H. Bruhn, Björn Tavelin, L. Rosenlund, R. Henriksson
Glioblastoma is the most common malignant brain tumour in adults. Non-invasive clinical parameters could play a crucial role in treatment planning and serve as predictors of patient survival. Our register-based real-life study aimed to investigate the prognostic value of presenting symptoms. Data on presenting symptoms and survival, as well as known prognostic factors, were retrieved for all glioblastoma patients in Sweden registered in the Swedish Brain Tumour Registry between 2018 and 2021. The prognostic impact of different presenting symptoms was calculated using the Cox proportional hazard model. Data from 1458 adults with pathologically verified IDH wild-type glioblastoma were analysed. Median survival time was 345 days. The two-year survival rate was 21.5%. Registered presenting symptoms were focal neurological deficits, cognitive dysfunction, headache, epilepsy, signs of raised intracranial pressure and cranial nerve symptoms, with some patients having multiple symptoms. Patients with initial cognitive dysfunction had significantly shorter survival than patients without; 265 days (245-285) vs. 409 days (365-453) (p<0.001). The reduced survival remained after Cox regression adjusting for known prognostic factors. Patients presenting with seizures and patients with headaches had significantly longer overall survival compared to patients without these symptoms, but the difference was not retained in multivariate analysis. Patients with cognitive deficits were less likely to have radical surgery and to receive extensive anti-neoplastic nonsurgical treatment. This extensive real-life study reveals that initial cognitive impairment acts as an independent negative predictive factor for treatment decisions and adversely affects survival outcomes in glioblastoma patients.
{"title":"Do Presenting Symptoms Predict Treatment Decisions and Survival in Glioblastoma? -Real World Data from 1458 patients in the Swedish Brain Tumour Registry","authors":"H. Bruhn, Björn Tavelin, L. Rosenlund, R. Henriksson","doi":"10.1093/nop/npae036","DOIUrl":"https://doi.org/10.1093/nop/npae036","url":null,"abstract":"\u0000 \u0000 \u0000 Glioblastoma is the most common malignant brain tumour in adults. Non-invasive clinical parameters could play a crucial role in treatment planning and serve as predictors of patient survival. Our register-based real-life study aimed to investigate the prognostic value of presenting symptoms.\u0000 \u0000 \u0000 \u0000 Data on presenting symptoms and survival, as well as known prognostic factors, were retrieved for all glioblastoma patients in Sweden registered in the Swedish Brain Tumour Registry between 2018 and 2021. The prognostic impact of different presenting symptoms was calculated using the Cox proportional hazard model.\u0000 \u0000 \u0000 \u0000 Data from 1458 adults with pathologically verified IDH wild-type glioblastoma were analysed. Median survival time was 345 days. The two-year survival rate was 21.5%. Registered presenting symptoms were focal neurological deficits, cognitive dysfunction, headache, epilepsy, signs of raised intracranial pressure and cranial nerve symptoms, with some patients having multiple symptoms. Patients with initial cognitive dysfunction had significantly shorter survival than patients without; 265 days (245-285) vs. 409 days (365-453) (p<0.001). The reduced survival remained after Cox regression adjusting for known prognostic factors. Patients presenting with seizures and patients with headaches had significantly longer overall survival compared to patients without these symptoms, but the difference was not retained in multivariate analysis. Patients with cognitive deficits were less likely to have radical surgery and to receive extensive anti-neoplastic nonsurgical treatment.\u0000 \u0000 \u0000 \u0000 This extensive real-life study reveals that initial cognitive impairment acts as an independent negative predictive factor for treatment decisions and adversely affects survival outcomes in glioblastoma patients.\u0000","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140668013","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}
G. Halkett, Emma McDougall, Melissa N Berg, Jenny Clarke, Haryana Dhillon, E. Lobb, J. Phillips, PL Hudson, Mona M Faris, Rachel Campbell, Joanne Shaw, Elisabeth Coyne, Brian Kelly, T. Ownsworth, Dianne Legge, Anna K Nowak
Carers play an important role in supporting patients diagnosed with High Grade Glioma (HGG). However, this experience is frequently distressing and many carers require support. Objective: to describe unmet needs of highly distressed carers of people with HGG) and recommendations and referrals made by a nurse to support them within the Care-IS trial. Descriptive case series. Carers of people with HGG in the Care-IS trial reporting: severe anxiety and/or depression at baseline and/or 4 months and high distress at baseline (during chemoradiotherapy) and at 4 months, were included. Carers completed the Partner and Caregiver Supportive Care Needs Scale and Brain Tumour Specific Unmet Needs Survey for carers at baseline, 2, 4, 6, 12 months. Monthly nurse telephone assessments documented carers’ needs and recommendations and referrals made. Data are reported descriptively. Four highly distressed carers were identified (N=98). Each reported a moderate-high need at ≥1 timepoint for: financial support and/or travel insurance; making life decisions in uncertainty; information about cancer prognosis/likely outcome; and coping with unexpected treatment outcomes. Specific brain tumour unmet needs were: adjusting to changes in personality, mental and thinking abilities; and accessing government assistance. Nurses provided information about treatment, side effects and practical support. Recommendations for clinical care and referrals to community-based services, and medical specialists were offered. Highly distressed carers have diverse support needs in many domains which can change over time. Nurses were critical in identifying carers’ needs, providing support, and making referrals. Carers’ distress and needs require ongoing screening and management.
{"title":"A nurse-led intervention for carers of people with high grade glioma: a case series of carers reporting high distress","authors":"G. Halkett, Emma McDougall, Melissa N Berg, Jenny Clarke, Haryana Dhillon, E. Lobb, J. Phillips, PL Hudson, Mona M Faris, Rachel Campbell, Joanne Shaw, Elisabeth Coyne, Brian Kelly, T. Ownsworth, Dianne Legge, Anna K Nowak","doi":"10.1093/nop/npae033","DOIUrl":"https://doi.org/10.1093/nop/npae033","url":null,"abstract":"\u0000 \u0000 \u0000 Carers play an important role in supporting patients diagnosed with High Grade Glioma (HGG). However, this experience is frequently distressing and many carers require support. Objective: to describe unmet needs of highly distressed carers of people with HGG) and recommendations and referrals made by a nurse to support them within the Care-IS trial.\u0000 \u0000 \u0000 \u0000 Descriptive case series. Carers of people with HGG in the Care-IS trial reporting: severe anxiety and/or depression at baseline and/or 4 months and high distress at baseline (during chemoradiotherapy) and at 4 months, were included.\u0000 Carers completed the Partner and Caregiver Supportive Care Needs Scale and Brain Tumour Specific Unmet Needs Survey for carers at baseline, 2, 4, 6, 12 months. Monthly nurse telephone assessments documented carers’ needs and recommendations and referrals made. Data are reported descriptively.\u0000 \u0000 \u0000 \u0000 Four highly distressed carers were identified (N=98). Each reported a moderate-high need at ≥1 timepoint for: financial support and/or travel insurance; making life decisions in uncertainty; information about cancer prognosis/likely outcome; and coping with unexpected treatment outcomes. Specific brain tumour unmet needs were: adjusting to changes in personality, mental and thinking abilities; and accessing government assistance.\u0000 Nurses provided information about treatment, side effects and practical support. Recommendations for clinical care and referrals to community-based services, and medical specialists were offered.\u0000 \u0000 \u0000 \u0000 Highly distressed carers have diverse support needs in many domains which can change over time. Nurses were critical in identifying carers’ needs, providing support, and making referrals. Carers’ distress and needs require ongoing screening and management.\u0000","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140692500","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}
Timothy A. Gregory, S. Knight, A. Aaroe, K. Highsmith, Zachary C. Janatpour, Barbara J O’Brien, Nazanin K. Majd, M. Loghin, Chirag Patel, S. Weathers, V. Puduvalli, C. Kamiya-Matsuoka
We observed rapid tumor progression following COVID-19 infection among patients with glioblastoma and sought to systematically characterize their disease course in a retrospective case-control study. Using an institutional database, we retrospectively identified a series of COVID-19–positive glioblastoma cases and matched them by age and sex 1:2 to glioblastoma controls who had a negative COVID-19 test during their disease course. Demographic and clinical data were analyzed. Hyperprogression was defined using modified RECIST criteria. Time to progression and overall survival were estimated using the Kaplan-Meier method. Thirty-two glioblastoma cases with positive COVID-19 testing were matched to 64 glioblastoma controls with negative testing; age, sex, and molecular profiles did not differ between groups. Progression events occurred in 27 cases (84%) and 46 controls (72%). Of these, 14 cases (52%) presented with multifocal disease or leptomeningeal disease at progression compared with 10 controls (22%; p=0·0082). Hyperprogression was identified in 13 cases (48%) but only 4 controls (9%; p=0·0001). Cases had disease progression at a median of 35 days following COVID-19 testing, compared with 164 days for controls (p=0·0001). Median survival from COVID-19 testing until death was 8·3 months for cases but 17 months for controls (p=0·0016). Median overall survival from glioblastoma diagnosis was 20·7 months for cases and 24·6 months for controls (p=0·672). Patients with glioblastoma may have accelerated disease progression in the first 2 months after COVID-19 infection. Infected patients should be monitored vigilantly. Future investigations should explore tumor-immune microenvironment changes linking tumor progression and COVID-19.
{"title":"Accelerated tumor progression after COVID-19 infection in patients with glioblastoma: a retrospective case-control study","authors":"Timothy A. Gregory, S. Knight, A. Aaroe, K. Highsmith, Zachary C. Janatpour, Barbara J O’Brien, Nazanin K. Majd, M. Loghin, Chirag Patel, S. Weathers, V. Puduvalli, C. Kamiya-Matsuoka","doi":"10.1093/nop/npae029","DOIUrl":"https://doi.org/10.1093/nop/npae029","url":null,"abstract":"\u0000 \u0000 \u0000 We observed rapid tumor progression following COVID-19 infection among patients with glioblastoma and sought to systematically characterize their disease course in a retrospective case-control study.\u0000 \u0000 \u0000 \u0000 Using an institutional database, we retrospectively identified a series of COVID-19–positive glioblastoma cases and matched them by age and sex 1:2 to glioblastoma controls who had a negative COVID-19 test during their disease course. Demographic and clinical data were analyzed. Hyperprogression was defined using modified RECIST criteria. Time to progression and overall survival were estimated using the Kaplan-Meier method.\u0000 \u0000 \u0000 \u0000 Thirty-two glioblastoma cases with positive COVID-19 testing were matched to 64 glioblastoma controls with negative testing; age, sex, and molecular profiles did not differ between groups. Progression events occurred in 27 cases (84%) and 46 controls (72%). Of these, 14 cases (52%) presented with multifocal disease or leptomeningeal disease at progression compared with 10 controls (22%; p=0·0082). Hyperprogression was identified in 13 cases (48%) but only 4 controls (9%; p=0·0001). Cases had disease progression at a median of 35 days following COVID-19 testing, compared with 164 days for controls (p=0·0001). Median survival from COVID-19 testing until death was 8·3 months for cases but 17 months for controls (p=0·0016). Median overall survival from glioblastoma diagnosis was 20·7 months for cases and 24·6 months for controls (p=0·672).\u0000 \u0000 \u0000 \u0000 Patients with glioblastoma may have accelerated disease progression in the first 2 months after COVID-19 infection. Infected patients should be monitored vigilantly. Future investigations should explore tumor-immune microenvironment changes linking tumor progression and COVID-19.\u0000","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140732312","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}
William M Savage, Mitchell D Yeary, Anthony J Tang, Colin P. Sperring, Michael G. Argenziano, Arjun R Adapa, Nina Yoh, P. Canoll, Jeffrey N. Bruce
Glioblastoma (GBM) is the most common primary brain cancer, comprising half of all malignant brain tumors. Patients with GBM have a poor prognosis, with a median survival of 14-15 months. Current therapies for GBM, including chemotherapy, radiotherapy, and surgical resection, remain inadequate. Novel therapies are required to extend patient survival. Although immunotherapy has shown promise in other cancers, including melanoma and non-small lung cancer, its efficacy in GBM has been limited to subsets of patients. Identifying biomarkers of immunotherapy response in GBM could help stratify patients, identify new therapeutic targets, and develop more effective treatments. This article reviews existing and emerging biomarkers of clinical response to immunotherapy in GBM. The scope of this review includes immune checkpoint inhibitor and antitumoral vaccination approaches, summarizing the variety of molecular, cellular, and computational methodologies that have been explored in the setting of anti-GBM immunotherapies.
{"title":"Biomarkers Of Immunotherapy In Glioblastoma","authors":"William M Savage, Mitchell D Yeary, Anthony J Tang, Colin P. Sperring, Michael G. Argenziano, Arjun R Adapa, Nina Yoh, P. Canoll, Jeffrey N. Bruce","doi":"10.1093/nop/npae028","DOIUrl":"https://doi.org/10.1093/nop/npae028","url":null,"abstract":"\u0000 Glioblastoma (GBM) is the most common primary brain cancer, comprising half of all malignant brain tumors. Patients with GBM have a poor prognosis, with a median survival of 14-15 months. Current therapies for GBM, including chemotherapy, radiotherapy, and surgical resection, remain inadequate. Novel therapies are required to extend patient survival. Although immunotherapy has shown promise in other cancers, including melanoma and non-small lung cancer, its efficacy in GBM has been limited to subsets of patients. Identifying biomarkers of immunotherapy response in GBM could help stratify patients, identify new therapeutic targets, and develop more effective treatments. This article reviews existing and emerging biomarkers of clinical response to immunotherapy in GBM. The scope of this review includes immune checkpoint inhibitor and antitumoral vaccination approaches, summarizing the variety of molecular, cellular, and computational methodologies that have been explored in the setting of anti-GBM immunotherapies.","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140765122","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}
C. Saberian, D. Milton, Julie M Simon, R. Amaria, A. Diab, Jennifer McQuade, S. Patel, Hussein Tawbi, Cassian Yee, M. Wong, I. McCutcheon, Michael A. Davies, S. Ferguson, Isabella C. Glitza Oliva
Melanoma leptomeningeal disease (LMD) has poor prognosis. However, the management of patients with advanced melanoma has evolved with time, including those with LMD. We reviewed a large cohort of melanoma LMD patients to assess factors associated with survival. Retrospective clinical data was collected on patients diagnosed with LMD at MD Anderson Cancer Center from 2015-2020. Overall survival (OS) was determined from LMD diagnosis to date of death or last follow-up. The Kaplan-Meier method and log-rank test were used to estimate OS and to assess univariate group differences, respectively. Multivariable associations of survival with variables of interest were determined using Cox proportional hazards regression models. 172 patients were identified. The median age at LMD diagnosis was 53 (range 20-79) years, and all patients had radiographic evidence of LMD on MRI of either brain or spine. 143 patients previously received systemic therapy (83%), with a median of two prior treatments (range 0-5). 81 patients (47%) had concurrent uncontrolled systemic disease and 80 patients (53%) had elevated serum LDH at the time of diagnosis. With a median follow-up of 4.0 months (range 0.1-65.3 months), median OS for all patients from LMD diagnosis was 4.9 months. Patients (n=45) who received intrathecal (IT) therapy or systemic immunotherapy for LMD had a median OS of 8.0 months and 10.2 months, respectively. On multivariable analysis, decreased performance status, positive CSF cytology, elevated LDH, and whole brain radiation were associated with worse OS. Despite many advances in therapeutic options, the outcomes of melanoma patients with LMD remains poor. However, a subset of patients appears to derive benefit from LMD-directed treatment.
{"title":"Survival and treatment outcomes in patients with leptomeningeal disease from metastatic melanoma","authors":"C. Saberian, D. Milton, Julie M Simon, R. Amaria, A. Diab, Jennifer McQuade, S. Patel, Hussein Tawbi, Cassian Yee, M. Wong, I. McCutcheon, Michael A. Davies, S. Ferguson, Isabella C. Glitza Oliva","doi":"10.1093/nop/npae026","DOIUrl":"https://doi.org/10.1093/nop/npae026","url":null,"abstract":"\u0000 \u0000 \u0000 Melanoma leptomeningeal disease (LMD) has poor prognosis. However, the management of patients with advanced melanoma has evolved with time, including those with LMD. We reviewed a large cohort of melanoma LMD patients to assess factors associated with survival.\u0000 \u0000 \u0000 \u0000 Retrospective clinical data was collected on patients diagnosed with LMD at MD Anderson Cancer Center from 2015-2020. Overall survival (OS) was determined from LMD diagnosis to date of death or last follow-up. The Kaplan-Meier method and log-rank test were used to estimate OS and to assess univariate group differences, respectively. Multivariable associations of survival with variables of interest were determined using Cox proportional hazards regression models.\u0000 \u0000 \u0000 \u0000 172 patients were identified. The median age at LMD diagnosis was 53 (range 20-79) years, and all patients had radiographic evidence of LMD on MRI of either brain or spine. 143 patients previously received systemic therapy (83%), with a median of two prior treatments (range 0-5). 81 patients (47%) had concurrent uncontrolled systemic disease and 80 patients (53%) had elevated serum LDH at the time of diagnosis. With a median follow-up of 4.0 months (range 0.1-65.3 months), median OS for all patients from LMD diagnosis was 4.9 months. Patients (n=45) who received intrathecal (IT) therapy or systemic immunotherapy for LMD had a median OS of 8.0 months and 10.2 months, respectively. On multivariable analysis, decreased performance status, positive CSF cytology, elevated LDH, and whole brain radiation were associated with worse OS.\u0000 \u0000 \u0000 \u0000 Despite many advances in therapeutic options, the outcomes of melanoma patients with LMD remains poor. However, a subset of patients appears to derive benefit from LMD-directed treatment.\u0000","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140361534","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}
E. V. van Grinsven, F. Cialdella, Y. Gmelich Meijling, Joost J C Verhoeff, Marielle M Philippens, M. V. van Zandvoort
The increasing incidence of brain metastases (BMs) and improved survival rates underscore the necessity to investigate the effects of treatments on individuals. The aim of this study was to evaluate the individual trajectories of subjective and objective cognitive performance after radiotherapy in patients with BMs. The study population consisted of adult patients with BMs referred for radiotherapy. A semi-structured interview and comprehensive neurocognitive assessment (NCA) were used to assess both subjective and objective cognitive performance before, 3 months and ≥11 months after radiotherapy. Reliable change indices were used to identify individual, clinically meaningful changes. Thirty-six patients completed the 3-month follow-up, and 14 patients completed the ≥11-months follow-up. Depending on the domain, subjective cognitive decline was reported by 11-22% of patients. In total, 50% of patients reported subjective decline on at least one cognitive domain. Intracranial progression 3 months post-radiotherapy was a risk-factor for self-reported deterioration (p=.031). Objective changes were observed across all domains, with a particular vulnerability for decline in memory at 3 months post-radiotherapy. The majority of patients (81%) experienced both a deterioration as well as improvement (e.g. mixed response) in objective cognitive functioning. Results were similar for the long-term follow-up (3-≥11 months). No risk factors for objective cognitive change 3 months post-radiotherapy were identified. Our study revealed that the majority of patients with BMs will show a mixed cognitive response following radiotherapy, reflecting the complex impact. This underscores the importance of patient-tailored NCAs three months post-radiotherapy to guide optimal rehabilitation strategies.
{"title":"Individualized trajectories in post-radiotherapy neurocognitive functioning of patients with brain metastases","authors":"E. V. van Grinsven, F. Cialdella, Y. Gmelich Meijling, Joost J C Verhoeff, Marielle M Philippens, M. V. van Zandvoort","doi":"10.1093/nop/npae024","DOIUrl":"https://doi.org/10.1093/nop/npae024","url":null,"abstract":"\u0000 \u0000 \u0000 The increasing incidence of brain metastases (BMs) and improved survival rates underscore the necessity to investigate the effects of treatments on individuals. The aim of this study was to evaluate the individual trajectories of subjective and objective cognitive performance after radiotherapy in patients with BMs.\u0000 \u0000 \u0000 \u0000 The study population consisted of adult patients with BMs referred for radiotherapy. A semi-structured interview and comprehensive neurocognitive assessment (NCA) were used to assess both subjective and objective cognitive performance before, 3 months and ≥11 months after radiotherapy. Reliable change indices were used to identify individual, clinically meaningful changes.\u0000 \u0000 \u0000 \u0000 Thirty-six patients completed the 3-month follow-up, and 14 patients completed the ≥11-months follow-up. Depending on the domain, subjective cognitive decline was reported by 11-22% of patients. In total, 50% of patients reported subjective decline on at least one cognitive domain. Intracranial progression 3 months post-radiotherapy was a risk-factor for self-reported deterioration (p=.031). Objective changes were observed across all domains, with a particular vulnerability for decline in memory at 3 months post-radiotherapy. The majority of patients (81%) experienced both a deterioration as well as improvement (e.g. mixed response) in objective cognitive functioning. Results were similar for the long-term follow-up (3-≥11 months). No risk factors for objective cognitive change 3 months post-radiotherapy were identified.\u0000 \u0000 \u0000 \u0000 Our study revealed that the majority of patients with BMs will show a mixed cognitive response following radiotherapy, reflecting the complex impact. This underscores the importance of patient-tailored NCAs three months post-radiotherapy to guide optimal rehabilitation strategies.\u0000","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140364821","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}
M. Stockdill, A. King, Morgan Johnson, Z. Karim, D. Cooper, Terri S Armstrong
Social determinants of health (SDOH) impact cancer-related health outcomes, including survival, but their impact on symptoms is less understood among the primary brain tumor (PBT) population. We conducted a systematic review to examine the relationships between SDOH and neurocognitive and mood-related symptoms among the PBT population. PubMed, EMBASE, and CINAHL were searched using PROGRESS criteria (Place of residence, Race/ethnicity, Occupation, Gender/Sex, Religion, Education, Socioeconomic status, Social capital) on March 8th, 2022. Two individuals screened and assessed study quality using the NHLBI Assessment Tool for Observational Cohort and Cross-sectional Studies. Of 3,006 abstracts identified, 150 full-text articles were assessed, and 48 were included for a total sample of 28,454 study participants. Twenty-two studies examined one SDOH; none examined all eight. Four studies measured place of residence, 2 race/ethnicity, 13 occupation, 42 gender, 1 religion, 18 education, 4 socioeconomic status, and 15 social capital. Fifteen studies assessed neurocognitive and 37 mood-related symptoms. While higher education was associated with less neurocognitive symptoms and among individuals with meningioma sustained unemployment after surgery with depressive symptoms, results were otherwise disparate among SDOH and symptoms. Most studies were descriptive or exploratory, lacking comprehensive inclusion of SDOH. Standardizing SDOH collection, reducing bias, and recruiting diverse samples is recommended in future interventions.
{"title":"The Relationship between Social Determinants of Health and Neurocognitive and Mood-Related Symptoms in the Primary Brain Tumor Population: A Systematic Review","authors":"M. Stockdill, A. King, Morgan Johnson, Z. Karim, D. Cooper, Terri S Armstrong","doi":"10.1093/nop/npae016","DOIUrl":"https://doi.org/10.1093/nop/npae016","url":null,"abstract":"\u0000 Social determinants of health (SDOH) impact cancer-related health outcomes, including survival, but their impact on symptoms is less understood among the primary brain tumor (PBT) population. We conducted a systematic review to examine the relationships between SDOH and neurocognitive and mood-related symptoms among the PBT population. PubMed, EMBASE, and CINAHL were searched using PROGRESS criteria (Place of residence, Race/ethnicity, Occupation, Gender/Sex, Religion, Education, Socioeconomic status, Social capital) on March 8th, 2022. Two individuals screened and assessed study quality using the NHLBI Assessment Tool for Observational Cohort and Cross-sectional Studies. Of 3,006 abstracts identified, 150 full-text articles were assessed, and 48 were included for a total sample of 28,454 study participants. Twenty-two studies examined one SDOH; none examined all eight. Four studies measured place of residence, 2 race/ethnicity, 13 occupation, 42 gender, 1 religion, 18 education, 4 socioeconomic status, and 15 social capital. Fifteen studies assessed neurocognitive and 37 mood-related symptoms. While higher education was associated with less neurocognitive symptoms and among individuals with meningioma sustained unemployment after surgery with depressive symptoms, results were otherwise disparate among SDOH and symptoms. Most studies were descriptive or exploratory, lacking comprehensive inclusion of SDOH. Standardizing SDOH collection, reducing bias, and recruiting diverse samples is recommended in future interventions.","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140078960","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}
T. Gómez Vecchio, I. Rydén, A. Ozanne, M. Blomstrand, L. Carstam, A. Smits, A. Jakola
At group level, health-related quality of life (HRQoL) in patients with IDH-mutant diffuse glioma grade 2 and 3 seems to remain stable over time. However, clinical experience indicates that there are patients with unfavorable outcomes on key HRQoL subdomains. The aim of this longitudinal population-based study, following patients over a period of 12 months from surgery, was to describe individual level data on global health status and fatigue score and explore possible predictors of deterioration. All patients undergoing surgery for presumed glioma grade 2 or 3 at the Sahlgrenska University Hospital during 2017-2022, were screened for the study. Patients were invited to complete the EORTC core questionnaires and brain module at baseline, 3 and 12 months postoperatively. Data is reported with respect to minimal clinical important difference (MCID). We included 51 patients with IDH-mutant diffuse glioma grade 2 or 3. There was no difference in group level data of either global health status or fatigue score from baseline to the 12-month follow-up (p-value >0.05). Unfavorable individual changes (beyond MCID) in global health status and fatigue score were observed in 12 and in 17 patients respectively (23.5% and 33.3%). A lower proportion of proton radiotherapy was found in patients with unfavorable changes in fatigue (10/15, 66.7%) compared to all other patients undergoing radiotherapy (22/23, 95.7%, p-value 0.03). Deterioration beyond MCID was seen in approximately one-third of patients. Changes in global health status could not be predicted, but changes in fatigue may be influenced by tumor-targeted and symptomatic treatment.
{"title":"Global health status and fatigue score in IDH-mutant diffuse glioma grades 2 and 3 – A longitudinal population-based study from surgery to 12-month follow-up","authors":"T. Gómez Vecchio, I. Rydén, A. Ozanne, M. Blomstrand, L. Carstam, A. Smits, A. Jakola","doi":"10.1093/nop/npae017","DOIUrl":"https://doi.org/10.1093/nop/npae017","url":null,"abstract":"\u0000 \u0000 \u0000 At group level, health-related quality of life (HRQoL) in patients with IDH-mutant diffuse glioma grade 2 and 3 seems to remain stable over time. However, clinical experience indicates that there are patients with unfavorable outcomes on key HRQoL subdomains. The aim of this longitudinal population-based study, following patients over a period of 12 months from surgery, was to describe individual level data on global health status and fatigue score and explore possible predictors of deterioration.\u0000 \u0000 \u0000 \u0000 All patients undergoing surgery for presumed glioma grade 2 or 3 at the Sahlgrenska University Hospital during 2017-2022, were screened for the study. Patients were invited to complete the EORTC core questionnaires and brain module at baseline, 3 and 12 months postoperatively. Data is reported with respect to minimal clinical important difference (MCID).\u0000 \u0000 \u0000 \u0000 We included 51 patients with IDH-mutant diffuse glioma grade 2 or 3. There was no difference in group level data of either global health status or fatigue score from baseline to the 12-month follow-up (p-value >0.05). Unfavorable individual changes (beyond MCID) in global health status and fatigue score were observed in 12 and in 17 patients respectively (23.5% and 33.3%). A lower proportion of proton radiotherapy was found in patients with unfavorable changes in fatigue (10/15, 66.7%) compared to all other patients undergoing radiotherapy (22/23, 95.7%, p-value 0.03).\u0000 \u0000 \u0000 \u0000 Deterioration beyond MCID was seen in approximately one-third of patients. Changes in global health status could not be predicted, but changes in fatigue may be influenced by tumor-targeted and symptomatic treatment.\u0000","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140088345","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}
James J. Clarke, G. Halkett, Emma McDougall, H. Dhillon, E. Lobb, J. L. Phillips, PL Hudson, Anna K Nowak
Concerning levels of stress, strain, and poorer mental health are observed in family carers of patients diagnosed with High Grade Glioma (HGG). Understanding the reported unmet needs of these carers will enable future interventions to address such needs to improve their preparedness for care and well-being. In this secondary analysis, we aimed to explore: i) what carers of people with HGG perceive could improve their preparedness to care; and ii) what needs carers reported they required additional support with. Responses from 188 carers of patients with HGG participating in a randomised controlled trial of the Care-IS intervention were analysed to identify reported unmet needs. Of this larger sample, 92 participants answered a qualitative question seeking to identify perceived unmet needs in carer preparedness over 12 months. These responses comprised the data for the current secondary analysis. Content analysis was used to analyse the qualitative data and observe trends across participant responses. Five overarching themes were identified: carer needs, providing emotional and practical care, coping with uncertainty, coping with the consequences of illness progression and processing and supporting end of life care. Notably, the content analysis identified differences in response numbers between groups in the Care-IS trial, particularly with the control group having more needs regarding illness progression and end of life care. Future interventions aimed at improving the well-being and preparedness of carers of people with HGG should consider providing better support centred on carer needs, their changed circumstances, living with uncertainty and care transition.
{"title":"What do carers of people with High Grade Glioma perceive could improve their preparedness to care; and what additional support do they require?","authors":"James J. Clarke, G. Halkett, Emma McDougall, H. Dhillon, E. Lobb, J. L. Phillips, PL Hudson, Anna K Nowak","doi":"10.1093/nop/npae015","DOIUrl":"https://doi.org/10.1093/nop/npae015","url":null,"abstract":"\u0000 \u0000 \u0000 Concerning levels of stress, strain, and poorer mental health are observed in family carers of patients diagnosed with High Grade Glioma (HGG). Understanding the reported unmet needs of these carers will enable future interventions to address such needs to improve their preparedness for care and well-being. In this secondary analysis, we aimed to explore: i) what carers of people with HGG perceive could improve their preparedness to care; and ii) what needs carers reported they required additional support with.\u0000 \u0000 \u0000 \u0000 Responses from 188 carers of patients with HGG participating in a randomised controlled trial of the Care-IS intervention were analysed to identify reported unmet needs. Of this larger sample, 92 participants answered a qualitative question seeking to identify perceived unmet needs in carer preparedness over 12 months. These responses comprised the data for the current secondary analysis. Content analysis was used to analyse the qualitative data and observe trends across participant responses.\u0000 \u0000 \u0000 \u0000 Five overarching themes were identified: carer needs, providing emotional and practical care, coping with uncertainty, coping with the consequences of illness progression and processing and supporting end of life care. Notably, the content analysis identified differences in response numbers between groups in the Care-IS trial, particularly with the control group having more needs regarding illness progression and end of life care.\u0000 \u0000 \u0000 \u0000 Future interventions aimed at improving the well-being and preparedness of carers of people with HGG should consider providing better support centred on carer needs, their changed circumstances, living with uncertainty and care transition.\u0000","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139961115","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}
J. G. Röttgering, J. W. Taylor, M. Brie, T. Luks, S. Hervey-Jumper, S. Phan, P. Bracci, E. Smith, P. C. de Witt Hamer, L. Douw, C. Weyer-Jamora, M. Klein
Fatigue and neurocognitive impairment are highly prevalent in patients with glioma, significantly impacting health-related quality of life. Despite the presumed association between these two factors, evidence remains sparse. Therefore, we aimed to investigate this relationship using multinational data. We analyzed data on self-reported fatigue and neurocognitive outcomes from postoperative patients with glioma from the University of California San Francisco (n = 100, UCSF) and Amsterdam University Medical Center (n = 127, Amsterdam UMC). We used multiple linear regression models to assess associations between fatigue and seven (sub)domains of neurocognitive functioning and latent profile analysis to identify distinct patterns of fatigue and neurocognitive functioning. UCSF patients were older (median age 49 vs. 43 years, p = 0.002), had a higher proportion of grade 4 tumors (32% vs. 18%, p = 0.03), and had more neurocognitive deficits (p = 0.01). While the number of clinically fatigued patients was similar between sites (64% vs. 58%, p = 0.12), fatigue and the number of impaired neurocognitive domains were not correlated (p = 0.16-0.72). At UCSF, neurocognitive domains were not related to fatigue, and at Amsterdam UMC attention and semantic fluency explained only 4 to 7% of variance in fatigue. Across institutions, we identified four distinct patterns of neurocognitive functioning, which were not consistently associated with fatigue. Although individual patients might experience both fatigue and neurocognitive impairment, the relationship between the two is weak. Consequently, both fatigue and neurocognitive functioning should be independently assessed and treated with targeted therapies.
{"title":"Understanding the association between fatigue and neurocognitive functioning in patients with glioma: a cross-sectional multinational study","authors":"J. G. Röttgering, J. W. Taylor, M. Brie, T. Luks, S. Hervey-Jumper, S. Phan, P. Bracci, E. Smith, P. C. de Witt Hamer, L. Douw, C. Weyer-Jamora, M. Klein","doi":"10.1093/nop/npae011","DOIUrl":"https://doi.org/10.1093/nop/npae011","url":null,"abstract":"\u0000 \u0000 \u0000 Fatigue and neurocognitive impairment are highly prevalent in patients with glioma, significantly impacting health-related quality of life. Despite the presumed association between these two factors, evidence remains sparse. Therefore, we aimed to investigate this relationship using multinational data.\u0000 \u0000 \u0000 \u0000 We analyzed data on self-reported fatigue and neurocognitive outcomes from postoperative patients with glioma from the University of California San Francisco (n = 100, UCSF) and Amsterdam University Medical Center (n = 127, Amsterdam UMC). We used multiple linear regression models to assess associations between fatigue and seven (sub)domains of neurocognitive functioning and latent profile analysis to identify distinct patterns of fatigue and neurocognitive functioning.\u0000 \u0000 \u0000 \u0000 UCSF patients were older (median age 49 vs. 43 years, p = 0.002), had a higher proportion of grade 4 tumors (32% vs. 18%, p = 0.03), and had more neurocognitive deficits (p = 0.01). While the number of clinically fatigued patients was similar between sites (64% vs. 58%, p = 0.12), fatigue and the number of impaired neurocognitive domains were not correlated (p = 0.16-0.72). At UCSF, neurocognitive domains were not related to fatigue, and at Amsterdam UMC attention and semantic fluency explained only 4 to 7% of variance in fatigue. Across institutions, we identified four distinct patterns of neurocognitive functioning, which were not consistently associated with fatigue.\u0000 \u0000 \u0000 \u0000 Although individual patients might experience both fatigue and neurocognitive impairment, the relationship between the two is weak. Consequently, both fatigue and neurocognitive functioning should be independently assessed and treated with targeted therapies.\u0000","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139850444","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}
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