Neuro-oncology最新文献

{"title":"Association between temozolomide-related hematologic toxicity and health-related quality of life (HRQoL) in patients with newly diagnosed glioblastoma.","authors":"Abigirl Machingura, Johannes Weller, Johan A F Koekkoek, Linda Dirven, Matthias Preusser, Patrick Roth, Roger Stupp, Michael Weller, Madeline Pe, Thierry Gorlia, Martin J B Taphoorn, Emilie Le Rhun, Clemens Seidel","doi":"10.1093/neuonc/noag224","DOIUrl":"https://doi.org/10.1093/neuonc/noag224","url":null,"abstract":"<p><strong>Background: </strong>Hematologic toxicity is a major adverse event of temozolomide chemoradiotherapy for newly diagnosed glioblastoma. Although severe hematologic toxicity occurs in approximately 10% of patients, its impact on HRQoL is unknown. This study evaluated the association between temozolomide-related hematologic toxicity and HRQoL in patients with newly diagnosed glioblastoma.</p><p><strong>Material and methods: </strong>Patients with newly diagnosed glioblastoma treated with temozolomide chemoradiotherapy and available HRQoL data from three clinical trials were included. Primary HRQoL outcomes were physical, social, and role functioning, pain, fatigue, nausea/vomiting, and global health status. Severe hematologic toxicity was defined grade 3-4 neutropenia, lymphopenia, thrombocytopenia, or anemia; febrile neutropenia; or prolonged (>30 days) grade 2 toxicity. Associations between severe hematologic toxicity and HRQoL were evaluated using linear mixed models. Clinical relevance was interpreted as glioma-specific minimally important difference thresholds.</p><p><strong>Results: </strong>Among 1288 patients, 8% experienced severe hematologic toxicity during the concomitant phase, 6% during the maintenance and 1% during both. During the concomitant phase, severe hematologic toxicity was more frequent in females and in patients with MGMT promoter methylation. From baseline to week 6, global health mean scores declined by - 8.52 points in patients with severe toxicity and -4.78 points in those without, with a non-significant difference (p = 0.24). Similar patterns were observed for physical, social, and role functioning. Symptom scales were numerically worse in severe toxicity, but not significantly different. During maintenance phase, differences were minor.</p><p><strong>Conclusion: </strong>Severe temozolomide-related hematologic toxicity showed no statistically significant association with impaired HRQoL, suggesting limited impact on patient-reported functioning and symptoms. Possible effects on psychological functioning should be examined further.</p>","PeriodicalId":19377,"journal":{"name":"Neuro-oncology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduced-dose Radiotherapy without Chemotherapy for Intracranial Germinomas: Results from an Asian Multicenter Study.","authors":"Chan Woo Wee, Hwa Kyung Byun, Yi-Wei Chen, Jaeho Cho, Yu-Mei Kang, Yen-Lin Liu, Dong-Seok Kim, Kyu-Won Shim, Jung Woo Han, Chuhl Joo Lyu, I-Chun Lai, Cheng-Shien Shieh, Chang-Ok Suh, Tai-Tong Wong, Hong In Yoon, Hsin Lun Lee","doi":"10.1093/neuonc/noag219","DOIUrl":"https://doi.org/10.1093/neuonc/noag219","url":null,"abstract":"<p><strong>Background: </strong>Long-term efficacy data supporting the use of reduced-dose radiotherapy (rdRT) alone for intracranial pure germinoma remain limited. In this study, we evaluated the long-term efficacy and safety of rdRT alone in patients with this condition.</p><p><strong>Methods: </strong>We retrospectively analyzed the data of 139 patients with intracranial pure germinoma treated with RT alone, using whole-ventricle irradiation (73.6%), whole-brain irradiation (9.3%), or craniospinal irradiation (CSI, 17.1%). Patients who had M+ disease were included, whereas those treated with local RT alone were excluded. The most commonly prescribed dose to gross tumors was 30.0-30.6 Gy delivered in 15-17 fractions (median total dose, 35.5 Gy). The median extended-field (whole-ventricle, whole-brain, or craniospinal) dose was 23.4 Gy. Survival outcomes were analyzed according to total RT dose, whole-ventricle dose, RT field, and disease distribution.</p><p><strong>Results: </strong>At a median follow-up of 102 months, the 5- and 10-year event-free survival (EFS) rates were 90.0% and 88.4%, respectively, and the corresponding overall survival rates were 100.0% and 98.4%. Dose escalation beyond 30.6 Gy did not improve EFS (P = 1.000). A whole-ventricle dose of 18 Gy was not associated with inferior EFS compared with >18 Gy (P = 0.155). In patients with bifocal disease (suprasellar and pineal, n = 24), CSI significantly improved 5-year EFS (100.0% vs. 63.3%, P = 0.040). In the study-defined optimal RT group (total dose ≥30 Gy, excluding bifocal disease without CSI; n = 125), the 3- and 5-year EFS rates were 94.2% and 92.4%, respectively. No grade ≥3 acute or late RT-related toxicities or secondary malignancies were observed.</p><p><strong>Conclusions: </strong>RdRT alone, administered with an appropriate dose and RT field according to disease status, provided excellent long-term tumor control with minimal toxicity. Tumor and extended-field doses of 30.6 Gy and 18 Gy, respectively, appeared adequate. A prospective phase 2 trial is planned to further validate this treatment strategy.</p>","PeriodicalId":19377,"journal":{"name":"Neuro-oncology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommendations in cIPMACT-NOW Update 12 Should Identify Grade 2 IDH-Mutant Astrocytoma Patients with Truly Low Risk Disease by Pathology.","authors":"Daniel J Brat, Martin J van den Bent","doi":"10.1093/neuonc/noag216","DOIUrl":"https://doi.org/10.1093/neuonc/noag216","url":null,"abstract":"","PeriodicalId":19377,"journal":{"name":"Neuro-oncology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of prognostically relevant residual tumor in glioblastoma after surgery: A comparative analysis of MR-based RANO resect classes vs. [18F]FET PET.","authors":"Jens Blobner, Katharina J Schmidbauer, Michael Müther, Wolfgang Roll, Elene Nikolaishvili, Jonas Reis, Maximilian J Mair, Niklas Thon, Stephan Schoenecker, Patrick N Harter, Darius Kalasauskas, Louisa von Baumgarten, Rudolf A Werner, Florian Ringel, Walter Stummer, Joerg-Christian Tonn, Philipp Karschnia, Nathalie L Albert","doi":"10.1093/neuonc/noag212","DOIUrl":"https://doi.org/10.1093/neuonc/noag212","url":null,"abstract":"<p><strong>Background: </strong>Assessment of postoperative tumor burden is essential in IDH-wildtype glioblastoma. The RANO resect classification stratifies patients based on residual tumor volume on postoperative MRI. [¹⁸F]FET PET can detect metabolically active tumor-suspicious tissue invisible on MRI. Its additional prognostic contribution remains ill-defined.</p><p><strong>Methods: </strong>This retrospective bicentric study analyzed 140 patients with newly diagnosed IDH-wildtype glioblastoma and postoperative MRI and [¹⁸F]FET PET. MRI-derived residual tumor was classified by RANO resect; PET-derived volumes were defined using PET RANO 1.0 criteria. Spatial concordance was quantified using Dice coefficients. Prognostic associations were assessed by Cox regression. PET's incremental prognostic value was evaluated using a two-stage framework comparing MRI-only, PET-augmented, and fully adjusted models.</p><p><strong>Results: </strong>Postoperative PET-defined volumes were substantially larger than MRI-defined volumes and showed minimal spatial overlap across RANO resect classes. PET-, T1CE-, and T2/FLAIR-based tumor volumes were independently associated with OS. Residual PET-volume was associated with increasing mortality risk and remained independently associated with OS (HR 1.021 per cm³, **p = 0.002). In an imaging-only model addition of PET improved time-dependent discrimination (ΔAUC(t) 0.03-0.07) and increased Harrell's C (ΔC ≈ 0.03), indicating improved prognostic discrimination. In the fully adjusted model, adding PET significantly improved model fit (*p = 0.0049), indicating prognostic information beyond MRI-derived tumor burden and clinical covariates.</p><p><strong>Conclusions: </strong>Postoperative PET visualized tumor-suspicious volume not identified by MRI and provided additional prognostic information. These findings support the potential role of PET for refined postoperative risk stratification, while prospective studies are needed to determine whether PET-informed postoperative management improves clinical outcomes.</p>","PeriodicalId":19377,"journal":{"name":"Neuro-oncology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular upgrading of grade 2 astrocytomas in the era of targeted IDH inhibition: are we ready for the therapeutic consequences?","authors":"Quintino Giorgio D'Alessandris, Silvia Chiesa, Marco Gessi","doi":"10.1093/neuonc/noag215","DOIUrl":"https://doi.org/10.1093/neuonc/noag215","url":null,"abstract":"","PeriodicalId":19377,"journal":{"name":"Neuro-oncology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EGFR-co-amplified lncRNA ELDR drives glioblastoma tumorigenicity by enhancing BMI1 activity.","authors":"Xiaozhou Yu, Runxin Wu, Tianzhi Huang, Deanna Tiek, Maya Walker, Qiu He, Craig Horbinski, Bo Hu, Shi-Yuan Cheng","doi":"10.1093/neuonc/noag213","DOIUrl":"https://doi.org/10.1093/neuonc/noag213","url":null,"abstract":"<p><strong>Background: </strong>In glioblastoma (GBM), epidermal growth factor receptor (EGFR) amplification, one of the most prevalent genetic alterations, often occurs on extrachromosomal DNAs (ecDNAs) that contain amplified oncogenes and regulatory elements, driving tumor progression. Despite the central oncogenic role of EGFR amplification, therapeutic strategies targeting EGFR have demonstrated limited clinical efficacy, suggesting that additional mechanisms may underlie EGFR-driven GBM malignancy and treatment resistance. Long non-coding RNAs (lncRNAs) are critical regulators in cancer; however, the roles of EGFR-associated lncRNAs-particularly those localized on ecDNA-in GBM tumorigenicity and therapeutic resistance remain poorly understood.</p><p><strong>Methods: </strong>Transcriptomic and genomic analyses were performed to identify lncRNAs co-amplified with EGFR. Biochemical and molecular biological studies were carried out to reveal the mechanisms. In vivo xenograft models were used to evaluate the tumorigenicity and the therapeutic efficacy of combination treatment strategies.</p><p><strong>Results: </strong>The lncRNA EGFR long non-coding downstream RNA (ELDR) was co-amplified with EGFR on ecDNA and chromosomes and was associated with poor prognosis in glioma. ELDR promoted GBM tumorigenicity through a BMI1-dependent epigenetic mechanism operating in parallel with canonical EGFR signaling. Mechanistically, ELDR interacted with purine-rich element-binding protein A (PURA), disrupted the inhibitory PURA-BMI1 interaction, and thereby enhanced the activity of BMI1, a core component of Polycomb repressive complex 1 (PRC1). Therapeutically, combining a BMI1 inhibitor or ELDR-targeting antisense oligonucleotides (ASOs) with an EGFR inhibitor erlotinib significantly enhanced antitumor efficacy in preclinical models of  EGFR  -amplified GBM with high ELDR expression.</p><p><strong>Conclusion: </strong>EGFR co-amplified ELDR promotes GBM tumorigenicity by enhancing BMI1 activity. Targeting the ELDR-BMI1 axis in combination with EGFR inhibition represents a promising therapeutic strategy for a subset of  EGFR  -amplified GBMs with high ELDR expression.</p>","PeriodicalId":19377,"journal":{"name":"Neuro-oncology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ascertainment of overall survival and the proposed molecular grading tier in IDH-mutant astrocytoma.","authors":"Samuel N Emerson","doi":"10.1093/neuonc/noag210","DOIUrl":"https://doi.org/10.1093/neuonc/noag210","url":null,"abstract":"","PeriodicalId":19377,"journal":{"name":"Neuro-oncology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to \"Ascertainment of overall survival and the proposed molecular grading tier in IDH-mutant astrocytoma\".","authors":"Michael Christian Virata, Jorge Samanamud, Cheyanne C Slocum, Shrishtee Kandoi, Phuong Nguyen, Milan R Savani, Diana D Shi, Sachein Sharma, Satomi Hiya, Carolina Maldonado-Díaz, Kevin Clare, Raquel T Yokoda, Meenakshi Vij, Ema Mir, Yurika Nishikawa, Melissa Umphlett, Raymund L Yong, Joshua B Bederson, Thenzing J Silva-Hurtado, Steven Brem, Dolores Hambardzumyan, Matija Snuderl, Mariano S Viapiano, Kalil G Abdullah, Samuel K McBrayer, Kimmo J Hatanpaa, Jamie M Walker, Nadejda M Tsankova, Timothy E Richardson","doi":"10.1093/neuonc/noag211","DOIUrl":"https://doi.org/10.1093/neuonc/noag211","url":null,"abstract":"","PeriodicalId":19377,"journal":{"name":"Neuro-oncology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conventionally Fractionated Re-irradiation for Recurrent Ependymoma.","authors":"Thomas E Merchant, Hannah M Worrall, Shengjie Wu, Yimei Li, Valerie J Groben, Elizabeth A Burghen, Haley M Ruleman, Kathryn Witt, Christina Bosley, Erika Krzeminski, Christopher L Tinkle, Raja B Khan, Amar Gajjar, Kelsey C Bertrand, Asim Bag, Noah D Sabin, Julie H Harreld, David W Ellison, Frederick A Boop, Paul Klimo","doi":"10.1093/neuonc/noag181","DOIUrl":"10.1093/neuonc/noag181","url":null,"abstract":"<p><strong>Background: </strong>Reirradiation is used for children and adolescents with recurrent ependymoma after prior surgery and focal irradiation. This study assessed the long-term benefits and risks of a second course of fractionated radiotherapy, patient selection, factors associated with progression-free survival (PFS) and overall survival (OS), and the role of craniospinal irradiation (CSI) at first recurrence.</p><p><strong>Methods: </strong>From July 1994 to January 2024, 150 pediatric ependymoma patients at St. Jude Children's Research Hospital received a second course of fractionated radiotherapy. Sixty-four were enrolled in a prospective trial. Inclusion required conventional fractionation (≥50.4Gy) for both courses, with CSI for metastatic disease. Kaplan-Meier estimates measured PFS and OS, Cox models assessed associations with covariates, and competing risks analysis evaluated necrosis and death from complications.</p><p><strong>Results: </strong>At 10 and 20 years, PFS/OS for the cohort were 19.5%/34.3% and 9.0%/13.1%, respectively. Females had significantly better outcomes, and survival varied by initial failure pattern. No significant difference in PFS (p = 0.1351) or OS (p = 0.2705) was found between focal irradiation and CSI for patients with local failure. Necrosis was higher with proton therapy versus photons; grade 3 necrosis after reirradiation occurred in 19.9%. The 10-year cumulative incidence of death from complications or secondary tumors was 8.5%.</p><p><strong>Conclusions: </strong>A second course of conventionally fractionated radiotherapy can extend survival in recurrent pediatric ependymoma, but prognosis remains poor, especially for those with combined local and distant failure or adverse features. CSI did not improve outcomes for local failures. Proton therapy increased necrosis risk, emphasizing the need for careful selection and follow-up.</p>","PeriodicalId":19377,"journal":{"name":"Neuro-oncology","volume":" ","pages":""},"PeriodicalIF":13.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inferring DNA methylation class from digitized pathology images and artificial intelligence: A worthy and timely application with room for improved clinical performance.","authors":"Marina Ayad, Lee A D Cooper, Daniel J Brat","doi":"10.1093/neuonc/noag149","DOIUrl":"10.1093/neuonc/noag149","url":null,"abstract":"","PeriodicalId":19377,"journal":{"name":"Neuro-oncology","volume":" ","pages":"2067-2068"},"PeriodicalIF":13.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13550670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148361610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}