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Clinical outcomes of dose-escalated re-irradiation in patients with recurrent high-grade glioma. 高级别胶质瘤复发患者剂量递增再照射的临床效果。
IF 2.7 Q2 CLINICAL NEUROLOGY Pub Date : 2022-10-01 DOI: 10.1093/nop/npac032
Corbin A Helis, Shih-Ni Prim, Christina K Cramer, Roy Strowd, Glenn J Lesser, Jaclyn J White, Stephen B Tatter, Adrian W Laxton, Christopher Whitlow, Hui-Wen Lo, Waldemar Debinski, James D Ververs, Paul J Black, Michael D Chan

Background: Re-irradiation for recurrent gliomas is a controversial treatment option with no clear standard dose or concurrent systemic therapy.

Methods: This series represents a single-institution retrospective review of patients treated with re-irradiation for recurrent high-grade glioma. After 2012, patients were commonly offered concurrent bevacizumab as a cytoprotective agent against radiation necrosis. Kaplan-Meier method was used to estimate overall survival and progression-free survival. Cox proportional hazards regression was used to identify factors associated with overall survival and progression-free survival.

Results: Between 2001 and 2021, 52 patients underwent re-irradiation for a diagnosis of recurrent high-grade glioma. 36 patients (69.2%) had a histologic diagnosis of glioblastoma at the time of re-irradiation. The median BED10 (biological equivalent dose 10 Gy) of re-irradiation was 53.1 Gy. Twenty-one patients (40.4%) received concurrent bevacizumab with re-irradiation. Median survival for the entire cohort and for glioblastoma at the time of recurrence patients was 6.7 months and 6.0 months, respectively. For patients with glioblastoma at the time of recurrence, completing re-irradiation (HR 0.03, P < .001), use of concurrent bevacizumab (HR 0.3, P = .009), and the BED10 (HR 0.9, P = .005) were predictive of overall survival. Nine patients developed grade 3-5 toxicity; of these, 2 received concurrent bevacizumab and 7 did not (P = .15).

Conclusion: High dose re-irradiation with concurrent bevacizumab is feasible in patients with recurrent gliomas. Concurrent bevacizumab and increasing radiation dose may improve survival in patients with recurrent glioblastoma.

背景:复发性胶质瘤的再照射是一种有争议的治疗选择,没有明确的标准剂量或同步全身治疗。方法:本研究是对复发性高级别胶质瘤再放射治疗患者的单机构回顾性研究。2012年之后,患者通常同时使用贝伐单抗作为抗放射性坏死的细胞保护剂。Kaplan-Meier法估计总生存期和无进展生存期。Cox比例风险回归用于确定与总生存期和无进展生存期相关的因素。结果:2001年至2021年间,52名患者接受了复发性高级别胶质瘤的再放射治疗。36例(69.2%)患者在再照射时组织学诊断为胶质母细胞瘤。再照射的中位BED10(生物等效剂量10 Gy)为53.1 Gy。21例患者(40.4%)同时接受贝伐单抗再照射。整个队列和胶质母细胞瘤患者复发时的中位生存期分别为6.7个月和6.0个月。对于复发时的胶质母细胞瘤患者,完成再照射(HR 0.03, P < .001)、同时使用贝伐单抗(HR 0.3, P = .009)和BED10 (HR 0.9, P = .005)是总生存的预测指标。9例出现3-5级毒性;其中2例同时接受贝伐单抗治疗,7例未接受贝伐单抗治疗(P = 0.15)。结论:高剂量再照射并发贝伐单抗治疗复发性胶质瘤是可行的。同时增加贝伐单抗和放疗剂量可能提高复发性胶质母细胞瘤患者的生存率。
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引用次数: 0
Optimizing the radiotherapy treatment planning process for glioblastoma. 优化胶质母细胞瘤放射治疗计划流程。
IF 2.7 Q2 CLINICAL NEUROLOGY Pub Date : 2022-10-01 DOI: 10.1093/nop/npac051
Rupesh R Kotecha, Minesh P Mehta
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引用次数: 0
Detection of vincristine-induced neuropathy in patients with oligodendroglioma. 长春新碱对少突胶质细胞瘤患者神经病变的检测。
IF 2.7 Q2 CLINICAL NEUROLOGY Pub Date : 2022-10-01 DOI: 10.1093/nop/npac045
Louisa Nitsch, Ulrich Herrlinger, Niklas Schäfer
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引用次数: 0
Extra-CNS and dural metastases in FGFR3::TACC3 fusion+ adult glioblastoma, IDH-wildtype. FGFR3: TACC3融合+成人胶质母细胞瘤的外中枢神经系统和硬脑膜转移,idh -野生型。
IF 2.7 Q2 CLINICAL NEUROLOGY Pub Date : 2022-10-01 DOI: 10.1093/nop/npac042
B K Kleinschmidt-DeMasters, Ahmed Gilani

Background: Adult glioblastomas (GBMs), IDH-wildtype, WHO grade 4 with FGFR3::TACC3 fusion have a better prognosis than standard GBMs. Whether this extended survival leads to late biological consequences is unknown. Although constituting only 4% of all GBMs, FGFR3::TACC3 fusion-positive GBMs manifest recurrent morphological features that allow prediction of this subtype, possibly affecting trial eligibility and/or targeted therapies. However, we have previously shown that an identical histological pattern can be present in wildtype examples, and conversely, occasional FGFR3::TACC3 fusion-positive tumors lack this stereotypic morphology; thus, ultimately molecular characterization is required. We now report for the first time an adult with FGFR3::TACC3 fusion-positive GBM showing archetypal histological features who developed extracranial metastases to provide further insight into potential behavior of the GBM type.

Methods: Report of a 70-year-old man with left parietal GBM who developed 2 subsequent metastases, all 3 of which were assessed by next-generation sequencing (NGS) and DNA methylation.

Results: Biopsy-proven dural metastases occurred at 8 months and cervical lymph node metastasis at 12-month post-diagnosis before the patient succumbed at 23 months. By NGS, all 3 tumors showed FGFR3::TACC3 fusion as well as an additional PDZD2::TERT fusion of uncertain significance. DNA methylation profiling demonstrated mesenchymal subtype in the initial biopsy and RTKII subtype in subsequent dural and lymph node metastases, indicating intratumor spatial heterogeneity or temporal evolution.

Conclusion: Rarely, FGFR3::TACC3 fusion-positive GBM patients may develop dural and extracranial metastatic spread, the latter with subclass switching on epigenomic analysis.

背景:成人胶质母细胞瘤(GBMs), idh野生型,WHO分级4级,FGFR3::TACC3融合比标准GBMs预后更好。这种延长的生存是否会导致晚期的生物学后果尚不清楚。虽然仅占所有GBMs的4%,但FGFR3::TACC3融合阳性GBMs表现出复发的形态学特征,可以预测该亚型,可能影响试验资格和/或靶向治疗。然而,我们之前的研究表明,在野生型样本中可以存在相同的组织学模式,相反,偶尔的FGFR3::TACC3融合阳性肿瘤缺乏这种刻板形态;因此,最终需要分子表征。我们现在首次报道了一例成年FGFR3::TACC3融合阳性GBM,表现出典型的组织学特征,并发展为颅外转移,以进一步了解GBM类型的潜在行为。方法:报告一名70岁男性左顶叶GBM患者,随后发生2例转移,所有3例均通过下一代测序(NGS)和DNA甲基化评估。结果:确诊后8个月活检证实硬脑膜转移,12个月颈部淋巴结转移,23个月死亡。通过NGS检测,所有3例肿瘤均显示FGFR3::TACC3融合以及PDZD2::TERT的不确定意义融合。DNA甲基化分析在初始活检中显示为间质亚型,在随后的硬脑膜和淋巴结转移中显示为RTKII亚型,表明肿瘤内的空间异质性或时间演化。结论:FGFR3::TACC3融合阳性的GBM患者可能发生硬脑膜和颅外转移扩散,后者在表观基因组分析中具有亚类切换。
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引用次数: 3
Valproic acid as a radio-sensitizer in glioma: A systematic review and meta-analysis. 丙戊酸作为神经胶质瘤的放射增敏剂:系统综述和荟萃分析。
IF 2.7 Q2 CLINICAL NEUROLOGY Pub Date : 2022-09-30 eCollection Date: 2023-02-01 DOI: 10.1093/nop/npac078
Jessica K Sullivan, Paul P Fahey, Kinglsey E Agho, Simon P Hurley, Zhihui Feng, Richard O Day, David Lim

Background: Histone deacetylase inhibitors (HDACi) including valproic acid (VPA) have the potential to improve radiotherapy (RT) efficacy and reduce treatment adverse events (AE) via epigenetic modification and radio-sensitization of neoplastic cells. This systematic review and meta-analysis aimed to assess the efficacy and AE associated with HDACi used as radio-sensitizers in adult solid organ malignancy patients.

Methods: A systematic review utilized electronic searches of MEDLINE(Ovid), Embase(Ovid), The Cochrane Library, and the International Clinical Trials Registry Platform to identify studies examining the efficacy and AEs associated with HDACi treatment in solid organ malignancy patients undergoing RT. Meta-analysis was performed with overall survival (OS) reported as hazard ratios (HR) as the primary outcome measure. OS reported as median survival difference, and AEs were secondary outcome measures.

Results: Ten studies reporting on the efficacy and/or AEs of HDACi in RT-treated solid organ malignancy patients met inclusion criteria. All included studies focused on HDACi valproic acid (VPA) in high-grade glioma patients, of which 9 studies (n = 6138) evaluated OS and 5 studies (n = 1055) examined AEs. The addition of VPA to RT treatment protocols resulted in improved OS (HR = 0.80, 95% CI 0.67-0.96). No studies focusing on non-glioma solid organ malignancy patients, or non-VPA HDACi met the inclusion criteria for this review.

Conclusions: This review suggests that glioma patients undergoing RT may experience prolonged survival due to HDACi VPA administration. Further randomized controlled trials are required to validate these findings. Additionally, more research into the use of HDACi radio-adjuvant treatment in non-glioma solid organ malignancies is warranted.

背景:包括丙戊酸(VPA)在内的组蛋白脱乙酰酶抑制剂(HDACi)有可能通过表观遗传学修饰和肿瘤细胞的放射增敏来提高放疗(RT)疗效并减少治疗不良事件(AE)。这项系统综述和荟萃分析旨在评估HDACi作为成人实体器官恶性肿瘤患者的放射增敏剂的疗效和不良事件。方法:一项系统综述利用MEDLINE(Ovid)、Embase(Ovid)、The Cochrane Library和国际临床试验注册平台的电子搜索来确定检查HDACi治疗接受RT的实体器官恶性肿瘤患者的疗效和不良事件的研究。进行荟萃分析,将总生存率(OS)报告为风险比(HR)作为主要结果衡量标准。OS报告为中位生存差异,AE是次要的结果指标。结果:10项关于HDACi在RT治疗的实体器官恶性肿瘤患者中的疗效和/或AE的研究符合纳入标准。所有研究都集中在高级别胶质瘤患者的HDACi丙戊酸(VPA)上,其中9项研究(n = 6138)评估OS和5项研究(n = 1055)检查AE。在RT治疗方案中加入VPA可改善OS(HR = 0.80,95%CI 0.67-0.96)。没有针对非胶质瘤实体器官恶性肿瘤患者或非VPA-HDACi的研究符合本综述的纳入标准。结论:这篇综述表明,接受RT的神经胶质瘤患者可能会因HDACi VPA的给药而延长生存期。需要进一步的随机对照试验来验证这些发现。此外,有必要对HDACi放射辅助治疗非胶质瘤实体器官恶性肿瘤的应用进行更多的研究。
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引用次数: 1
Stroke-associated infections in patients with and without cancer. 癌症和非癌症患者的卒中相关感染。
IF 2.7 Q2 CLINICAL NEUROLOGY Pub Date : 2022-09-25 eCollection Date: 2023-04-01 DOI: 10.1093/nop/npac075
Katharina Seystahl, Juliane Schweizer, Mira Katan, Sung Ju Weber, Alessia Hug, Miriam Wanner, Andreas R Luft, Sabine Rohrmann, Susanne Wegener, Michael Weller

Background: Cancer in stroke patients is associated with higher levels of inflammatory biomarkers and unfavorable poststroke outcomes. We thus explored whether there is a link between cancer and stroke-associated infections.

Methods: Medical records of patients with ischemic stroke in 2014-2016 registered in the Swiss Stroke Registry of Zurich were retrospectively analyzed. Incidence, characteristics, treatment, and outcome of stroke-associated infections diagnosed within 7 days after stroke onset were tested for an association with cancer.

Results: Among 1181 patients with ischemic stroke, 102 patients with cancer were identified. Stroke-associated infections occurred in 179 and 19 patients (17% and 19%) without and with cancer (P = .60), respectively, among them pneumonia in 95 and 10 patients (9% and 10%) and urinary tract infections in 68 and 9 patients (6% and 9%) (P = .74 and P = .32). Use of antibiotics was similar between groups. Levels of C-reactive protein (CRP) (P < .001), erythrocyte sedimentation rate (ESR) (P = .014) and procalcitonin (P = .015) were higher and levels of albumin (P = .042) and protein (P = .031) were lower in patients with cancer than without cancer. Among patients without cancer, higher CRP (P < .001), ESR (P < .001) and procalcitonin (P = .04) and lower albumin (P < .001) were associated with stroke-associated infections. Among cancer patients with or without infections, no significant differences in these parameters were observed. In-hospital mortality was associated with cancer (P < .001) and with stroke-associated infections (P < .001). However, among patients with stroke-associated infections, cancer was not associated with in-hospital mortality (P = .24) or 30-day mortality (P = .66).

Conclusions: Cancer does not represent a risk factor for stroke-associated infections in this patient cohort.

背景:中风患者中的癌症与较高水平的炎症生物标志物和不利的卒中后结果相关。因此,我们探讨了癌症与中风相关感染之间是否存在联系。方法:回顾性分析2014-2016年在苏黎世瑞士卒中登记处登记的缺血性卒中患者的医疗记录。在中风发病后7天内诊断的中风相关感染的发病率、特征、治疗和结果与癌症的相关性进行了测试。结果:在1181例缺血性脑卒中患者中,发现102例癌症患者。无癌症和有癌症的患者分别为179例和19例(17%和19%)(P=.60),其中肺炎95例和10例(9%和10%),尿路感染68例和9例(6%和9%)(P=.74和P=.32)。癌症患者的C-反应蛋白(CRP)水平(P<.001)、血沉(ESR)水平(P=.014)和降钙素原水平(P=0.015)高于非癌症患者,白蛋白(P=.042)和蛋白质(P=.031)水平低于非癌症患者。在没有癌症的患者中,较高的CRP(P<0.001)、ESR(P<001)、降钙素原(P=.04)和较低的白蛋白(P<.001)与中风相关感染相关。在有或无感染的癌症患者中,没有观察到这些参数的显著差异。住院死亡率与癌症(P<0.001)和卒中相关感染(P<.001)相关。然而,在卒中相关感染患者中,癌症与住院死亡率(P=.24)或30天死亡率(P<.66)无关。结论:癌症不代表该患者队列中卒中相关感染的危险因素。
{"title":"Stroke-associated infections in patients with and without cancer.","authors":"Katharina Seystahl,&nbsp;Juliane Schweizer,&nbsp;Mira Katan,&nbsp;Sung Ju Weber,&nbsp;Alessia Hug,&nbsp;Miriam Wanner,&nbsp;Andreas R Luft,&nbsp;Sabine Rohrmann,&nbsp;Susanne Wegener,&nbsp;Michael Weller","doi":"10.1093/nop/npac075","DOIUrl":"10.1093/nop/npac075","url":null,"abstract":"<p><strong>Background: </strong>Cancer in stroke patients is associated with higher levels of inflammatory biomarkers and unfavorable poststroke outcomes. We thus explored whether there is a link between cancer and stroke-associated infections.</p><p><strong>Methods: </strong>Medical records of patients with ischemic stroke in 2014-2016 registered in the Swiss Stroke Registry of Zurich were retrospectively analyzed. Incidence, characteristics, treatment, and outcome of stroke-associated infections diagnosed within 7 days after stroke onset were tested for an association with cancer.</p><p><strong>Results: </strong>Among 1181 patients with ischemic stroke, 102 patients with cancer were identified. Stroke-associated infections occurred in 179 and 19 patients (17% and 19%) without and with cancer (<i>P</i> = .60), respectively, among them pneumonia in 95 and 10 patients (9% and 10%) and urinary tract infections in 68 and 9 patients (6% and 9%) (<i>P</i> = .74 and <i>P</i> = .32). Use of antibiotics was similar between groups. Levels of C-reactive protein (CRP) (<i>P</i> < .001), erythrocyte sedimentation rate (ESR) (<i>P</i> = .014) and procalcitonin (<i>P</i> = .015) were higher and levels of albumin (<i>P</i> = .042) and protein (<i>P</i> = .031) were lower in patients with cancer than without cancer. Among patients without cancer, higher CRP (<i>P</i> < .001), ESR (<i>P</i> < .001) and procalcitonin (<i>P</i> = .04) and lower albumin (<i>P</i> < .001) were associated with stroke-associated infections. Among cancer patients with or without infections, no significant differences in these parameters were observed. In-hospital mortality was associated with cancer (<i>P</i> < .001) and with stroke-associated infections (<i>P</i> < .001). However, among patients with stroke-associated infections, cancer was not associated with in-hospital mortality (<i>P</i> = .24) or 30-day mortality (<i>P</i> = .66).</p><p><strong>Conclusions: </strong>Cancer does not represent a risk factor for stroke-associated infections in this patient cohort.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"10 2","pages":"176-185"},"PeriodicalIF":2.7,"publicationDate":"2022-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10037946/pdf/npac075.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9546600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Navigating disability insurance in the American healthcare system for the low-grade glioma patient. 在美国医疗系统中为低级别神经胶质瘤患者提供残疾保险。
IF 2.7 Q2 CLINICAL NEUROLOGY Pub Date : 2022-09-25 eCollection Date: 2023-02-01 DOI: 10.1093/nop/npac076
Lalanthica Yogendran, Mark Rudolf, Drew Yeannakis, Kathleen Fuchs, David Schiff

In the United States, diagnosis of grade 3 or 4 glioma qualifies patients for Social Security disability benefits. Low-grade gliomas (LGGs) can be similarly debilitating, with at least 31% of patients presenting with cognitive deficits and 80% with tumor-related epilepsy. A diagnosis of LGG does not in and of itself qualify patients for disability benefits; the burden of proof is substantially higher. We outline the American healthcare system process of medical documentation to support disability benefits, Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). We provide a template to assist providers in facilitating the application process for patients with LGG. The provider's role is not to simply "declare" a patient disabled, but to provide comprehensive documentation regarding diagnosis, treatment, disease status, symptoms, and functional status in the medical record. As cognitive symptoms and seizures are 2 key sources of disability in LGG patients, selective referrals to neuropsychology and epileptology may improve patient care and bolster documentation of the patient's symptoms in these domains. Likewise, connecting patients with social workers and disability claims representatives can assist them in navigating the complicated application process. We provide an extensive review for patient eligibility in the United States to receive disability. We map a comprehensive care process that may have relevance to multiple regions outside the United States. Providers are better able to help their patients navigate the disability application process when they understand how to address physical and cognitive changes for thorough care of their patient.

在美国,诊断为3级或4级神经胶质瘤的患者有资格享受社会保障残疾福利。低级别胶质瘤(LGG)也可能同样使人衰弱,至少31%的患者表现出认知缺陷,80%的患者表现为肿瘤相关癫痫。LGG的诊断本身并不能使患者有资格获得残疾福利;举证责任要高得多。我们概述了美国医疗保健系统的医疗文件流程,以支持残疾福利、社会保障残疾保险(SSDI)和补充保障收入(SSI)。我们提供了一个模板,帮助提供者为LGG患者的申请流程提供便利。提供者的职责不是简单地“宣布”患者残疾,而是在医疗记录中提供有关诊断、治疗、疾病状态、症状和功能状态的全面文件。由于认知症状和癫痫发作是LGG患者残疾的两个主要来源,选择性转诊到神经心理学和癫痫学可以改善患者护理,并加强对患者在这些领域症状的记录。同样,将患者与社会工作者和残疾索赔代表联系起来可以帮助他们处理复杂的申请过程。我们对美国的残疾患者资格进行了广泛的审查。我们绘制了一个可能与美国以外多个地区相关的全面护理流程图。当提供者了解如何应对身体和认知变化以彻底照顾患者时,他们能够更好地帮助患者完成残疾申请流程。
{"title":"Navigating disability insurance in the American healthcare system for the low-grade glioma patient.","authors":"Lalanthica Yogendran,&nbsp;Mark Rudolf,&nbsp;Drew Yeannakis,&nbsp;Kathleen Fuchs,&nbsp;David Schiff","doi":"10.1093/nop/npac076","DOIUrl":"10.1093/nop/npac076","url":null,"abstract":"<p><p>In the United States, diagnosis of grade 3 or 4 glioma qualifies patients for Social Security disability benefits. Low-grade gliomas (LGGs) can be similarly debilitating, with at least 31% of patients presenting with cognitive deficits and 80% with tumor-related epilepsy. A diagnosis of LGG does not in and of itself qualify patients for disability benefits; the burden of proof is substantially higher. We outline the American healthcare system process of medical documentation to support disability benefits, Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). We provide a template to assist providers in facilitating the application process for patients with LGG. The provider's role is not to simply \"declare\" a patient disabled, but to provide comprehensive documentation regarding diagnosis, treatment, disease status, symptoms, and functional status in the medical record. As cognitive symptoms and seizures are 2 key sources of disability in LGG patients, selective referrals to neuropsychology and epileptology may improve patient care and bolster documentation of the patient's symptoms in these domains. Likewise, connecting patients with social workers and disability claims representatives can assist them in navigating the complicated application process. We provide an extensive review for patient eligibility in the United States to receive disability. We map a comprehensive care process that may have relevance to multiple regions outside the United States. Providers are better able to help their patients navigate the disability application process when they understand how to address physical and cognitive changes for thorough care of their patient.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"10 1","pages":"5-12"},"PeriodicalIF":2.7,"publicationDate":"2022-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9837773/pdf/npac076.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9116987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Screening for long-term complications in brain tumor care, thinking one step ahead. 在脑肿瘤治疗中筛查长期并发症,先人一步。
IF 2.4 Q2 CLINICAL NEUROLOGY Pub Date : 2022-09-13 eCollection Date: 2022-12-01 DOI: 10.1093/nop/npac072
Annette Compter, Joost J C Verhoeff
{"title":"Screening for long-term complications in brain tumor care, thinking one step ahead.","authors":"Annette Compter, Joost J C Verhoeff","doi":"10.1093/nop/npac072","DOIUrl":"10.1093/nop/npac072","url":null,"abstract":"","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"9 6","pages":"459-460"},"PeriodicalIF":2.4,"publicationDate":"2022-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9665050/pdf/npac072.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10223956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The emotional journey of neuro-oncology: Primary brain tumor patients share their experience during this life-threatening disease. 神经肿瘤学的情感之旅:原发性脑肿瘤患者分享他们在这种危及生命的疾病中的经历。
IF 2.4 Q2 CLINICAL NEUROLOGY Pub Date : 2022-09-07 eCollection Date: 2023-02-01 DOI: 10.1093/nop/npac067
Ashlee R Loughan, Morgan Reid, Kelcie D Willis, Sarah Barrett, Karen Lo

Background: To achieve patient-centric quality care in neuro-oncology, all aspects of the disease and its impact on quality survival need to be considered. This includes the psychological consequences of a brain tumor diagnosis and subsequent life-altering experiences. Far too often the voice of our patients is unheard. Empowering patients to advocate for their own psychological needs is essential.

Methods: Data were derived from four focus groups with adult patients with brain tumors (N = 15; M age = 46 years, 53% female). A trained moderator led each 90-min group and posed semi-structured questions regarding patients' care needs throughout their neuro-oncological disease trajectory. Emphasis was placed on the quality of life and distress reduction. Common themes were identified via thematic content analysis using NVivo software. A high inter-rater reliability (M kappa = 0.92, range = 0.85-0.93) was achieved. Two themes are presented here: Emotional Response to Stressors and Existential Considerations.

Results: Of the two themes presented, 14 codes emerged. Codes were classified into three broad categories: Fear, Despair, and Resilience. The frequency of each category ranged from 31.4% to 34.7%. Example quotes and a discussion of each category follows.

Conclusions: It is imperative that we include the patient perspective in the development of neuro-oncology programs, thereby considering the quality of survival in addition to quantity. Neuro-oncology quality care must be driven by our patients' experiences and should integrate support for emotional distress while promoting resilience throughout this life-threatening illness.

背景:为了在神经肿瘤学领域实现以患者为中心的优质护理,需要考虑疾病的方方面面及其对生存质量的影响。这包括脑肿瘤诊断的心理后果和随后改变生活的经历。患者的声音往往被忽视。让患者有能力维护自身的心理需求至关重要:数据来源于与成年脑肿瘤患者(N = 15;M 年龄 = 46 岁,53% 为女性)进行的四次焦点小组讨论。每组 90 分钟,由一名训练有素的主持人主持,并就患者在整个神经肿瘤疾病过程中的护理需求提出半结构化问题。重点放在生活质量和减少痛苦上。通过使用 NVivo 软件进行主题内容分析,确定了共同主题。评分者之间的可靠性很高(M kappa = 0.92,范围 = 0.85-0.93)。这里介绍两个主题:结果:在这两个主题中,共出现了 14 个代码。代码分为三大类:恐惧、绝望和复原力。每个类别的出现频率从 31.4% 到 34.7% 不等。下面是引文示例和对每个类别的讨论:当务之急是在神经肿瘤学项目的发展中纳入患者视角,从而在数量之外考虑生存质量。神经肿瘤学优质护理必须以患者的体验为驱动力,并应整合对情绪困扰的支持,同时在这种威胁生命的疾病中促进患者的恢复能力。
{"title":"The emotional journey of neuro-oncology: Primary brain tumor patients share their experience during this life-threatening disease.","authors":"Ashlee R Loughan, Morgan Reid, Kelcie D Willis, Sarah Barrett, Karen Lo","doi":"10.1093/nop/npac067","DOIUrl":"10.1093/nop/npac067","url":null,"abstract":"<p><strong>Background: </strong>To achieve patient-centric quality care in neuro-oncology, all aspects of the disease and its impact on quality survival need to be considered. This includes the psychological consequences of a brain tumor diagnosis and subsequent life-altering experiences. Far too often the voice of our patients is unheard. Empowering patients to advocate for their own psychological needs is essential.</p><p><strong>Methods: </strong>Data were derived from four focus groups with adult patients with brain tumors (<i>N</i> = 15; <i>M</i> <sub><i>age</i></sub> = 46 years, 53% female). A trained moderator led each 90-min group and posed semi-structured questions regarding patients' care needs throughout their neuro-oncological disease trajectory. Emphasis was placed on the quality of life and distress reduction. Common themes were identified via thematic content analysis using NVivo software. A high inter-rater reliability (<i>M</i> <sub><i>kappa</i></sub> = 0.92, range = 0.85-0.93) was achieved. Two themes are presented here: Emotional Response to Stressors and Existential Considerations.</p><p><strong>Results: </strong>Of the two themes presented, 14 codes emerged. Codes were classified into three broad categories: Fear, Despair, and Resilience. The frequency of each category ranged from 31.4% to 34.7%. Example quotes and a discussion of each category follows.</p><p><strong>Conclusions: </strong>It is imperative that we include the patient perspective in the development of neuro-oncology programs, thereby considering the <i>quality</i> of survival in addition to quantity. Neuro-oncology quality care must be driven by our patients' experiences and should integrate support for emotional distress while promoting resilience throughout this life-threatening illness.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"10 1","pages":"71-78"},"PeriodicalIF":2.4,"publicationDate":"2022-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9837771/pdf/npac067.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10176338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Inherited genetics of adult diffuse glioma and polygenic risk scores-a review. 成人弥漫性胶质瘤的遗传遗传学和多基因风险评分综述。
IF 2.7 Q2 CLINICAL NEUROLOGY Pub Date : 2022-08-01 DOI: 10.1093/nop/npac017
Jeanette E Eckel-Passow, Daniel H Lachance, Paul A Decker, Thomas M Kollmeyer, Matthew L Kosel, Kristen L Drucker, Susan Slager, Margaret Wrensch, W Oliver Tobin, Robert B Jenkins

Knowledge about inherited and acquired genetics of adult diffuse glioma has expanded significantly over the past decade. Genomewide association studies (GWAS) stratified by histologic subtype identified six germline variants that were associated specifically with glioblastoma (GBM) and 12 that were associated with lower grade glioma. A GWAS performed using the 2016 WHO criteria, stratifying patients by IDH mutation and 1p/19q codeletion (as well as TERT promoter mutation), discovered that many of the known variants are associated with specific WHO glioma subtypes. In addition, the GWAS stratified by molecular group identified two additional novel regions: variants in D2HGDH that were associated with tumors that had an IDH mutation and a variant near FAM20C that was associated with tumors that had both IDH mutation and 1p/19q codeletion. The results of these germline associations have been used to calculate polygenic risk scores, from which to estimate relative and absolute risk of overall glioma and risk of specific glioma subtypes. We will review the concept of polygenic risk models and their potential clinical utility, as well as discuss the published adult diffuse glioma polygenic risk models. To date, these prior genetic studies have been done on European populations. Using the published glioma polygenic risk model, we show that the genetic associations published to date do not generalize across genetic ancestries, demonstrating that genetic studies need to be done on more diverse populations.

在过去的十年中,关于成人弥漫性胶质瘤的遗传和获得性遗传学的知识有了显著的扩展。按组织学亚型分层的全基因组关联研究(GWAS)鉴定出6种生殖系变异与胶质母细胞瘤(GBM)特异性相关,12种与低级别胶质瘤相关。使用2016年WHO标准进行的GWAS,通过IDH突变和1p/19q编码(以及TERT启动子突变)对患者进行分层,发现许多已知变异与特定的WHO胶质瘤亚型相关。此外,按分子组分层的GWAS发现了另外两个新区域:与具有IDH突变的肿瘤相关的D2HGDH变异和与具有IDH突变和1p/19q密码缺失的肿瘤相关的FAM20C附近的变异。这些种系关联的结果已被用于计算多基因风险评分,从中估计总体胶质瘤的相对和绝对风险以及特定胶质瘤亚型的风险。我们将回顾多基因风险模型的概念及其潜在的临床应用,并讨论已发表的成人弥漫性胶质瘤多基因风险模型。迄今为止,这些先前的基因研究都是在欧洲人群中进行的。使用已发表的神经胶质瘤多基因风险模型,我们表明迄今为止发表的遗传关联并不能在遗传祖先中推广,这表明需要在更多样化的人群中进行遗传研究。
{"title":"Inherited genetics of adult diffuse glioma and polygenic risk scores-a review.","authors":"Jeanette E Eckel-Passow,&nbsp;Daniel H Lachance,&nbsp;Paul A Decker,&nbsp;Thomas M Kollmeyer,&nbsp;Matthew L Kosel,&nbsp;Kristen L Drucker,&nbsp;Susan Slager,&nbsp;Margaret Wrensch,&nbsp;W Oliver Tobin,&nbsp;Robert B Jenkins","doi":"10.1093/nop/npac017","DOIUrl":"https://doi.org/10.1093/nop/npac017","url":null,"abstract":"<p><p>Knowledge about inherited and acquired genetics of adult diffuse glioma has expanded significantly over the past decade. Genomewide association studies (GWAS) stratified by histologic subtype identified six germline variants that were associated specifically with glioblastoma (GBM) and 12 that were associated with lower grade glioma. A GWAS performed using the 2016 WHO criteria, stratifying patients by <i>IDH</i> mutation and 1p/19q codeletion (as well as <i>TERT</i> promoter mutation), discovered that many of the known variants are associated with specific WHO glioma subtypes. In addition, the GWAS stratified by molecular group identified two additional novel regions: variants in <i>D2HGDH</i> that were associated with tumors that had an <i>IDH</i> mutation and a variant near <i>FAM20C</i> that was associated with tumors that had both <i>IDH</i> mutation and 1p/19q codeletion. The results of these germline associations have been used to calculate polygenic risk scores, from which to estimate relative and absolute risk of overall glioma and risk of specific glioma subtypes. We will review the concept of polygenic risk models and their potential clinical utility, as well as discuss the published adult diffuse glioma polygenic risk models. To date, these prior genetic studies have been done on European populations. Using the published glioma polygenic risk model, we show that the genetic associations published to date do not generalize across genetic ancestries, demonstrating that genetic studies need to be done on more diverse populations.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"9 4","pages":"259-270"},"PeriodicalIF":2.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9290891/pdf/npac017.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9439774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
期刊
Neuro-oncology practice
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