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An evaluation of biobanking and therapeutic clinical trial representation among adult glioma patients from rural and urban Utah. 犹他州农村和城市成年脑胶质瘤患者的生物库和治疗性临床试验代表性评估。
IF 2.7 Q2 Medicine Pub Date : 2023-05-13 eCollection Date: 2023-10-01 DOI: 10.1093/nop/npad026
Emma R Earl, Howard Colman, Joe Mendez, Randy L Jensen, Michael Karsy

Background: Social determinants of health (SDOHs)-specifically those related to rurality, health care accessibility, and income-may play as-yet-unidentified roles in prognosis for glioma patients, and their impact on access to clinical trials is important to understand. We examined SDOHs of patients enrolled in glioma clinical trials and evaluate disparities in trial participation and outcomes between rural and urban patients.

Methods: We retrospectively identified patients enrolled in glioma clinical trials at Huntsman Cancer Institute (HCI) from May 2012 to May 2022 to evaluate clinical trial participation. We used multivariable models to evaluate SDOHs and geographic information system mapping to assess representation across Utah's counties. We utilized the most recent 10-year datasets of patients treated for glioma at HCI and from the Utah Cancer Registry to analyze survival and incidence, respectively.

Results: A total of 570 participants (68 trials) resided in Utah, 84.4% from urban counties, 13.5% from rural counties, and 2.1% from frontier (least-populous) counties. Nineteen counties (65.5%) were underrepresented in trials (enrolled participants vs. eligible), 1 (3.5%) was represented in a near-1:1 ratio, and 9 (31.0%) were overrepresented. Counties with greater enrollment had greater population densities, highest per-capita income, and proximity to HCI. Among patients treated at HCI, patients from rural/frontier counties had equivalent survival with urban patients across nearly all glioma types, including glioblastomas, despite underrepresentation in clinical trials.

Conclusions: By highlighting disparities in clinical trial enrollment, our results can support efforts to improve recruitment in underrepresented regions, which can assist providers in delivering equitable care for all patients.

背景:健康的社会决定因素(SDOH),特别是与农村、医疗保健可及性和收入相关的社会决定因子,可能在神经胶质瘤患者的预后中发挥尚未确定的作用,了解它们对临床试验的影响很重要。我们检查了参与神经胶质瘤临床试验的患者的SDOH,并评估了农村和城市患者在试验参与和结果方面的差异。方法:我们回顾性地确定了2012年5月至2022年5月在亨斯迈癌症研究所(HCI)参加神经胶质瘤临床试验的患者,以评估临床试验的参与情况。我们使用多变量模型来评估SDOH和地理信息系统地图,以评估犹他州各县的代表性。我们利用HCI和犹他州癌症注册中心最近10年的神经胶质瘤治疗患者数据集,分别分析生存率和发病率。结果:共有570名参与者(68项试验)居住在犹他州,84.4%来自城市县,13.5%来自农村县,2.1%来自边境(人口最少)县。19个县(65.5%)在试验中的代表性不足(注册参与者与符合条件的参与者),1个县(3.5%)的代表性接近1:1,9个县(31.0%)的代表率过高。入学人数较多的县人口密度较大,人均收入最高,而且靠近HCI。在接受HCI治疗的患者中,来自农村/边境县的患者在几乎所有神经胶质瘤类型(包括胶质母细胞瘤)中的生存率与城市患者相当,尽管在临床试验中的代表性不足。结论:通过强调临床试验注册的差异,我们的研究结果可以支持在代表性不足的地区改善招募的努力,这可以帮助提供者为所有患者提供公平的护理。
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引用次数: 0
Forthcoming Meetings 即将到来的会议
Q2 Medicine Pub Date : 2023-05-12 DOI: 10.1093/nop/npad021
Journal Article Forthcoming Meetings Get access Neuro-Oncology Practice, Volume 10, Issue 3, June 2023, Page 315, https://doi.org/10.1093/nop/npad021 Published: 12 May 2023 Article history Corrected and typeset: 12 May 2023 Published: 12 May 2023
期刊文章即将召开的会议获取神经肿瘤学实践,第10卷,第3期,2023年6月,315页,https://doi.org/10.1093/nop/npad021发布:2023年5月12日文章历史更正和排版:2023年5月12日发布:2023年5月12日
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引用次数: 0
Preoperative neurocognitive function as an independent survival prognostic marker in primary glioblastoma. 术前神经认知功能作为原发性胶质母细胞瘤的独立生存预后标志物
IF 2.7 Q2 Medicine Pub Date : 2023-05-11 eCollection Date: 2023-12-01 DOI: 10.1093/nop/npad027
Evangelia Liouta, Christos Koutsarnakis, Spyridon Komaitis, Aristotelis V Kalyvas, Evangelos Drosos, Juan M García-Gómez, Javier Juan-Albarracín, Vasileios Katsaros, Lampis Stavrinou, George Stranjalis

Background: Aim of the present study is to investigate whether preoperative neurocognitive status is prognostically associated with overall survival (OS) in newly diagnosed glioblastoma (GBM) patients.

Methods: Ninety patients with dominant-hemisphere IDH-wild-type GBM were assessed by Mini Mental Status Exam (MMSE), Trail Making Test (TMT) A and B parts, and Control Word Association Test (COWAT) phonemic and semantic subtests. Demographics, Karnofsky Performance Scale, tumor parameters, type of surgery, and adjuvant therapy data were available for patients.

Results: According to Cox proportional hazards model the neurocognitive variables of TMT B (P < .01), COWAT semantic subset (P < .05), and the MMSE (P < .01) were found significantly associated with survival prediction. From all other factors, only tumor volume and operation type (debulking vs biopsy) showed a statistical association (P < .05) with survival prediction. Kaplan Meier Long rank test showed statistical significance (P < .01) between unimpaired and impaired groups for TMT B, with median survival for the unimpaired group 26 months and 10 months for the impaired group, for COWAT semantic (P < .01) with median survival 23 months and 12 months, respectively and for MMSE (P < .01) with medial survival 19 and 12 months respectively.

Conclusions: Our study demonstrates that neurocognitive status at baseline-prior to treatment-is an independent prognostic factor for OS in wild-type GBM patients, adding another prognostic tool to assist physicians in selecting the best treatment plan.

本研究的目的是调查新诊断的胶质母细胞瘤(GBM)患者术前神经认知状态是否与总生存率(OS)具有预后相关性。采用简易精神状态检查(MMSE)、追踪测试(TMT)A和B部分以及对照词联想测试(COWAT)音素和语义亚测验对90例显性半球IDH野生型GBM患者进行评估。患者可获得人口学、卡诺夫斯基表现量表(KPS)、肿瘤参数、手术类型和辅助治疗数据。根据Cox比例危险模型,发现TMT B(p<0.01)、COWAT语义子集(p<0.05)和MMSE(p<0.01)的神经认知变量与生存预测显著相关。从所有其他因素来看,只有肿瘤体积和手术类型(减瘤与活检)与生存预测具有统计学相关性(p<0.05)。Kaplan-Meier-Long秩检验显示,TMT B在未受损组和受损组之间具有统计学意义(p<0.01),未受损组的中位生存期分别为26个月和10个月,COWAT语义组(p<0.01)的中位存活期分别为23个月和12个月,MMSE组(p<0.01。我们的研究表明,治疗前基线时的神经认知状态是野生型GBM患者OS的一个独立预后因素,为帮助医生选择最佳治疗方案增加了另一个预后工具。
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引用次数: 1
Financial toxicity of radiotherapy for multiple brain metastases: Will it get worse or better? 多发性脑转移放射治疗的经济毒性:情况会恶化还是好转?
IF 2.4 Q2 CLINICAL NEUROLOGY Pub Date : 2023-05-03 eCollection Date: 2023-08-01 DOI: 10.1093/nop/npad018
Tomas Kazda, Katerina Polachova
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引用次数: 0
Epigenetic profiling reveals a strong association between lack of 5-ALA fluorescence and EGFR amplification in IDH-wildtype glioblastoma. 表观遗传学分析显示IDH野生型胶质母细胞瘤中5-ALA荧光的缺乏与EGFR扩增之间存在强烈的相关性。
IF 2.7 Q2 Medicine Pub Date : 2023-05-02 eCollection Date: 2023-10-01 DOI: 10.1093/nop/npad025
Richard Drexler, Thomas Sauvigny, Ulrich Schüller, Alicia Eckhardt, Cecile L Maire, Robin Khatri, Fabian Hausmann, Sonja Hänzelmann, Tobias B Huber, Stefan Bonn, Helena Bode, Katrin Lamszus, Manfred Westphal, Lasse Dührsen, Franz L Ricklefs

Background: 5-aminolevulinic acid (5-ALA) fluorescence-guided resection increases the percentage of complete CNS tumor resections and improves the progression-free survival of IDH-wildtype glioblastoma patients. A small subset of IDH-wildtype glioblastoma shows no 5-ALA fluorescence. An explanation for these cases is missing. In this study, we used DNA methylation profiling to further characterize non-fluorescent glioblastomas.

Methods: Patients with newly diagnosed and recurrent IDH-wildtype glioblastoma that underwent surgery were analyzed. The intensity of intraoperative 5-ALA fluorescence was categorized as non-visible or visible. DNA was extracted from tumors and genome-wide DNA methylation patterns were analyzed using Illumina EPIC (850k) arrays. Furthermore, 5-ALA intensity was measured by flow cytometry on human gliomasphere lines (BT112 and BT145).

Results: Of 74 included patients, 12 (16.2%) patients had a non-fluorescent glioblastoma, which were compared to 62 glioblastomas with 5-ALA fluorescence. Clinical characteristics were equally distributed between both groups. We did not find significant differences between DNA methylation subclasses and 5-ALA fluorescence (P = .24). The distribution of cells of the tumor microenvironment was not significantly different between the non-fluorescent and fluorescent tumors. Copy number variations in EGFR and simultaneous EGFRvIII expression were strongly associated with 5-ALA fluorescence since all non-fluorescent glioblastomas were EGFR-amplified (P < .01). This finding was also demonstrated in recurrent tumors. Similarly, EGFR-amplified glioblastoma cell lines showed no 5-ALA fluorescence after 24 h of incubation.

Conclusions: Our study demonstrates an association between non-fluorescent IDH-wildtype glioblastomas and EGFR gene amplification which should be taken into consideration for recurrent surgery and future studies investigating EGFR-amplified gliomas.

背景:5-氨基乙酰丙酸(5-ALA)荧光引导下切除增加了中枢神经系统肿瘤完全切除的百分比,并提高了IDH野生型胶质母细胞瘤患者的无进展生存率。IDH野生型胶质母细胞瘤的一小部分没有5-ALA荧光。对这些案例的解释不见了。在这项研究中,我们使用DNA甲基化图谱来进一步表征非荧光胶质母细胞瘤。方法:对经手术治疗的新诊断和复发的IDH野生型胶质母细胞瘤患者进行分析。术中5-ALA荧光强度分为不可见或可见。从肿瘤中提取DNA,并使用Illumina EPIC(850k)阵列分析全基因组DNA甲基化模式。此外,通过流式细胞术在人胶质母细胞球系(BT112和BT145)上测量5-ALA强度。结果:在74名纳入的患者中,12名(16.2%)患者患有非荧光性胶质母细胞瘤,与62名具有5-ALA荧光的胶质母细胞癌相比。两组患者的临床特征分布均匀。我们没有发现DNA甲基化亚类和5-ALA荧光之间的显著差异(P=.24)。非荧光肿瘤和荧光肿瘤的肿瘤微环境细胞分布没有显著差异。EGFR的拷贝数变化和同时表达EGFRvIII与5-ALA荧光密切相关,因为所有非荧光胶质母细胞瘤都是EGFR扩增的(P<0.01)。这一发现在复发性肿瘤中也得到了证实。类似地,EGFR扩增的胶质母细胞瘤细胞系在孵育24小时后没有显示5-ALA荧光。结论:我们的研究证明了非荧光IDH野生型胶质母细胞瘤与EGFR基因扩增之间的相关性,在复发性手术和未来研究EGFR扩增的胶质瘤时应考虑这一点。
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引用次数: 0
RNA fusion transcript panel identifies diverse repertoire of fusions in adult glioma patients with therapeutic implications. RNA 融合转录本面板确定了成人胶质瘤患者中具有治疗意义的各种融合。
IF 2.4 Q2 CLINICAL NEUROLOGY Pub Date : 2023-04-24 eCollection Date: 2023-08-01 DOI: 10.1093/nop/npad022
Shawn Kothari, Anna C Dusenbery, Abigail Doucette, Daniel Y Zhang, Dominique Ballinger, Arati Desai, Jennifer J D Morrissette, Stephen J Bagley, MacLean P Nasrallah

Background: Recurrent gliomas are therapeutically challenging diseases with few treatment options available. One area of potential therapeutic vulnerability is the presence of targetable oncogenic fusion proteins.

Methods: To better understand the clinical benefit of routinely testing for fusion proteins in adult glioma patients, we performed a retrospective review of 647 adult patients with glioma who underwent surgical resection at our center between August 2017 and May 2021 and whose tumors were analyzed with an in-house fusion transcript panel.

Results: Fifty-two patients (8%) were found to harbor a potentially targetable fusion with 11 (21%) of these patients receiving treatment with a fusion-targeted inhibitor. The targetable genes found to be involved in a fusion included FGFR3, MET, EGFR, NTRK1, NTRK2, BRAF, ROS1, and PIK3CA.

Conclusions: This analysis demonstrates that routine clinical testing for gene fusions identifies a diverse repertoire of potential therapeutic targets in adult patients with glioma and can offer rational therapeutic options for patients with recurrent disease.

背景:复发性胶质瘤是一种具有治疗挑战性的疾病,可供选择的治疗方案很少。潜在的治疗漏洞之一是存在可靶向的致癌融合蛋白:为了更好地了解对成年胶质瘤患者进行融合蛋白常规检测的临床益处,我们对2017年8月至2021年5月期间在本中心接受手术切除的647例成年胶质瘤患者进行了回顾性复查,并使用内部融合转录物面板分析了这些患者的肿瘤:52名患者(8%)被发现携带潜在的可靶向融合基因,其中11名患者(21%)接受了融合靶向抑制剂治疗。发现参与融合的可靶向基因包括 FGFR3、MET、EGFR、NTRK1、NTRK2、BRAF、ROS1 和 PIK3CA:这项分析表明,基因融合的常规临床检测可确定成年胶质瘤患者的各种潜在治疗靶点,并为复发患者提供合理的治疗方案。
{"title":"RNA fusion transcript panel identifies diverse repertoire of fusions in adult glioma patients with therapeutic implications.","authors":"Shawn Kothari, Anna C Dusenbery, Abigail Doucette, Daniel Y Zhang, Dominique Ballinger, Arati Desai, Jennifer J D Morrissette, Stephen J Bagley, MacLean P Nasrallah","doi":"10.1093/nop/npad022","DOIUrl":"10.1093/nop/npad022","url":null,"abstract":"<p><strong>Background: </strong>Recurrent gliomas are therapeutically challenging diseases with few treatment options available. One area of potential therapeutic vulnerability is the presence of targetable oncogenic fusion proteins.</p><p><strong>Methods: </strong>To better understand the clinical benefit of routinely testing for fusion proteins in adult glioma patients, we performed a retrospective review of 647 adult patients with glioma who underwent surgical resection at our center between August 2017 and May 2021 and whose tumors were analyzed with an in-house fusion transcript panel.</p><p><strong>Results: </strong>Fifty-two patients (8%) were found to harbor a potentially targetable fusion with 11 (21%) of these patients receiving treatment with a fusion-targeted inhibitor. The targetable genes found to be involved in a fusion included <i>FGFR3, MET, EGFR, NTRK1, NTRK2, BRAF, ROS1,</i> and <i>PIK3CA</i>.</p><p><strong>Conclusions: </strong>This analysis demonstrates that routine clinical testing for gene fusions identifies a diverse repertoire of potential therapeutic targets in adult patients with glioma and can offer rational therapeutic options for patients with recurrent disease.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10346416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10184109","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
Lower middle-income countries: A risk factor for lower survival in glioblastoma? Evidence for health care providers. 中低收入国家:胶质母细胞瘤存活率较低的风险因素?为医疗服务提供者提供的证据。
IF 2.4 Q2 CLINICAL NEUROLOGY Pub Date : 2023-04-21 eCollection Date: 2023-08-01 DOI: 10.1093/nop/npad020
Stefan Oberndorfer
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引用次数: 0
Depression and anxiety in glioma patients. 胶质瘤患者的抑郁和焦虑。
IF 2.7 Q2 Medicine Pub Date : 2023-04-20 eCollection Date: 2023-08-01 DOI: 10.1093/nop/npad019
Pim B van der Meer, Linda Dirven, Caroline Hertler, Florien W Boele, Albert Batalla, Tobias Walbert, Alasdair G Rooney, Johan A F Koekkoek

AbstractGlioma patients carry the burden of having both a progressive neurological disease and cancer, and may face a variety of symptoms, including depression and anxiety. These symptoms are highly prevalent in glioma patients (median point prevalence ranging from 16-41% for depression and 24-48% for anxiety when assessed by self-report questionnaires) and have a major impact on health-related quality of life and even overall survival time. A worse overall survival time for glioma patients with depressive symptoms might be due to tumor progression and/or its supportive treatment causing depressive symptoms, an increased risk of suicide or other (unknown) factors. Much is still unclear about the etiology of depressive and anxiety symptoms in glioma. These psychiatric symptoms often find their cause in a combination of neurophysiological and psychological factors, such as the tumor and/or its treatment. Although these patients have a particular idiosyncrasy, standard treatment guidelines for depressive and anxiety disorders apply, generally recommending psychological and pharmacological treatment. Only a few nonpharmacological trials have been conducted evaluating the efficacy of psychological treatments (eg, a reminiscence therapy-based care program) in this population, which significantly reduced depressive and anxiety symptoms. No pharmacological trials have been conducted in glioma patients specifically. More well-designed trials evaluating the efficacy of nonpharmacological treatments for depressive and anxiety disorders in glioma are urgently needed to successfully treat psychiatric symptoms in brain tumor patients and to improve (health-related) quality of life.

摘要 脑胶质瘤患者同时承受着神经系统疾病和癌症进展的双重负担,可能会出现各种症状,包括抑郁和焦虑。这些症状在胶质瘤患者中非常普遍(通过自我报告问卷评估,抑郁和焦虑的中位流行率分别为16%-41%和24%-48%),对健康相关的生活质量甚至总体生存时间都有重大影响。有抑郁症状的胶质瘤患者总体生存时间较短,可能是由于肿瘤进展和/或其支持性治疗导致抑郁症状、自杀风险增加或其他(未知)因素。胶质瘤患者抑郁和焦虑症状的病因尚不明确。这些精神症状往往是神经生理和心理因素(如肿瘤和/或治疗)共同作用的结果。尽管这些患者具有特殊的特异性,但抑郁和焦虑症的标准治疗指南仍然适用,一般建议采用心理和药物治疗。只有少数非药物试验对心理治疗(如基于回忆疗法的护理计划)在这类人群中的疗效进行了评估,结果显示心理治疗可显著减轻抑郁和焦虑症状。目前还没有专门针对胶质瘤患者的药物治疗试验。要成功治疗脑肿瘤患者的精神症状并改善(与健康相关的)生活质量,迫切需要更多设计良好的试验来评估非药物治疗对胶质瘤抑郁和焦虑症的疗效。
{"title":"Depression and anxiety in glioma patients.","authors":"Pim B van der Meer, Linda Dirven, Caroline Hertler, Florien W Boele, Albert Batalla, Tobias Walbert, Alasdair G Rooney, Johan A F Koekkoek","doi":"10.1093/nop/npad019","DOIUrl":"10.1093/nop/npad019","url":null,"abstract":"<p><p>AbstractGlioma patients carry the burden of having both a progressive neurological disease and cancer, and may face a variety of symptoms, including depression and anxiety. These symptoms are highly prevalent in glioma patients (median point prevalence ranging from 16-41% for depression and 24-48% for anxiety when assessed by self-report questionnaires) and have a major impact on health-related quality of life and even overall survival time. A worse overall survival time for glioma patients with depressive symptoms might be due to tumor progression and/or its supportive treatment causing depressive symptoms, an increased risk of suicide or other (unknown) factors. Much is still unclear about the etiology of depressive and anxiety symptoms in glioma. These psychiatric symptoms often find their cause in a combination of neurophysiological and psychological factors, such as the tumor and/or its treatment. Although these patients have a particular idiosyncrasy, standard treatment guidelines for depressive and anxiety disorders apply, generally recommending psychological and pharmacological treatment. Only a few nonpharmacological trials have been conducted evaluating the efficacy of psychological treatments (eg, a reminiscence therapy-based care program) in this population, which significantly reduced depressive and anxiety symptoms. No pharmacological trials have been conducted in glioma patients specifically. More well-designed trials evaluating the efficacy of nonpharmacological treatments for depressive and anxiety disorders in glioma are urgently needed to successfully treat psychiatric symptoms in brain tumor patients and to improve (health-related) quality of life.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8c/c7/npad019.PMC10346395.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10098814","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
Forthcoming Meetings 即将到来的会议
Q2 Medicine Pub Date : 2023-04-14 DOI: 10.1093/nop/npad034
{"title":"Forthcoming Meetings","authors":"","doi":"10.1093/nop/npad034","DOIUrl":"https://doi.org/10.1093/nop/npad034","url":null,"abstract":"","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135077959","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}
引用次数: 0
Association between preoperative neurocognitive status and IDH1 mutation status in high-grade gliomas. 高级别胶质瘤患者术前神经认知状态与IDH1突变状态的关系
IF 2.7 Q2 Medicine Pub Date : 2023-04-01 DOI: 10.1093/nop/npac077
Evangelia Liouta, Aristotelis V Kalyvas, Spyridon Komaitis, Evangelos Drosos, Christos Koutsarnakis, Juan M García-Gómez, Javier Juan-Albarracín, Vasileios Katsaros, Theodosis Kalamatianos, Theodoros Argyrakos, George Stranjalis

Background: High-grade glioma (HGG) patients present with variable impairment in neurocognitive function (NCF). Based on that, isocitrate dehydrogenase 1 (IDH1) wild-type HGGs are more aggressive than IDH1 mutant-type ones, we hypothesized that patients with IDH1 wild-type HGG would exhibit more severe NCF deficits than their IDH1 mutant counterparts.

Methods: NCF was assessed by Mini Mental Status Exam (MMSE), Trail Making Test (TMT), Digit Span (DS), and Controlled Word Association Test (COWAT) tests in 147 HGG patients preoperatively.

Results: Analyses between IDH1 groups revealed a significant difference on MMSE concentration component (p ≤ .01), DS (p ≤ .01), TMTB (p ≤ .01), and COWAT (p ≤ .01) scores, with the IDH1 wild group performing worse than the IDH1 mutant one. Age and tumor volume were inversely correlated with MMSE concentration component (r = -4.78, p < .01), and with MMSE concentration (r = -.401, p < .01), TMTB (r = -.328, p < .01), and COWAT phonemic scores (r = -.599, p < .01), respectively, but only for the IDH1 wild-type group. Analyses between age-matched subsamples of IDH1 groups revealed no age effect on NCF. Tumor grade showed nonsignificance on NCF (p > .05) between the 2 IDH1 mutation subgroups of grade IV tumor patients. On the contrary, grade III group showed a significant difference in TMTB (p < .01) and DS backwards (p < .01) between IDH1 subgroups, with the mutant one outperforming the IDH1 wild one.

Conclusions: Our findings indicate that IDH1 wild-type HGG patients present greater NCF impairment, in executive functions particularly, compared to IDH1 mutant ones, suggesting that tumor growth kinetics may play a more profound role than other tumor and demographic parameters in clinical NCF of HGG patients.

背景:高级别胶质瘤(HGG)患者表现为神经认知功能(NCF)的可变损害。基于此,异柠檬酸脱氢酶1 (IDH1)野生型HGG比IDH1突变型HGG更具侵袭性,我们假设IDH1野生型HGG患者比IDH1突变型HGG患者表现出更严重的NCF缺陷。方法:对147例HGG患者术前采用Mini Mental Status examination (MMSE)、Trail Making Test (TMT)、Digit Span (DS)、Controlled Word Association Test (COWAT)进行NCF评估。结果:IDH1组间MMSE浓度组成(p≤0.01)、DS (p≤0.01)、TMTB (p≤0.01)、COWAT (p≤0.01)评分差异均有统计学意义,且IDH1野生组表现差于IDH1突变组。年龄、肿瘤体积与MMSE浓度组分呈负相关(r = -4.78, p < 0.01),与MMSE浓度组分呈负相关(r = -)。401, p < 0.01), TMTB (r = -。328, p < 0.01),而COWAT音位评分(r = -。599, p < 0.01),但仅适用于IDH1野生型组。对年龄匹配的IDH1组亚样本的分析显示,年龄对NCF没有影响。肿瘤分级对IV级肿瘤患者2个IDH1突变亚组NCF的影响无统计学意义(p > 0.05)。III级组在TMTB (p < 0.01)和DS倒位(p < 0.01)上在IDH1亚组间有显著差异,突变型优于野生型。结论:我们的研究结果表明,与IDH1突变型HGG患者相比,IDH1野生型HGG患者存在更大的NCF损伤,特别是在执行功能方面,这表明肿瘤生长动力学可能比其他肿瘤和人口统计学参数在HGG患者的临床NCF中发挥更深远的作用。
{"title":"Association between preoperative neurocognitive status and IDH1 mutation status in high-grade gliomas.","authors":"Evangelia Liouta,&nbsp;Aristotelis V Kalyvas,&nbsp;Spyridon Komaitis,&nbsp;Evangelos Drosos,&nbsp;Christos Koutsarnakis,&nbsp;Juan M García-Gómez,&nbsp;Javier Juan-Albarracín,&nbsp;Vasileios Katsaros,&nbsp;Theodosis Kalamatianos,&nbsp;Theodoros Argyrakos,&nbsp;George Stranjalis","doi":"10.1093/nop/npac077","DOIUrl":"https://doi.org/10.1093/nop/npac077","url":null,"abstract":"<p><strong>Background: </strong>High-grade glioma (HGG) patients present with variable impairment in neurocognitive function (NCF). Based on that, isocitrate dehydrogenase 1 (IDH1) wild-type HGGs are more aggressive than IDH1 mutant-type ones, we hypothesized that patients with IDH1 wild-type HGG would exhibit more severe NCF deficits than their IDH1 mutant counterparts.</p><p><strong>Methods: </strong>NCF was assessed by Mini Mental Status Exam (MMSE), Trail Making Test (TMT), Digit Span (DS), and Controlled Word Association Test (COWAT) tests in 147 HGG patients preoperatively.</p><p><strong>Results: </strong>Analyses between IDH1 groups revealed a significant difference on MMSE concentration component (<i>p</i> ≤ .01), DS (<i>p</i> ≤ .01), TMTB (<i>p</i> ≤ .01), and COWAT (<i>p</i> ≤ .01) scores, with the IDH1 wild group performing worse than the IDH1 mutant one. Age and tumor volume were inversely correlated with MMSE concentration component (<i>r</i> = -4.78, <i>p</i> < .01), and with MMSE concentration (<i>r</i> = -.401, <i>p</i> < .01), TMTB (<i>r</i> = -.328, <i>p</i> < .01), and COWAT phonemic scores (<i>r</i> = -.599, <i>p</i> < .01), respectively, but only for the IDH1 wild-type group. Analyses between age-matched subsamples of IDH1 groups revealed no age effect on NCF. Tumor grade showed nonsignificance on NCF (<i>p</i> > .05) between the 2 IDH1 mutation subgroups of grade IV tumor patients. On the contrary, grade III group showed a significant difference in TMTB (<i>p</i> < .01) and DS backwards (<i>p</i> < .01) between IDH1 subgroups, with the mutant one outperforming the IDH1 wild one.</p><p><strong>Conclusions: </strong>Our findings indicate that IDH1 wild-type HGG patients present greater NCF impairment, in executive functions particularly, compared to IDH1 mutant ones, suggesting that tumor growth kinetics may play a more profound role than other tumor and demographic parameters in clinical NCF of HGG patients.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10037936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9246419","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: 2
期刊
Neuro-oncology practice
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