Chinese Neurosurgical Journal最新文献

{"title":"One-stage hybrid operation for hypervascular central nervous system tumors: a single-center experience of 31 cases.","authors":"Mingze Wang, Zhikang Zhao, Shuo Wang, Yong Cao, Jizong Zhao","doi":"10.1186/s41016-025-00400-y","DOIUrl":"https://doi.org/10.1186/s41016-025-00400-y","url":null,"abstract":"<p><strong>Background: </strong>Surgical resection for hypervascular central nervous system tumors poses a significant challenge for neurosurgeons. Controversy remains about the effect and safety of the traditional therapeutic mode, which combines preoperative embolization and delayed tumor resection, remain controversial. Whether a one-stage hybrid operation modality offers a novel approach to address treatment challenges in a safer and more effective way remains unknown.</p><p><strong>Methods: </strong>From the neurosurgical operation database, we retrospectively reviewed patients with hypervascular central nervous system tumor patients who underwent one-stage hybrid operation between January 1, 2014, and September 30, 2024. Intraoperative blood loss, the percentage of tumor devascularization, and complications associated with embolization were recorded. Novel embolization strategies used to facilitate the resection of tumors in one-stage hybrid operations were analyzed.</p><p><strong>Results: </strong>In total, 31 hypervascular central nervous system tumor patients were recruited. The main pathological types included various types of meningiomas (45.2%), hemangioblastomas (16.1%), paragangliomas (9.7%), and solitary fibrous tumors (9.7%). Embolization of tumor-feeding arterial pedicles alone was achieved in 25 patients, and various materials, such as ethylene-vinyl alcohol copolymer, Guglielmi detachable coil, and silk suture segments, were used, in which the tumor blood supply was blocked satisfactorily and the texture became softer postembolization. Intratumoral vascular beds were embolized in six patients. The mean occlusion rate of the target pedicle was 83.3%. Gross-total resection was achieved in 22 patients (71.0%), with a mean blood loss volume of 1127 ± 1114.4 mL (ranging from 150 - 4500 ml). No embolization-related complications occurred. Deterioration of neurological deficits was observed in three patients (9.7%) at discharge.</p><p><strong>Conclusion: </strong>A one-stage hybrid operation is safe for the treatment of hypervascular central nervous system tumors. A prospective study to evaluating its safety and efficacy compared with separate-stage treatment is needed.</p>","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"11 1","pages":"14"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761667","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":"EEA for sellar chodrosarcomas: case series with literature review.","authors":"GuoFo Ma, Ning Qiao, Wentao Wu, BoChao Zhang, Kefan Cai, SongBai Gui","doi":"10.1186/s41016-025-00397-4","DOIUrl":"10.1186/s41016-025-00397-4","url":null,"abstract":"<p><p>BACKGROUND : Chondrosarcoma is a rare and malignant tumor in the sellar region. Due to the limited understanding of its oncological behavior, it is often misdiagnosed as other lesions, such as chordoma or invasive pituitary adenoma. In the past, craniotomy was considered the primary treatment option. However, with the advancement of neuroendoscopic techniques, many centers have begun adopting endoscopic approaches for this disease. In this article, we summarized our case series and reviewed the previous papers to evaluate the clinical outcomes of neuroendoscopic resection for sellar chondrosarcomas.</p><p><strong>Methods: </strong>Four patients with sellar chondrosarcomas who underwent tumor resection by endonasal endoscopic approach (EEA) in our institute from 2017 to 2021 were reviewed. In addition, we reviewed the current literatures on sellar chondrosarcomas.</p><p><strong>Results: </strong>Our series included 4 patients, and 8 cases of sellar chondrosarcomas were reported in previous literatures. In the pooled cohort, there were 6 males and 6 females. The median age at diagnosis was 28.5 years (interquartile range, 22.8-39.3). The most common clinical presentation was blurring of vision (66.7%) and headache (50%). The incidence of preoperative endocrine disorder in such patients was 33.3%; these abnormalities could return to normal after surgery. Complete resection and incomplete resection were achieved in 7 (58.3%) and 5 (41.7%) cases, respectively. Among the 12 patients, only one patient was diagnosed with chondrosarcoma preoperatively; other patients were misdiagnosed with chordoma (n = 5; 41.7%), invasive non-functioning pituitary adenoma (INPA) (n = 4; 33.3%), or craniopharyngioma (n = 2; 16.7%).</p><p><strong>Conclusions: </strong>The preoperative diagnosis of sellar chondrosarcoma remains challenging and often requires differentiation from chordoma, INPA, or craniopharyngioma. When a calcified mass in the sellar region presents with intact or slightly disturbed anterior pituitary function, heterogeneous enhancement and no diffusion restriction on Magnetic Resonance Imaging(MRI) sequences, and surrounding bony destruction and bony attachment on Computed Tomography(CT) scans, a chondrosarcoma should be suspected preferentially. Complete resection is the optimal goal for the management of sellar chondrosarcoma, but adjuvant radiotherapy and periodic follow-up should be highlighted.</p>","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"11 1","pages":"13"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508695","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":"Carotid endarterectomy and blood-brain barrier permeability in subjects with bilateral carotid artery stenosis.","authors":"Changyu Lu, Chenyu Zhu, Wenjie Li, Huan Zhu, Qihang Zhang, Tong Liu, Tongyu Yang, Yan Zhang","doi":"10.1186/s41016-025-00398-3","DOIUrl":"10.1186/s41016-025-00398-3","url":null,"abstract":"<p><strong>Background: </strong>The increased permeability of the blood-brain barrier (BBB) is related to the occurrence and development of diseases such as acute ischemic stroke, chronic ischemia, or small vessel disease. Patients with carotid artery stenosis have chronic ischemia. The exact effect of carotid endarterectomy on the blood-brain barrier is still unclear. The aim of the study was to assess the effect of carotid endarterectomy on basic perfusion parameters and permeability surface area-product (PS).</p><p><strong>Methods: </strong>The study included a total of 17 subjects (13 men), of which bilateral carotid artery stenosis was greater than 70%. All patients underwent unilateral carotid endarterectomy. Differences in the following computed tomography perfusion (CTP) parameters were compared before and after operation: cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), time to peak (TTP), and PS. PS acquired by CTP is used to measure the permeability of the BBB to contrast material.</p><p><strong>Results: </strong>Before surgery, the operative side exhibited significantly lower CBF (p = 0.001) and prolonged MTT (p = 0.002) and TTP (p = 0.001) compared to the nonoperative side, while PS and CBV showed no significant differences. After carotid endarterectomy, only the operative side demonstrated improvements, with CBV increasing by 9.4%, MTT decreasing by 20.3%, TTP decreasing by 14.1%, and PS decreasing by 27.5% (all p < 0.01). No significant changes were observed on the nonoperative side.</p><p><strong>Conclusions: </strong>Carotid endarterectomy augmented BBB permeability can be controlled by carotid endarterectomy in patients with carotid artery stenosis.</p>","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"11 1","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12172347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318210","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":"Clinical characteristics and prognosis of acute stroke in pregnancy and puerperium (ASPP) patients and their offspring: a retrospective, observational, nationwide, multicenter study protocol.","authors":"Zhongji Zhang, Zihan Yin, Tong Liu, Xiaolin Zhang, Qihang Zhang, Junlin Lu, Long Mu, Yang Dong, Juning Liu, Yi Xiao, Yanming Chen, Chenyang Song, Zengguang Wang, Yuheng Liu, Wei Ding, Li Zhang, Huaizhang Shi, Jingtao Qi, Bin Tang, Fei Wang, Pin Guo, Yongjun Tang, Mingsheng Yu, Wenjian Zheng, Qinglong He, Jian Yu, Aihua Zhu, Dazhao Fang, Gang Li, Yu Bai, Yushuang Zhang, Jiaxi Li, Yuli Wang, Faliang Gao, Yonggang Ma, Yifan Liu, Li Ma, Bao Yang, Yahui Zhao, Xun Ye, Qian Zhang, Yan Zhang, Xingju Liu, Jizong Zhao","doi":"10.1186/s41016-025-00396-5","DOIUrl":"10.1186/s41016-025-00396-5","url":null,"abstract":"<p><strong>Background: </strong>Previous studies on the risk factors and prognosis of acute stroke in pregnancy and puerperium (ASPP) mainly used European and American national healthcare databases, lacking detailed patient-level data and precise event timing.</p><p><strong>Aim: </strong>(1) To identify the risk factors and prognostic factors for ASPP, (2) to assess the risk of recurrent stroke, particularly during subsequent pregnancies, and (3) to evaluate offspring prognosis.</p><p><strong>Design: </strong>This study is a retrospective, observational, nationwide, multicenter research project planned to include 400 ASPP patients from 36 centers across 22 provinces in China, from 2015 to 2024. ASPP is defined as acute ischemic or hemorrhagic stroke during pregnancy or within 6 weeks postpartum, confirmed by neuroimaging. Two matched groups will be included for comparison: 400 pregnant/puerperal participants without a stroke history and 400 nonpregnant/puerperal participants with a recent stroke, matched by age and/or stroke etiology.</p><p><strong>Methods: </strong>All participants will be followed up through telephone interviews. The initial follow-up is scheduled to take place between December 2024 and February 2025. The follow-up phase will consist of three rounds, each lasting 3 months and conducted every 3 years. Primary outcomes include unfavorable functional outcomes (mRS > 2 or EQ-5D index score < 0.7) at follow-up for Aim 1, recurrent strokes (neuroimaging-confirmed) for Aim 2, and neonatal asphyxia (Apgar scoring) and future development (ASQ-3) of offspring for Aim 3.</p><p><strong>Discussion: </strong>The ASPP study is the first nationwide multicenter study to systematically evaluate the risk factors, prognosis, and risk of recurrent stroke in ASPP patients, particularly during subsequent pregnancies. This research may offer new insights into the long-term impacts of pregnancy-related stroke.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (NCT06527807).</p>","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"11 1","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227018","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":"Artificial Intelligence in Glioblastoma-Transforming Diagnosis and Treatment.","authors":"Alen Rončević, Nenad Koruga, Anamarija Soldo Koruga, Robert Rončević","doi":"10.1186/s41016-025-00399-2","DOIUrl":"10.1186/s41016-025-00399-2","url":null,"abstract":"<p><p>Glioblastoma (GBM) is the most aggressive and common primary brain malignancy in adults, characterized by poor prognosis and treatment resistance. Despite advancements in treatment options, the median survival is roughly 15 months, underlining the need for novel and effective treatments. Artificial intelligence (AI) has emerged as a transformative technology in healthcare, offering outstanding capabilities in data analysis, pattern recognition, and helping in decision-making. This review explores the current and potential role of AI in GBM care, focusing on its applications in diagnosis, treatment planning, prognostication, and drug discovery. AI-based algorithms have demonstrated promising potential in enhancing diagnostics through imaging analysis, radiomics, and tumor segmentation. These technologies could enable non-invasive molecular profiling and early detection of GBM. In treatment planning, AI could improve approaches by optimizing surgical resection, radiotherapy regimen, and chemotherapy protocols. Furthermore, machine learning models can integrate multimodal data to develop personalized treatments. They can also enhance prognostication by predicting survival, recurrence, and treatment responses, helping clinicians to make more informed decisions. AI is also revolutionizing pharmacotherapy by identifying novel molecular targets and optimizing combination therapies. Despite notable progress, challenges persist. Limited data quality and quantity, algorithm interpretability, integration problems, and ethical considerations, remain significant challenges to clinical implementation. This review emphasizes the need for continued research and interdisciplinary collaboration to overcome many barriers and realize the transformative potential of AI in GBM care.</p>","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"11 1","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209804","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 role of FAM111B in the malignant progression and molecular regulation of human glioma through the PI3K/Akt pathway.","authors":"Heng Wang, Junrou Zhu, Haiyang Wang, Wenhao Zheng, Linjie Wang, Jinhao Zhu, Zheng Wang, Quan Du","doi":"10.1186/s41016-025-00395-6","DOIUrl":"10.1186/s41016-025-00395-6","url":null,"abstract":"<p><strong>Background: </strong>Gliomas represent the most prevalent primary neoplasm in the adult central nervous system. Despite advancements in therapeutic modalities, such as surgical intervention, radiotherapy, chemotherapy, and tumor treatment, the 5-year survival rate of glioma patients remains low. Therefore, there is an urgent need to develop additional treatment methods. Recent studies have suggested that FAM111B is involved in DNA repair, cell cycle regulation, and apoptosis. FAM111B mutations and overexpression are related to cancer.</p><p><strong>Methods: </strong>We found that FAM111B was significantly overexpressed in glioma tissues compared to the adjacent tissues by analyzing data from the TCGA_GBM&LGG and CGGA databases. Moreover, overexpression of FAM111B was associated with shorter overall survival, and disease-specific survival and tended to increase with disease stage progression. Cellular experiments confirmed these results. These results suggest that overexpression of FAM111B promotes the proliferation, migration, and invasion of glioma cells, whereas the knockdown of FAM111B inhibits these activities. We also found that FAM111B regulated glioma cell proliferation, migration, and invasion via the PI3K/AKT pathway.</p><p><strong>Results: </strong>FAM111B is capable of enhancing the proliferation, invasion, and migration capabilities of glioma cells and promotes the malignant progression of glioma via the PI3K/Akt signaling pathway.</p><p><strong>Conclusions: </strong>This is the first study to demonstrate that FAM111B plays a crucial role in the proliferation, migration, and invasion of glioma cells. The malignant phenotype of FAM111B has also been shown to be closely associated with the PI3K/AKT pathway. FAM111B may be a predictive biomarker and a potential therapeutic target for gliomas.</p>","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"11 1","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102870","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":"Treatment strategies for unruptured intracranial aneurysms in the Chinese population: China Treatment Trial for Unruptured Intracranial Aneurysm (ChTUIA).","authors":"Kaige Zheng, Zheng Wen, Kaiwen Wang, Shaohua Mo, Jun Wu, Xiaolin Chen, Bing Zhao, Qingyuan Liu, Shuo Wang","doi":"10.1186/s41016-025-00394-7","DOIUrl":"10.1186/s41016-025-00394-7","url":null,"abstract":"<p><strong>Background: </strong>Intracranial aneurysm is a leading cause of subarachnoid hemorrhage and affects approximately 7% of the Chinese population, posing a significant public health concern. Due to the lack of a national cohort of unruptured intracranial aneurysms (UIAs) in China, optimal surgical management for UIAs remain insufficiently explored.</p><p><strong>Methods: </strong>The China Treatment Trial for Unruptured Intracranial Aneurysm (ChTUIA) is a national, prospective, observational, multi-center registry study designed to identify optimal surgical management for UIAs in the Chinese population. Eligible patients were recruited from 83 regional neurological centers in China between December 2021 and December 2022. All patients will be followed up routinely for at least two years.</p><p><strong>Results: </strong>A total of 25,438 patients with UIAs have been enrolled in the study, of whom 9794 (38.5%) were male, with a median age of 59 years (interquartile range: 52-67 years). The mean follow-up period was 4.28 years (interquartile range: 2.86-6.37 years). Among the patients, 6,712 (26.4%) patients underwent microsurgical clipping, and 18,726 (73.6%) patients underwent endovascular treatment, including 3,017 (16.1%) receiving coil alone or balloon-assisted coiling, 11,431 (61.1%) underwent stent-assisted coiling, and 4,278 (22.8%) treated with flow diverters. Comprehensive data collection encompassed 874,890 demographic and clinical records, 42,109 radiological records, 13,528 hemodynamic records, and 12,727 biological records, with a lost-to-follow-up rate of 5.4% and a data-missing rate of 8.3%.</p><p><strong>Conclusions: </strong>The ChTUIA study represents the first national prospective investigation into surgical management protocols and treatment trends toward UIAs in the Chinese population. This study will provide critical evidence to guide the clinical management of UIA patients.</p><p><strong>Trial registration: </strong>NCT05844163 ( https://clinicaltrials.gov/study/NCT05844163 ).</p>","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"11 1","pages":"8"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781333","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":"Exploring conservative avenues in subacute subdural hematoma: the potential role of atorvastatin and dexamethasone as lifesaving allies.","authors":"Tao Liu, Chenrui Wu, Weiwei Jiang, Mingqi Liu, Zhuang Sha, Rongcai Jiang","doi":"10.1186/s41016-025-00393-8","DOIUrl":"10.1186/s41016-025-00393-8","url":null,"abstract":"<p><strong>Background: </strong>Most cases of acute subdural hematoma (ASDH) require emergency surgery; only a few patients can survive without surgery in the early stages and then develop into subacute subdural hematoma (sASDH). However, the optimal conservative treatment has not yet been established for these sASDH patients. Based on our previous studies, atorvastatin plus dexamethasone may be safe and effective for them. This article aims to document such cases and analyze the possible mechanisms.</p><p><strong>Case presentation: </strong>We selected five patients with sASDH who received a treatment regimen of atorvastatin plus low-dose dexamethasone without surgery. We then observed the clinical and radiological features during treatment and follow-up. The PubMed database and Google Scholar were retrieved for literature regarding the efficacy and safety of conservative treatment in patients with ASDH/sASDH. We extracted information including authors, sample size, gender, number of patients (death, poor prognosis, delayed surgery), and risk factors.</p><p><strong>Results: </strong>Of the five patients, all patients who refused surgery for various reasons were resolved after treatment with atorvastatin plus low-dose dexamethasone for their conditions. No hematomas recurred or progressed during an at least 6-month follow-up. We identified 6 studies after searching the database; a total of 1374 patients (F:M = 3:7) with ASDH/sASDH received initial conservative treatment. The pooled results showed that 13.1% of patients who initially received conservative treatment deteriorated and required delayed surgical treatment. Of 1374, the overall incidence of poor prognosis was 19.2%, and 7% of patients eventually died.</p><p><strong>Conclusions: </strong>It is essential to establish an optimal conservative treatment for patients with sASDH who cannot undergo surgery in an emergency for various reasons. Atorvastatin plus dexamethasone may be an alternative treatment in such a subgroup of sASDH, although a randomized proof-of-concept clinical trial is needed.</p>","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"11 1","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774584","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 utility of stereotactic biopsy of intracranial lesions in the diagnosis of leukemia complicated by central nervous system lesions.","authors":"Xiaolong Wu, Yiqiang Zhou, Leiming Wang, Feng Yan, Huaqiang Zhang, Xiaotong Fan, Penghu Wei, Yongzhi Shan, Yaming Wang","doi":"10.1186/s41016-025-00392-9","DOIUrl":"10.1186/s41016-025-00392-9","url":null,"abstract":"<p><strong>Background: </strong>Leukemia complicated by central nervous system (CNS) lesions (LCNSL) includes leukemia involving the CNS (CNSL) and CNS secondary lesions related to leukemia treatment (e.g., CNS infections, leukoencephalopathy, inflammatory demyelination, and vascular diseases). The clinical manifestations and imaging characteristics of different types of LCL are similar, increasing the possibility of misdiagnosis. This study aimed to enhance our understanding and management of LCL.</p><p><strong>Methods: </strong>We retrospectively collected clinical data from 22 patients with LCL and analyzed their magnetic resonance imaging and pathological characteristics. Pathological diagnoses were made using stereotactic intracranial puncture biopsy.</p><p><strong>Results: </strong>Between April 2003 and December 2023, 22 patients with LCL were admitted, including 18 males and 4 females aged 7-71 years. Bone marrow aspiration identified 14 cases of acute lymphoblastic leukemia (ALL), one of chronic lymphoblastic leukemia, six of acute myeloid leukemia (AML), and one of chronic myelomonocytic leukemia (CMML). Most patients presented with non-specific symptoms, including headache, nausea, vomiting, limb convulsions, and changes in mental status. A few patients had localized neurological deficits, such as limb weakness and blurred vision. Common systemic symptoms included fever, night sweats, and weight loss. The pathological diagnoses of the 22 patients were CNSL in 13 patients, CNS infections in five patients, and neurodegenerative diseases in four patients. Discrepancies were found between the clinical and pathological diagnoses in eight cases.</p><p><strong>Conclusions: </strong>Stereotactic intracranial lesion biopsy is minimally invasive, safe, convenient, and critical in the early and differential diagnosis of LCL. Early identification of the lesions' nature and timely implementation of accurate and precise treatments can improve patient prognosis.</p>","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"11 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664656","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":"Chemoradiation treatment with or without concurrent tumor-treating fields (TTFields) therapy in newly diagnosed glioblastoma (GBM) patients in China.","authors":"Liping Liang, Lingchao Chen, Chunxia Ni, Wenyin Shi, Zhirui Zhou, Shu Chen, Wenjia Zhu, Jiabing Liu, Xianxin Qiu, Wanzun Lin, Junyan Zhang, Zhiyong Qin, Yang Wang","doi":"10.1186/s41016-025-00391-w","DOIUrl":"10.1186/s41016-025-00391-w","url":null,"abstract":"<p><strong>Background: </strong>Tumor-treating fields (TTFields) therapy and radiotherapy may have synergistic anti-glioma effect based on preclinical studies. The combination of chemoradiation therapy (CRT) with TTFields therapy has noticeably attracted clinicians' attention. This study aimed to provide insights into the clinical outcomes of patients with newly diagnosed glioblastoma who received either concurrent CRT and TTFields therapy or adjuvant TTFields therapy following CRT. The findings were based on a cohort of patients who were treated at Huashan Hospital (Shanghai, China).</p><p><strong>Methods: </strong>This retrospective study analyzed ndGBM patients' clinical outcomes who were treated at Huashan Hospital and received TTFields therapy. Patients were categorized into two groups: one group received adjuvant TTFields therapy after completing CRT (referred to as the A-TTF group), while the other received TTFields therapy concurrently with CRT and continued TTFields after treatment (referred to as the CA-TTF group). The study evaluated treatment efficacy and toxicities, comparing outcomes between the two groups. Overall survival (OS) and progression-free survival (PFS) were analyzed using the Kaplan-Meier method. To mitigate confounding factors, efficacy was assessed using the Cox proportional hazards regression model, propensity score matching, and inverse probability of treatment weighting (IPTW) based on the propensity score.</p><p><strong>Results: </strong>A total of 72 patients with ndGBM were included in the study. Among them, 41 patients received concurrent and adjuvant TTFields therapy in combination with CRT (CA-TTF group), and 31 patients received adjuvant TTFields therapy with temozolomide (A-TTF group). The median follow-up time was 18.0 months. No significant differences were observed in median PFS (14.2 vs. 15.0 months, P = 0.92) or OS (20.8 vs. 20.0 months, P = 0.92) between the CA-TTF and A-TTF groups. Skin toxicity was common, while manageable, with no significant difference between the two groups. Following IPTW adjustment, the hazard ratios for PFS and OS indicated a potential advantage for the CA-TTF group, although this difference was not statistically significant.</p><p><strong>Conclusion: </strong>Concurrent CRT and TTFields therapy emerged safe for newly diagnosed GBM patients. Although no significant survival differences were found between the CA-TTF and A-TTF groups, the potential benefit of concurrent TTFields warrants further investigation through large-scale clinical trials.</p>","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"11 1","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587315","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}