Neuro-oncology practice最新文献

{"title":"Neoadjuvant stereotactic radiosurgery for brain metastases: A systematic review and meta-analysis.","authors":"Bardia Hajikarimloo, Mohammad Amin Habibi, Ibrahim Mohammadzadeh, Salem M Tos, Ali Mortezaei, Saleh Behzadi, Parsa Lorestani, Kiarash Soltani, Mohammad Ali Nazari, Azin Ebrahimi, Mohammadamin Sabbagh Alvani","doi":"10.1093/nop/npaf086","DOIUrl":"10.1093/nop/npaf086","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant stereotactic radiosurgery (SRS) has emerged as a novel therapeutic option in managing patients with brain metastasis (BM). Neoadjuvant SRS can address the current limitations of postoperative SRS through accurate lesion delineation and improved radiation dosimetry. This study evaluated the role of neoadjuvant SRS in patients with BM.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted. Studies that assessed the local control (LC), distant brain failure (DBF), leptomeningeal disease (LMD), overall survival (OS), and adverse radiation effects (ARE) rates in neoadjuvant SRS in BM were included.</p><p><strong>Results: </strong>Ten studies involving 791 patients were included. The meta-analysis revealed a pooled 12- and 24-month LC rate of 91% (95% CI: 84%-96%) and 89% (95% CI: 81%-94%), respectively. The meta-analysis revealed 12- and 24-month DBF rates of 35% (95% CI: 31%-39%) and 44% (95% CI: 40%-47%), respectively. The meta-analysis exhibited a pooled 12- and 24-month LMD rate of 4% (95% CI: 2%-5%) and 5% (95% CI: 3%-7%), respectively. The meta-analysis showed a pooled 12- and 24-month ARE rate of 4% (95% CI: 3%-6%) and 5% (95% CI: 3%-7%), respectively. The meta-regression demonstrated that hypofractionated SRS (HF-SRS) was associated with a more favorable LC rate than single-fraction SRS (SF-SRS).</p><p><strong>Conclusions: </strong>Neoadjuvant SRS is a promising option for BMs, offering favorable outcomes and a low toxicity profile. HF-SRS may be linked to a more favorable outcome than SF-SRS. Prospective randomized trials are necessary to compare neoadjuvant and postoperative SRS alongside evaluations of SF-SRS and HF-SRS.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 1","pages":"48-59"},"PeriodicalIF":2.5,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378037","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":"Reproductive health considerations for IDH-mutant glioma patients considering IDH inhibitor therapy: A retrospective cohort study.","authors":"Tyler A Lanman, Ethan A Wetzel, Kajal Verma, L Nicolas Gonzalez Castro","doi":"10.1093/nop/npaf071","DOIUrl":"10.1093/nop/npaf071","url":null,"abstract":"<p><strong>Background: </strong>Reproductive health considerations are critical to patients with IDH-mutant (IDHm) glioma as they are mainly diagnosed during their reproductive years. Given the recent introduction of IDH inhibitors (IDHi) for the treatment of IDHm glioma, we sought to review the current understanding of reproductive implications of IDHi therapy, and report how frequently documented reproductive health conversations take place in the clinic when considering IDHi initiation.</p><p><strong>Methods: </strong>We searched the literature for studies evaluating the effects of IDHi therapy on reproductive health. We additionally retrospectively collected clinical data from reproductive-age patients with IDHm glioma treated at the Dana-Farber Cancer Institute and Mass General Brigham who received or were considered for IDHi therapy between 2018 and 2024. Medical records were reviewed for documentation of fertility and contraception discussions at the time of IDHi consideration.</p><p><strong>Results: </strong>Other than limited preclinical studies described on Food and Drug Administration labels, no other data on the effects of IDHi on reproductive health were found. Of 119 patients considered for IDHi therapy, 54 (45%) had no documented fertility conversation in relation to IDHi, and 92 (77%) had no documented contraception conversation. On univariable analysis, factors significantly associated with not having fertility conversations were older age (OR: 0.94, CI: 0.88-1.0), male sex (OR: 0.50, CI: 0.23-1.07), and prior fertility conversation (OR: 0.41, CI: 0.18-0.88).</p><p><strong>Conclusions: </strong>According to our institutional data, conversations regarding IDHi reproductive risks are not generally documented, contrary to guideline recommendations. Future studies are required to better understand the impact of IDHi therapy on fertility and fetal development.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"12 6","pages":"1040-1050"},"PeriodicalIF":2.5,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12741829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850453","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":"Patient and caregiver experiences with selumetinib for the treatment of pediatric patients with neurofibromatosis type 1 and plexiform neurofibromas.","authors":"Julia Meade, Michael Blackowicz, Ayo Adeyemi, Randolph de la Rosa Rodriguez, Xiaoqin Yang, Theresa Dettling","doi":"10.1093/nop/npaf078","DOIUrl":"10.1093/nop/npaf078","url":null,"abstract":"<p><strong>Background: </strong>Plexiform neurofibromas (PN) affect 20%-50% of patients with neurofibromatosis type 1 (NF1) and can lead to pain, disfigurement, motor dysfunction, compression of vital structures, and risk of malignant degeneration. Selumetinib was the first pharmacotherapy approved for children aged ≥2 years with symptomatic, inoperable PN in the United States and other countries. This qualitative study was conducted to better understand the drivers for initiating selumetinib and the impact of treatment on quality of life (QoL) from the perspective of pediatric patients with NF1-PN and their caregivers.</p><p><strong>Methods: </strong>The study included pediatric patients in the United States (aged 9-18 years) who had been prescribed selumetinib (≥6 months), and their caregivers. Interviews were conducted, and thematic analyses were performed to identify key concepts. A saturation approach established the point at which no new key concepts were being identified with successive interviews.</p><p><strong>Results: </strong>Prior to initiating selumetinib, children (<i>N</i> = 10) and their caregivers (<i>N</i> = 19) reported that PN-related issues, such as pain, impacted the lives of those with NF1-PN. Caregivers played a key role in treatment decisions, and initiation of selumetinib helped meet treatment goals, including PN size reduction, pain improvement, and improved QoL. Patients experienced increased energy, and improvements in pain and all QoL domains post-selumetinib initiation.</p><p><strong>Conclusions: </strong>Overall, patients and caregivers reported improvements in pain and QoL after selumetinib initiation. The qualitative, real-world nature of this study provides insights into patient and caregiver perspectives, and the impact of selumetinib on the patient journey.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 1","pages":"86-96"},"PeriodicalIF":2.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378054","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":"Cognitive function in long-term survivors after treatment for brain metastases compared with normative samples.","authors":"Guro Lindviksmoen Astrup, Monica Kløvstad Siksjø, Nina Aass, Guido Alves, Kolbjørn Kallesten Brønnick, Marianne Jensen Hjermstad, Stein Kaasa, Astrid Telhaug Karlsson, Nils Inge Landrø, Ole-Bjørn Tysnes, Therese Seierstad, Olav E Yri","doi":"10.1093/nop/npaf083","DOIUrl":"10.1093/nop/npaf083","url":null,"abstract":"<p><strong>Background: </strong>Few studies have examined cognitive function in long-term survivors with brain metastases (BM). The aim of this study was to assess performance-based cognitive function and compare it with normative samples.</p><p><strong>Methods: </strong>Patients with ≥2-year survival after a first-time BM diagnosis completed neuropsychological tests assessing the following neurocognitive domains: processing speed, executive functioning, mental flexibility, visual learning and memory, verbal learning and memory, attention, and working memory. Test scores were converted into standardized <i>z</i>-scores using normative sample means and standard deviations (SD). The proportions of patients with an individual <i>z</i>-score of ≤-1 and ≤-1.5 SD below the normative sample means were calculated to indicate subclinical and clinically significant impairment.</p><p><strong>Results: </strong>Forty-one patients (median age 58, 24 women) completed assessments at a median of 32 months (min-max: 26-47) after the BM diagnosis. On a group level, patients performed poorer than normative samples in tests within all domains except verbal learning and memory. The deviation was most pronounced in a subtest assessing mental flexibility. The proportion of patients with subclinical or clinically significant impairment ranged from 29% to 59% and 7% to 51% between domains, respectively. Seventy-three percent had at least subclinical and 59% had clinically significant impairment in at least 1 domain.</p><p><strong>Conclusions: </strong>Long-term survivors with BM performed poorer than normative samples within nearly all neurocognitive domains, particularly executive functioning and mental flexibility. This domain is important for daily living and social functioning, and clinicians should provide information about the implications of BM and tailor patient care to optimize functioning and quality of life.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 1","pages":"178-188"},"PeriodicalIF":2.5,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377868","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":"Preserved IDH mutation and methylation class in vorasidenib nonresponders: A report of 2 cases.","authors":"Mehdi Touat, Jacqueline Lehmann-Che, Salah Eddine O Kacimi, Besma Barka, Homa Adle-Biassette, Chiara Villa, Brigitte Poirot, Sébastien Froelich, Franck Bielle, Emmanuel Mandonnet","doi":"10.1093/nop/npaf081","DOIUrl":"10.1093/nop/npaf081","url":null,"abstract":"<p><strong>Background: </strong>The INDIGO trial recently showed that vorasidenib improves progression-free survival in patients with grade 2 IDH-mutated glioma. However, 20%-25% of patients experienced disease progression within the first year, referred to here as nonresponders. This finding raises the question of whether such resistance may be linked to the selection of an IDH-wildtype clone, potentially decreasing subsequent response to conventional treatments.</p><p><strong>Case summary: </strong>We present 2 patients in whom postoperative administration of vorasidenib following initial resection failed to prevent the progression of residual tumor. After vorasidenib discontinuation, both patients were successfully managed with a combination of conventional treatments, including new surgery, chemotherapy, and radiation therapy. Molecular analysis confirmed the preservation of the IDH mutation, MGMT status, and methylation class in the recurrent tumor in both cases. At the last follow-up, 3 years after vorasidenib discontinuation, the disease remained stable in 1 patient, while the other one had recurred.</p><p><strong>Conclusions: </strong>Vorasidenib does not appear to select an IDH-wildtype clone that would potentially reduce the tumor's sensitivity to standard therapies typically used in IDH-mutated glioma.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 1","pages":"217-221"},"PeriodicalIF":2.5,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377994","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 constitutes optimal care coordination for primary brain tumors and how do we assess it in Australia and Aotearoa New Zealand? A Delphi consensus study.","authors":"Megan S Jeon, Sharon He, Joanne Shaw, Eng-Siew Koh, Brian Kelly, Mark B Pinkham, Dianne M Legge, Georgia K B Halkett, Raymond J Chan, Tamara Ownsworth, Ursula M Sansom-Daly, Marina Kastelan, Haryana M Dhillon","doi":"10.1093/nop/npaf082","DOIUrl":"10.1093/nop/npaf082","url":null,"abstract":"<p><strong>Background: </strong>People with primary brain tumors (PBT) and their carers experience diverse issues and functional impairments, which can form barriers to accessing tailored health care. Care coordination (CC) addresses this dual challenge and is critical to achieving high-quality care for PBT. We aimed to develop a consensus framework and assessable quality indicators for optimal CC for PBT.</p><p><strong>Methods: </strong>A 2-phase, modified Delphi process was conducted. In Phase 1, a preliminary framework of 4 domains and 140 items was identified from a scoping review and expert stakeholder advisory group discussion (<i>n</i> = 14). In Phase 2, multidisciplinary panel members (<i>n</i> = 40) with expertise in clinical management and support for PBT indicated level of agreement (consensus criteria: ≥80% agreement and a median score of ≥4) on proposed items using a 5-point Likert scale. The expert stakeholder advisory group finalized components and indicators based on panel consensus findings.</p><p><strong>Results: </strong>Consensus was achieved for 97/140 items across four domains (definition, objective, components, and indicators), and a further 33 items approached consensus following 2 survey rounds. Panelist ratings on quality indicators for CC varied, especially for items related to indicators of healthcare system governance (range 48%-79% agreement). The expert stakeholder advisory group finalized the inclusion of 6 additional items based on feedback from panelists, producing a final list of 136 items.</p><p><strong>Conclusions: </strong>We defined a novel framework of CC specific to PBT, which presents a consensus-based definition and objectives for CC and comprehensive lists of components and quality indicators. The framework provides a useful template for developing models of CC.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 1","pages":"162-177"},"PeriodicalIF":2.5,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378132","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, H3-wildtype, IDH-wildtype: Refining diagnostic criteria and exploring clinical associations.","authors":"Supriya Bhardwaj, Jyotsna Singh, Swati Singh, Charli Roy, Hemlata Jangir, Srinidhi Vasant, Shweta Kedia, Ajay Garg, Ashish Suri, Mehar Chand Sharma, Chitra Sarkar, Vaishali Suri","doi":"10.1093/nop/npaf079","DOIUrl":"10.1093/nop/npaf079","url":null,"abstract":"<p><strong>Background: </strong>Diffuse pediatric-type high-grade gliomas (pHGGs), H3-wildtype (H3 WT), and IDH-wildtype (IDH WT), represent a newly recognized, highly malignant brain tumor entity with unique molecular and epigenetic profiles. Despite their recent inclusion in the WHO 2021 classification, their histological and molecular diversity presents significant diagnostic and therapeutic challenges.</p><p><strong>Methods: </strong>This study analyzed 12 cases of pHGGs, H3 WT and IDH WT, identified through whole-genome methylation profiling. Clinical, radiological, and histopathological evaluations were complemented by immunohistochemical profiling, employing an extended spectrum of antibodies, and molecular studies. Methylation profiling enabled precise tumor classification and correlation with known subtypes such as RTK-1, RTK-2, and MYCN.</p><p><strong>Results: </strong>Among the 12 cases, 7 were classified under the RTK-1 subtype, 3 under RTK2 subtype, and a case each under MYCN, pHGGs, H3 WT, and IDH WT subtype B. Notably, 5/12 cases demonstrated a loss of H3K27me3 expression, contradicting the WHO 2021 recommendation for its retention as a diagnostic criterion. Furthermore, 6/7 RTK-1 subtype cases were linked to either mismatch-repair (MMR) deficiency or radiation-induced gliomas, highlighting an enrichment of these clinical scenarios within this subgroup. MGMT promoter methylation was observed in only 4/12 of these cases, consistent with its low prevalence in this tumor category.</p><p><strong>Conclusions: </strong>This study provides a comprehensive characterization of pHGGs, H3 WT, IDH WT, and emphasizes the clinical and molecular complexity of this rare tumor entity. The findings challenge current WHO diagnostic criteria regarding H3K27me3 retention and demonstrate the critical role of molecular diagnostics, particularly methylation profiling, in refining classification and guiding clinical management. These results advocate for re-evaluation of existing diagnostic frameworks to better accommodate the observed variability and associations in this challenging tumor subtype.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 1","pages":"97-104"},"PeriodicalIF":2.5,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377974","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":"Tumor inflammation-associated neurotoxicity in children with diffuse intrinsic pontine glioma receiving B7-H3-targeting CAR T cells on BrainChild-03.","authors":"Rebecca Ronsley, Michelle Choe, Jason Wright, Kristy Seidel, Amy Lee, Jason Wendler, Colleen Annesley, Michael C Jensen, Julie R Park, Nicholas A Vitanza, Juliane Gust","doi":"10.1093/nop/npaf080","DOIUrl":"10.1093/nop/npaf080","url":null,"abstract":"<p><strong>Background: </strong>Chimeric antigen receptor (CAR) T cell therapy is a promising treatment for central nervous system (CNS) tumors like diffuse intrinsic pontine glioma (DIPG) and diffuse midline glioma (DMG). Unlike systemic administration, locoregional CAR T therapy may result in tumor inflammation-associated neurotoxicity (TIAN), which was recently defined. This study retrospectively applies TIAN criteria to patients with DIPG/pontine DMG treated with intraventricular B7-H3 CAR T cells in the BrainChild-03 (BC-03) trial (NCT04185038).</p><p><strong>Methods: </strong>A retrospective analysis of DIPG/pontine DMG patients treated with locoregional B7-H3 CAR T cells in BC-03 was conducted. Neurological symptoms, headache, fever, hydrocephalus, and inflammatory markers were extracted from case reports and medical records. TIAN was classified as type 1 (mechanical damage) or type 2 (electrophysiologic dysfunction), and symptom patterns, resolution, imaging findings, and management were analyzed.</p><p><strong>Results: </strong>Among 21 patients (ages 2-22) receiving ≥1 infusion, 16 (76%) met TIAN criteria at least once. TIAN occurred in 49 of 152 infusions (32%), mostly grade 1 (<i>n</i> = 34) or grade 2 (<i>n</i> = 14), with one grade 3 event. Common symptoms included headache with fever (51%) and neurologic changes with headache (31%). In most patients, Type 1 vs Type 2 TIAN could not be defined; however, 1 patient required CSF diversion (type 1 TIAN), and 13 had worsening preexisting deficits (type 2). Median symptom resolution was <24 h (range: 0-33).</p><p><strong>Conclusions: </strong>TIAN was common within this cohort but mostly low-grade and transient. Refining its classification and understanding its clinical impact will aid safety assessments and trial comparisons for CNS-directed CAR T therapies.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 1","pages":"105-111"},"PeriodicalIF":2.5,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378111","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":"Self-reported physical functioning and physical fitness in glioma patients.","authors":"Marieke E C Blom, Maxine Gorter, Vera Belgers, Jantine G Röttgering, Philip C de Witt Hamer, Johanna M Niers, Marike R van Lingen, Mona L M Zimmermann, Hans Knoop, Martin Klein, Linda Douw","doi":"10.1093/nop/npaf076","DOIUrl":"10.1093/nop/npaf076","url":null,"abstract":"<p><strong>Background: </strong>Knowledge about glioma patients' physical functioning and physical fitness throughout the disease trajectory is limited. We analyzed self-reported functioning and fitness in a large sample of glioma patients preoperatively and after primary treatment.</p><p><strong>Methods: </strong>We used the physical functioning subscale of the 36-Item Short Form Health Survey (SF36) and three questions about physical fitness from the Checklist of Individual Strength (CIS20). Scores were compared to age-, sex-, and education-matched population controls, preoperatively and after treatment. In patients with repeated assessments, changes over time were analyzed. Correlations between patient, disease, and treatment characteristics and functioning and fitness at both time points, and with change over time, were explored. Analyses were performed separately for World Health Organization grade II, III, and IV glioma.</p><p><strong>Results: </strong>Grade III patients had significantly lower functioning than controls, both preoperatively and after treatment, and declined over time. No significant differences with controls were found for grade II and IV patients, or for fitness. Grade II patients reported better functioning than grade III and IV preoperatively and better than grade III after treatment. Lower Karnofsky Performance Status was generally related to lower functioning and fitness, while older age, female sex, and lower education appeared in subgroup analyses. Age, neurological disabilities and tumor histology were associated with changes over time.</p><p><strong>Conclusions: </strong>Grade III glioma patients showed poorer functioning than population controls, which declined over time. Grade II patients reported better outcomes than the other subgroups, although individual variability was high. These findings highlight the need for personalized approaches addressing functioning and fitness in glioma.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 1","pages":"149-161"},"PeriodicalIF":2.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378126","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 outcomes following awake surgery in adult glioma patients: A systematic review.","authors":"Laura Amores-Carrera, Isabel Martín-Monzón","doi":"10.1093/nop/npaf075","DOIUrl":"10.1093/nop/npaf075","url":null,"abstract":"<p><strong>Background: </strong>Awake craniotomy is essential for glioma resection in functionally integrated brain regions, allowing real-time monitoring to reduce cognitive and emotional deficits. Although widely used, its long-term neuropsychological effects remain debated. This systematic review aims to investigate cognitive and emotional outcomes after awake brain surgery and the factors that influence recovery, including extent of resection, follow-up timing, and neural plasticity.</p><p><strong>Methods: </strong>This systematic review analyzes 34 studies on pre- and postoperative functional outcomes in glioma patients undergoing awake surgery. Following PRISMA guidelines, studies were selected with adult glioma patients (WHO grade I-IV) who had neuropsychological assessments before and after surgery. Data on preoperative cognitive profiles, recovery trajectories, and follow-up durations were examined, focusing on methodological consistency and assessment tools.</p><p><strong>Results: </strong>The findings demonstrated substantial variability in functional outcomes, with many patients recovering within 3 to 6 months post-surgery, while others experienced persistent deficits. Functional recovery was influenced not only by the extent of tumor resection but also by network-level reorganization. Methodological inconsistencies in neuropsychological assessments highlighted the need for standardized, personalized evaluation protocols, emphasizing the importance of comprehensive functional assessments.</p><p><strong>Conclusions: </strong>This review emphasizes the shift from a localized cortical approach to a dynamic, network-based view of cognitive and emotional recovery. It calls for standardized, personalized neuropsychological assessments to optimize rehabilitation, along with extended follow-ups, and multidisciplinary care for long-term quality of life. Future research should refine assessment methods and strategies to better understand neuroplasticity and improve clinical outcomes in neuro-oncology.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 1","pages":"23-47"},"PeriodicalIF":2.5,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378034","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}