Neuro-oncology practice最新文献

{"title":"The COVID-19 pandemic experience for patients with central nervous system tumors: Differences in patient-reported outcomes and practice recommendations.","authors":"Amanda L King, Kayla N Roche, Elizabeth Vera, Valentina Pillai, Lily Polskin, Alvina A Acquaye-Mallory, Lisa Boris, Eric Burton, Anna Choi, Ewa Grajkowska, Heather E Leeper, Marissa Panzer, Marta Penas-Prado, Jennifer Reyes, Solmaz Sahebjam, Brett J Theeler, Jing Wu, Mark R Gilbert, Terri S Armstrong","doi":"10.1093/nop/npae067","DOIUrl":"https://doi.org/10.1093/nop/npae067","url":null,"abstract":"<p><strong>Background: </strong>This study explored differences in patient-reported outcomes (PROs) for patients with central nervous system (CNS) tumors during COVID, compared to pre-pandemic assessments, in light of impacted access to in-person care.</p><p><strong>Methods: </strong>Patient-reported outcomes (PROMIS-Anxiety and Depression Short-Forms, EQ-5D-3L, MDASI-BT/Spine, NeuroQoL-Perceived Cognitive Functioning) were collected from 149 participants on the Neuro-Oncology Branch Natural History Study seen during the first year of COVID between March 2020 and February 2021, which were compared to assessments collected pre-COVID. Paired sample <i>t</i>-tests and proportion tests (<i>z</i>-tests) were used to compare PROs with effect sizes reported using Hedges <i>g</i> and Cohen's <i>h</i>. Logistic regression models with backwards selection were used to identify risk factors for high levels of depression and anxiety pre- and during COVID.</p><p><strong>Results: </strong>Participants were primarily male (54%) and Caucasian (84%) with a median age of 46 (range 20-79) and 66% had high-grade tumors. More patients reported moderate-severe depressive symptoms during the COVID year, compared to pre-COVID assessments (13% vs 8%, Cohen's <i>h</i> = 0.17, <i>P</i> = .021), with modest increases in symptom burden and cognitive dysfunction reported as well. Logistic regressions revealed that during COVID, concurrent moderate-severe distress and low tumor grade predicted depression and anxiety, with psychotropic medication use also predicting depression while active treatment predicted anxiety.</p><p><strong>Conclusion: </strong>During COVID, patients experienced higher levels of depression, which has the potential to negatively influence treatment success and survival. Future work is needed to incorporate innovative tools and interventions that can be utilized remotely to identify and target mood disturbance in these vulnerable patients.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"12 1","pages":"76-86"},"PeriodicalIF":2.4,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365333","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":"Histopathologic and molecular profile of gliomas diagnosed in Lagos, Nigeria.","authors":"Lateef A Odukoya, Cristiane M Ida, Jeanette E Eckel-Passow, Thomas M Kollmeyer, Rachael Vaubel, Daniel H Lachance, Ekokobe Fonkem, Kabir B Badmos, Olufemi B Bankole, Henry Llewellyn, Gasper J Kitange, Kenneth Aldape, Adetola O Daramola, Charles C Anunobi, Robert B Jenkins","doi":"10.1093/nop/npae059","DOIUrl":"10.1093/nop/npae059","url":null,"abstract":"<p><strong>Background: </strong>The optimal diagnosis and management of patients with brain tumors currently uses the 2021 WHO integrated diagnosis of histomorphologic and molecular features. However, neuro-oncology practice in resource-limited settings usually relies solely on histomorphology. This study aimed to classify glioma cases diagnosed in the Department of Anatomic and Molecular Pathology, Lagos University Teaching Hospital, using the 2021 WHO CNS tumor classification.</p><p><strong>Methods: </strong>Fifty-six brain tumors from 55 patients diagnosed with glioma between 2013 and 2021 were reevaluated for morphologic diagnosis. Molecular features were determined from formalin-fixed paraffin-embedded (FFPE) tissue using immunohistochemistry (IHC) for IDH1-R132H, ATRX, BRAF-V600E, p53, Ki67, and H3-K27M, OncoScan chromosomal microarray for copy number, targeted next generation sequencing for mutation and fusion and methylation array profiling.</p><p><strong>Results: </strong>Of 55 central nervous system tumors, 3 were excluded from histomorphologic reevaluation for not being of glial or neuroepithelial origin. Of the remaining 52 patients, the median age was 20.5 years (range: 1 to 60 years), 38(73%) were males and 14(27%) were females. Seventy-one percent of the gliomas evaluated provided adequate DNA from archival FFPE tissue blocks. After applying the 2021 WHO diagnostic criteria the initial morphologic diagnosis changed for 35% (18/52) of cases. Diagnoses of 5 (9.6%) gliomas were upgraded, and 7 (14%) were downgraded.</p><p><strong>Conclusions: </strong>This study shows that the incorporation of molecular testing can considerably improve brain tumor diagnoses in Nigeria. Furthermore, this study highlights the diagnostic challenges in resource-limited settings and what is at stake in the global disparities of brain tumor diagnosis.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"11 6","pages":"753-762"},"PeriodicalIF":2.4,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11567748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648519","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":"Prospective assessment of end-of-life symptoms and quality of life in patients with high-grade glioma.","authors":"Tobias Walbert, Lonni Schultz, Tom Mikkelsen, James Matthew Snyder, Joel Phillips, John T Fortunato","doi":"10.1093/nop/npae056","DOIUrl":"10.1093/nop/npae056","url":null,"abstract":"<p><strong>Background: </strong>Glioblastoma and high-grade glioma (HGG) remain non-curable diseases. Symptoms and Quality-of-life (QoL) in the end-of-life (EoL) phase have not been prospectively studied with validated instruments. Therefore, we prospectively assessed symptom progression, symptom management, and hospice utilization in patients with treatment-refractory progressive HGG.</p><p><strong>Methods: </strong>Patients failing bevacizumab and presenting with a Karnofsky performance score of ≤60, and their caregivers, were eligible. Symptoms, medication, and clinical management were tracked with serial telephone calls every 2 weeks until death utilizing clinical evaluations and the MD Anderson Symptom Inventory Brain Tumor Module (MDASI-BT). The MDASI-BT rates symptoms on a scale from 0 (no symptoms) to 10 (worst).</p><p><strong>Results: </strong>Fifty-four patient-caregiver dyads were enrolled in the study. Amongst 50 evaluable patients, the most severe symptoms during the last 2 weeks prior to death were drowsiness (9.09 ± 1.44), difficulty with concentration (8.87 ± 2.29), fatigue (8.63 ± 2.03), difficulty speaking (8.44 ± 2.42), weakness (8.27 ± 3.44), and difficulty with understanding (7.71 ± 2.94). All symptoms, except weakness and memory impairment, which were high at baseline, showed statistically significant progression. Seizures were rare and did not progressively worsen near the end of life (1.38 ± 3.02). The decision-making composite score almost doubled during the EoL phase (8.58 ± 1.53).</p><p><strong>Conclusions: </strong>This is the first prospective study describing symptoms and QoL issues in patients with HGG. Patients suffer from high morbidity in the EoL phase and should be offered early palliative and hospice care to assure proper symptom management and advance care planning.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"11 6","pages":"733-739"},"PeriodicalIF":2.4,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11567736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648543","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":"The disparity in pediatric spinal cord tumor clinical trials: A scoping review of registered clinical trials from 1989 to 2023.","authors":"Obed Posada Villanueva, Joanna E Papadakis, Amanda M Mosher, Tabitha Cooney, Katie P Fehnel","doi":"10.1093/nop/npae041","DOIUrl":"10.1093/nop/npae041","url":null,"abstract":"<p><strong>Background: </strong>Spinal cord tumors (SCTs) comprise 10% of all central nervous system (CNS) tumors. Pediatric SCTs are often excluded and underrepresented in clinical trials though exclusion rates haven't been reported.</p><p><strong>Methods: </strong>We reviewed all interventional clinical trials recruiting patients <21 years with SCTs on ClinicalTrials.gov between 1989 and 2023.</p><p><strong>Results: </strong>Five hundred and two CNS tumor trials were identified, of which 255 included SCTs and/or spincal metastases. Among these, 96.5% were open to all CNS tumors (brain or spine); however, only 3.5% were exclusive to spine tumors. One trial was specific to pediatric spine tumors (inclusive of bone, soft tissue, and neural tumors); no trial was specific to primary pediatric SCTs. Most trials were located in North America, with multisite investigations being more common than single-institution designs. Trials frequently evaluated interventions/treatments (89%), supportive care/quality of life measures (7.1%), or diagnostic protocols (3.1%). Among included treatment paradigms, systemic therapies using cytotoxic chemotherapies, targeted therapies, and/or immunotherapies were more common among brain/spine trials, while radiotherapy, surgical adjuncts, and/or local drug delivery more frequently occurred in spinal tumor trials.</p><p><strong>Conclusions: </strong>Though SCTs comprise 10% of pediatric CNS tumors, they remain underrepresented in clinical trials. This lack of trials specific to advancing pediatric SCTs management highlights an area of clinical and research need.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"11 5","pages":"532-545"},"PeriodicalIF":2.4,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11398943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292230","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":"Life with a lower-grade glioma: How can neuro-oncologists advance its understanding and management?","authors":"Amélie Darlix, Estelle Guerdoux","doi":"10.1093/nop/npae031","DOIUrl":"10.1093/nop/npae031","url":null,"abstract":"","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"11 3","pages":"223-225"},"PeriodicalIF":2.4,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11085829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140911289","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":"A longer and/or better life for the oldest old with glioblastoma.","authors":"Katrina Roberto, James R Perry","doi":"10.1093/nop/npae007","DOIUrl":"10.1093/nop/npae007","url":null,"abstract":"","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"11 2","pages":"113-114"},"PeriodicalIF":2.4,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10940815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140143915","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":"Strategies for meaningful patient and public involvement in neuro-oncological research.","authors":"Karin Piil, Kresten Bundgaard Johannessen, Helle Pappot","doi":"10.1093/nop/npad080","DOIUrl":"10.1093/nop/npad080","url":null,"abstract":"","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"11 2","pages":"109-110"},"PeriodicalIF":2.4,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10940832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140143917","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":"Choreographed expansion of services results in decreased patient burden without compromise of outcomes: An assessment of the Ontario experience.","authors":"Kathryn Rzadki, Wafa Baqri, Olga Yermakhanova, Steven Habbous, Sunit Das","doi":"10.1093/nop/npad076","DOIUrl":"10.1093/nop/npad076","url":null,"abstract":"<p><strong>Background: </strong>Neuro-oncology care in Ontario, Canada has been historically centralized, at times requiring significant travel on the part of patients. Toward observing the goal of patient-centered care and reducing patient burden, 2 additional regional cancer centres (RCC) capable of neuro-oncology care delivery were introduced in 2016. This study evaluates the impact of increased regionalization of neuro-oncology services, from 11 to 13 oncology centers, on healthcare utilization and travel burden for glioblastoma (GBM) patients in Ontario.</p><p><strong>Methods: </strong>We present a cohort of GBM patients diagnosed between 2010 and 2019. Incidence of GBM and treatment modalities were identified using provincial health administrative databases. A geographic information system and spatial analysis were used to estimate travel time from patient residences to neuro-oncology RCCs.</p><p><strong>Results: </strong>Among the 5242 GBM patients, 79% received radiation as part of treatment. Median travel time to the closest RCC was higher for patients who did not receive radiation as part of treatment than for patients who did (<i>P</i> = .03). After 2016, the volume of patients receiving radiation at their local RCC increased from 62% to 69% and the median travel time to treatment RCCs decreased (<i>P</i> = .0072). The 2 new RCCs treated 35% and 41% of patients within their respective catchment areas. Receipt of standard of care, surgery, and chemoradiation (CRT), increased by 11%.</p><p><strong>Conclusions: </strong>Regionalization resulted in changes in the healthcare utilization patterns in Ontario consistent with decreased patient travel burden for patients with GBM. Focused regionalization did not come at the cost of decreased quality of care, as determined by the delivery of a standard of care.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"11 2","pages":"178-187"},"PeriodicalIF":2.4,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10940827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140143916","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":"Diagnosing Pseudoprogression in Glioblastoma: A challenging clinical issue","authors":"N. Galldiks","doi":"10.1093/nop/npad078","DOIUrl":"https://doi.org/10.1093/nop/npad078","url":null,"abstract":"","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"148 S290","pages":""},"PeriodicalIF":2.7,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139006467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Neurocognitive and Psychological Outcomes in Meningioma Survivors: Individual Changes Over Time and Radiation Dosimetry","authors":"Angela Sekely, Konstantine K Zakzanis, Donald Mabbott, Derek S Tsang, Paul Kongkham, Gelareh Zadeh, Kim Edelstein","doi":"10.1093/nop/npad072","DOIUrl":"https://doi.org/10.1093/nop/npad072","url":null,"abstract":"Abstract Background This study investigates long-term changes in neurocognitive performance and psychological symptoms in meningioma survivors, and associations with radiation dose to circumscribed brain regions. Methods We undertook a retrospective study of meningioma survivors who underwent longitudinal clinical neurocognitive assessments. Change in neurocognitive performance or psychological symptoms was assessed using reliable change indices. Radiation dosimetry, if prescribed, was evaluated based on treatment-planning computerized tomography co-registered with contrast-enhanced 3D T1-weighted magnetic resonance imaging. Mixed effects analyses were used to explore whether incidental radiation to brain regions outside the tumor influence neurocognitive and psychological outcomes. Results Most (range=41-93%) survivors demonstrated stable – albeit often below average - neurocognitive and psychological trajectories, although some also exhibited improvements (range=0-31%) or declines (range=0-36%) over time. Higher radiation dose to the parietal-occipital region (partial R2=0.462) and cerebellum (partial R2=0.276) was independently associated with slower visuomotor processing speed. Higher dose to the hippocampi was associated with increases in depression (partial R2=0.367) and trait anxiety (partial R2=0.236). Conclusions Meningioma survivors experience neurocognitive deficits and psychological symptoms many years after diagnosis, and a proportion of them decline over time. This study offers proof of concept that incidental radiation to brain regions beyond the tumor site may contribute to these sequelae. Future investigations should include radiation dosimetry when examining risk factors that contribute to quality of survivorship in this growing population.","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"14 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135725902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}