Journal of Neuro-Oncology最新文献

{"title":"Prognostic factors for local failure and overall survival in patients with epidural disease at the cauda equina following stereotactic body radiotherapy: a clinical, anatomic and dosimetric analysis.","authors":"Sondos Zayed, Mark Ruschin, Eshetu G Atenafu, Hanbo Chen, Deepak Dinakaran, Jay Detsky, Sten Myrehaug, Hany Soliman, Christopher Witiw, Jeremie Larouche, Pejman Maralani, Arjun Sahgal, Chia-Lin Tseng","doi":"10.1007/s11060-025-05157-z","DOIUrl":"10.1007/s11060-025-05157-z","url":null,"abstract":"<p><strong>Purpose: </strong>The relationship between spine SBRT outcomes and the extent of epidural cauda equina compression (ECEC) by malignant epidural disease has yet to be reported. Our objective was to determine clinical, anatomic and dosimetric factors that predict for local failure (LF) and overall survival (OS) specific to ECEC.</p><p><strong>Methods: </strong>Consecutive patients with ECEC treated with spine SBRT were retrospectively reviewed. ECEC parameters including anatomic measurements, lumbar stenosis grading, anatomic disease position and various dosimetric factors, were analyzed for their prognostic utility. Covariates with a p-value ≤ 0.20 on univariate analysis were selected for multivariable analysis (MVA), and those statistically significant (p < 0.05) were included in the final model.</p><p><strong>Results: </strong>Ninety-four spinal segments (79 patients) with ECEC were identified, 69 (73%) were intact (non-operated) and 25 (27%) post-operative. MVA identified a significantly lower risk of LF with systemic-therapy prior to SBRT (HR 0.164, p = 0.0005), ECEC encompassing ≤ 1/3 of the circumference of the spinal canal (HR 0.216, p = 0.0194) and an epidural disease volume < 0.45cm³ (HR 0.000, p < 0.001). In the intact cohort, a greater volume of epidural disease receiving 50 Gy (V50Gy) as an Equivalent Dose in 2 Gy Fractions (EQD2) using an α/β = 10 was associated with a lower LF (HR 0.909, p = 0.0122). Oligometastatic disease and ECEC limited to a single spinal-level were significant prognostic factors for OS in both cohorts.</p><p><strong>Conclusion: </strong>The volume and circumferential extent of epidural disease within the spinal canal are important factors for LF in ECEC treated by SBRT, suggesting a possible therapeutic role for surgical cytoreduction to enable optimal treatment planning.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"621-631"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649738","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 concept, intention, and evaluation of the term treatment-refractory meningioma.","authors":"Lasse Rehné Jensen, Andrea Daniela Maier, Tareq A Juratli, Stéphane Goutagny, Luca Bertero, Thomas Graillon, Benjamin Brokinkel, Tejpal Gupta, Sverre Helge Torp, Roberta Rudà, Paul M Clement, Martijn van Essen, María Dolores Tabernero, Konstantinos Gousias, Álvaro Otero Rodríguez, Jong Hee Chang, Chang-Ok Suh, Andrés Felipe Cardona, Oscar Arrieta, Alejandro Ruiz-Patiño, Daniela A Bota, Maya Hrachova, David Scheie, Bjarne Winther Kristensen, Tina Nørgaard Munch, Ian Law, Kåre Fugleholm, Torstein Ragnar Meling, Julia Furtner, Matthias Preusser, Martin Alexander Walter, Tiit Mathiesen, Christian Mirian","doi":"10.1007/s11060-025-05154-2","DOIUrl":"10.1007/s11060-025-05154-2","url":null,"abstract":"<p><strong>Background: </strong>Treatment-refractory meningioma is a widely used term but lacks standardized criteria, impairing research comparability and treatment evaluation. The aim of this study was to assess the heterogeneity of patient populations labeled as treatment-refractory and to explore recommendations for better consistency.</p><p><strong>Methods: </strong>We systematically reviewed 69 studies published before 2024 and analyzed individual participant data from 15 cohorts (n = 211) that included treatment-refractory patients who underwent experimental therapy with somatostatin receptor (SSTR)-targeted therapies. A reference cohort (n = 102) with newly diagnosed WHO-3 meningiomas was used descriptively for comparison. Progression and death were the primary endpoints. Hazard rate ratios were estimated via Poisson regression, and inter-study heterogeneity was quantified using I² statistics.</p><p><strong>Results: </strong>Definitions of treatment-refractory varied substantially across previous studies. WHO-1 patients showed high statistical inter-study variability, particularly for the long-acting SSTR-analogues group when assessing progression (I² = 81.7%) and death (I² =74.8%). Patients with treatment-refractory WHO-2 and WHO-3 meningioma exhibited more consistency across endpoints and SSTR-targeted therapies (I² percentages ≤ 16.0%). Risk of progression and death differed significantly by WHO grade, regardless of SSTR-targeted therapy.</p><p><strong>Conclusions: </strong>Our findings demonstrate an inconsistent use of the term treatment-refractory and substantial variability of effect estimates dependeing on the individual cohorts. Pooling patients across WHO grades is unfeasible for assessing treatment effects. Based on the present study and prior evidence, we outline recommendations to improve consistency in future trial design and enable more meaningful comparisons across studies. The recommendations are grouped into four categories: radiographic evaluation, endpoints, clinical core elements, and molecular classification.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"599-610"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784560","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":"Hemagglutinating virus of Japan envelope encapsulating microRNA-34a-5p robustly induces apoptosis of malignant meningioma cells by suppressing survivin.","authors":"Takaaki Ishikawa, Masahide Matsuda, Yasufumi Kaneda, Eiichi Ishikawa","doi":"10.1007/s11060-025-05172-0","DOIUrl":"10.1007/s11060-025-05172-0","url":null,"abstract":"<p><strong>Purpose: </strong>Malignant meningiomas are characterized by high recurrence rates and limited therapeutic options beyond surgery and radiation. This study aimed to develop a novel nucleic acid-based therapeutic approach for malignant meningiomas and to evaluate its efficacy both in vitro and in vivo.</p><p><strong>Methods: </strong>IOMM-Lee and HKBMM cell lines were used as models of malignant meningioma. Inhibitory effects of hemagglutinating virus of Japan envelope (HVJ-E) and microRNA-34a-5p (miR-34a-5p) were assessed using cell viability assays, apoptosis assays, RT-qPCR, and western blotting. Finally, the tumor suppressive effect of HVJ-E encapsulating miR-34a-5p was evaluated using a subcutaneous xenograft model in nude mice.</p><p><strong>Result: </strong>HVJ-E significantly reduced viability of malignant meningioma cells. Furthermore, HVJ-E encapsulating miR-34a-5p demonstrated enhanced anti-tumor activity by inducing apoptosis through downregulation of survivin expression. This tumor-suppressive effect was also confirmed in a subcutaneous mouse model.</p><p><strong>Conclusion: </strong>Our findings indicate that HVJ-E encapsulating miR-34a-5p effectively inhibits the growth of malignant meningioma cells both in vitro and in vivo. This novel combination therapy holds promise as a potential treatment strategy for malignant meningiomas.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"753-762"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675008","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 and genomic factors differ in pediatric and adult pilocytic astrocytoma: a single-center experience with over 350 patients.","authors":"Katherine E Chandler, Julia N Grigorian, Vivek A Pisharody, Zvipo Chisango, Jocelyn Chow, Shuting Mao, Tianwen Ma, Arman Jahangiri, Joshua J Chern, Kimberly Hoang","doi":"10.1007/s11060-025-05145-3","DOIUrl":"10.1007/s11060-025-05145-3","url":null,"abstract":"<p><strong>Purpose: </strong>Pilocytic astrocytoma (PA) is rare in adults despite being the most common pediatric brain tumor. KIAA1549::BRAF fusion and BRAF p.V600E mutation are common in PA, yet prognostic impact of these alterations remains uncertain. We highlight clinical characteristics and tumor genomics in PA across the lifespan, exploring factors associated with disease progression.</p><p><strong>Methods: </strong>Pediatric and adult patients who underwent biopsy or resection of PA from 2000 to 2023 were retrospectively studied. Clinical data and tumor genomics were collected, and progression/recurrence-free survival (PRFS) analysis was performed.</p><p><strong>Results: </strong>We identified 334 pediatric and 32 adult PA patients. Tumor location distribution did not differ between groups, with the cerebellum being the predominant location (59.3% pediatric and 50.0% adult). Gross total resection (GTR) was more common in children (79.1% versus 62.1%, p = 0.04). KIAA1549::BRAF fusion was more frequent in children (59.6% versus 23.1%, p = 0.02). BRAF p.V600E mutations were rarer in both groups (14.6% pediatric versus 8.3% adult, p = 1). In children, GTR was associated lower rates of tumor progression/recurrence (9.8% versus 41.2%, p < 0.001) and longer PRFS (p < 0.001). Cerebellar tumors in children were also associated with lower rates of tumor progression/recurrence (13.1% versus 31.6%, p < 0.001) and longer PRFS (p < 0.001). No operative/genomic predictors of PRFS were identified in adults. Overall rate of tumor progression/recurrence did not differ between groups (21.3% pediatric versus 15.6% adult, p = 0.65).</p><p><strong>Conclusion: </strong>Clinical characteristics and factors influencing tumor progression/recurrence differ in children and adults with PA. This work highlights current knowledge gaps on age-related differences in PA, providing clinical and genomic context for future studies.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"539-547"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799419","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":"Shared decision-making interventions in neuro-oncology practice: a systematic review.","authors":"Jasmine G Hughes, Francesca M Cozzi, Veronica Phillips, Stephen J Price","doi":"10.1007/s11060-025-05141-7","DOIUrl":"10.1007/s11060-025-05141-7","url":null,"abstract":"<p><strong>Background: </strong>Shared decision-making (SDM) has been shown to be beneficial to patients and improve health outcomes. While more research is being conducted on the topic of SDM, the incorporation of interventions to facilitate or improve SDM in neuro-oncology has not been widely studied. This study aimed to systematically review the types and impact of SDM interventions used in neuro-oncology.</p><p><strong>Methods: </strong>Systematic searches were conducted in Medline, Embase, Global Health, Cinahl, Web of Science, and Scopus from inception to May 2024. Full-text, peer-reviewed articles were evaluated based on inclusion criteria. Data extracted from articles included the author, year, location, type of intervention, and variable outcomes.</p><p><strong>Results: </strong>The searches resulted in 4674 original articles. Four studies with a total of 172 patients diagnosed with anaplastic oligodendroglioma, anaplastic astrocytoma, high-grade glioma (HGG), low-grade glioma (LGG), glioblastoma, and brain metastases met the inclusion criteria. Types of SDM interventions included SDM training for health care workers, decision grids, three-dimensional (3D) printed models of brain tumors, goals of care videos, and an online tool providing information on disease progression. Overall impact of SDM interventions resulted in improvement in patients' understanding of their medical condition, treatment options, and satisfaction with the SDM process.</p><p><strong>Conclusion: </strong>SDM can be improved through the use of interventions and aids and can have a positive impact on brain tumor patients. However, there is a significant gap within neuro-oncology literature on SDM interventions. Therefore, to understand how to best improve SDM from the perspective of patients, there is a pressing need for more research on SDM interventions in neuro-oncology.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"471-479"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475636","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":"Further points to consider regarding the resection strategy of eloquent brain metastasis in the era of postoperative stereotactic radiotherapy.","authors":"Pavel S Pichardo-Rojas, Bardia Hajikarimloo, Jason P Sheehan","doi":"10.1007/s11060-025-05153-3","DOIUrl":"10.1007/s11060-025-05153-3","url":null,"abstract":"<p><p>Häni et al. present an important analysis evaluating outcomes following resection of eloquent brain metastases without surgical margins in the context of postoperative stereotactic radiotherapy. While their findings support functional preservation without compromising local control, we believe several clinical nuances warrant further discussion. In this letter, we address the heterogeneity of tumor histologies, highlight the potential of upfront SRS in select small, eloquent lesions, and draw parallels to established strategies in benign intracranial tumors. These considerations may help refine treatment paradigms for patients with eloquent brain metastases.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"469-470"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675007","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":"Repeated responders to bevacizumab combination treatment in recurrent glioblastoma: a retrospective case study.","authors":"Maya Jeje Schuang Lü, Signe Regner Michaelsen, Alessio Locallo, Christina Schjellerup Eickhart-Dalbøge, David Scheie, Linea Cecilie Melchior, Joachim Weischenfeldt, Ulrik Lassen, Hans Skovgaard Poulsen, Thomas Urup","doi":"10.1007/s11060-025-05162-2","DOIUrl":"10.1007/s11060-025-05162-2","url":null,"abstract":"<p><strong>Purpose: </strong>Bevacizumab combination treatment rechallenge in glioblastoma (GBM) patients who initially responded at recurrence has shown renewed responses in up to 60% of cases, with associated survival benefits. This study sought to characterise such repeat responders and identify predictive biomarkers.</p><p><strong>Methods: </strong>A total of 254 IDHwt GBM patients treated with bevacizumab plus chemotherapy (BevCT) were evaluated for eligibility. Five patients met the inclusion criteria for this case study by exhibiting repeated responses to BevCT and having tumour tissue available for molecular analysis. Histopathological re-assessments were performed to confirm GBM diagnoses. Angiotensinogen (AGT) promoter methylation status was analysed in all primary tumour samples, while bulk RNA sequencing and TSO500 assays were conducted on all available samples.</p><p><strong>Results: </strong>In our cohort, 40% of patients who were rechallenged with BevCT following a treatment pause exhibited a response both during the initial course and upon rechallenge. Bulk RNA sequencing revealed downregulation of HILPDA and IGF2 as potentially predictive of repeated bevacizumab response. Additionally, AGT promoter methylation analysis identified high methylation levels as another potential predictive biomarker.</p><p><strong>Conclusions: </strong>A subgroup of GBM patients responds to BevCT up to three times in the recurrent setting, and these repeated responders exhibit prolonged survival. No definitive prognostic variables or histopathological features were found in this study. Further investigation into the downregulation of HILPDA and IGF2, along with high AGT promoter methylation levels and other potential predictive biomarkers, is warranted to better understand the mechanisms underlying repeated BevCT response.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"869-878"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642834","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":"Recurrent meningioma treated with boron neutron capture therapy: a feasibility study with dosimetric and clinical correlates.","authors":"Tien-Li Lan, Chun-Fu Lin, Yi-Yen Lee, Feng-Chi Chang, Shih-Chieh Lin, Fong-In Chou, Jinn-Jer Peir, Po-Shen Pan, Jen-Kun Chen, Lu-Han Lai, Hiroki Tanaka, Shih-Ming Hsu, Yi-Wei Chen","doi":"10.1007/s11060-025-05184-w","DOIUrl":"10.1007/s11060-025-05184-w","url":null,"abstract":"<p><strong>Background: </strong>Boron neutron capture therapy (BNCT) is a targeted radiotherapy modality that has shown promise in the treatment of recurrent gliomas and head and neck cancers. Although meningiomas are generally slow-growing, recent studies have demonstrated favorable uptake of boron-containing compounds, particularly boronophenylalanine (BPA), suggesting a potential role for BNCT in recurrent meningioma.</p><p><strong>Methods: </strong>We retrospectively analyzed 13 patients with recurrent meningiomas treated with salvage BNCT at the Tsing Hua Open-Pool Reactor between August 2020 and May 2024. Tumor uptake was assessed using either ¹⁸F-BPA or ¹⁸F-Fluciclovine PET. Treatment response was evaluated using RANO criteria, and outcomes were analyzed in relation to dosimetric and clinical factors.</p><p><strong>Results: </strong>Of the 13 patients (1 WHO grade 3, 6 grade 2, and 6 grade 1), 5 (38%) responded to BNCT. Responders had significantly higher tumor mean dose (45.10 vs. 25.85 GyE, p = 0.003). Tumor location influenced dosimetry; non-skull base tumors received higher doses and showed a trend toward better response. TNR and tumor size were not predictive of response. No severe adverse events were observed.</p><p><strong>Conclusions: </strong>Salvage BNCT is a feasible and well-tolerated treatment for recurrent meningioma, with dose distribution and tumor location significantly influencing treatment response. Further studies are warranted to refine imaging and planning strategies, particularly for skull base lesions and in the context of Fluciclovine PET.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"879-886"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760280","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":"The Spinal Chordoma Patient Reported Outcome Survey (spCPROS): a patient-centered, disease-specific tool for assessing quality of life in spinal chordoma patients.","authors":"Saket Myneni, Linda Tang, Hanan Akbari, Raquel Mayne, Foad Kazemi, Ruiwen Xiong, Kristin J Redmond, Mark H Bilsky, Raphaële Charest-Morin, Daniel G Tobert, Vikram Chakravarthy, Ganesh M Shankar, Sheng-Fu L Lo, John H Shin, Jean-Paul Wolinsky, Daniel M Sciubba, Ziya L Gokaslan, Nicolas Dea, Daniel Lubelski, A Karim Ahmed, Debraj Mukherjee","doi":"10.1007/s11060-025-05181-z","DOIUrl":"10.1007/s11060-025-05181-z","url":null,"abstract":"<p><strong>Purpose: </strong>Chordomas present most frequently in the lumbosacral spine. Spinal chordomas and treatment sequelae significantly affect quality of life (QOL) due to proximity of major neurovascular structures and the aggressive management required. However, since there are no validated instruments for this population, we aimed to develop a novel QOL metric for spinal chordoma patients.</p><p><strong>Methods: </strong>Qualitative analysis of interview transcripts from 27 chordoma patients identified common symptoms categorized into 7 themes. Seventy-nine items from existing instruments addressing these themes formed an initial questionnaire distributed to 26 different spinal chordoma patients and 11 providers. Respondents rated items' relevance on a 5-point Likert scale. An average rating above 3.0 met the relevance threshold. Scores were compared between patients and providers, and mobile spine and sacrum lesions using two-sided Mann-Whitney U-tests (significance level: 0.05).</p><p><strong>Results: </strong>Forty-seven items surpassed the threshold. We removed redundant items to create the 35-item Spinal Chordoma Patient Reported Outcome Survey (spCPROS). These items were categorized in 8 patient-facing domains: general(3), mood(7), daily activities(6), pain(4), sleep(4), sensory and motor(9), and social activities(2). The categories with the most items with significant patient-provider discrepancies included mood(42%), sensory and motor(44%), pain(50%), and social activities(50%). Four items, including bladder control (3.53 vs. 1.90, p = 0.03) and bowel incontinence (4.07 vs. 1.70, p < 0.01), were more relevant to sacral lesions than mobile spine lesions.</p><p><strong>Conclusion: </strong>We developed a patient-centered tool for measuring QOL specific to spinal chordomas. Utilizing the spCPROS in preoperative and postoperative clinical encounters may allow clinicians to effectively assess symptom burden and provide guidance for high-quality patient-centered care.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"813-824"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731789","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":"Intraoperative neuromonitoring with direct cortical stimulation motor-evoked potentials in supratentorial glioma surgeries with preoperative moderate-to-severe motor weakness.","authors":"Ryosuke Matsuda, Tsunenori Takatani, Hironobu Hayashi, Ryuta Matsuoka, Ryota Sasaki, Ryosuke Maeoka, Kengo Yamada, Yudai Morisaki, Kenta Nakase, Shohei Yokoyama, Yasuhiro Takeshima, Masahiko Kawaguchi, Ichiro Nakagawa","doi":"10.1007/s11060-025-05185-9","DOIUrl":"10.1007/s11060-025-05185-9","url":null,"abstract":"<p><strong>Purpose: </strong>Intraoperative neuromonitoring (IONM) is essential for safe brain tumor surgeries. Little is known about how to assess damaged motor function. To preserve damaged motor function in these patients, we evaluated the results of direct cortical stimulation motor-evoked potential (D-MEP) monitoring in glioma surgeries performed in and near the primary motor cortex (PMC) and cortico-spinal tract (CST).</p><p><strong>Methods: </strong>IONM using D-MEPs in patients with preoperative moderate-to-severe motor weakness was performed in 16 cases (14 patients). Before the tumor resection, a single six-contact subdural strip electrode was placed on the PMC. Muscle responses for the upper and lower extremities were confirmed during the tumor resection. Bipolar stimulation was then performed between adjacent or more distant electrodes. D-MEP monitoring was defined as successful if any D-MEP could be measured for either the upper or lower limb with Manual Muscle Test score below 3.</p><p><strong>Results: </strong>The success rate of D-MEP monitoring in these patients was 81.2% (13/16 cases) and 50% (13/26 limbs). The baseline median intensities of stimulation for D-MEPs in the upper and lower extremities were 23.3 ± 6.1 mA and 24.7 ± 9.2 mA, respectively. The 13 cases wherein D-MEP was successfully recorded in at least in one limb with moderate-to-severe motor weakness showed no deterioration of motor function postoperatively. Among the remaining three cases with unsuccessful D-MEP measurements, one showed worsened motor weakness.</p><p><strong>Conclusion: </strong>IONM with D-MEP-based monitoring may be a promising method for preserving damaged motor function in glioma surgeries in and near the PMC and CST.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"887-895"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731854","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}