopher Lambert, Kirsten Marienhagen, Lasse Andreassen, Tom Børge Johannesen, Pitt Niehusmann, Leif Oltedal, Stephanie Schipmann, Anne Jarstein Skjulsvik, Ole Solheim, Tora Skeidsvoll Solheim, Terje Sundstrøm, Einar Osland Vik-Mo, Petter Brandal, Tor Ingebrigtsen, Erlend Skaga","doi":"10.1007/s11060-025-05218-3","DOIUrl":"https://doi.org/10.1007/s11060-025-05218-3","url":null,"abstract":"<p><strong>Purpose: </strong>Surveillance of patient outcomes with real-world data is essential to uncover regional disparities in clinical practice or quality of care. This study explored survival differences among glioblastoma patients in Norway and investigated the role of demographic and treatment factors.</p><p><strong>Methods: </strong>We analyzed real-world data from the Norwegian Cancer Registry on 1158 adults with histologically confirmed glioblastoma during 2019-2023. Surgical treatment rates per 100,000 inhabitants per region (South-East, West, Mid, North) were compared using adjusted Poisson models. Full treatment included surgical resection, radiotherapy (≥ 55 Gy for ≤ 70 years; ≥30 Gy for > 70 years), and temozolomide. Standardized survival was estimated with flexible parametric models, standardized for age, sex, year, and distances to treatment facilities.</p><p><strong>Results: </strong>Patients from the North were older and lived further from treatment centers. For patients aged 18-70, treatment and survival did not significantly differ across regions; national median standardized survival was 14.4 months (95%CI:13.6-15.2). For elderly patients (71-89 years), the North demonstrated a higher surgical treatment rate (rate ratio = 1.32; 95%CI = 0.99-1.77), but lesser use of postoperative radiotherapy and temozolomide. Median standardized survival for elderly patients in the North was 4.5 months (95%CI: 3.5-5.7) versus 7.7 (6.9-8.6) months nationally. Early mortality was particularly high for elderly patients in the North, yet those surviving beyond six months matched other regions' survival probability.</p><p><strong>Conclusion: </strong>Lower glioblastoma survival in the North was associated with higher early mortality among elderly patients, likely due to selecting frailer patients for surgery, who less often subsequently received anti-neoplastic treatment.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033540","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":"Utility and performance of cerebrospinal fluid cytology in discriminating central nervous system infections and brain tumors.","authors":"Miao Su, Huiqian Duan, Qian Lei, Zhimei Tan, Yuxin Shi, Jia Liu, Liqun Xu, Qiuxiang Li, Jing Li, Zhaohui Luo","doi":"10.1007/s11060-025-05214-7","DOIUrl":"https://doi.org/10.1007/s11060-025-05214-7","url":null,"abstract":"<p><strong>Background and objective: </strong>Differentiating central nervous system infections (CNSIs) from brain tumors (BTs) is difficult due to overlapping features and the limited individual indicators, and cerebrospinal fluid (CSF) cytology remains underutilized. To improve differential diagnosis, we developed a model based on 9 early, cost-effective cerebrospinal fluid parameters, including CSF cytology.</p><p><strong>Methods: </strong>Patients diagnosed with CNSIs or BTs at Xiangya Hospital of Central South University between October 1st, 2017 and March 31st, 2024 were enrolled and divided into the training set and the test set. Lasso analysis, random forest, and multivariable logistic regression were used to construct a diagnostic model to distinguish CNSIs from BTs by utilizing differences in basic CSF parameters and CSF cytology results. And its diagnostic efficacy was evaluated using the receiver operating characteristic (ROC) curve. A nomogram was used for model visualization.</p><p><strong>Results: </strong>A total of 783 patients were included in this study. 9 important CSF parameters significantly contribute to the differentiation between CNSIs and BTs, including CSF pressure, protein, glucose, adenosine deaminase, chloride, and the counts of lymphocytes, monocytes, plasma cells and phagocytes. CSF phagocytes and monocytes were elevated in BTs, whereas lymphocytes and plasma cells were higher in CNSIs. The model demonstrated strong diagnostic performance, achieving an area under the ROC curve (AUC) of 0.889 in the training set and 0.900 in the test set.</p><p><strong>Conclusions: </strong>We developed a diagnostic model based on 9 CSF indicators. In our study, CSF phagocytes and monocytes were associated with BTs, while lymphocytes and plasma cells indicated CNSIs.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029695","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":"Physician-led versus questionnaire-based psychosocial screening in adults with high-grade glioma: a cluster-randomized controlled trial (GLIOPT).","authors":"Mirjam Renovanz, Melina Hippler, Robert Kuchen, Lorenz Doerner, David Rieger, Joachim P Steinbach, Michael W Ronellenfitsch, Martin Voss, Almuth F Kessler, Vera Nickl, Martin Misch, Julia Sophie Onken, Marion Rapp, Minou Nadji-Ohl, Marcus Mehlitz, Jürgen Meixensberger, Michael Karl Fehrenbach, Naureen Keric, Florian Ringel, Jan Coburger, Carolin Weiß Lucas, Jens Wehinger, Friederike Schmidt-Graf, Jens Gempt, Marcos Tatagiba, Ghazaleh Tabatabai, Melanie Schranz, Susanne Singer","doi":"10.1007/s11060-025-05223-6","DOIUrl":"https://doi.org/10.1007/s11060-025-05223-6","url":null,"abstract":"<p><strong>Purpose: </strong>Patients diagnosed with high-grade gliomas (HGG) often experience substantial psychosocial dis-tress. However, due to neurological and neurocognitive deficits its assessment remains challenging, and needs remain unmet. We compared a novel face-to-face assessment during doctor-patient conversations with questionnaire-based screening.</p><p><strong>Methods: </strong>In this multicenter, two-arm cluster-randomized study involving 13 centers patients in the interven-tion group (IG) were screened for distress via physician-patient conversations, while the control group (CG) completed the Distress Thermometer. Primary outcome was the proportion of patients with poor emotional functioning (measured with the EORTC Quality of Life Questionnaire) who received specialized psychosocial care (PC) within 3 months. Data were collected via patient and physician reports and medical records. Analysis employed mixed models logistic regression.</p><p><strong>Results: </strong>In total, 763 patients were enrolled at baseline, and 506 completed the follow-up. The emotional functioning was poor in 302/506 (59.7%). The frequency of patients reporting PC utilization was comparable between groups (IG 93/168, 55.4% vs. CG 87/134, 64.9%, odds ratio (OR) =0.67, 95% confidence interval (CI)=0.40-1.11, p=0.115). Likewise, the provision of information about special-ized psycho-oncological care was similar (IG 112/168, 66.7% vs. CG 94/134, 70.1%, OR=0.95, 95%CI=0.39-2.29, p=0.904).</p><p><strong>Conclusion: </strong>Physician-led, face-to-face distress screening was not superior to questionnaire-based screening in facilitating psychosocial care referrals. Nonetheless, it represents a feasible and patient-centered alternative, particularly for patients with high-grade gliomas suffering from neurocognitive or func-tional deficits.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033560","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 outcomes of modern radiation therapy for pituitary adenoma - different techniques: single institute experience.","authors":"Alexandra Brand, Linda Agolli, Kerem Tuna Tas, Phillip Lishwiski, Markus Schymalla, Klemens Zink, Hilke Vorwerk, Ioanna Fragkandrea-Nixon, Thomas Held, Daniel Habermehl, Sebastian Adeberg, Ahmed Gawish","doi":"10.1007/s11060-025-05228-1","DOIUrl":"https://doi.org/10.1007/s11060-025-05228-1","url":null,"abstract":"<p><strong>Background: </strong>Pituitary adenomas are relatively common benign intracranial tumors that may cause significant hormonal imbalances and visual impairments. Radiotherapy (RT) remains an important treatment option, particularly for patients with residual tumor after surgery, recurrent disease, or ongoing hormonal hypersecretion. This study summarizes long-term clinical outcomes and radiation-associated toxicities in patients with pituitary adenomas treated with contemporary radiotherapy techniques at a single institution.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 122 patients treated with RT for pituitary adenomas at the tertiary Hospital in Germany between 1992 and 2023. Patient data were assessed for tumor characteristics, treatment modalities, and outcomes. Overall survival (OS), and local control (LC) were evaluated using Kaplan-Meier analysis. Statistical comparisons between subgroups were performed with the log-rank test. Treatment-related toxicities were graded according to the Common Terminology Criteria for Adverse Events (CTCAE), version 5.0.</p><p><strong>Results: </strong>Median follow-up was 107 months from initial diagnosis and 63 months post-RT. Most patients (96%) received fractionated stereotactic radiotherapy (FSRT), and 4% underwent single-session radiosurgery. RT achieved LC rates of 95% and 75% at 5 and 20 years, respectively. Proton therapy significantly improved LC and overall survival (OS) compared to photon-based treatments (p < 0.01). Hypopituitarism was the most common long-term toxicity, occurring in 40% of patients, while visual impairments were rare (< 3%). Tumor recurrence occurred in 9% of patients, primarily in those treated with delayed RT after incomplete resection.</p><p><strong>Conclusion: </strong>Modern RT techniques, particularly proton therapy, provide durable tumor control and manageable toxicity profiles for pituitary adenomas. Optimized timing and precision in RT delivery are critical to enhancing outcomes and minimizing complications. Long-term follow-up remains essential to monitor disease progression and late toxicities.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029631","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 patient frailty in resection of newly diagnosed motor eloquent glioblastomas guided by a navigated transcranial magnetic stimulation and tractography approach.","authors":"Thomas Eibl, Adrian Liebert, Leonard Ritter, Markus Neher, Karl-Michael Schebesch","doi":"10.1007/s11060-025-05206-7","DOIUrl":"https://doi.org/10.1007/s11060-025-05206-7","url":null,"abstract":"<p><strong>Purpose: </strong>Resection of glioblastomas infiltrating the motor cortex and corticospinal tract (CST) is often linked to increased perioperative morbidity. Navigated transcranial magnetic stimulation (nTMS) motor mapping has been advocated to increase patient safety in these cases. The additional impact of patient frailty on overall outcome after resection of cases with increased risk for postoperative motor deficits as identified with nTMS needs to be investigated.</p><p><strong>Methods: </strong>Patients with newly diagnosed motor eloquent glioblastomas were retrospectively evaluated. Patients underwent nTMS- and tractography-based neuronavigation. Demographic, imaging- and nTMS-derived data and the 11-item modified frailty index (mFI-11) were collected. Primary endpoint was discharge home after tumor resection. A 4-item score comprising preoperative motor deficit, mFI-11 ≥ 2 points, distance to the CST < 12 mm and infiltration of nTMS-positive cortex was established to predict overall outcome.</p><p><strong>Results: </strong>N = 64 patients with a mean age of 64.8 ± 9.6 years (60.9% male) were included. 46 patients (71.9%) could be discharged to their homes. Risk factors for non-home discharge were greater mFI-11 (p = 0.027), surgery-related motor deficit (p < 0.001) and overall complications (p < 0.001 for non-surgical and p = 0.006 for surgical complications). In multiple regression analyses, mFI-11 and surgery-related deficit were statistically robust. The 4-item score predicted non-home discharge with an AUC = 0.745, 95%CI = 0.62-0.87, p < 0.001.</p><p><strong>Conclusion: </strong>In patients with newly diagnosed motor-eloquent glioblastomas, nTMS-based planning helps to predict postoperative surgery-related motor deficits. Patient frailty needs to be respected in decision making in addition to nTMS- and tractography-based planning in order to avoid postsurgical motor deficits and to keep overall surgical morbidity on a low level.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023483","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 dynamic nature of frailty in metastatic spine disease patients.","authors":"Oludotun Ogunsola, Edward S Harake, Sean Smith, Michael Albdewi, Varun Kathawate, Sebele Ogunsola, William Jackson, Joseph Evans, Vikram Chakravarthy, Nicholas Szerlip","doi":"10.1007/s11060-025-05213-8","DOIUrl":"https://doi.org/10.1007/s11060-025-05213-8","url":null,"abstract":"<p><strong>Purpose: </strong>Frailty measures are critical for predicting outcomes in metastatic spine disease (MSD) patients. This study aimed to evaluate frailty measures throughout the disease process.</p><p><strong>Methods: </strong>This retrospective analysis measured frailty in MSD patients at multiple time points using a modified Metastatic Spinal Tumor Frailty Index (MSTFI). Scores were 0: \"not frail,\" 1: \"mild\", 2: \"moderate, and ≥ 3: \"severe.\" Measurements were taken at cancer diagnosis, spine metastasis (SM) diagnosis, and 4-month intervals up to 2-years. The change in frailty distribution was described at the general cohort and patient levels. Two-year survival was assessed from baseline frailty status at SM diagnosis.</p><p><strong>Results: </strong>This study included 465 patients with an average age of 62.3 years (± 12.7), 33.8% female. Prostate cancer was most common (20.9%), followed by renal cell carcinoma (15.3%), non-small cell lung cancer (NSCLC, 13.5%), and others. Frailty changed dynamically, most significantly early in the disease. Initially, 79.4% were not frail; this dropped to 60.1% at SM diagnosis and to 42.7% at 4 months. Patients with short-term (4 month) data showed rapid frailty progression, with 57% becoming moderately to severely frail (p = 0.01), whereas 45% with long-term (24 months) data remained non-frail (p < 0.0001). Contributing factors included anemia (32.7%), electrolyte abnormalities (16.9%), and malnutrition (11.4%). Histological classification influenced frailty. Higher frailty scores at metastatic diagnosis correlated with worse 2-year survival outcomes (p: <0.001-0.04), underscoring frailty's prognostic significance.</p><p><strong>Conclusion: </strong>Frailty is dynamic, with a potential early intervention point to maintain or reverse it. Further research is needed to assess which frailty measures are most dynamic and amenable to intervention.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023442","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 Journal of Neuro-Oncology and Journal of Neuro-Oncology: Discovery : Better meeting the needs of our global neuro-oncology community.","authors":"Jason Sheehan","doi":"10.1007/s11060-025-05222-7","DOIUrl":"https://doi.org/10.1007/s11060-025-05222-7","url":null,"abstract":"","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023445","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":"NOTCH3 drives fatty acid oxidation and ferroptosis resistance in aggressive meningiomas.","authors":"Nishanth S Sadagopan, Mateo Gomez, Shashwat Tripathi, Leah K Billingham, Susan L DeLay, Martha A Cady, Harrshavasan T S Congivaram, Tzu-Yi Chia, Hanxiao Wan, Si Wang, David R Raleigh, Faith C Kaluba, Evan C Lien, Amy B Heimberger, Catalina Lee-Chang, Mark W Youngblood, Stephen T Magill, Jason M Miska","doi":"10.1007/s11060-025-05208-5","DOIUrl":"https://doi.org/10.1007/s11060-025-05208-5","url":null,"abstract":"<p><strong>Purpose: </strong>NOTCH3 is increasingly implicated for its oncogenic role in many malignancies, including meningiomas. While prior work has linked NOTCH3 expression to higher-grade meningiomas and treatment resistance, the metabolic phenotype of NOTCH3 activation remains unexplored in meningioma.</p><p><strong>Methods: </strong>We performed single-cell RNA sequencing on NOTCH3 + human meningioma cell lines. Using the CH157-MN meningioma cell model, we overexpressed NOTCH3 intracellular domain (ICD) and performed untargeted metabolomic, lipidomic, and bulk RNA sequencing analyses as well as functional metabolic assays.</p><p><strong>Results: </strong>We show that NOTCH3 mediates a metabolic shift towards fatty acid oxidation (FAO), depleting lipid availability and conferring resistance to ferroptosis. Single-cell RNA sequencing revealed a correlation with CD36, a key fatty acid transporter. Furthermore, patient-derived primary meningioma lines stratified by NOTCH3 expression confirmed higher CD36 expression and increased maximal mitochondrial respiration in NOTCH3-high cells in the presence of palmitate, supporting enhanced FAO. NOTCH3 ICD overexpression (OE) exhibited depletion of fatty acid pools, alongside transcriptional upregulation of canonical FAO genes. Functional mitochondrial assays confirmed elevated oxidative respiration in the presence of palmitate compared with controls. Additionally, NOTCH3 OE cells exhibit increased resistance to RSL3-induced ferroptosis, a phenotype that was reversed with CPT1 inhibition.</p><p><strong>Conclusion: </strong>These data establish a link between NOTCH3 signaling, lipid metabolic reprogramming, and ferroptosis evasion in aggressive meningioma cells. This metabolic shift may contribute to the malignant behavior observed in NOTCH3 + meningiomas, offering new insight into the biochemical vulnerabilities of these tumors.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023501","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":"Photodynamic therapy for glioblastoma: a narrative review.","authors":"Gabrielle Price, Stephen C Frederico, Jhair Colan, Frederika Rentzeperis, Sakibul Huq, Constantinos Hadjipanayis","doi":"10.1007/s11060-025-05217-4","DOIUrl":"https://doi.org/10.1007/s11060-025-05217-4","url":null,"abstract":"<p><strong>Purpose: </strong>Glioblastoma (GBM) remains one of the most aggressive primary brain tumors with poor survival outcomes and a lack of approved therapies. A promising novel approach for GBM is the application of photodynamic therapy (PDT), a localized, light-activated treatment using tumor-selective photosensitizers. This narrative review describes the mechanisms, delivery systems, photosensitizers, and available evidence regarding the potential of PDT as a novel therapeutic approach for GBM.</p><p><strong>Methods: </strong>A comprehensive review of the preclinical and clinical literature was conducted on the role of PDT for GBM. Special emphasis was placed on PDT's mechanisms of action, immunomodulatory effects, delivery systems, and combinatorial potential with other treatment regimens. All clinical trials on this topic were reviewed and described.</p><p><strong>Results: </strong>PDT exerts tumor-specific cytotoxic effects via reactive oxygen species generation, vascular disruption, and immune activation. Photosensitizers such as 5-aminolevulinic acid (5-ALA), chlorins, and phthalocyanines demonstrate selective accumulation in glioma cells and enhance treatment precision. Preclinical studies demonstrate that PDT can induce apoptosis, improve blood-brain barrier permeability, and synergize with existing chemotherapeutics. Early-phase clinical trials, including the INDYGO and talaporfin sodium-based studies, report promising safety profiles and extended survival in newly diagnosed and recurrent GBM patients.</p><p><strong>Conclusion: </strong>PDT offers a novel targeted approach for improving local control of GBM. With continued innovation in photosensitizer design, delivery technologies, and combinatorial strategies, PDT holds promise as a viable therapeutic adjunct in GBM treatment. Further clinical validation through randomized controlled trials is warranted to establish its efficacy and gain regulatory approval with the eventual goal of integration into standard neuro-oncology practice.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023439","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}