Neuro-oncology practice最新文献

{"title":"Is the \"unresected\" glioblastoma population a real specific entity?","authors":"Frederic Dhermain","doi":"10.1093/nop/npad051","DOIUrl":"10.1093/nop/npad051","url":null,"abstract":"","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10666799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44360386","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":"Impact of socioeconomic status and chemotherapy on neurocognitive performance in children with brain tumors","authors":"Leslie Chang, Palak P Patel, Yifan Zhang, Alan Cohen, Kenneth Cohen, Lisa Jacobson, Matthew Ladra, Rachel K Peterson, Sahaja Acharya","doi":"10.1093/nop/npad049","DOIUrl":"https://doi.org/10.1093/nop/npad049","url":null,"abstract":"Abstract Background Although the relationship between radiation and neurocognition has been extensively studied in the pediatric brain tumor population, it is increasingly recognized that neurocognitive impairment is multifactorial. Therefore, we quantified the effect of socioeconomic status (SES) and chemotherapy on neurocognitive impairment and decline post-treatment. Methods Eligible patients included those diagnosed with a brain tumor at < 22 years of age with ≥1 neurocognitive assessment. Neurocognitive impairment was defined as performance 1.5 standard deviations below the normative mean using age-standardized measures of intellectual function. Neurocognitive decline was defined as a negative slope. Neurocognitive outcomes included Wechsler indices of Full-Scale Intelligence Quotient (IQ). Logistic regression identified variables associated with neurocognitive impairment. Longitudinal data was analyzed using linear mixed models. Results Eligible patients (n = 152, median age at diagnosis = 9.6 years) had a mean neurocognitive follow-up of 50.2 months. After accounting for age and receipt of craniospinal irradiation, patients with public insurance had 8-fold increased odds of impaired IQ compared to private insurance (odds ratio [OR]: 7.59, P < .001). After accounting for age, change in IQ was associated with chemotherapy use (slope: −0.45 points/year with chemotherapy vs. 0.71 points/year without chemotherapy, P = .012). Conclusions Public insurance, an indicator of low SES, was associated with post-treatment impairment in IQ, highlighting the need to incorporate SES measures into prospective studies. Chemotherapy was associated with change in IQ. Further work is needed to determine whether impairment associated with low SES is secondary to baseline differences in IQ prior to brain tumor diagnosis, brain tumor/therapy itself, or some combination thereof.","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135164887","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":"Should simple bedside neurocognitive data now be routinely gathered prior to brain tumor surgery?","authors":"Robin Grant","doi":"10.1093/nop/npad048","DOIUrl":"https://doi.org/10.1093/nop/npad048","url":null,"abstract":"Journal Article Accepted manuscript Should simple bedside neurocognitive data now be routinely gathered prior to brain tumor surgery? Get access Robin Grant Robin Grant Consultant Neurologist, Edinburgh robin.grant7@gmail.com https://orcid.org/0000-0003-2597-9510 Search for other works by this author on: Oxford Academic Google Scholar Neuro-Oncology Practice, npad048, https://doi.org/10.1093/nop/npad048 Published: 07 August 2023 Article history Received: 30 July 2023 Published: 07 August 2023","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135998571","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":"Utility of a prognostic assessment tool to predict survival following surgery for brain metastases.","authors":"Hadleigh Cuthbert, Max Riley, Shreya Bhatt, Claudia Kate Au-Yeung, Ayesha Arshad, Sondos Eladawi, Athanasios Zisakis, Georgios Tsermoulas, Colin Watts, Victoria Wykes","doi":"10.1093/nop/npad047","DOIUrl":"10.1093/nop/npad047","url":null,"abstract":"<p><strong>Background: </strong>Brain metastases account for more than 50% of all intracranial tumors and are associated with poor outcomes. Treatment decisions in this highly heterogenous cohort remain controversial due to the myriad of treatment options available, and there is no clearly defined standard of care. The prognosis in brain metastasis patients varies widely with tumor type, extracranial disease burden and patient performance status. Decision-making regarding treatment is, therefore, tailored to each patient and their disease.</p><p><strong>Methods: </strong>This is a retrospective cohort study assessing survival outcomes following surgery for brain metastases over a 50-month period (April 1, 2014-June 30, 2018). We compared predicted survival using the diagnosis-specific Graded Prognostic Assessment (ds-GPA) with actual survival.</p><p><strong>Results: </strong>A total of 186 patients were included in our cohort. Regression analysis demonstrated no significant correlation between actual and predicted outcome. The most common reason for exclusion was insufficient information being available to the neuro-oncology multidisciplinary team (MDT) meeting to allow GPA calculation.</p><p><strong>Conclusions: </strong>In this study, we demonstrate that \"predicted survival\" using the ds-GPA does not correlate with \"actual survival\" in our operated patient cohort. We also identify a shortcoming in the amount of information available at MDT in order to implement the GPA appropriately. Patient selection for aggressive therapies is crucial, and this study emphasizes the need for treatment decisions to be individualized based on patient and cancer clinical characteristics.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10666803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41493433","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":"Current status of DNA methylation profiling in neuro-oncology as a diagnostic support tool: A review.","authors":"Jyotsna Singh, Saumya Sahu, Trishala Mohan, Swati Mahajan, Mehar C Sharma, Chitra Sarkar, Vaishali Suri","doi":"10.1093/nop/npad040","DOIUrl":"10.1093/nop/npad040","url":null,"abstract":"<p><p>Over the last 2 decades, high throughput genome-wide molecular profiling has revealed characteristic genetic and epigenetic alterations associated with different types of central nervous system (CNS) tumors. DNA methylation profiling has emerged as an important molecular platform for CNS tumor classification with improved diagnostic accuracy and patient risk stratification in comparison to the standard of care histopathological analysis and any single molecular tests. The emergence of DNA methylation arrays have also played a crucial role in refining existing types and the discovery of new tumor types or subtypes. The adoption of methylation data into neuro-oncology has been greatly aided by the development of a freely accessible machine learning-based classifier. In this review, we discuss methylation workflow, address the utility of DNA methylation profiling in CNS tumors in a routine diagnostic setting, and provide an overview of the methylation-based tumor types and new types or subtypes identified with this platform.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10666812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41267773","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":"Paving the way to evidence-based clinical practice: Establishing effective caregiver and family support interventions.","authors":"Karin Piil, Florien Boele","doi":"10.1093/nop/npad041","DOIUrl":"10.1093/nop/npad041","url":null,"abstract":"","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10666806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44543206","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 return to work after a primary brain tumor.","authors":"Emma Nicklin, Isaac Phang, Susan C Short, Petra Hoogendoorn, Florien W Boele","doi":"10.1093/nop/npad039","DOIUrl":"10.1093/nop/npad039","url":null,"abstract":"<p><strong>Background: </strong>Studies focusing on the return to work (RTW) experiences of patients with a brain tumor (BT) are scarce. We aimed to explore, in-depth, the occupational expectations, experiences, and satisfaction of patients who RTW after a BT diagnosis and treatment, those not able to, and their family caregivers.</p><p><strong>Methods: </strong>This multicenter, cross-sectional study utilized semi-structured interviews and reflexive thematic analysis. Interviews were conducted with adults diagnosed with primary BT, in employment/self-employed before diagnosis, currently in follow-up care, and also with their caregivers.</p><p><strong>Results: </strong>In total, 23 interviews (17 patients/6 caregivers) took place. Five themes were developed: (1) Early (adjustments and) expectations: \"Thought I would be back at work the following Monday\"; pre-treatment patients wanted to be better informed about potential recovery time and side-effects. (2) Drivers to RTW: \"Getting my life back on track\"; RTW was seen as a symbol of normality and also dictated by financial pressures. (3) Experiences returning to work: \"It's had its ups and downs\": patients who had successfully returned were supported by employers financially, emotionally, and practically. (4) Required support: \"He had surgery and that was it\": suggested support included a back-to-work scheme and comprehensive financial support. (5) Caring and paid work: The \"juggling act\": carer's work was significantly impacted; often reducing/increasing their working hours while managing increasing caring demands.</p><p><strong>Conclusions: </strong>Future research focusing on RTW in neuro-oncology populations is needed. Interventions should be developed to improve employer/employee communication, and increase knowledge about BT care and possibilities for RTW, to support patients and caregivers towards sustained employment.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10666801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42408215","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":"An Impact Factor for <i>Neuro-Oncology Practice</i>.","authors":"Martin J B Taphoorn","doi":"10.1093/nop/npad036","DOIUrl":"10.1093/nop/npad036","url":null,"abstract":"","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10346385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10184111","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 benefit of complete resection of contrast enhancing tumor in glioblastoma patients: A population-based study.","authors":"Eduardo Erasmo Mendoza Mireles, Erlend Skaga, Andres Server, Henning Leske, Petter Brandal, Eirik Helseth, Pål A Rønning, Einar O Vik-Mo","doi":"10.1093/nop/npad037","DOIUrl":"10.1093/nop/npad037","url":null,"abstract":"<p><strong>Background: </strong>New treatment modalities have not been widely adopted for patients with glioblastoma (GBM) after the addition of temozolomide to radiotherapy. We hypothesize that increased extent of resection (EOR) has resulted in improved survival for surgically treated patients with glioblastoma at the population level.</p><p><strong>Methods: </strong>Retrospective analysis of adult patients operated for glioblastoma in the population of South-Eastern Norway. Patients were stratified into Pre-temozolomide- (2003-2005), temozolomide- (2006-2012), and resection-focused period (2013-2019) and evaluated according to age and EOR.</p><p><strong>Results: </strong>The study included 1657 adult patients operated on for supratentorial glioblastoma. The incidence of histologically confirmed glioblastoma increased from 3.7 in 2003 to 5.3 per 100 000 in 2019. The median survival was 11.4 months. Complete resection of contrast-enhancing tumor (CRCET) was achieved in 386 patients, and this fraction increased from 13% to 32% across the periods. Significant improvement in median survival was found between the first 2 periods and the last (10.5 and 10.6 vs. 12.3 months; <i>P</i> < .01), with a significant increase in 3- and 5-year survival probability to 12% and 6% (<i>P</i> < .01). Patients with CRCET survived longer than patients with non-CRCET (16.1 vs. 10.8 months; <i>P</i> < .001). The median survival doubled in patients ≥70 years and (12.1 months). Survival was similar between the time periods in patients where CRCET was achieved.</p><p><strong>Conclusions: </strong>We demonstrate an improved survival of GBM patients at the population level associated with an increased fraction of patients with CRCET. The data support the importance of CRCET to improve glioblastoma patient outcomes.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10666813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49222398","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":"Prevalence of pathogenic germline variants in adult-type diffuse glioma.","authors":"Malcolm F McDonald, Lyndsey L Prather, Cassandra R Helfer, Ethan B Ludmir, Alfredo E Echeverria, Shlomit Yust-Katz, Akash J Patel, Benjamin Deneen, Ganesh Rao, Ali Jalali, Shweta U Dhar, Chris I Amos, Jacob J Mandel","doi":"10.1093/nop/npad033","DOIUrl":"10.1093/nop/npad033","url":null,"abstract":"<p><strong>Background: </strong>No consensus germline testing guidelines currently exist for glioma patients, so the prevalence of germline pathogenic variants remains unknown. This study aims to determine the prevalence and type of pathogenic germline variants in adult glioma.</p><p><strong>Methods: </strong>A retrospective review at a single institution with paired tumor/normal sequencing from August 2018-April 2022 was performed and corresponding clinical data were collected.</p><p><strong>Results: </strong>We identified 152 glioma patients of which 15 (9.8%) had pathogenic germline variants. Pathogenic germline variants were seen in 11/84 (13.1%) of Glioblastoma, <i>IDH</i> wild type; 3/42 (7.1%) of Astrocytoma, <i>IDH</i> mutant; and 1/26 (3.8%) of Oligodendroglioma, <i>IDH</i> mutant, and 1p/19q co-deleted patients. Pathogenic variants in <i>BRCA2</i>, <i>MUTYH,</i> and <i>CHEK2</i> were most common (3/15, 20% each). <i>BRCA1</i> variants occurred in 2/15 (13%) patients, with variants in <i>NF1</i>, <i>ATM</i>, <i>MSH2</i>, and <i>MSH3</i> occurring in one patient (7%) each. Prior cancer diagnosis was found in 5/15 patients (33%). Second-hit somatic variants were seen in 3/15 patients (20%) in <i>NF1</i>, <i>MUTYH,</i> and <i>MSH2</i>. Referral to genetics was performed in 6/15 (40%) patients with pathogenic germline variants. 14/15 (93%) of patients discovered their pathogenic variant as a result of their paired glioma sequencing.</p><p><strong>Conclusions: </strong>These findings suggest a possible overlooked opportunity for determination of hereditary cancer syndromes with impact on surveillance as well as potential broader treatment options. Further studies that can determine the role of variants in gliomagenesis and confirm the occurrence and types of pathogenic germline variants in patients with <i>IDH</i> wild type compared to <i>IDH</i> mutant tumors are necessary.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10502787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10309646","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}