Neuro-oncology practice最新文献

{"title":"Cannabis use among Dutch patients with a primary brain tumor.","authors":"Vera Belgers, Niek A Rietveld, Philip C de Witt Hamer, Johanna M Niers","doi":"10.1093/nop/npaf009","DOIUrl":"10.1093/nop/npaf009","url":null,"abstract":"<p><strong>Background: </strong>Cancer patients commonly use cannabis to improve symptoms or for presumed anticancer effects. However, the extent and type of cannabis use among Dutch primary brain tumor patients, along with their motivations, remains unclear. This study aims to determine the prevalence of prior or current cannabis use in patients with a primary brain tumor, the type of cannabis used, their motivation, how they perceived the effects of the cannabis, and what adverse effects they noticed.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey of adult primary brain tumor patients who visited the neuro-oncology outpatient clinic at Amsterdam UMC between August and October 2023.</p><p><strong>Results: </strong>Of 100 responding patients, 51% had ever used cannabis and 14% currently used cannabis. Of the total group, 19% currently or previously used cannabis for tumor-related reasons, including symptom relief (<i>n</i> = 14; 74%) and presumed effect on the tumor (<i>n</i> = 8; 42%), indicating that some patients used it for multiple therapeutic purposes. Patients favored cannabidiol (CBD) over Δ⁹-tetrahydrocannabinol (THC). Self-reported sleep, anxiety, worrying, and depressive symptoms most frequently improved due to cannabis use, and the most common self-reported adverse events included drowsiness, dry mouth, and dizziness.</p><p><strong>Conclusions: </strong>A considerable amount of primary brain tumor patients use cannabis, often for symptom relief or presumed antitumor effects. The user rate underscores a demand for clinical research into the therapeutic efficacy of cannabis, particularly concerning its impact on symptoms like sleep disturbances, depressive symptoms, and anxiety/worrying, as well as its tumor-inhibiting capabilities.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"12 4","pages":"714-722"},"PeriodicalIF":2.5,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12349755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855856","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":"Severe temozolomide-induced thrombocytopenia is linked to increased healthcare utilization in glioblastoma and disproportionally impacts female patients.","authors":"Leon van Hout, Alessia D Borgo, Nienke Grun, Maaike Schuur, Martijn P G Broen, Bart A Westerman, Imke Bartelink, William Peter Vandertop, Birgit I Lissenberg-Witte, Mathilde C M Kouwenhoven","doi":"10.1093/nop/npaf013","DOIUrl":"10.1093/nop/npaf013","url":null,"abstract":"<p><strong>Background: </strong>Thrombocytopenia is a major temozolomide-induced adverse event during the standard treatment of glioblastoma. Consequently, platelet transfusions and treatment modifications may impact quality of life and long-term treatment outcomes. Understanding the impact of thrombocytopenia on healthcare utilization is crucial to mitigate the need for healthcare resources in glioblastoma patients. Here, we assess the influence of thrombocytopenia-related healthcare among patients diagnosed with glioblastoma.</p><p><strong>Methods: </strong>We retrospectively collected patient information treated at the Brain Tumor Center Amsterdam between 2008 and 2021. The occurrence of thrombocytopenia, patient demographics, treatment details, and healthcare utilization data were gathered from patients who received standard glioblastoma treatment. Associations between temporal severity of thrombocytopenia as categorized by the Common Terminology Criteria for Adverse Events, patient characteristics, and healthcare utilization were analyzed using Generalized Linear Mixed Models.</p><p><strong>Results: </strong>We included 206 patients with a median age of 58 years, 35.9% were female and we found that thrombocytopenia (any grade) occurred in 61.1% of patients. The occurrence of thrombocytopenia during CRT was associated with increased healthcare utilization and was largest in females who developed grade 4 thrombocytopenia compared to those who did not develop thrombocytopenia (OR = 5.9, <i>P</i> < .001 in females vs OR = 4.4, <i>P</i> < .001 in males). Grade 4 thrombocytopenia was also associated with heightened healthcare utilization during the adjuvant phase (OR = 7.6, <i>P</i> < .001), and was comparable between sexes.</p><p><strong>Conclusions: </strong>Severe thrombocytopenia during glioblastoma treatment is linked to increased healthcare utilization, disproportionally impacting females. These data suggest that prevention and early management of thrombocytopenia can reduce healthcare utilization in patients with glioblastoma.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"12 4","pages":"678-690"},"PeriodicalIF":2.5,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12349765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855883","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":"Advance care planning in primary malignant brain tumors: Knowledge, experiences, and preferences of patients and caregivers.","authors":"Ai Chikada, Yoshiki Arakawa, Sayaka Takenouchi, Yoshitaka Narita","doi":"10.1093/nop/npaf008","DOIUrl":"10.1093/nop/npaf008","url":null,"abstract":"<p><strong>Background: </strong>Advance care planning (ACP) can help patients with primary malignant brain tumors to align treatments with their preferences. However, insights into patients' and caregivers' engagement with ACP remain scarce. This study elaborates on their knowledge, experiences, and preferences concerning ACP.</p><p><strong>Methods: </strong>This was a secondary analysis of data from the \"National Survey on the Needs and Support of Brain Tumor Patients and Caregivers\" in Japan. Responses from 128 patients and 106 caregivers were included. Descriptive statistics, logistic regression, and qualitative analyses of free-text responses were performed.</p><p><strong>Results: </strong>Patients were more willing than caregivers to participate in decisions regarding their treatment (96.8% vs. 82.5%, <i>P</i> < .001). Knowledge about ACP was low in both groups (12.3% of patients and 10.7% of caregivers), but willingness to participate in ACP was high (68.9% of patients and 65.9% of caregivers). Preference to initiate ACP at diagnosis was low in both groups, with caregivers showing a higher preference than patients (29.0% vs. 11.1%). A greater percentage of patients preferred to start ACP at recurrence than caregivers (47.0% vs. 18.3%, <i>P</i> < .0001). Frequent family discussions were significantly associated with actual experiences of ACP (OR = 3.7, 95% CI = 1.6-9.3, <i>P</i> = .0019).</p><p><strong>Conclusions: </strong>The mismatch between respondents' willingness to participate in ACP and their knowledge and experience reveals a need to increase ACP awareness. Differences in ACP preferences between patients and their caregivers may indicate the need for improved communication strategies by healthcare professionals. Further research is needed to understand these differences.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"12 4","pages":"732-742"},"PeriodicalIF":2.5,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12349760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855855","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":"\"What is this brain's story?\" Healthcare professionals' perspectives on managing brain tumor-related personality and behavior changes.","authors":"Emma McDougall, Anna K Nowak, Haryana M Dhillon, Lauren J Breen, Karin Piil, Georgia K B Halkett","doi":"10.1093/nop/npaf007","DOIUrl":"10.1093/nop/npaf007","url":null,"abstract":"<p><strong>Background: </strong>Managing brain tumor-related personality and behavior changes (BTrPBc) is complex with contributors including tumor location, type, and grade; treatment side effects; and psychological adjustment to a primary brain tumor diagnosis. Although carers of people with high-grade glioma consistently report BTrPBc as an area where they require support, there is a lack of guidelines for healthcare professionals to address BTrPBc. We aimed to explore how neuro-oncology healthcare professionals manage personality and behavior changes in adults with a primary brain tumor.</p><p><strong>Methods: </strong>This study used an interpretive description approach. Semi-structured interviews were conducted with healthcare professionals practicing in neuro-oncology across Australia via face-to-face, telephone, and video conference. Codebook thematic analysis methods were used.</p><p><strong>Results: </strong>Healthcare professionals (<i>N</i> = 22) from a range of medical and allied health disciplines participated in interviews with an average duration of 34 minutes. Four themes described how healthcare professionals seek to manage patients' personality and behavior changes: (i) Building trusting relationships, (ii) What is this brain's story?, (iii) Brief intervention; and (iv) Targeted intervention. Sub-themes were developed within each theme.</p><p><strong>Conclusions: </strong>Our results highlight the diverse support healthcare professionals provide for the management of BTrPBc. There is a need for interventions to be formulation-driven, involve individualized care, provide education, and focus on the patient-carer dyad. A stepped-care approach to managing BTrPBc is recommended; however, further evaluation in clinical practice is necessary.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"12 3","pages":"437-447"},"PeriodicalIF":2.4,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248915","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":"Should we be testing for germline and \"actionable\" mutations in all glioma patients?","authors":"Jerome J Graber","doi":"10.1093/nop/npae121","DOIUrl":"10.1093/nop/npae121","url":null,"abstract":"","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"12 1","pages":"3-4"},"PeriodicalIF":2.4,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365331","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":"Seizure risk factors and management approaches in patients with brain metastases.","authors":"Eugene J Vaios, Spencer Maingi, Kristen Batich, Sebastian F Winter, Jorg Dietrich, Trey Mullikin, Scott R Floyd, John P Kirkpatrick, Zachary J Reitman, Katherine B Peters","doi":"10.1093/nop/npaf001","DOIUrl":"10.1093/nop/npaf001","url":null,"abstract":"<p><p>A significant proportion of patients with brain metastases experience a seizure event during their disease course, which can impact morbidity and long-term outcomes. A host of factors elevate the risk for seizures in patients with brain metastases, including patient factors, metabolic imbalances, tumor burden, and treatment modality. While reducing tumor burden via local and systemic therapies remains a critical component to mitigating seizure events, select patients may remain at risk. The use of prophylactic anti-seizure medications may be warranted in a subset of patients, though several clinical trials and guidelines from medical societies currently recommend against prophylactic use. Variability in the use of prophylactic anti-seizure medications in clinical practice underscores the need to update our current understanding of seizure risk in the era of multi-modality treatment and to identify opportunities to improve risk stratification and management. Herein, we provide a comprehensive literature review summarizing the current standard for seizure management in patients with brain metastases and assess the impact of multi-modal therapies on seizure risk. We additionally highlight gaps in the literature and present opportunities for future investigation.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"12 3","pages":"389-400"},"PeriodicalIF":2.4,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248929","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":"Shared decision-making in neuro-oncology: Existing practices and future steps.","authors":"Helle Sorensen von Essen","doi":"10.1093/nop/npaf005","DOIUrl":"10.1093/nop/npaf005","url":null,"abstract":"","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"12 2","pages":"179-180"},"PeriodicalIF":2.4,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664064","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":"Predicting critical surgical characteristics of intracranial meningiomas on MRI-A prospective study on 100 consecutive patients.","authors":"Fabian Winter, Julia Furtner, Astrid Dunst, Gregor Kasprian, Michael Weber, Adelheid Woehrer, Karl Roessler, Christian Dorfer","doi":"10.1093/nop/npaf004","DOIUrl":"10.1093/nop/npaf004","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to identify magnetic resonance imaging (MRI) markers predictive of essential surgical characteristics in meningiomas, including consistency, ease of dissection of meningioma from surrounding brain tissue, and vascularity, which are crucial for surgical decisions and outcomes.</p><p><strong>Methods: </strong>We conducted preoperative MRI using a standardized protocol to measure signal intensities (SI) within meningiomas. Additionally, we administered intraoperative questionnaires and performed histological analyses on each tumor.</p><p><strong>Results: </strong>A total of 100 consecutive patients (mean age, 58 years ± 13, 69 female) were enrolled in this prospective clinical trial. Meningioma volumes varied (0.4-185.6 cm³) with surgeries lasting on average 176 min (range 35-610 min). SI measurements on T1-weighted, time-of-flight (TOF), and T2-weighted imaging were significantly associated with tumor consistency and vascularity. Specifically, the sensitivity and specificity for predicting consistency grades above 3 (on a 1-5 grade scale) were 75% and 55% postcontrast on T1-weighted imaging (SI ≥ 711) and 73% and 70% on TOF imaging (SI ≥ 124.5). For vascularity grades above 5 (on a 1-10 grade scale), the values were 73% sensitivity and 54% specificity on TOF imaging (SI ≥ 123). No correlation was found between the surgical cleavage plane and MRI data; however, dissection plane type significantly influenced surgery duration and hospitalization length. A lower SI on T2-weighted imaging correlated with specific histological features.</p><p><strong>Conclusion: </strong>Key surgical aspects of meningiomas can be predicted using conventional MRI sequences. This may improve patient counseling and surgical planning.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"12 3","pages":"458-466"},"PeriodicalIF":2.4,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248926","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":"Well-being and coping: Key aspects of unmet need of people living with glioma.","authors":"Elin Baddeley, Stephanie Sivell, Ameeta Retzer, Annmarie Nelson, Helen Bulbeck, Kathy Seddon, Robin Grant, Richard Adams, Colin Watts, Olalekan Lee Aiyegbusi, Melanie Calvert, Anthony Byrne","doi":"10.1093/nop/npae127","DOIUrl":"10.1093/nop/npae127","url":null,"abstract":"<p><strong>Background: </strong>The challenges and needs of people with brain tumors are complex and unique, particularly-but not limited to-the neurocognitive impacts they experience. These effects are subsequently impactful on their primary caregivers. Evidence suggests people with glioma and their caregivers experience a range of unmet needs in the clinical care setting.</p><p><strong>Methods: </strong>Semi-structured interviews with people across the spectrum of glioma, and their caregivers in the United Kingdom, as part of a study exploring core outcomes for use across glioma trials. Interviews were analyzed using thematic analysis.</p><p><strong>Results: </strong>Nineteen people with glioma and seven caregivers were interviewed. Three major themes were identified: (1) Well-being, support and coping, (2) Communication and care, and (3) Impact on caregivers. People with glioma and their caregivers experience uncertainty, and progressive impacts long after diagnosis. People with glioma across the spectrum of the disease have many challenges in common including long-term adjustments, impacts of glioma and its treatment, and communication/information gaps including prognostic uncertainty. These impacts also affect caregivers. While most patients and caregivers engaged in self-directed approaches to mitigate the impacts of glioma, gaps in follow-up support for lasting effects were a major source of frustration, impacting on ability to cope and manage the effects of glioma.</p><p><strong>Conclusions: </strong>These interviews highlight the unmet needs of people with glioma and their caregivers. A consistent, systematic, and focused approach to assessing the needs of glioma patients and their caregivers in the clinical setting and support for long-term adjustment is required.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"12 3","pages":"413-425"},"PeriodicalIF":2.4,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248932","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":"Identifying components of care coordination for primary brain tumor: A scoping review.","authors":"Megan S Jeon, Hannah Banks, Sharon He, Thomas Carlick, Joanne M Shaw, Brian Kelly, Eng-Siew Koh, Georgia K B Halkett, Tamara Ownsworth, Raymond J Chan, Mark B Pinkham, Ursula M Sansom-Daly, Haryana M Dhillon","doi":"10.1093/nop/npaf003","DOIUrl":"10.1093/nop/npaf003","url":null,"abstract":"<p><p>For people with primary brain tumors (PBT) and their carers, care coordination (CC) offers comprehensive, timely, person-centered care. This review aimed to systematically scope the breadth of literature relevant to approaches to CC for PBT. Four databases were searched (PubMed, PsycINFO, EMBASE, and CINAHL) for empirical research, and gray literature was searched for doctoral theses, clinical guidelines, and education resources for healthcare professionals (HCPs) related to the concept/model of CC in neuro-oncology. Data were systematically evaluated and synthesized following PRISMA-SCR guidelines. From 1163 screened abstracts, 30 eligible reports were reviewed (13 addressed CC interventions, 9 narrative reports, 5 describing CC/navigator positions, and 3 clinical guidelines). Most reports described nurse-led models of care within single tertiary care centers in metropolitan settings: a single HCP acting as primary contact, educator, and liaison, screening patient/carer distress and providing referrals as key components of CC. Clinical guidelines emphasize healthcare system navigation and access to medical care in CC. A CC approach overseeing the whole PBT trajectory was lacking. Facilitators of CC included availability of HCP dedicated to CC; HCPs' competency in relationship-based and communication skills; and improved access to resources. System-level and resource barriers to CC were identified. Knowledge about CC is largely based on descriptions of nurse-led models of PBT care. Further research is required to refine the framework of CC reflecting factors of known importance in PBT care, and identify training and support needs of HCPs who may play a pivotal role in current models of neuro-oncology CC.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"12 3","pages":"357-375"},"PeriodicalIF":2.4,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248923","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}