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Neuro-oncology Practice

Jacqueline B Stone, Joanne F Kelvin, Lisa M DeAngelis
Background: Fertility preservation (FP) is an infrequently addressed issue for young adults with primary brain tumors. Given the improved prognosis and enhanced technology in reproductive medicine, more primary brain tumor patients see procreation as feasible, making the discussion of FP increasingly important. The goals of this study were to describe patients who received FP counseling by a fertility nurse specialist (FNS) and determine which sociodemographic and disease-related factors predict acceptance of referral to a reproductive specialist...
March 2017: Neuro-oncology Practice
Motomasa Furuse, Naosuke Nonoguchi, Toshihiko Kuroiwa, Susumu Miyamoto, Yoshiki Arakawa, Jun Shinoda, Kazuhiro Miwa, Toshihiko Iuchi, Koji Tsuboi, Kiyohiro Houkin, Shunsuke Terasaka, Yusuke Tabei, Hideo Nakamura, Motoo Nagane, Kazuhiko Sugiyama, Mizuhiko Terasaki, Tatsuya Abe, Yoshitaka Narita, Nobuhito Saito, Akitake Mukasa, Kuniaki Ogasawara, Takaaki Beppu, Toshihiro Kumabe, Tadashi Nariai, Naohiro Tsuyuguchi, Eiji Nakatani, Shoko Kurisu, Yoko Nakagawa, Shin-Ichi Miyatake
BACKGROUND: Brain radiation necrosis (BRN) can be a complication of radiotherapy for primary and secondary brain tumors, as well as head and neck tumors. Since vascular endothelial growth factor (VEGF) is also a vascular permeability factor in the brain, bevacizumab, a humanized antibody that inhibits VEGF, would be expected to reduce perilesional edema that often accompanies BRN. METHODS: Patients with surgically untreatable, symptomatic BRN refractory to conventional medical treatments (eg, corticosteroid, anticoagulants, or hyperbaric oxygen therapy) were enrolled...
December 2016: Neuro-oncology Practice
Jennifer C Thigpen, Matthew Pearson, Kristen E Robinson, Charissa Andreotti, Jennifer P Dunbar, Kelly H Watson, Leandra Dejardins, Lindsay Holmes, Rebecca Byram, Claire Fraley, Bruce E Compas
BACKGROUND: Establishing a presurgical baseline of neurocognitive functioning for pediatric brain tumor patients is a high priority to identify level of functioning prior to medical interventions. However, few studies have obtained adequate samples of presurgery assessments. METHODS: This study examines the feasibility of completing tests to assess pre-surgical neurocognitive functioning in 59 identified pediatric brain tumor patients. RESULTS: Eighty-five percent of patients ( n = 50) were referred by the neurosurgery team before surgery and 83% of patients ( n = 49) enrolled in the study...
December 2016: Neuro-oncology Practice
Yan Ji, Rachel Isaksson Vogel, Emil Lou
BACKGROUND: Pituitary carcinomas (PC) and atypical pituitary adenomas (APA) are rare variants of pituitary tumors for which no evidence-based treatment currently exists. We sought to determine whether temozolomide represents an effective chemotherapeutic option for patients with PC and APA. METHODS: A systematic review was performed using all published cases of PC and APA treated with temozolomide, and for which information on treatment regimen, clinical response, and survival could be identified...
September 2016: Neuro-oncology Practice
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June 2016: Neuro-oncology Practice
Sergio Cabrera, Kim Edelstein, Warren P Mason, Maria Carmela Tartaglia
BACKGROUND: Personality changes following brain tumors may be due to disruption of frontal-subcortical networks. The relation between personality changes and tumor parameters such as volumes of the surgical cavity, residual tumor, or nonspecific white matter abnormalities is unknown. In this study we examined the relation between these tumor parameters and abnormal behaviors typically associated with frontal lobe dysfunction. METHODS: Thirty-one patients with intracranial tumors who completed the Frontal Systems Behavior Scale (FrSBe) during clinical neuropsychological assessment and had a solitary, well-delimited brain lesion on MRI within 3 months of that assessment were included...
June 2016: Neuro-oncology Practice
Anne Long, Georgia K B Halkett, Elizabeth A Lobb, Thérèse Shaw, Elizabeth Hovey, Anna K Nowak
BACKGROUND: Few studies have explored the unmet needs of carers of people with high-grade glioma. We aimed to determine carers' levels of distress during treatment, understand their support needs and explore predictors of distress. METHODS: Carers of people with high-grade glioma undergoing chemoradiotherapy were recruited to this prospective, longitudinal cohort study. Carers completed the validated Supportive Care Needs Survey, Brain Tumour Specific Supportive Care Needs Scale, Distress Thermometer (DT), and General Health Questionnaire (GHQ-12)...
June 2016: Neuro-oncology Practice
Alison White, Vicki Fabian, Kerrie McDonald, Anna K Nowak
BACKGROUND: Diagnostic pathology reports inform management plans for patients with glioma, and there is an increasing clinical need for molecular testing. We assessed the quality of histopathology reports of grade III/IV gliomas. METHODS: Reports were obtained as part of a tumor biobank. From 720 pathology reports, 594 eligible reports were assessed for 28 elements derived from published checklists. A summary quality score incorporated 9 critical parameters for clinical decision making: diagnosis using World Health Organization 2007 criteria; cell type; grade; narrative supporting cell type and grade; absence of equivocal language; conclusion reporting cell type and grade; and conclusion aligned with report narrative...
June 2016: Neuro-oncology Practice
Terri Rice, Daniel H Lachance, Annette M Molinaro, Jeanette E Eckel-Passow, Kyle M Walsh, Jill Barnholtz-Sloan, Quinn T Ostrom, Stephen S Francis, Joseph Wiemels, Robert B Jenkins, John K Wiencke, Margaret R Wrensch
During the past six years, researchers have made major progress identifying common inherited genetic variation that increases risk for primary adult glioma. This paper summarizes knowledge about rare familial cancer syndromes that include adult glioma and reviews the available literature on the more recently discovered common inherited variation. Ten independent inherited variants in eight chromosomal regions have been convincingly associated with increased risk for adult glioma. Most of these variants increase relative risk of primary adult glioma by 20% to 40%, but the TP53 variant rs78378222 confers a two-fold relative risk (ie, 200%), and rs557505857 on chromosome 8 confers a six-fold relative risk of IDH-mutated astrocytomas and oligodendroglial tumors (ie, 600%)...
March 2016: Neuro-oncology Practice
Paul D Brown, S Keith Anderson, Xiomara W Carrero, Brian P O'Neill, Caterina Giannini, Eva Galanis, Sunjay A Shah, Ross A Abrams, Walter J Curran, Jan C Buckner, Edward G Shaw
BACKGROUND: Pilocytic astrocytoma is a rare tumor in adults. This report is of a prospective clinical trial with long-term follow-up. METHODS: Between 1986 and 1994, 20 eligible adults with supratentorial pilocytic astrocytomas were enrolled in a prospective intergroup trial of radiotherapy (RT) after biopsy (3 patients) or observation after gross (11 patients) or subtotal (6 patients) resection. RESULTS: At the time of analysis (median follow-up, 20...
December 2015: Neuro-oncology Practice
Roy E Strowd, Mackenzie C Cervenka, Bobbie J Henry, Eric H Kossoff, Adam L Hartman, Jaishri O Blakeley
Dietary glycemic modulation through high-fat, low-carbohydrate diets, which induce a state of systemic ketosis and alter systemic metabolic signaling, have been incorporated into the clinical management of patients with neurological disease for more than a century. Mounting preclinical evidence supports the antitumor, proapoptotic, and antiangiogenic effects of disrupting glycolytic metabolism through dietary intervention. In recent years, interest in incorporating such novel therapeutic strategies in neuro-oncology has increased...
September 2015: Neuro-oncology Practice
Bhageeradh H Mulpur, L Burt Nabors, Reid C Thompson, Jeffrey J Olson, Renato V LaRocca, Zachary Thompson, Kathleen M Egan
BACKGROUND: Complementary therapy (CAM) is common in cancer patients. We undertook this study to assess the association of complementary therapy usage with mortality in glioblastoma (GBM) patients. METHODS: The analysis was based on 470 patients. Information on current use of CAM was collected in structured interviews conducted a median of 6 weeks following GBM diagnosis. Proportional hazards regression was used to estimate hazard ratios (HRs) for GBM-related death according to the use of individual supplements with multivariate adjustment for known prognostic factors including age, KPS, and extent of tumor resection (ESR)...
September 2015: Neuro-oncology Practice
Rimas V Lukas, Minesh P Mehta, Maciej S Lesniak
INTRODUCTION: The 19th Annual Meeting of the Society for Neuro-Oncology (SNO) took place in November of 2014. The focus of many abstracts, as well as the Education Day, was on recent advances in the study of central nervous system (CNS) metastases. TUMOR BIOLOGY: Key studies evaluating the factors in tumors and their microenvironment associated with the development and growth of brain metastases are reviewed. PROGNOSTICATION: Studies investigating the factors that independently influence survival in participants with brain metastases are presented...
June 2015: Neuro-oncology Practice
Lauren E Cox, Jason M Ashford, Kellie N Clark, Karen Martin-Elbahesh, Kristina K Hardy, Thomas E Merchant, Robert J Ogg, Sima Jeha, Victoria W Willard, Lu Huang, Hui Zhang, Heather M Conklin
BACKGROUND: Childhood cancer survivors frequently develop working memory (WM) deficits as a result of disease and treatment. Medication-based and therapist-delivered interventions are promising but have limitations. Computerized interventions completed at home may be more appealing for survivors. We evaluated the feasibility and acceptability of a remotely administered, computerized WM intervention (Cogmed) for pediatric cancer survivors using a single-blind, randomized, wait-list control design...
June 2015: Neuro-oncology Practice
Michael Back, Cecelia E Gzell, Marina Kastelan, Linxin Guo, Helen R Wheeler
BACKGROUND: Clinical studies of re-irradiation (ReRT) for relapsed high-grade glioma (HGG) have generally reported the use of small volume ReRT techniques such as stereotactic radiosurgery in selected patients with isolated focal relapse. This study reports the outcome with large-volume ReRT to manage the more common mescenario of extensive diffuse relapse of HGG. METHODS: All HGG patients managed with an overlapping second course of radiation therapy (RT) for refractory progression of HGG between October 2009 and April 2013 were included...
March 2015: Neuro-oncology Practice
Khinh Ranh Voong, Benjamin Farnia, Qianghu Wang, Dershan Luo, Mary F McAleer, Ganesh Rao, Nandita Guha-Thakurta, Anna Likhacheva, Amol J Ghia, Paul D Brown, Jing Li
BACKGROUND: Brainstem metastases (BSMs) represent a significant treatment challenge. Stereotactic radiosurgery (SRS) is often used to treat BSM. We report our experience in the treatment of BSM with Gamma Knife SRS (GK_SRS). METHODS: The records of 1962 patients with brain metastases treated with GK_SRS between 2009 and 2013 were retrospectively reviewed. Seventy-four patients with 77 BSMs and follow-up brain imaging were identified. Local control (LC), overall survival (OS), progression-free survival (PFS), and toxicity were assessed...
March 2015: Neuro-oncology Practice
Kristina K Hardy, Victoria W Willard, Alissa B Wigdor, Taryn M Allen, Melanie J Bonner
BACKGROUND: Survivors of childhood cancer are at risk for neuropsychological late effects, yet identifying those in need of evaluation and obtaining needed services can be challenging for the medical team. Finding time- and cost-effective screening measures that can be used to identify children in need of evaluation is a clinical priority. Our objective was to investigate the association between parent-rated attention problems and related neuropsychological impairments in childhood cancer survivors as a means of identifying those at high risk for difficulties...
March 2015: Neuro-oncology Practice
Karin Gehring, Martin J B Taphoorn, Margriet M Sitskoorn, Neil K Aaronson
BACKGROUND: Studies in cancer and noncancer populations demonstrate lower than expected correlations between subjective cognitive symptoms and cognitive functioning as determined by standardized neuropsychological tests. This paper systematically examines the association between subjective and objective cognitive functioning in patients with low-grade glioma and the associations of these indicators of cognitive function with clusters of sociodemographic, clinical, and self-reported physical and mental health factors...
March 2015: Neuro-oncology Practice
Roy C Martin, Adam Gerstenecker, Louis B Nabors, Daniel C Marson, Kristen L Triebel
BACKGROUND: We aimed to investigate the relationship between medical decisional capacity (MDC) and Karnofsky Performance Status (KPS) in adults with malignant brain tumors. METHODS: Participants were 71 adults with primary (n = 26) or metastatic (n = 45) brain tumors. Testing to determine KPS scores and MDC was performed as close together as possible for each patient. Participants were administered a standardized measure of medical decision-making capacity (Capacity to Consent to Treatment Instrument [CCTI]) to assess 3 treatment consent abilities (ie, appreciation, reasoning, and understanding)...
March 2015: Neuro-oncology Practice
Patrick Roth, Caroline Happold, Michael Weller
Because of the lack of curative approaches for most patients with malignant brain tumors, supportive therapy, which aims at maintaining quality of life and functional independence, has a central role in the treatment of many patients. Steroids are particularly important in the setting of supportive therapy. They are commonly used to treat tumor-associated edema, and their administration is typically associated with rapid symptom relief, such as the resolution of headaches. Besides their antiedema activity, corticosteroids are characterized by their potent antilymphoma properties and their effects against acute or delayed emesis caused by systemic chemotherapy in cancer patients...
March 2015: Neuro-oncology Practice
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