Neuro-oncology practice最新文献

{"title":"Understanding the unmet needs of patients with brain metastases referred for stereotactic radiotherapy and their caregivers: A prospective cohort study.","authors":"Fia Cialdella, Eva E van Grinsven, Steven H J Nagtegaal, Arthur T J van der Boog, Celeste C Hinkert, Marion G Jentink, Ernst J Smid, An Claes, Catharina E Kleynen, Tom J Snijders, Filip Y F de Vos, Marielle E P Philippens, Martine J E van Zandvoort, Szabolcs David, Joost J C Verhoeff","doi":"10.1093/nop/npaf105","DOIUrl":"10.1093/nop/npaf105","url":null,"abstract":"<p><strong>Abstract: </strong>BackgroundBrain metastases (BMs) affect >30% of patients with cancer. Beyond survival, quality of life (QoL), and disease progression are critical concerns for both patients and their caregivers. We present the design of COIMBRA (Cohort for patient-reported Outcomes, Imaging, and trial inclusion in Metastatic BRAin disease), clinical characteristics, and pre-radiotherapy QoL data for patients and caregivers.</p><p><strong>Methods: </strong>COIMBRA is an observational, prospective, single-center cohort at UMC Utrecht, the Netherlands, focusing on BMs patients planned for (fractionated) stereotactic radiosurgery (SRS) and their caregivers. We collected clinical characteristics, imaging, and QoL (patient and caregiver) data via patient-reported outcome (PRO) questionnaires. PROs include the EORTC QLQ-C30, BN20, EQ-5D-3L (including VAS), CFQ, HADS, MFI, and CSI. PROs were compared with reference values from the literature for healthy, cancer, and brain tumor populations.</p><p><strong>Results: </strong>From April 2019 to April 2023, 377 patients (50.4% male, median age 66 years) who received stereotactic radiosurgery, were included. Two hundred and seventy-six patients and 115 caregivers consented to PROs. Patients reported lower QoL compared to healthy individuals and primary brain tumor patients, with worse role- and cognitive functioning compared to patients with cancer. Pre-radiotherapy, 1/3 of the caregivers felt overwhelmed. Almost 40% of them report signs of anxiety, which is less than caregivers of cancer or primary brain tumor patients.</p><p><strong>Conclusions: </strong>These data from a large cohort of patients with BMs and their caregivers underscore the unique clinical profile of this vulnerable population. These findings highlight the urgent need for targeted support systems to address unmet needs of both patients and caregivers.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 2","pages":"262-275"},"PeriodicalIF":2.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869111","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":"Pediatric high-grade gliomas in patients with neurofibromatosis type 1-A collaborative cohort study from the SIOPE HGG/DIPG working group.","authors":"Michael Karremann, Tabea Gerdes, Gerrit H Gielen, Robert Kwiecien, Thomas Perwein, Marion Hoffmann, Amedeo A Azizi, Florian Babor, Carla Barrios-Bussmann, Lars Behrens, Martin Benesch, Luca Bertero, Veronica Biassoni, Brigitte Bison, Francesca R Buttarelli, Gabriele Calaminus, Alexander Claviez, Felix Distelmaier, Martin Ebinger, Moatasem Elayadi, Jana Ernst, Matthias Eyrich, Gudrun Fleischhack, Carsten Friedrich, Lea L Friker, Maria Luisa Garre, Nicolas U Gerber, Johannes Gojo, Darren Hargrave, Svenja Häuser, Pablo Hernaiz-Driever, Stefan Holm, Marcus Jakob, Stephanie Knirsch, Christian Kratz, Jeanne Marie Krischer, Caspar Kühnöl, Ella Kumirova, Maura Massimino, Maria Vinci, Lisethe Meijer, Markus Metzler, Claudia Milanaccio, Andres Morales La Madrid, Giovanni Morana, Gunther Nussbaumer, Gianluca Piccolo, Bianca Pollo, Guido Reifenberger, Christian Reimann, Thorsten Rosenbaum, Elisabetta Schiavello, Jaroslav Sterba, Dominik Sturm, Elwira Szychot, Chiara Valentini, Stefano Gabriele Vallero, Eunike Velleuer-Carlberg, Miriam van Buiren, Angela Mastronuzzi, Dannis van Vuurden, André O von Bueren, Maria Wiese, Claudia Zinke, Jozef Zlocha, Torsten Pietsch, Christof M Kramm","doi":"10.1093/nop/npaf104","DOIUrl":"10.1093/nop/npaf104","url":null,"abstract":"<p><strong>Background: </strong>We assessed clinical features, treatment, and survival of pediatric patients with neurofibromatosis type 1 (NF1) with high-grade glioma (HGG).</p><p><strong>Methods: </strong>Patients from this retrospective cohort study were identified through an international collaborative effort by the SIOPE HGG/DIPG working group. NF1 was diagnosed based on clinical presentation and confirmed by either a pathogenic germline <i>NF1</i> gene alteration or the exclusion of mismatch repair deficiency. A control cohort without genetic cancer predisposition was matched in a 2:1-ratio from the HIT-HGG database.</p><p><strong>Results: </strong>We identified 29 pediatric patients with NF1-associated HGG. Median age at diagnosis of HGG was 11 years. All but 1 tumor arose outside the optic pathway and included circumscribed and diffuse HGG. Molecular analysis in a subset of tumors identified an enrichment of alterations in <i>CDKN2A</i>, <i>TP53</i>, and <i>ATRX</i>. Event-free and overall survival were as poor as in matched sporadic HGG patients. The prognosis was not superior with upfront radiotherapy compared with delayed radiotherapy.</p><p><strong>Conclusions: </strong>NF1-associated HGGs behave as aggressively as their sporadic counterparts. The relevance of delaying radiotherapy until the time of progression and adjuvant MEK inhibitor treatment needs further investigation.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 1","pages":"71-85"},"PeriodicalIF":2.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377981","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":"Neuropsychological late effects in young children with medulloblastoma: A longitudinal analysis after 5 and 15 years from the HIT-SKK-'87/'92 studies.","authors":"Holger Ottensmeier, Matthias Eyrich, René Schmidt, Paul-Gerhardt Schlegel, Bernhard Zimolong, Stefanie Frahsek, Andreas Faldum, Martin Mynarek, Lisa Bußenius, Katja Von Hoff, Johannes E Wolff, Monika Warmuth-Metz, Jürgen Krauss, Udo Bode, Rolf-Dieter Kortmann, Joachim Kuehl, Stefan Rutkowski","doi":"10.1093/nop/npaf100","DOIUrl":"10.1093/nop/npaf100","url":null,"abstract":"<p><strong>Background: </strong>Young children with medulloblastoma (MB) are especially susceptible for tumor and treatment-related brain damage. Craniospinal irradiation (CSI) has been identified as a main risk factor for cognitive and motor dysfunction 2-5 years after diagnosis. Longitudinal follow-up data on these children beyond 10 years after diagnosis are scarce.</p><p><strong>Methods: </strong>To characterize their long-term neurocognitive outcome, we analyzed a cohort of 24 MB patients below the age of 3 years at diagnosis treated within the HIT-SKK'87 (systemic chemotherapy and deferred CSI) and HIT-SKK'92 (systemic chemotherapy and intraventricular methotrexate (MTX^i.vt.), no radiotherapy) trials after 5 and 15 years. A comprehensive test battery was used to measure cognitive operations, executive functions with selective attention, and psychomotor abilities.</p><p><strong>Results: </strong>Overall, MB survivors showed subnormal test results independent of treatment, especially in the domain of motor function. CSI had an additional detrimental effect on general and fluid intelligence and simultaneous processing, whereas MTX^i.vt.-recipients never scored worse than irradiated patients. Upon longitudinal follow-up, tests assessing sequential processing and general IQ showed stable or even improved results. In contrast, fluid intelligence, visual-motor integration, and most pronounced tapping speed further declined at 15 years in both the treatment groups and reached the disability zone.</p><p><strong>Conclusion: </strong>Impairment of motor and cognitive skills represents a major handicap for MB survivors. Long-term development of fluid intelligence and visuomotor integration is hindered in all children. CSI further aggravated these dysfunctions. Visual or auditory domains and memory performance are less affected. Long-term neurocognitive support is warranted in young pediatric survivors of MB.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 3","pages":"597-607"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13161898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147931902","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":"Proof of concept: Portable ultra-low-field MRI for the assessment of brain tumors.","authors":"Thomas Zeyen, Hemmen Sabir, Tobias Bauer, Oliver Henke, Nils Lehnen, Mousa Zidan, Simon Olbrich, Annalena Lange, Justus Bisten, Anne Groteklaes, Jennifer Faber, Lea Röver, Niklas Schäfer, Johannes Weller, Walter Bruchhausen, Alexander Radbruch, Ulrich Herrlinger, Theodor Rüber","doi":"10.1093/nop/npaf101","DOIUrl":"10.1093/nop/npaf101","url":null,"abstract":"<p><strong>Background: </strong>High-field (HF) MRI is a standard diagnostic tool for brain cancer, but its high cost and technical demands limit accessibility in low- and middle-income countries. Recent advancements in ultra-low field (ULF) MRI technology, including the development of portable scanners, offer a promising solution to these challenges. This study evaluates the diagnostic capabilities of ULF-MRI in detecting brain cancer and compares radiological evaluation using ULF- with HF-MRI.</p><p><strong>Methods: </strong>Consecutive patients with suspected or confirmed brain tumors undergoing routine 3T HF-MRI at the University Hospital Bonn were recruited for this study and underwent ULF-MRI. Eligible patients were at least 18 years old and had MRI-abnormalities in the HF-MRI. The 0.064 Tesla Swoop portable MR Imaging System was utilized. HF-MRI and ULF-MRI scans were independently evaluated by two experienced neuroradiologists and results were compared.</p><p><strong>Results: </strong>Thirteen patients were recruited, of whom 11 (85%) were diagnosed with brain tumors. In 11/11 (100%) patients with brain tumors, ULF-MRI identified tumor lesions corresponding to the findings of HF-MRI. In 7/11 (63.6%) identification of all tumor lesions could be achieved. Three of four further relevant imaging findings in HF-MRI (e.g. acute hydrocephalus or concomitant ischemia) were also found in in ULF-MRI.</p><p><strong>Conclusion: </strong>This single-center study demonstrates that ULF-MRI is a practical tool in neuro-oncology, which may particularly be helpful in resource-limited settings. Further research is required to define the role of ULF-MRI alongside existing imaging modalities for brain cancer diagnosis and management.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 2","pages":"415-421"},"PeriodicalIF":2.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869093","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":"Perspectives and challenges of multidisciplinary collaboration in the treatment of metastatic spinal disease: Insights from an international survey.","authors":"Jantijn J G J Amelink, Bram T van Munster, Olivier Q Groot, Britt B M Suelmann, Philip J Saylor, Nicolien Kasperts, Shannon MacDonald, Mark H Bilsky, Jorrit-Jan Verlaan, Daniel G Tobert","doi":"10.1093/nop/npaf102","DOIUrl":"10.1093/nop/npaf102","url":null,"abstract":"<p><strong>Abstract: </strong>BackgroundAdvances in systemic therapies, radiotherapy, and surgery have made the management of metastatic spinal disease (MSD) more complex, increasing the need for multidisciplinary collaboration. This study aims to explore physicians' perspectives on multidisciplinary collaboration and to identify challenges in delivering multidisciplinary care for patients with MSD.</p><p><strong>Methods: </strong>A cross-sectional, global, internet-based survey was distributed among medical oncologists, radiation oncologists, orthopedic surgeons, and neurosurgeons involved in the management of MSD. Questions focused on the effectiveness of current multidisciplinary collaboration, outcomes of multidisciplinary collaboration, and barriers to providing multidisciplinary care.</p><p><strong>Results: </strong>A total of 120 physicians completed the survey: 26 (22%) medical oncologists, 34 (28%) radiation oncologists, 31 (26%) orthopedic surgeons, and 29 (24%) neurosurgeons. Across all four specialties, approximately 75% considered current collaboration among medical oncologists, radiation oncologists, and spine surgeons effective. In total, 49% of respondents observed cases in which preventable complications occurred due to a perceived lack of multidisciplinary collaboration, and 69% reported observing cases where a lack of multidisciplinary collaboration resulted in the selection of suboptimal treatment strategies. Overall, respondents reported 162 challenges in delivering multidisciplinary care for patients with MSD, most commonly citing limited regional coordination between hospitals (28%) and insufficient collaboration among specialties (18%).</p><p><strong>Conclusions: </strong>Although most respondents viewed current multidisciplinary collaboration as effective, many reported observing cases where a lack of collaboration led to preventable complications or suboptimal care. These findings highlight the importance of strengthening multidisciplinary collaboration and enhancing regional coordination to improve outcomes for patients with MSD.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 2","pages":"322-330"},"PeriodicalIF":2.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869042","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":"Longitudinal cortical thickness changes in children with posterior fossa tumors.","authors":"Anne E M Leenders, Szabolcs David, Bruno M De Brito Robalo, Hannah Heckmanns, John H Maduro, Maarten H Lequin, Eelco Hoving, Marita Partanen","doi":"10.1093/nop/npaf098","DOIUrl":"10.1093/nop/npaf098","url":null,"abstract":"<p><strong>Abstract: </strong>Background Children with posterior fossa tumors (PFTs) are at risk of long-term neurocognitive deficits, yet the impact of tumor grade and treatment intensity on cortical development remains poorly understood. The aim of this study was to determine whether cortical thickness trajectories differ between children with low- versus high-grade PFTs and whether radiation dose influences cortical development in medulloblastoma patients.</p><p><strong>Methods: </strong>We conducted a retrospective longitudinal study of 55 children (37 low-grade, 18 high-grade medulloblastoma) diagnosed between 2018 and 2020. A total of 406 T1-weighted MRI scans acquired up to five years post-diagnosis were processed using CAT12 in SPM12 to estimate cortical thickness. Vertex-wise linear mixed-effects models assessed cortical thickness changes over time, adjusting for age at diagnosis, sex, and hydrocephalus. Within the high-grade group, we evaluated the effect of craniospinal irradiation (CSI) dose (23.4 vs. ≥36 Gy) on cortical development.</p><p><strong>Results: </strong>Children with low-grade tumors showed significant bilateral cortical thinning over time, consistent with typical neurodevelopment. In contrast, medulloblastoma patients treated with surgery, chemotherapy, and radiation therapy showed relative cortical stability across follow-up. Significant group-by-time interactions were observed, with low-grade patients demonstrating greater cortical thinning in parietal, temporal, and occipital regions. No significant differences in cortical trajectories were found between high- and standard-dose CSI subgroups.</p><p><strong>Conclusions: </strong>Cortical development trajectories in pediatric PFT survivors differ by tumor grade and treatment intensity. While low-grade patients exhibit expected maturational thinning, cortical stability in high-grade patients may reflect disrupted neurodevelopment. These findings underscore the need for longitudinal neuroimaging in pediatric neuro-oncology survivorship care.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 2","pages":"394-407"},"PeriodicalIF":2.5,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868953","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":"Transforming molecular neuropathology for adult brain tumor patients in the UK: Insights on implementation, adoption, and patient access (2021-2024).","authors":"Kathreena M Kurian, Andrew P Wright, Fereshteh Sari, Mayen Briggs, Camille Goetz, Ros Quinlivan, Katie Bushby, Richard Gilbertson, Nicky Huskens","doi":"10.1093/nop/npaf099","DOIUrl":"10.1093/nop/npaf099","url":null,"abstract":"<p><p>BackgroundMolecular neuropathology is evolving rapidly, driven by novel genomic technologies, national policies, and the urgent need for precision brain tumor care. Inequity in access to genomic testing highlighted in previous reports warrants further investigation.</p><p><strong>Methods: </strong>We analyzed anonymized data from 21 United Kingdom (UK) neuro-oncology centers (covering an estimated 84% of the population) collected in 2021 and 2024 via the Tessa Jowell Centre of Excellence for Adults program. We assessed trends in genomic testing (including methylation arrays, gene panels, whole genome sequencing [WGS]), tumor snap freezing, turnaround times (TATs), and auditing.</p><p><strong>Results: </strong>From 2021 to 2024, total genomic tests submitted across the 21 centers increased 128% from 2946 to 6730, while glioma cases increased 18% (from 3159 to 3722). Methylation arrays, gene panels, and WGS samples submitted rose by 342%, 174%, and 291%, respectively. Centers requesting WGS increased from 4/21 (19%) to 15/21 (71%), with 90% centers (19/21) reporting snap freezing of brain tumor samples in 2024 (mean 173, range 0-650 samples frozen per center). Mean molecular diagnosis TATs rose from 16 to 21 days; centers meeting a 14-day TAT dropped from 48% (10/21) to 30% (6/20). Auditing of TATs increased from 6/21 (29%) to 18/21 (86%).</p><p><strong>Conclusions: </strong>UK molecular neuropathology testing grew substantially 2021-2024. However, variations in testing and snap freezing, and bottlenecks in diagnostic TATs, emphasize the need for: (1) targeted training and investment in rapid technologies to ensure sustainable service delivery; (2) focus on remaining inequities and (3) continued engagement with national benchmarking initiatives.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 3","pages":"465-477"},"PeriodicalIF":2.5,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13161907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147931966","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":"Quality measurements in neuro-oncology: A critical look at glioblastoma indicators and the path forward.","authors":"Nimish A Mohile, Tobias Walbert","doi":"10.1093/nop/npaf077","DOIUrl":"10.1093/nop/npaf077","url":null,"abstract":"","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"12 5","pages":"745-746"},"PeriodicalIF":2.5,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12508738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280848","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":"Planting seeds for seasons ahead: Communication strategies for prognostic disclosure in pediatric neuro-oncology.","authors":"Carolyn Humphrey, Brittany Cowfer, Amy Porter, Emma Chow, Josephine Campbell, Nidhi Mali, Erica C Kaye","doi":"10.1093/nop/npaf087","DOIUrl":"10.1093/nop/npaf087","url":null,"abstract":"<p><strong>Background: </strong>High-quality communication about prognosis is essential in pediatric neuro-oncology care; however, effective communication strategies for introducing prognostic information over time (\"seed-planting\") remain poorly described in the setting of pediatric brain cancer. This study aimed to characterize how pediatric neuro-oncologists use seed-planting across the illness trajectory. This work will inform the development of communication skills training to facilitate high-quality prognostic communication for children with high-risk or advanced central nervous system (CNS) tumors and their families.</p><p><strong>Methods: </strong>In this prospective, longitudinal study, serial medical encounters between children with poor-prognosis CNS tumors (overall survival ≤50%), their families, and their neuro-oncologists were audio-recorded at disease reevaluation timepoints over 24 months or until the child's death. Rapid qualitative analysis was conducted to identify distinct seed-planting strategies used by neuro-oncologists across advancing illness.</p><p><strong>Results: </strong>From 132 recorded encounters (2481 min of dialogue) involving 30 families and 7 neuro-oncologists, 7 key seed-planting strategies were characterized: (1) exercise vigilance, (2) share personal sentiment, (3) recommend backup plan, (4) specify noncurative intent, (5) recognize window of opportunity, (6) partner hope and realism, and (7) engage in psychological distancing. Seed-planting occurred in nearly half of recordings (<i>n</i> = 63, 48%), with all oncologists employing this approach at least once and most patients experiencing at least one instance of seed-planting (<i>n</i> = 24, 80%).</p><p><strong>Conclusions: </strong>Pediatric neuro-oncologists in this study employed diverse approaches to seed-planting, albeit inconsistently, across encounters. Future work will investigate the value of integrating these 7 key strategies into communication skills training for pediatric neuro-oncology clinicians.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 2","pages":"373-384"},"PeriodicalIF":2.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869135","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":"Corticosteroid use in pediatric neuro-oncology symptom management: A rapid review.","authors":"Neevika Manoharan, Nicole Armitage, Claudia Virdun","doi":"10.1093/nop/npaf097","DOIUrl":"10.1093/nop/npaf097","url":null,"abstract":"<p><strong>Background: </strong>Corticosteroids are used routinely in pediatric patients with central nervous system tumors. However, the efficacy profiles of these medications, prevalence of adverse effects, dosing schedules, and impact on patients' quality-of-life are poorly elucidated. The aim of this study was to identify, appraise, and synthesize available international evidence regarding the role of corticosteroids in the symptom management of pediatric neuro-oncology patients.</p><p><strong>Methods: </strong>A rapid review of articles studying the role of corticosteroids in pediatric neuro-oncology was undertaken in August 2024. This study is reported using the PRISMA statement and was registered with PROSPERO (CRD42024567489). Five databases were searched, and data were analyzed using narrative synthesis.</p><p><strong>Results: </strong>Of the 1935 identified papers, 9 met the inclusion criteria (<i>n</i> = 6 retrospective cohort studies and <i>n</i> = 3 survey studies). Four key themes were identified in this rapid review: (1) variability in indication, dosing schedules, and prescribing practices for corticosteroids; (2) limited evidence available regarding symptomatic benefits from corticosteroid use; (3) adverse effects from prolonged corticosteroid use; and (4) clinicians recommend consensus guidelines to inform corticosteroid prescribing practice.</p><p><strong>Conclusion: </strong>As the first review utilizing systematic methodology exploring the topic of corticosteroid use in pediatric neuro-oncology, we identified a paucity of pediatric studies addressing corticosteroid efficacy. Dosing is variable, adverse effects are duration-dependent and multi-system and there is an urgent need for the development of guidelines to inform best practice. High-income countries and inpatient perioperative settings dominate the published literature. There is an absence of consumer voices addressing the impact on quality-of-life from corticosteroid use.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 2","pages":"227-237"},"PeriodicalIF":2.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869043","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}