Neuro-oncology practice最新文献

{"title":"Core Outcome Sets for Meningioma In Clinical studies (COSMIC): An international patient and healthcare professional consensus for research studies.","authors":"Christopher P Millward, Terri S Armstrong, Sabrina Bell, Andrew R Brodbelt, Helen Bulbeck, Linda Dirven, Paul L Grundy, Abdurrahman I Islim, Mohsen Javadpour, Sumirat M Keshwara, Shelli D Koszdin, Anthony G Marson, Michael W McDermott, Torstein R Meling, Kathy Oliver, Puneet Plaha, Matthias Preusser, Thomas Santarius, Nisaharan Srikandarajah, Martin J B Taphoorn, Carole Turner, Colin Watts, Michael Weller, Paula R Williamson, Gelareh Zadeh, Amir H Zamanipoor Najafabadi, Michael D Jenkinson","doi":"10.1093/nop/npaf023","DOIUrl":"10.1093/nop/npaf023","url":null,"abstract":"<p><strong>Background: </strong>Core Outcome Sets (COS) define the minimum outcomes that should be measured and reported in all clinical trials for a specific health condition or health area. The aim was to develop 2 COS for intracranial meningioma to be used in future clinical studies: COSMIC: Intervention for effectiveness trials and COSMIC: Observation for studies of incidental/untreated meningioma.</p><p><strong>Methods: </strong>A study advisory group was formed with representation from international stakeholder groups: EORTC BTG, ICOM, EANO, SNO, RANO-PRO, BNOS, SBNS, BIMS, TBTC, International Brain Tumour Alliance, and Brainstrust. Outcomes of potential relevance to key stakeholders were identified and rationalized to populate 2 eDelphi surveys. Participants were recruited internationally and asked to rate each outcome on its importance for inclusion in the COS. The 2 final COS were ratified through 2, one-day, online consensus meetings.</p><p><strong>Results: </strong>The COSMIC: Intervention eDelphi survey contained 25 items and was completed by 199 participants. Following the consensus meeting, 15 outcomes were included. The COSMIC: Observation eDelphi survey contained 17 items and was completed by 129 participants. Sixteen outcomes were included. Eight core outcomes were common to both COS; tumor growth, physical, emotional, and neurocognitive functioning, overall quality of life, progression-free survival, meningioma-specific mortality and overall survival. Role and social functioning were core outcomes in COSMIC: Observation but not COSMIC: Intervention.</p><p><strong>Conclusions: </strong>Uptake of these COS in relevant future meningioma clinical studies will ensure that stakeholder-determined, critically important outcomes are consistently measured and reported across similar clinical studies.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"12 4","pages":"700-713"},"PeriodicalIF":2.5,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12349768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histopathologically confirmed radiation necrosis: Risk factors and clinical outcomes in patients with primary brain tumors.","authors":"Mohammad Hazaymeh, Vesna Malinova, Lidia Stork, Imke Metz, Christine Stadelmann, Torge Huckhagel, Leif Hendrik Dröge, Rami El Shafie, Dorothee Mielke, Veit Rohde, Tammam Abboud","doi":"10.1093/nop/npaf021","DOIUrl":"10.1093/nop/npaf021","url":null,"abstract":"<p><strong>Background: </strong>Radiation necrosis is a recognized complication following radiotherapy for primary brain tumors, presenting diagnostic and therapeutic challenges, and potentially masquerading as tumor recurrence. This study aims to delineate the clinical trajectory, management strategies, and outcomes of histologically confirmed radiation necrosis in patients treated for primary brain tumors.</p><p><strong>Methods: </strong>We conducted a retrospective review of patients who underwent surgical intervention for suspected tumor recurrence at our institution between 2010 and 2022, following adjuvant radiotherapy. Cases with histopathologically confirmed radiation necrosis were identified and analyzed for onset, clinical symptoms, radiological features, correlation with radio- and chemotherapy, management approaches, and disease progression.</p><p><strong>Results: </strong>Out of 276 patients operated for suspected recurrent brain tumors, 14 (5%) were histopathologically diagnosed with radiation necrosis. The latency period from radiotherapy to diagnosis ranged from 3 to 40 months. Notably, patients with oligodendrogliomas exhibited a significantly higher incidence of radiation necrosis (26%), underscoring a substantial risk association (<i>P</i> < 0.001). Conversely, the rates of radiation necrosis in patients with glioblastoma and astrocytoma (WHO grade II and III) were lower, at 2% and 0%, respectively, suggesting a lower risk association (<i>P</i> < 0.001 and <i>P</i> = 0.036, respectively). The majority (79%) of these patients were asymptomatic and exhibited a favorable clinical course, with most cases showing no progression of necrosis. During the follow-up period, tumor recurrence was verified in 2 patients.</p><p><strong>Conclusion: </strong>Radiation necrosis post-radiotherapy for primary brain tumors occurs infrequently but predominantly in patients with oligodendrogliomas, often following a benign course. The study underscores the importance of close monitoring for this condition, given the potential for sampling errors and the critical need for histopathological confirmation to guide appropriate management.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"12 4","pages":"670-677"},"PeriodicalIF":2.5,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12349754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal assessments of multilevel social determinant factors on meningioma disparities in the United States.","authors":"David J Fei-Zhang, Rishabh Sethia, Larry W Wang, Anthony M Sheyn, Jill N D'Souza, Daniel C Chelius, Jeffrey C Rastatter","doi":"10.1093/nop/npaf020","DOIUrl":"10.1093/nop/npaf020","url":null,"abstract":"<p><strong>Background: </strong>Prior investigations into meningioma disparities have explored associative relationships of socioeconomic status (SES) and race-ethnicity but face gaps in the range of other social determinants/drivers of health (SDoH) factors considered and sample size. Furthermore, none have explored causal relationships between SDoH-factors and outcomes. Thus, this study aims to utilize a recent, national sampling of meningioma patients incorporating comprehensive inferential and causal-mediation approaches to delineate which SDoH-factors objectively drive care and prognostic disparities.</p><p><strong>Methods: </strong>This retrospective study of a specialized Surveillance-Epidemiology-End Results 2020 dataset for community-/census tract-level (Yost-Index, a composite SES measure and Rurality-Urbanicity) and individual-level (sex, race-ethnicity) SDoH-factors performed age-adjusted multivariate cox-hazards and logistic regressions, and covariate-adjusted causal-mediation analyses to assess differences in overall survival, treatment receipt, and delay of treatment initiation.</p><p><strong>Results: </strong>In age-adjusted multivariate analyses of 110,042 meningioma patients from 2010-2018, lower community-level SES significantly increased overall mortality (HR 1.31, 95%CI 1.28-1.34), decreased interventional treatment receipt (Surgery-OR 0.89, 95%CI 0.87-0.91; Radiation 0.83, 0.79-0.87), and increased treatment delay (1.13, 1.09-1.16). Minoritized race/ethnicity featured increased interventional treatment receipt (Surgery 1.18, 1.15-1.22; Radiation 1.18, 1.12-1.24) and decreased treatment delay (0.90, 0.87-0.93). In covariate-adjusted causal analyses, community-level SES showed total mediation effects of race-ethnicity in influencing overall survival and negative partial mediation effects in treatment receipt and delay.</p><p><strong>Conclusion: </strong>For overall survival, community-level SES primarily drove meningioma disparities even when accounting for other SDoH-factors. For treatment receipt and delay, race-ethnicity caused greater differences that were partially affected by community-level SES. In turn, these comprehensive analyses provide definitive causes of meningioma disparities.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"12 4","pages":"691-699"},"PeriodicalIF":2.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12349759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reviewer List for the year 2024.","authors":"","doi":"10.1093/nop/npae126","DOIUrl":"https://doi.org/10.1093/nop/npae126","url":null,"abstract":"","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"12 1","pages":"173-174"},"PeriodicalIF":2.4,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for brain metastases in patients with advanced non-small cell lung cancer and an actionable genomic alteration: A structured literature review.","authors":"Jarno W J Huijs, Martina Bortolot, Anna S Berghoff, Priscilla K Brastianos, Juliette H R J Degens, Dirk K M De Ruysscher, Annette Compter, Lizza E L Hendriks","doi":"10.1093/nop/npaf018","DOIUrl":"10.1093/nop/npaf018","url":null,"abstract":"<p><strong>Background: </strong>Brain metastases (BM) frequently occur in patients with non-small cell lung cancer (NSCLC) with actionable genomic alterations (AGA). Targeted therapies (TTs) improve outcomes, but differences in BM screening and eligibility criteria across trials make comparisons challenging. While stage IV NSCLC guidelines recommend BM screening, it is not mandatory, and imaging techniques vary.</p><p><strong>Methods: </strong>Registrational and phase II/III trials of FDA/EMA-approved TTs for advanced NSCLC with AGA, published since 2012, were included. Main focus of the review was evaluation of baseline brain screening practices across trials. Information on BM follow-up, BM incidence, and BM-related outcomes was retrieved.</p><p><strong>Results: </strong>Of 51 trials, 71% mandated baseline BM screening, and 27% mandated follow-up imaging for all patients. MRI was specified for BM assessment in 31% of the trials. BM incidence at baseline was high, up to 40% in the first-line setting. While most trials included patients with BM, eligibility criteria varied, and 43% of trials prespecified BM-related outcomes; 56% of phase III trials used BM as a stratification factor.</p><p><strong>Conclusion: </strong>This review highlights the increasing attention to BM screening in NSCLC TT trials. However, substantial heterogeneity remains in BM eligibility, screening, outcomes, and follow-up. Standardizing these aspects in future trials is essential.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"12 4","pages":"545-570"},"PeriodicalIF":2.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12349771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Race and \"omic\" data in glioma: A systematic review of contemporary research to explore the digital divide.","authors":"Olaoluwa Ezekiel Dada, Zvipo Chisango, Kwadwo Antwi Boasiako Nkansah-Poku, Mareshah N Sowah, Amanda Cyntia Lima Fonseca Rodrigues, Olivia Duru, Matthew Myers, Sophie T Williams, Shungu Ushewokunze, Spencer J Collis, Nathan A Shlobin, Sylvester Omoruyi, Ola Rominiyi","doi":"10.1093/nop/npaf016","DOIUrl":"10.1093/nop/npaf016","url":null,"abstract":"<p><strong>Background: </strong>The expanding repertoire of studies generating genome-scale omic datasets from glioma samples provides a generational opportunity to uncover mechanisms driving aggressive biology and develop new treatments. However, ensuring such studies reflect the breadth of racial groups and ethnicities affected by gliomas is critical to support equity in future therapeutic advances. We therefore report a contemporary snapshot of the representation of race and ethnicity in omic glioma studies.</p><p><strong>Methods: </strong>We searched PubMed, Embase, Web of Science, and Scopus and systematically reviewed articles published between January and November 2023 reporting de novo genome-scale sequencing data generated using samples from patients diagnosed with glioma (according to World Health Organization 2021 criteria) to characterize the reporting and composition of race and ethnicity data.</p><p><strong>Results: </strong>Thirty-five studies involving 5601 patients were analyzed. Race or ethnicity data was reported in only 3 studies (8.6%), of which none provided omic data in a format that could be stratified by race or ethnicity. Reporting varied by continent with all 3 studies including race or ethnicity data based in North America. Where racial data was available, we found that samples used for genome-scale characterization came from patients reported as being White in 91.1% cases (41 patients), with 6.7% (3 patients) reported as Black and 2.2% (1 patient) as Hispanic.</p><p><strong>Conclusions: </strong>These studies underscore an urgent need for improved reporting and representation to enhance our understanding of glioma biology across different populations and guide targeted initiatives from policymakers and funders to support equitable improvements in healthcare.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"12 4","pages":"585-599"},"PeriodicalIF":2.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12349769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival, quality of life, and motor function in brain metastases surgery: The role of complete resection.","authors":"Rebecca R Winther, Marianne J Hjermstad, Olav Erich Yri, Eva Skovlund, Nina Aass, Guro L Astrup, Stein Kaasa, Cathrine Saxhaug, Einar Osland Vik-Mo","doi":"10.1093/nop/npaf011","DOIUrl":"10.1093/nop/npaf011","url":null,"abstract":"<p><strong>Background: </strong>One in 3 patients with advanced cancer develops brain metastases. Surgical resection of brain metastases is done in 15%-20% of these patients. While gross total resection (GTR) is believed to extend overall survival (OS), concerns exist regarding increased morbidity. This study examines the impact of surgical resection, particularly GTR, on self-reported symptoms, focusing on quality of life (QoL) and motor dysfunction.</p><p><strong>Methods: </strong>We conducted a prospective cohort study involving adult patients undergoing surgical resection for brain metastases from solid tumors in a defined region of Norway between 2017 and 2021. Clinical data were collected at inclusion prior to surgery and every 3 months the first year. Patients completed monthly questionnaires assessing QoL and motor dysfunction. QoL was measured using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C15-PAL, while motor dysfunction was evaluated using the EORTC QLQ-BN20.</p><p><strong>Results: </strong>A total of 155 patients were included and median OS was 13 months. GTR was achieved in 69 (44%) patients and was associated with longer median OS compared to subtotal resection (17.7 vs. 10.9 months, <i>P</i> = .04). Mean QoL remained stable throughout the follow-up period. Improved motor dysfunction 1 month after surgery was reported by 23% of the patients, while 25% reported worse motor dysfunction. Factors associated with a high motor dysfunction score at 1 month were age >70 years, higher baseline motor dysfunction, and multiple brain metastases. Neither GTR nor location of metastases in motor-associated areas were associated with worsened motor dysfunction.</p><p><strong>Conclusion: </strong>Self-reported QoL is maintained after surgery for brain metastases. Complete resection is associated with extended OS without compromising self-reported motor function.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"12 4","pages":"644-653"},"PeriodicalIF":2.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12349758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Operative performance of RAPNO DIPG imaging criteria-a study from the International DIPG/DMG Registry.","authors":"Hamza S Gorsi, Melike Guryildirim, Michael Kuwabara, Jovan Dhatt, Lindsey M Hoffman, Kenneth J Cohen","doi":"10.1093/nop/npaf015","DOIUrl":"10.1093/nop/npaf015","url":null,"abstract":"<p><strong>Background: </strong>The Response Assessment in Pediatric Neuro-Oncology (RAPNO) working group for diffuse intrinsic pontine glioma (DIPG) recently published its recommendations. We aim to test the operative performance of the RAPNO DIPG criteria imaging component by retrospectively applying it to a patient sample from the International DIPG/DMG Registry (IDIPGR).</p><p><strong>Methods: </strong>Longitudinal MRIs for 46 patients were independently reviewed by 2 pediatric neuro-radiologists. Utilizing RAPNO DIPG imaging criteria for the pontine lesions, response was categorized as complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD). The response category for each MRI was compared between 2 readers and classified as concordant if they agreed, minor discordant if one reported SD and the other reported PR or PD, and major discordant if one reported PR and the other reported PD.</p><p><strong>Results: </strong>A total of 277 paired MRIs were analyzed, and 124 paired MRIs were evaluated for concordance. The response category was concordant between readers in 84 (68%) MRI comparisons. In 31 MRI comparisons (25%) the reads were minor discordant, and major discordant in 9 (7%). No CRs were reported. Minor discordant cases were within 10% of the boundary for PR or PD in 20 (65%) of these cases. The median difference between the 2 readers' measurements was 2 mm (range 0-29 mm).</p><p><strong>Conclusion: </strong>This study demonstrated that RAPNO DIPG imaging criteria can be applied with concordance or minor discordance between readers in 93% of the cases. Discordant measurements were largely at the boundaries of response type.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"12 4","pages":"637-643"},"PeriodicalIF":2.5,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12349774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phase II randomized glioma study to evaluate efficacy and satisfaction of rolapitant plus ondansetron in preventing chemoradiation-induced nausea and vomiting.","authors":"Mary Lou Affronti, Mallika P Patel, Erin K Severance, Charles Loughlin, Claire Bradbury, James E Herndon, Kendra Boyd, Eric S Lipp, Henry S Friedman, Annick Desjardins, Margaret O Johnson, Katherine B Peters","doi":"10.1093/nop/npaf014","DOIUrl":"10.1093/nop/npaf014","url":null,"abstract":"<p><strong>Background: </strong>Nausea and vomiting remain feared cancer treatment-related side effects. Antiemetic guideline trials exclude malignant glioma patients. In patients receiving radiation with concurrent temozolomide, chemoradiation-induced nausea; vomiting (cRINV) rates are 35% and 26%, respectively, which reduce quality of life, treatment adherence, and cancer control.</p><p><strong>Methods: </strong>This randomized phase-II open-label trial, evaluated efficacy, patient preference, and satisfaction of ondansetron (short-acting 5HT3-RA; 3 h-half-life) monotherapy versus rolapitant (long-acting NK1-RA; 180 h-half-life) plus ondansetron in preventing cRINV during 6 weeks of temozolomide (75 mg/m²/day × 42 day) with radiation. Fifty-three eligible patients were randomized to Sequence-A (ondansetron-8 mg days: 1-42, day 22 rolapitant-180 mg) or Sequence-B (rolapitant day 1 plus daily ondansetron). <i>Primary endpoint</i> was percentage achieving cRINV-complete response (no vomiting/antiemetic rescue) during the <i>first 2 weeks</i> of radiation. <i>Secondary endpoints</i>: cRIN/cRIV rates, preference/satisfaction for rolapitant/ondansetron, toxicity, and adherence.</p><p><strong>Results: </strong>Forty-eight (Sequence-A: 25; Sequnce-B: 23) initiated chemoradiation. Mean age = 53, 58% male, 73% Karnofsky performance status (KPS) > 90%, and 73% glioblastoma. During first 2 weeks of radiation, cRINV-CR was 57% with ondansetron and 74% receiving rolapitant/ondansetron (<i>P</i> = .27). Patient-reported 6-week cRINV-CR was 55% for both arms. First 2-week cRIN rates (38% Sequence-A; 32% Sequence-B) were more than cRIV rates (19% Sequence-A; 0% Sequence-B). Patients receiving ondansetron alone vomited more during the first 2 weeks and overall (26%) than with rolapitant/ondansetron (11%). Among 35 completers, 20% preferred rolapitant/ondansetron, 60% preferred ondansetron, and 20% had no preference (<i>P</i> = .0004). Adverse-events attributable to antiemetics were grade 1-2.</p><p><strong>Conclusions: </strong>No difference was found in cRINV-CRs between the first 2-week treatments or overall satisfaction. Although not a positive study, less vomiting occurred with rolapitant/ondansetron. While patients prefer ondansetron monotherapy, most perceived better effectiveness with rolapitant/ondansetron.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"12 4","pages":"618-630"},"PeriodicalIF":2.5,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12349775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative radiotherapy in brain metastasis surgery allows faster transition to systemic therapy.","authors":"Philipp Krauss, Christina Wolfert, Jason Bakos, Bastian Stemmer, Georg Stueben, Klaus Henning Kahl, Ehab Shiban","doi":"10.1093/nop/npaf012","DOIUrl":"10.1093/nop/npaf012","url":null,"abstract":"<p><strong>Background: </strong>In patients with brain metastases (BMs), delay of systemic therapy (CTX) after oncologic surgery due to wound healing issues and postoperative radiotherapy might influence the oncologic outcome. Intraoperative radiotherapy (IORT) is an emerging option in neurooncology, possibly shortening the time for comprehensive treatment compared to conventional external beam radiotherapy (EBRT). The aim of this study was to compare the transition time to CTX in patients undergoing IORT or EBRT.</p><p><strong>Methods: </strong>We performed a retrospective chart review analysis of patients undergoing surgery for BMs at our institution with either IORT or adjuvant EBRT. Either therapy was applied according to an internal standard operation procedure favoring IORT if feasible. The time (days) from surgery until the beginning of CTX was compared together with overall hospitalization time.</p><p><strong>Results: </strong>Ninety-nine patients were analyzed from which 59 underwent adjuvant EBRT and 40 IORT. Patients undergoing resection of BMs with IORT had significantly shorter intervals to CTX (EBRT vs. IORT; 65.4 ± 54.3 days vs. 32.3 ± 28.0 days (mean±SD); <i>P</i> < .001). Comparing the interval to CTX between the last EBRT fraction and IORT showed no significant difference EBRT vs. IORT (26.2 ± 55.8 days vs. 32.3 ± 28.0 days (mean±SD); <i>P</i> = .52). The time spent hospitalized until CTX was significantly lower in the IORT group (EBRT vs. IORT 20.2 ± 9.4 days vs. 9.5 ± 7.1 days (mean±SD); <i>P</i> < .001).</p><p><strong>Conclusions: </strong>IORT for BM surgery allows a faster transition to systemic oncologic therapy than conventional adjuvant EBRT.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"12 4","pages":"663-669"},"PeriodicalIF":2.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12349766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}