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Impact of socioeconomic status and chemotherapy on neurocognitive performance in children with brain tumors 社会经济地位和化疗对脑肿瘤患儿神经认知表现的影响
Q2 CLINICAL NEUROLOGY Pub Date : 2023-08-14 DOI: 10.1093/nop/npad049
Leslie Chang, Palak P Patel, Yifan Zhang, Alan Cohen, Kenneth Cohen, Lisa Jacobson, Matthew Ladra, Rachel K Peterson, Sahaja Acharya
Abstract Background Although the relationship between radiation and neurocognition has been extensively studied in the pediatric brain tumor population, it is increasingly recognized that neurocognitive impairment is multifactorial. Therefore, we quantified the effect of socioeconomic status (SES) and chemotherapy on neurocognitive impairment and decline post-treatment. Methods Eligible patients included those diagnosed with a brain tumor at < 22 years of age with ≥1 neurocognitive assessment. Neurocognitive impairment was defined as performance 1.5 standard deviations below the normative mean using age-standardized measures of intellectual function. Neurocognitive decline was defined as a negative slope. Neurocognitive outcomes included Wechsler indices of Full-Scale Intelligence Quotient (IQ). Logistic regression identified variables associated with neurocognitive impairment. Longitudinal data was analyzed using linear mixed models. Results Eligible patients (n = 152, median age at diagnosis = 9.6 years) had a mean neurocognitive follow-up of 50.2 months. After accounting for age and receipt of craniospinal irradiation, patients with public insurance had 8-fold increased odds of impaired IQ compared to private insurance (odds ratio [OR]: 7.59, P < .001). After accounting for age, change in IQ was associated with chemotherapy use (slope: −0.45 points/year with chemotherapy vs. 0.71 points/year without chemotherapy, P = .012). Conclusions Public insurance, an indicator of low SES, was associated with post-treatment impairment in IQ, highlighting the need to incorporate SES measures into prospective studies. Chemotherapy was associated with change in IQ. Further work is needed to determine whether impairment associated with low SES is secondary to baseline differences in IQ prior to brain tumor diagnosis, brain tumor/therapy itself, or some combination thereof.
背景虽然在儿童脑肿瘤人群中辐射与神经认知的关系已被广泛研究,但越来越多的人认识到神经认知障碍是多因素的。因此,我们量化了社会经济地位(SES)和化疗对治疗后神经认知功能障碍和衰退的影响。方法入选的患者包括:经诊断为脑肿瘤的患者;年龄22岁,神经认知评估≥1分。神经认知障碍定义为使用年龄标准化智力功能测量的表现低于规范平均值1.5个标准差。神经认知衰退被定义为负斜率。神经认知结果包括韦氏全面智商指数(IQ)。逻辑回归确定了与神经认知障碍相关的变量。纵向数据采用线性混合模型进行分析。结果符合条件的患者(n = 152,诊断时中位年龄= 9.6岁)平均神经认知随访50.2个月。在考虑年龄和接受颅脊髓照射后,公共保险患者的智商受损几率是私人保险患者的8倍(优势比[OR]: 7.59, P <措施)。考虑到年龄后,IQ的变化与化疗使用相关(斜率:化疗组- 0.45分/年vs.未化疗组0.71分/年,P = 0.012)。结论公共保险作为低社会经济地位的一个指标,与治疗后的智商损害有关,强调了将社会经济地位测量纳入前瞻性研究的必要性。化疗与智商的变化有关。需要进一步的工作来确定低社会经济地位相关的损害是否继发于脑肿瘤诊断、脑肿瘤/治疗本身或两者的某种组合之前的智商基线差异。
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引用次数: 1
Should simple bedside neurocognitive data now be routinely gathered prior to brain tumor surgery? 简单的床边神经认知数据现在应该在脑肿瘤手术前常规收集吗?
Q2 CLINICAL NEUROLOGY Pub Date : 2023-08-07 DOI: 10.1093/nop/npad048
Robin Grant
Journal Article Accepted manuscript Should simple bedside neurocognitive data now be routinely gathered prior to brain tumor surgery? Get access Robin Grant Robin Grant Consultant Neurologist, Edinburgh robin.grant7@gmail.com https://orcid.org/0000-0003-2597-9510 Search for other works by this author on: Oxford Academic Google Scholar Neuro-Oncology Practice, npad048, https://doi.org/10.1093/nop/npad048 Published: 07 August 2023 Article history Received: 30 July 2023 Published: 07 August 2023
简单的床边神经认知数据现在应该在脑肿瘤手术前常规收集吗?访问Robin Grant Robin Grant顾问神经科医生,爱丁堡robin.grant7@gmail.com https://orcid.org/0000-0003-2597-9510搜索作者的其他作品:牛津学术谷歌学者神经肿瘤学实践,npad048, https://doi.org/10.1093/nop/npad048发布日期:2023年8月07日文章历史接收日期:2023年7月30日发布日期:2023年8月07日
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引用次数: 1
An Impact Factor for Neuro-Oncology Practice. 神经肿瘤学实践的影响因子。
IF 2.4 Q2 CLINICAL NEUROLOGY Pub Date : 2023-07-13 eCollection Date: 2023-08-01 DOI: 10.1093/nop/npad036
Martin J B Taphoorn
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引用次数: 0
Prevalence of pathogenic germline variants in adult-type diffuse glioma. 成人型弥漫性胶质瘤中致病性种系变异的患病率。
IF 2.4 Q2 CLINICAL NEUROLOGY Pub Date : 2023-06-21 eCollection Date: 2023-10-01 DOI: 10.1093/nop/npad033
Malcolm F McDonald, Lyndsey L Prather, Cassandra R Helfer, Ethan B Ludmir, Alfredo E Echeverria, Shlomit Yust-Katz, Akash J Patel, Benjamin Deneen, Ganesh Rao, Ali Jalali, Shweta U Dhar, Chris I Amos, Jacob J Mandel

Background: No consensus germline testing guidelines currently exist for glioma patients, so the prevalence of germline pathogenic variants remains unknown. This study aims to determine the prevalence and type of pathogenic germline variants in adult glioma.

Methods: A retrospective review at a single institution with paired tumor/normal sequencing from August 2018-April 2022 was performed and corresponding clinical data were collected.

Results: We identified 152 glioma patients of which 15 (9.8%) had pathogenic germline variants. Pathogenic germline variants were seen in 11/84 (13.1%) of Glioblastoma, IDH wild type; 3/42 (7.1%) of Astrocytoma, IDH mutant; and 1/26 (3.8%) of Oligodendroglioma, IDH mutant, and 1p/19q co-deleted patients. Pathogenic variants in BRCA2, MUTYH, and CHEK2 were most common (3/15, 20% each). BRCA1 variants occurred in 2/15 (13%) patients, with variants in NF1, ATM, MSH2, and MSH3 occurring in one patient (7%) each. Prior cancer diagnosis was found in 5/15 patients (33%). Second-hit somatic variants were seen in 3/15 patients (20%) in NF1, MUTYH, and MSH2. Referral to genetics was performed in 6/15 (40%) patients with pathogenic germline variants. 14/15 (93%) of patients discovered their pathogenic variant as a result of their paired glioma sequencing.

Conclusions: These findings suggest a possible overlooked opportunity for determination of hereditary cancer syndromes with impact on surveillance as well as potential broader treatment options. Further studies that can determine the role of variants in gliomagenesis and confirm the occurrence and types of pathogenic germline variants in patients with IDH wild type compared to IDH mutant tumors are necessary.

背景:目前还没有针对神经胶质瘤患者的一致种系检测指南,因此种系致病性变异的流行率仍然未知。本研究旨在确定成人胶质瘤中致病性种系变异的患病率和类型。方法:从2018年8月至2022年4月,在一家具有配对肿瘤/正常测序的机构进行回顾性审查,并收集相应的临床数据。结果:我们鉴定了152例神经胶质瘤患者,其中15例(9.8%)具有致病性种系变异。致病性种系变异见于11/84(13.1%)的胶质母细胞瘤,IDH野生型;3/42(7.1%)星形细胞瘤,IDH突变体;以及1/26(3.8%)的少突胶质瘤、IDH突变体和1p/19q共缺失患者。BRCA2、MUTYH和CHEK2的致病性变异最常见(3/15,各占20%)。BRCA1变异发生在2/15(13%)名患者中,其中NF1、ATM、MSH2和MSH3变异各发生在一名患者中(7%)。15例患者中有5例(33%)曾被诊断为癌症。在NF1、MUTYH和MSH2的3/15名患者(20%)中发现了第二次命中的体细胞变异。6/15(40%)有致病性种系变异的患者进行了遗传学转诊。14/15(93%)的患者通过配对神经胶质瘤测序发现了其致病性变体。结论:这些发现表明,确定遗传性癌症综合征的机会可能被忽视,对监测和潜在的更广泛的治疗选择有影响。有必要进行进一步的研究,以确定变异在胶质瘤形成中的作用,并确认与IDH突变肿瘤相比,IDH野生型患者的致病性种系变异的发生率和类型。
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引用次数: 0
Psychosocial interventions for personality and behavior changes in adults with a brain tumor: A scoping review. 成人脑瘤患者人格和行为变化的心理社会干预:范围界定综述。
IF 2.7 Q2 CLINICAL NEUROLOGY Pub Date : 2023-06-13 eCollection Date: 2023-10-01 DOI: 10.1093/nop/npad031
Emma McDougall, Lauren J Breen, Anna K Nowak, Haryana M Dhillon, Georgia K B Halkett

Background: The objective of this scoping review was to describe the intervention characteristics and effectiveness of psychosocial interventions aimed at managing personality and behavior changes in people with brain tumors. A secondary objective was to explore if these interventions had an impact on outcomes for carers. Personality and behavior changes considered included aggression, apathy, paranoia, disinhibition, and emotional lability.

Methods: This review was conducted following the Joanna Briggs Institute methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews. Searches were conducted in PsycINFO, CINAHL, Medline (Ovid), and Scopus. We synthesized studies published from 1996 to 2022 that evaluated interventions to manage brain tumor related personality and behavioral changes in adults. A data extraction tool were used based on the Joanna Briggs Institute template. Results are presented in a summary table and a narrative synthesis was conducted.

Results: Three thousand and five hundred and ninety-four records were screened. Title and abstract screening resulted in 29 potentially eligible studies. Full screening excluded 24 articles and 5 interventions met the inclusion criteria. The interventions were diverse in duration, delivery modality, setting, and participation (eg, the patient individually or patient and carer). The interventions reported improvements in the targeted personality and behavior change symptoms for patients with primary brain tumors. Four studies included a measure of personality and behavior change symptoms and two studies included a measure of outcomes for carers and reported improvements in carer knowledge and a reduction in carer distress. All studies sampled fewer than 100 participants. Studies had limited follow-up data and different tools were used to assess the presence and nature of personality and behavior changes.

Conclusions: There is a dearth of psychosocial interventions to support patients and their carers to manage brain tumor related personality and behavior changes.

背景:本范围综述的目的是描述旨在管理脑肿瘤患者个性和行为变化的心理社会干预的干预特征和有效性。次要目标是探讨这些干预措施是否对护理人员的结果产生影响。所考虑的性格和行为变化包括攻击性、冷漠、偏执、去抑制和情绪不稳定。方法:本审查按照乔安娜·布里格斯研究所的范围审查方法和系统审查和荟萃分析(PRISMA)的首选报告项目扩展范围审查进行。在PsycINFO、CINAHL、Medline(Ovid)和Scopus进行了搜索。我们综合了1996年至2022年发表的研究,这些研究评估了管理成人脑肿瘤相关人格和行为变化的干预措施。使用了基于乔安娜·布里格斯研究所模板的数据提取工具。结果显示在汇总表中,并进行了叙述性综合。结果:筛选了三千五百九十四份记录。标题和摘要筛选产生了29项可能符合条件的研究。全面筛查排除了24篇文章,5项干预措施符合纳入标准。干预措施在持续时间、分娩方式、环境和参与方面各不相同(例如,患者个人或患者和护理人员)。据报道,干预措施改善了原发性脑肿瘤患者的定向人格和行为改变症状。四项研究包括人格和行为变化症状的测量,两项研究包括护理人员的结果测量,并报告了护理人员知识的改善和护理人员痛苦的减少。所有研究的样本都不到100名参与者。研究的后续数据有限,使用不同的工具来评估个性和行为变化的存在和性质。结论:缺乏心理社会干预措施来支持患者及其护理人员管理脑肿瘤相关的个性和行为变化。
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引用次数: 0
Overcoming the exclusion of marginalized caregiver and patient groups in pediatric brain tumor research. 克服儿童脑肿瘤研究中边缘化照顾者和患者群体的排斥。
IF 2.4 Q2 CLINICAL NEUROLOGY Pub Date : 2023-06-12 eCollection Date: 2023-10-01 DOI: 10.1093/nop/npad030
Christina M Sharkey, Carolyn R Bates
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引用次数: 0
Acceptability and feasibility of cognitive assessments with adults with primary brain cancer and brain metastasis: A systematic review. 成人原发性脑癌和脑转移患者认知评估的可接受性和可行性:一项系统综述。
IF 2.7 Q2 CLINICAL NEUROLOGY Pub Date : 2023-06-01 DOI: 10.1093/nop/npac097
Melissa A Carlson, Elizabeth A Fradgley, Della Yates, Sarah Morris, Jordan Tait, Christine L Paul

Routine cognitive assessment for adults with brain cancers is seldom completed but vital for guiding daily living, maintaining quality of life, or supporting patients and families. This study aims to identify cognitive assessments which are pragmatic and acceptable for use in clinical settings. MEDLINE, EMBASE, PsycINFO, CINAHL, and Cochrane were searched to identify studies published in English between 1990 and 2021. Publications were independently screened by two coders and included if they: (1) were peer-reviewed; (2) reported original data relating to adult primary brain tumor or brain metastases; (3) used objective or subjective assessments; (4) reported assessment acceptability or feasibility. The Psychometric And Pragmatic Evidence Rating Scale was used. Consent, assessment commencement and completion, and study completion were extracted along with author-reported acceptability and feasibility data. PROSPERO Registration: CRD42021234794. Across 27 studies, 21 cognitive assessments had been assessed for feasibility and acceptability; 15 were objective assessments. Acceptability data were limited and heterogeneous, particularly consent (not reported in 23 studies), assessment commencement (not reported in 19 studies), and assessment completion (not reported in 21 studies). Reasons for non-completion could be grouped into patient-factors, assessment-factors, clinician-factors, and system-factors. The three cognitive assessments with the most acceptability and feasibility data reported were the MMSE, MoCA, and NIHTB-CB. Further acceptability and feasibility data are needed including consent, commencement and completion rates. Cost, length, time, and assessor burden are needed for the MMSE, MoCA, and NIHTB-CB, along with potentially new computerized assessments suited for busy clinical settings.

成人脑癌患者的常规认知评估很少完成,但对指导日常生活、维持生活质量或支持患者和家属至关重要。本研究旨在确定认知评估是实用的和可接受的,用于临床设置。检索了MEDLINE、EMBASE、PsycINFO、CINAHL和Cochrane,以确定1990年至2021年间用英语发表的研究。出版物由两名编码员独立筛选,如果它们:(1)经过同行评审;(2)与成人原发性脑肿瘤或脑转移相关的原始报告数据;(三)采用客观或者主观评价;(四)报告的评估可接受性或者可行性。采用心理测量与语用证据评定量表。同意、评估开始和完成、研究完成以及作者报告的可接受性和可行性数据被提取出来。普洛斯彼罗注册号:CRD42021234794。在27项研究中,21项认知评估评估了可行性和可接受性;15项为客观评价。可接受性数据有限且异质性,特别是同意(23项研究未报告)、评估开始(19项研究未报告)和评估完成(21项研究未报告)。未完成的原因可分为患者因素、评估因素、临床因素和系统因素。MMSE、MoCA和NIHTB-CB是三种最具可接受性和可行性数据的认知评估。需要进一步的可接受性和可行性数据,包括同意率、开工率和完成率。MMSE、MoCA和NIHTB-CB需要成本、长度、时间和评估人员负担,以及适合繁忙临床环境的潜在新计算机化评估。
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引用次数: 2
Unmet needs and wish for support of family caregivers of primary brain tumor patients. 原发性脑肿瘤患者家属照顾者未满足的需求与支持愿望。
IF 2.7 Q2 CLINICAL NEUROLOGY Pub Date : 2023-06-01 DOI: 10.1093/nop/npac099
Lucy Pointon, Robin Grant, Sharon Peoples, Sara Erridge, Paula Sherwood, Martin Klein, Florien Boele

Background: Most primary brain tumor patients rely on family caregivers for support. Caregiving can be rewarding, but also leads to significant burden from unmet needs. We aimed to: (1) identify and characterize caregivers' unmet needs; (2) determine associations between unmet needs and wish for support; (3) evaluate acceptability of the Caregiver Needs Screen (CNS) and perceived feasibility in clinical practice.

Methods: Family caregivers of primary brain tumor patients were recruited from outpatient clinics and asked to complete an adapted version of the CNS consisting of 33 common issues caregivers report (item scale 0-10), and the wish for support (yes/no). Participants ranked acceptability and feasibility (item scale 0-7; higher scores being positive) of the adapted CNS. Descriptive and non-parametric correlational analyses were applied.

Results: Caregivers (N = 71) reported 1-33 unmet caregiving needs (M = 17.20, sd = 7.98) but did not always wish for support (range 0-28, M = 5.82, sd = 6.96). A weak correlation was found between total number of unmet needs and wish for support (r = 0.296, P = .014). Most distressing items were patients' changes in memory/concentration (M = 5.75, sd = 3.29), patients' fatigue (M = 5.58, sd = 3.43), and signs of disease progression (M = 5.23, sd = 3.15).Caregivers most often wished support with recognizing disease progression (N = 24), and least often with managing spiritual issues (N = 0). Caregivers evaluated acceptability and feasibility of the CNS tool positively (mean scores ranged 4.2-6.2).

Conclusions: Family caregivers experience distress resulting from many neuro-oncology specific needs, but this is not directly related to wish for support. Family caregiver needs screening could be useful to tailor support to suit their preferences in clinical practice.

背景:大多数原发性脑肿瘤患者依赖于家庭照顾者的支持。照顾可能是有益的,但也会因未满足的需求而导致沉重的负担。我们的目标是:(1)识别和描述护理人员未满足的需求;(2)确定未满足需求与支持愿望之间的联系;(3)评估护理者需求筛查(CNS)在临床实践中的可接受性和感知可行性。方法:从门诊招募原发性脑肿瘤患者的家庭护理人员,要求他们完成一份改良版的CNS,包括护理人员报告的33个常见问题(项目量表0-10)和支持意愿(是/否)。参与者对可接受性和可行性进行排名(项目量表0-7;较高的分数为正)。采用描述性和非参数相关性分析。结果:护理人员(N = 71)报告了1-33个未满足的护理需求(M = 17.20, sd = 7.98),但并不总是希望得到支持(范围0-28,M = 5.82, sd = 6.96)。未满足需求总数与支持意愿之间存在弱相关(r = 0.296, P = 0.014)。最令人痛苦的项目是患者的记忆/注意力变化(M = 5.75, sd = 3.29),患者的疲劳(M = 5.58, sd = 3.43)和疾病进展的迹象(M = 5.23, sd = 3.15)。护理人员最希望得到的支持是识别疾病进展(N = 24),最不希望得到的支持是处理精神问题(N = 0)。护理人员积极评价CNS工具的可接受性和可行性(平均得分范围为4.2-6.2)。结论:由于许多神经肿瘤学的特殊需求,家庭照顾者经历了痛苦,但这与支持的愿望没有直接关系。在临床实践中,家庭照顾者需求筛查可以帮助定制支持以适应他们的偏好。
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引用次数: 1
The use of red flags during the referral chain of patients surgically treated for symptomatic spinal metastases. 在有症状的脊柱转移手术治疗的患者转诊链中使用红旗。
IF 2.7 Q2 CLINICAL NEUROLOGY Pub Date : 2023-06-01 DOI: 10.1093/nop/npad013
Floris R van Tol, Isabelle M L P Kamm, Anne L Versteeg, Karijn P M Suijkerbuijk, Helena M Verkooijen, Cumher Oner, Jorrit-Jan Verlaan

Background: The use of so-called "red flags" may be beneficial in identifying patients with metastatic spinal disease. This study examined the utility and efficacy of these red flags in the referral chain of patients surgically treated for spinal metastases.

Methods: The referral chains from the onset of symptoms until surgical treatment for all patients receiving surgery for spinal metastases between March 2009 and December 2020 were reconstructed. The documentation of red flags, as defined by the Dutch National Guideline on Metastatic Spinal Disease, was assessed for each healthcare provider involved.

Results: A total of 389 patients were included in the study. On average, 33.3% of red flags were documented as present, 3.6% were documented as absent, and 63.1% were undocumented. A higher rate of red flags documented as present was associated with a longer time to diagnosis, but a shorter time to definitive treatment by a spine surgeon. Moreover, red flags were documented as present more often in patients who developed neurological symptoms at any point during the referral chain than those who remained neurologically intact.

Conclusions: The association of red flags with developing neurological deficits highlights their significance in clinical assessment. However, the presence of red flags was not found to decrease delays prior to referral to a spine surgeon, indicating that their relevance is currently not sufficiently recognized by healthcare providers. Raising awareness of symptoms indicative of spinal metastases may expedite timely (surgical) treatment and thus improve treatment outcome.

背景:使用所谓的“危险信号”可能有助于识别转移性脊柱疾病患者。本研究考察了这些危险信号在脊柱转移手术患者转诊链中的效用和疗效。方法:重建2009年3月至2020年12月间所有脊柱转移手术患者从症状出现到手术治疗的转诊链。根据荷兰国家转移性脊柱疾病指南的定义,对涉及的每个医疗保健提供者进行了评估。结果:共纳入389例患者。平均而言,33.3%的危险信号被记录为存在,3.6%被记录为不存在,63.1%被记录为没有记录。记录在案的危险信号率越高,诊断时间越长,但脊柱外科医生最终治疗的时间越短。此外,在转诊过程中出现神经系统症状的患者比神经系统完好的患者更常出现危险信号。结论:危险信号与发展中的神经功能缺陷的关联突出了它们在临床评估中的重要性。然而,在转诊给脊柱外科医生之前,发现危险信号的存在并没有减少延误,这表明它们的相关性目前没有得到医疗保健提供者的充分认识。提高对脊柱转移症状的认识可以加快及时(手术)治疗,从而改善治疗效果。
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引用次数: 1
A feasibility, safety, and efficacy evaluation of supervised aerobic and resistance exercise for patients with glioblastoma undertaking adjuvant chemoradiotherapy. 对接受辅助放化疗的胶质母细胞瘤患者进行有氧和阻力运动的可行性、安全性和有效性评估。
IF 2.7 Q2 CLINICAL NEUROLOGY Pub Date : 2023-06-01 DOI: 10.1093/nop/npad006
Anna K Nowak, Robert U Newton, Travis Cruickshank, Prue Cormie, Georgia K B Halkett, Daphne Tsoi, Daniel A Galvão

Background: While therapeutically effective, chemoradiotherapy treatment for high-grade glioma (glioblastoma) is often accompanied by side effects. Exercise has been demonstrated to alleviate the adverse effects of such treatments in other cancers. We aimed to evaluate the feasibility and preliminary efficacy of supervised exercise incorporating autoregulation.

Methods: Thirty glioblastoma patients were recruited, five declined exercise and 25 were provided with a multimodal exercise intervention for the duration of their chemoradiotherapy treatment. Patient recruitment, retention, adherence to training sessions and safety were evaluated throughout the study. Physical function, body composition, fatigue, sleep quality, and quality of life were evaluated before and after the exercise intervention.

Results: Eight of the 25 participants commencing exercise withdrew prior to completion of the study (32%). Seventeen patients (68%) demonstrated low to high adherence (33%-100%) and exercise dosage compliance (24%-83%). There were no reported adverse events. Significant improvements were observed for all trained exercises and lower limb muscle strength and function with no significant changes observed for any other physical function, body composition, fatigue, sleep, or quality of life outcomes.

Conclusions: Only half of glioblastoma patients recruited were willing or able to commence, complete or meet minimum dose compliance for the exercise intervention during chemoradiotherapy indicating the intervention evaluated may not be feasible for part of this patient cohort. For those who were able to complete the exercise program, supervised, autoregulated, multimodal exercise was safe and significantly improved strength and function and may have prevented deterioration in body composition and quality of life.

背景:高级别胶质瘤(胶质母细胞瘤)的放化疗虽然治疗有效,但往往伴有副作用。运动已被证明可以减轻此类治疗对其他癌症的不良影响。我们的目的是评估纳入自动调节的监督运动的可行性和初步效果。方法:招募30例胶质母细胞瘤患者,其中5例减少运动,25例在放化疗期间进行多模式运动干预。在整个研究过程中,对患者的招募、保留、培训课程的依从性和安全性进行了评估。评估运动干预前后的身体功能、身体成分、疲劳、睡眠质量和生活质量。结果:25名开始锻炼的参与者中有8名在研究完成前退出(32%)。17例患者(68%)表现出低至高依从性(33%-100%)和运动剂量依从性(24%-83%)。没有不良事件的报道。在所有训练运动和下肢肌肉力量和功能方面均观察到显著改善,而在任何其他身体功能、身体成分、疲劳、睡眠或生活质量方面均未观察到显著变化。结论:只有一半的胶质母细胞瘤患者愿意或能够在放化疗期间开始、完成或达到最低剂量的运动干预,这表明评估的干预对该患者队列的一部分可能不可行。对于那些能够完成锻炼计划的人来说,有监督的、自动调节的、多模式的锻炼是安全的,可以显著提高力量和功能,并可能防止身体成分和生活质量的恶化。
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引用次数: 1
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Neuro-oncology practice
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