Neuro-oncology practice最新文献

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Precision in long-term language evaluation after awake brain tumor surgery. 清醒脑肿瘤术后长期语言评价的准确性。
IF 2.5
Neuro-oncology practice Pub Date : 2025-09-06 eCollection Date: 2026-04-01 DOI: 10.1093/nop/npaf090
Barbara Vogrincic, Saskia Mooijman, Arnaud Vincent, Bram Bulté, Elke De Witte, Evy Visch-Brink, Djaina Satoer
{"title":"Precision in long-term language evaluation after awake brain tumor surgery.","authors":"Barbara Vogrincic, Saskia Mooijman, Arnaud Vincent, Bram Bulté, Elke De Witte, Evy Visch-Brink, Djaina Satoer","doi":"10.1093/nop/npaf090","DOIUrl":"10.1093/nop/npaf090","url":null,"abstract":"<p><strong>Background: </strong>Language deficits caused by gliomas can persist beyond the short term, and should not be overlooked due to their influence on a patient's quality of life. The aim of this study was to investigate language impairments and long-term outcome after awake surgery.</p><p><strong>Methods: </strong>The Diagnostic Instrument for Mild Aphasia (DIMA) and traditional language tests were administered preoperatively (T1; <i>n</i> = 79), and 3 (T2; n = 68) and 12 months (T3; <i>n</i> = 35) postoperatively in the groups of patients with less (Group 1) and more (Group 2) invasive brain tumors.</p><p><strong>Results: </strong>Preoperative deficits were found with DIMA at the level of lexico-syntax in Group 1 in both hemispheres and at the level of phonology and lexico-syntax in Group 2. With traditional language tests, preoperative deficits were detected at the level of word retrieval and verbal fluency in all groups. Only DIMA revealed long-term mild language impairments, which were observed at the phonological and semantic level in patients with left-hemispheric tumors, and at the lexico-syntactic level in those with right-hemispheric tumors.</p><p><strong>Conclusions: </strong>In this cohort, mild language impairments were noted long-term with DIMA across different linguistic levels, irrespective of hemispheric tumor location. Alongside the traditional language tests, DIMA represents a valuable addition for the diagnostic evaluation of language impairments in patients with gliomas.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 2","pages":"276-291"},"PeriodicalIF":2.5,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869120","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}
引用次数: 0
Comparative analysis of outcome, recurrence patterns, and dosimetry in glioblastoma patients treated according to RTOG versus EORTC contouring guidelines. 根据RTOG和EORTC轮廓指南治疗的胶质母细胞瘤患者的结局、复发模式和剂量比较分析。
IF 2.5
Neuro-oncology practice Pub Date : 2025-09-02 eCollection Date: 2026-04-01 DOI: 10.1093/nop/npaf094
Gero Wieger, Patricia Meixner, Alicia Bicu, Frederik M Glatting, Frank A Giordano, Arne Mathias Ruder
{"title":"Comparative analysis of outcome, recurrence patterns, and dosimetry in glioblastoma patients treated according to RTOG versus EORTC contouring guidelines.","authors":"Gero Wieger, Patricia Meixner, Alicia Bicu, Frederik M Glatting, Frank A Giordano, Arne Mathias Ruder","doi":"10.1093/nop/npaf094","DOIUrl":"10.1093/nop/npaf094","url":null,"abstract":"<p><strong>Background: </strong>Optimal radiotherapy target volume delineation for glioblastoma (GBM) remains debated, with distinct guidelines from the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Direct comparisons of clinical outcomes based on these guidelines are lacking. This study compared overall survival (OS), progression-free survival (PFS), functional status, and dosimetry in GBM patients treated per RTOG or EORTC protocols at a single institution.</p><p><strong>Methods: </strong>We retrospectively analyzed 149 patients with isocitrate dehydrogenase (IDH) wildtype, CNS WHO grade 4 GBM treated with chemoradiotherapy (60 Gy) per RTOG (<i>n</i> = 106) or EORTC (<i>n</i> = 43) guidelines between 2016 and 2023. OS, PFS, Karnofsky performance score (KPS) changes, and radiation exposure to organs at risk (OARs) were compared.</p><p><strong>Results: </strong>No significant difference was found between groups for OS (median 17.0 months, <i>P</i> = .6) or PFS (median 7.1 months, <i>P</i> = .4). O⁶-methylguanine-DNA methyltransferase (MGMT) promoter methylation was prognostic for OS (Hazard Ratio [HR] 0.45, <i>P</i> < .001) and PFS (HR 0.41, <i>P</i> < .001). A KPS score < 70 before or after radiotherapy, or at first follow-up, predicted worse OS (HR 2.8-3.4, all <i>P</i> < .001), but not PFS. The RTOG group had significantly lower KPS at first follow-up (<i>P</i> = .031). RTOG target volumes were significantly larger (<i>P</i> < .001) and associated with higher radiation doses to brainstem, chiasm, optic nerves, hippocampi, pituitary, and greater tissue volume receiving at least 1 Gy (V1Gy) (all <i>P</i> ≤ .007).</p><p><strong>Conclusions: </strong>While RTOG and EORTC guidelines yielded comparable survival outcomes, the RTOG protocol was associated with larger irradiated volumes, higher OAR exposure, and greater decline in early post-treatment performance status. These findings support the clinical relevance of volume-sparing strategies in GBM radiotherapy.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 2","pages":"301-311"},"PeriodicalIF":2.5,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869118","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}
引用次数: 0
Prognostic factors in adult patients with medulloblastoma. 成神经管细胞瘤成年患者预后因素分析。
IF 2.5
Neuro-oncology practice Pub Date : 2025-09-01 eCollection Date: 2026-02-01 DOI: 10.1093/nop/npaf084
Ytel Garcilazo-Reyes, Pierre Dal Col, Franck Bielle, Karima Mokhtari, Loïc Feuvret, Julian Jacob, Alberto Duran-Peña, Laurent Capelle, Julien Savatovsky, Franck Bourdeaut, Julien Masliah-Planchon, Bernardo Cacho-Díaz, Khê Hoang-Xuan, Ahmed Idbaih, Florence Laigle-Donadey
{"title":"Prognostic factors in adult patients with medulloblastoma.","authors":"Ytel Garcilazo-Reyes, Pierre Dal Col, Franck Bielle, Karima Mokhtari, Loïc Feuvret, Julian Jacob, Alberto Duran-Peña, Laurent Capelle, Julien Savatovsky, Franck Bourdeaut, Julien Masliah-Planchon, Bernardo Cacho-Díaz, Khê Hoang-Xuan, Ahmed Idbaih, Florence Laigle-Donadey","doi":"10.1093/nop/npaf084","DOIUrl":"10.1093/nop/npaf084","url":null,"abstract":"<p><strong>Background: </strong>Medulloblastoma (MB) is a rare tumor in adults, with treatment strategies derived largely from pediatric data. Prognostic factors have not been uniformly defined in adults to date.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of 89 adult MB patients treated between 1995 and 2019 in our institution. Patient's characteristics, disease features, and treatment modalities were analyzed for prognostic factors using univariate and multivariate analysis.</p><p><strong>Results: </strong>Of the 89 patients, 66% were male. Most MBs were in the cerebellum (48%), with desmoplastic/nodular histology (43%), Sonic Hedgehog molecular type (79%), and M0 Chang´s stage (72%). Intermediate- and high-risk MBs were identified in ~46% and ~47% of cases, respectively. Complete/near complete tumor resection was achieved in 62% of cases. Surgery followed by chemoradiotherapy (CT/RT) was the most frequent treatment (76%) with carboplatin-based regimens used in 70% of cases. After the first-line treatment, complete response (CR) was achieved in 80% of patients. Median overall survival (mOS) was 124.4 months (95%CI 68.5-180.1) and the median progression free survival (mPFS) was 30.5 months (95%CI 13.5-47.5), the 5-year OS was 67% and the 5-year PFS was 51%. In multivariate analysis, Chang´s stage ≥ M2 metastatic classification (<i>P</i> = .001), RT without CT in first line setting (<i>P</i> = .005), and craniospinal RT < 30 Gy (<i>P</i> = .015) were associated with worse survival outcomes.</p><p><strong>Conclusions: </strong>Chang's stage ≥ M2, first-line treatment lacking CT, and first-line treatment with craniospinal RT < 30 Gy were significant predictors of poor survival. Chemoradiotherapy with craniospinal RT ≥ 30 Gy improved survival outcomes.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 1","pages":"112-125"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378156","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}
引用次数: 0
Evaluating work activity and societal burden in patients with grade 2 IDH-mutant glioma. 评估2级idh突变胶质瘤患者的工作活动和社会负担。
IF 2.5
Neuro-oncology practice Pub Date : 2025-09-01 eCollection Date: 2026-04-01 DOI: 10.1093/nop/npaf092
Slávka Lukacova, Aida Muhic, Oskar Ström, Morten Johnsen, Céline Aubin, Marc Massetti, Jane Skjøth-Rasmussen
{"title":"Evaluating work activity and societal burden in patients with grade 2 IDH-mutant glioma.","authors":"Slávka Lukacova, Aida Muhic, Oskar Ström, Morten Johnsen, Céline Aubin, Marc Massetti, Jane Skjøth-Rasmussen","doi":"10.1093/nop/npaf092","DOIUrl":"10.1093/nop/npaf092","url":null,"abstract":"<p><strong>Background: </strong>IDH-mutant (mIDH) gliomas affect relatively young and otherwise healthy patients with high workforce participation. Management typically involves surgery, radiotherapy, and/or chemotherapy (RT/CT), although immediate post-surgery treatment may be deferred in favor of active observation (AO) to preserve functioning. This study aimed to evaluate how disease progression and treatments impact work activity, medical and societal costs, and overall survival (OS) in grade 2 mIDH glioma patients initially managed with AO.</p><p><strong>Methods: </strong>This retrospective longitudinal study utilized Danish administrative registries. Patients with mIDH gliomas initially managed with AO between 2010 and 2022 were included. Employment rates, sick leaves, treatment patterns, medical resources and costs, and OS were examined from diagnosis to the end of follow-up or death.</p><p><strong>Results: </strong>Data from 237 patients were analyzed; 72.9% were alive at 10 years. After surgical recovery, ability to work was most impaired during RT/CT, necessitating nearly full-time sick leave. Work activity continuously decreased after each RT/CT treatment. Employment rates were similarly affected, from under 20% unemployment at baseline and during AO, up to 41% and 59% after first and second RT/CT. Similar trends were observed for medical resources and costs, and productivity losses.</p><p><strong>Conclusions: </strong>Patients with grade 2 mIDH glioma remain active at work after initial surgery when managed with AO. Work impairment increases over successive RT/CT courses, highlighting the need to preserve quality of life by integrating work ability into clinical practice and by developing new treatment strategies to delay aggressive therapies and avoid substantial medical and productivity costs.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 2","pages":"331-341"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869039","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}
引用次数: 0
Current and bereaved caregivers' experiences of participating in the adapted Telehealth Making Sense of Brain Tumour program in the context of high-grade glioma. 当前和失去亲人的照顾者在高级别神经胶质瘤的背景下参与改编的远程医疗使脑肿瘤计划的经验。
IF 2.5
Neuro-oncology practice Pub Date : 2025-08-30 eCollection Date: 2026-04-01 DOI: 10.1093/nop/npaf091
Abigail Billin, Katarzyna M Lion, Stephanie Jones, Mark B Pinkham, Georgia K B Halkett, Haryana M Dhillon, Tamara Ownsworth
{"title":"Current and bereaved caregivers' experiences of participating in the adapted Telehealth Making Sense of Brain Tumour program in the context of high-grade glioma.","authors":"Abigail Billin, Katarzyna M Lion, Stephanie Jones, Mark B Pinkham, Georgia K B Halkett, Haryana M Dhillon, Tamara Ownsworth","doi":"10.1093/nop/npaf091","DOIUrl":"10.1093/nop/npaf091","url":null,"abstract":"<p><strong>Background: </strong>The Telehealth Making Sense of Brain Tumour program (Tele-MAST) was adapted for caregivers (cTele-MAST) to address the lack of caregiver-specific psychological support interventions in the context of high-grade glioma. This study aimed to explore current and bereaved caregivers' reasons for seeking psychological support, experiences of participating in cTele-MAST, and impacts on mental health and quality of life.</p><p><strong>Methods: </strong>A longitudinal multi-methods design was employed, capturing qualitative and quantitative data prior to cTele-MAST (Time 1), 1-week (Time 2), and 3-month post-intervention (Time 3). Qualitative data were analyzed using reflexive thematic analysis and quantitative data using repeated measures ANOVA. Participants were offered individual cTele-MAST sessions via videoconferencing and completed semi-structured interviews and measures of mental health and quality of life (QoL). Eighteen caregivers (15 female, <i>M</i> age = 47.27, <i>SD</i> = 9.37) of people with high-grade glioma were recruited, and 15 completed cTele-MAST (<i>M</i> = 9.5 sessions).</p><p><strong>Results: </strong>Three themes were identified. \"Caregiver expectations of the self\" reflected a desire to become stronger, more resilient, and quickly adapt their lives around caregiving. \"Enabling, connecting and reframing\" represented perceived benefits of cTele-MAST in terms of accessibility, brain tumor-specific expertise, and support to reset self-expectations. \"Finding one's self\" reflected caregivers better acknowledging their own needs and understanding themselves in grief. Significant post-intervention reductions in distress and stress were evident, but not for depression, anxiety or QoL.</p><p><strong>Conclusions: </strong>Caregivers found participating in a psychological support program tailored to their needs beneficial. Early referral to cTele-MAST and flexible ongoing access to psychological support is recommended.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 2","pages":"342-353"},"PeriodicalIF":2.5,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869129","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}
引用次数: 0
Neurogenetic tumor syndromes: The current landscape of workup and treatment. 神经遗传性肿瘤综合征:检查和治疗的现状。
IF 2.5
Neuro-oncology practice Pub Date : 2025-08-28 eCollection Date: 2026-02-01 DOI: 10.1093/nop/npaf089
Rimas V Lukas, Ashley Cannon, Prashant Chittiboina, Harish N Vasudevan, Jaishri O Blakeley, Angela C Hirbe
{"title":"Neurogenetic tumor syndromes: The current landscape of workup and treatment.","authors":"Rimas V Lukas, Ashley Cannon, Prashant Chittiboina, Harish N Vasudevan, Jaishri O Blakeley, Angela C Hirbe","doi":"10.1093/nop/npaf089","DOIUrl":"10.1093/nop/npaf089","url":null,"abstract":"<p><p>Experts and generalists from numerous clinical disciplines are likely to encounter and be involved in the care of patients with neurogenetic tumor syndromes. Considerations for genetic testing are discussed. Specific conditions including neurofibromatosis type 1, neurofibromatosis type 2-related schwannomatosis, von Hippel-Lindau disease, tuberous sclerosis, Lynch syndrome, Turcot syndrome, Li-Fraumeni syndrome, and others are reviewed. A variety of targeted therapies which have received regulatory approval for these disorders are described and promising future directions for therapeutics are highlighted.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 1","pages":"14-22"},"PeriodicalIF":2.5,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378046","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}
引用次数: 0
Dabrafenib in pediatric patients with BRAF V600 mutation-positive high-grade glioma: Results from a phase 1/2a single-arm study. Dabrafenib用于BRAF V600突变阳性的高级别胶质瘤患儿:来自1/2a期单组研究的结果
IF 2.5
Neuro-oncology practice Pub Date : 2025-08-16 eCollection Date: 2025-12-01 DOI: 10.1093/nop/npaf061
Birgit Geoerger, Lucas Moreno, Eric Bouffet, Santhosh A Upadhyaya, Nicolas André, Isabelle Aerts, Ashley S Plant-Fox, Michael Roughton, Mark Russo, Darren Hargrave
{"title":"Dabrafenib in pediatric patients with <i>BRAF</i> V600 mutation-positive high-grade glioma: Results from a phase 1/2a single-arm study.","authors":"Birgit Geoerger, Lucas Moreno, Eric Bouffet, Santhosh A Upadhyaya, Nicolas André, Isabelle Aerts, Ashley S Plant-Fox, Michael Roughton, Mark Russo, Darren Hargrave","doi":"10.1093/nop/npaf061","DOIUrl":"10.1093/nop/npaf061","url":null,"abstract":"<p><strong>Background: </strong><i>BRAF</i> V600E mutations occur in many pediatric malignancies, including ~5% to 10% of pediatric high-grade gliomas (HGGs). Despite efforts over the decades, the prognosis of pediatric HGG remains dismal, with low survival rates. Dabrafenib has shown efficacy in pediatric patients with <i>BRAF</i> V600 mutation-positive malignancies in a phase 1/2a study. This report combines data from all pediatric patients with HGG in both dose escalation (part 1) and tumor-specific dose expansion (part 2) parts of the study, including patients with HGG for the first time in phase 2a.</p><p><strong>Methods: </strong>Patients aged 1 to < 18 years with <i>BRAF</i> V600 mutation-positive HGG who had refractory or progressive disease after standard therapy received oral dabrafenib 3.0 to 5.25 mg/kg/day (part 1) or the recommended dose (part 2) of 5.25 mg/kg/day (age < 12 years) or 4.5 mg/kg/day (age ≥ 12 years) as 2 equal doses twice daily. The primary objectives were safety and tolerability of dabrafenib (part 1; previously published) and clinical activity (part 2), defined as ORRs reported by investigator assessment and independent review using RANO 2010 criteria.</p><p><strong>Results: </strong>Overall, 35 pediatric patients with HGG were treated. Histologic diagnosis included pleomorphic xanthoastrocytoma (<i>n</i> = 8), glioblastoma (<i>n</i> = 7), anaplastic astrocytoma (<i>n</i> = 6), anaplastic ganglioglioma (<i>n</i> = 4), and other gliomas (<i>n</i> = 10). The ORRs were 29% (95% CI, 14.6, 46.3) and 46% (28.8, 63.4) by investigator assessment and independent review, respectively. The 24-month PFS rates were 30% and 40%, respectively. The most common treatment-related adverse events were dry skin (31%), fatigue (29%), and pyrexia (26%). No treatment-related deaths were reported.</p><p><strong>Conclusions: </strong>In pediatric patients with relapsed orrefractory <i>BRAF</i> V600-mutated HGG, dabrafenib exhibited sustained objective tumor responses and a manageable safety profile.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"12 6","pages":"1099-1111"},"PeriodicalIF":2.5,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12741824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850473","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}
引用次数: 0
Ethical considerations in randomization for neurosurgical oncology trials: A scoping review. 神经外科肿瘤学试验随机化的伦理考虑:范围综述。
IF 2.5
Neuro-oncology practice Pub Date : 2025-08-16 eCollection Date: 2026-02-01 DOI: 10.1093/nop/npaf085
Nathan A Shlobin, Mira C Hasner, Philipp Karschnia, Georg Widhalm, George E D Petrescu, Philippe Schucht, Thiebaud Picart, Marian C Neidert, Jens Gempt, Rachel Grossman, Asgeir S Jakola, Michael D Jenkinson, Roland Goldbrunner, Michael Weller, Johnny Duerinck, Marike L D Broekman
{"title":"Ethical considerations in randomization for neurosurgical oncology trials: A scoping review.","authors":"Nathan A Shlobin, Mira C Hasner, Philipp Karschnia, Georg Widhalm, George E D Petrescu, Philippe Schucht, Thiebaud Picart, Marian C Neidert, Jens Gempt, Rachel Grossman, Asgeir S Jakola, Michael D Jenkinson, Roland Goldbrunner, Michael Weller, Johnny Duerinck, Marike L D Broekman","doi":"10.1093/nop/npaf085","DOIUrl":"10.1093/nop/npaf085","url":null,"abstract":"<p><strong>Background: </strong>Increased interest in randomized controlled trials (RCTs) in neurosurgical oncology represents a significant advancement in the promotion of rigorous interventions in the field. However, the concept of randomization in neurosurgical oncology contains numerous ethical considerations. In this scoping review, we characterize the landscape of ethical challenges in randomization for neurosurgical oncology trials, highlight gaps in the literature, and delineate best practices for approaching randomization in these trials with a focus on the role of alternative study designs.</p><p><strong>Methods: </strong>A scoping review was conducted using the PubMed, Embase, and Scopus databases. Titles and abstracts were screened for relevance. Studies meeting prespecified inclusion criteria underwent full-text review. Relevant data were extracted.</p><p><strong>Results: </strong>Of 546 resultant articles, 20 were included. Seven (35%) studies focused on limitations of RCTs, 6 (30%) on utility of randomization, 4 (20%) on alternative designs, and 3 (15%) on informed consent. Randomization involves intrinsic ethical challenges in addition to practical challenges specific to neurosurgical oncology, including unrepresentative study populations, uncertainty regarding equipoise, and the inability to attain informed consent. Alternative study designs include preliminary prospective cohort studies with specific properties, on/off studies, seamless phase II/III trials, window-of-opportunity trials, and adaptive randomization models.</p><p><strong>Conclusions: </strong>Randomization in neurosurgical oncology RCTs is ethically challenging. RCTs are most useful when they significantly enhance the quality of evidence and have the potential to be practice-changing. When RCTs are the preferred study design, proper design and implementation may mitigate ethical challenges. In some cases, alternative study designs may advance research while safeguarding ethical priorities.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 1","pages":"3-13"},"PeriodicalIF":2.5,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378063","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}
引用次数: 0
High-grade gliomas and Lynch syndrome: A retrospective descriptive study with a literature review. 高级别胶质瘤和Lynch综合征:一项回顾性描述性研究并文献回顾。
IF 2.5
Neuro-oncology practice Pub Date : 2025-08-16 eCollection Date: 2026-02-01 DOI: 10.1093/nop/npaf088
Hugo Duprez, Apolline Monfilliette, Marie Csanyi, Claude-Alain Maurage, Fabienne Escande, Afane Brahimi, Anthony Turpin, Nicolas Reyns, Luc Defebvre, Enora Vauleon
{"title":"High-grade gliomas and Lynch syndrome: A retrospective descriptive study with a literature review.","authors":"Hugo Duprez, Apolline Monfilliette, Marie Csanyi, Claude-Alain Maurage, Fabienne Escande, Afane Brahimi, Anthony Turpin, Nicolas Reyns, Luc Defebvre, Enora Vauleon","doi":"10.1093/nop/npaf088","DOIUrl":"10.1093/nop/npaf088","url":null,"abstract":"<p><strong>Background: </strong>High-grade diffuse gliomas in adults are common malignant primary tumors of the central nervous system. The association with Lynch syndrome (LS) is documented but remains under-researched. However, there are implications for prevention, genetic counseling, and therapeutic approaches. The objective of this study is to conduct a descriptive cohort of patients with high-grade glial tumors in the context of LS.</p><p><strong>Methods: </strong>We included adult patients with glioblastoma (GBM) or grade 4 astrocytoma (WHO 2021 classification) associated with LS, diagnosed at Lille University Hospital or Valenciennes Hospital between 2014 and 2022. We retrospectively collected clinical, radiological, histopathological, molecular, and therapeutic data.</p><p><strong>Results: </strong>We included 6 GBM cases with a median age of 58.7 years (IQR 32.4-63.3). Five cases had <i>MSH2</i> mutations, and one had <i>PMS2</i> mutation. In one case, MMR protein expression was preserved, and the RER phenotype showed low microsatellite instability. Loss of ATRX expression, overexpression of p53, and giant cells were observed in 50%, 83%, and 66% of cases, respectively. <i>TP53</i> mutations were found in all cases, and <i>PTEN</i> mutations in 4 cases. Immunotherapy was given to two cases. The 24-month overall survival rate was 50%.</p><p><strong>Conclusions: </strong>GBMs associated with LS exhibit specific histopathological and molecular biology characteristics that may guide syndrome-related research. These tumors could represent a particular subclassification, potentially leading to specific therapies such as immunotherapy. We propose with a review of case in the literature an algorithm for investigating LS upon discovering a GBM. These exploratory results need to be confirmed by a larger cohort.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 1","pages":"139-148"},"PeriodicalIF":2.5,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378009","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}
引用次数: 0
Corrigendum to: Screening for brain metastases in patients with advanced non-small cell lung cancer and an actionable genomic alteration: A structured literature review. 对晚期非小细胞肺癌患者的脑转移筛查和可操作的基因组改变的更正:一篇结构化的文献综述。
IF 2.5
Neuro-oncology practice Pub Date : 2025-08-09 eCollection Date: 2025-12-01 DOI: 10.1093/nop/npaf072
{"title":"Corrigendum to: Screening for brain metastases in patients with advanced non-small cell lung cancer and an actionable genomic alteration: A structured literature review.","authors":"","doi":"10.1093/nop/npaf072","DOIUrl":"https://doi.org/10.1093/nop/npaf072","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/nop/npaf018.].</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"12 6","pages":"1131"},"PeriodicalIF":2.5,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12741827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850423","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}
引用次数: 0
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