bluuebunny/crossref_metadata_2025_split huggingface dataset:
NI-05 CLINICOPATHOLOGICAL ANALYSIS AND METHIONINE PET ANALYSIS IN PATIENTS WITH GLIOMATOSIS CEREBRI
Authors: Yano Hirohito , Nakayama Noriyuki , Ohe Naoyuki , Miyai Masafumi , Yamada Tetsuya , Miwa Kazuhiro , Shinoda Jun , Iwama Toru 
Published: December 2019

Abstract

OBJECTIVE
Gliomatosis cerebri (GC) was defined as the tumor infiltrating into more than three lobes in WHO2007, but was deleted in WHO2016 because they include genetically heterogeneous tissues. However, we often encounter the cases with strongly invasive glioma. Then, we clinically analyzed the cases of GC.

PATIENTS AND METHODS
Seven cases (five men, median age: 57 years (23-89y)) diagnosed as GC in our hospital were included. Data of methionine-positron emission tomography (Met-PET), IDH and p53 mutation, MIB1-labeling index (LI) by immunohistochemistry were searched. We compared the accumulation areas of the Met-PET with the hyperintensity area (T2/FLAIR-high) and gadolinium-enhanced area on the MRI. We also examined a biopsy method, sites and a treatment regimen and analyzed overall survival (OS) and progression-free survival (PFS).

RESULTS
The primary symptoms were disorientation in five, epileptic seizure and abnormal vision were two, respectively. The largest lesion area with the image was T2/FLAIR-high, followed by Met-PET and Gd in all. The surgical methods were stereotactic biopsy (2), navigation-guided biopsy (2), endoscopic biopsy (1), and craniotomy (2), The average of tumor/normal ratio in Met-PET was 2.92 (1.97–5.0). The pathological grade was diagnosed as Grade III in 4 and Grade II in 3. IDH1R132H was negative in all, p53 was positive in 5, and an average of MIB-1LI was 12% (2–35). The radiotherapy was performed in 6 cases, and, temozolomide was given to all, and bevacizumab was in 3. Six patients died of a tumor. Median PFS and OS were 8mos and 16.5mos, respectively.

CONCLUSION
Because the GC cannot expect improvement by surgery, it is necessary to obtain the pathological diagnosis by a quick and correct biopsy, and the neurologic deterioration by the biopsy technique should be avoided. The Met-PET suggesting the highest grade site was useful for the plan of the biopsy site.
NI-15 THE USEFULNESS OF PET IMAGING IN MOLECULAR DIAGNOSIS OF GLIOMA
Authors: Ogawa Tomoya , Miyake Keisuke , Fujimori Takeshi , Ogawa Daisuke , Okada Masaki , Hatakeyama Tetsuhiro , Okauchi Masanobu , Shindo Atsushi , Kawanishi Masahiko , Tamiya Takashi 
Published: December 2019

Abstract

OBJECTIVE
After WHO 2016 Classification of Tumors of the Central Nervous System have published, molecular diagnosis became part of the diagnostic criteria. In this study, we investigated the correlation between PET images and molecular diagnosis of glioma.

METHODS
We performed retrospective review of newly diagnosed supratentorial glioma patients who preoperatively underwent all four PET examinations (18F-FDG, 11C-MET, 18F-FLT and 18F-FMISO) from April 2009 to March 2019. The standardized uptake value (SUV) from the accumulation of each PET tracers, TNR (tumor to contralateral normal tissue ratio) of 18F-FDG,11C-MET and 18F-FLT, TBR (tumor to blood values ratio) of 18F-FMISO were measured. We investigated the correlation between these PET images and molecular diagnosis of glioma.

RESULTS
Data from total of 79 patients which were 42 cases of IDH wild type glioblastoma, 2 cases of IDH mutated glioblastoma, 9 cases of IDH wild type astrocytoma, 13 cases of IDH mutated astrocytoma and 13 cases of IDH mutated and 1p/19q co-deleted oligodendroglioma were included in this study. Both TNR of 11C-MET(p&lt;0.01) and 18F-FLT(p&lt;0.01), and also TBR of 18F-FMISO(p&lt;0.01) in IDH wild type gliomas showed significantly higher than IDH mutated gliomas. In WHO Gr2-3 gliomas, only TNR of 18F-FLT showed a significant difference between IDH wild type gliomas and IDH mutated gliomas(p&lt;0.01). TNR of 18F-FLT(p&lt;0.01) and TBR of 18F-FMISO(p&lt;0.01) in 1p/19q co-deleted gliomas were significantly lower than gliomas without 1p/19q co-deletion, but there were no significant differences in WHO Gr2-3 gliomas. Among IDH mutated gliomas, TNR of 11C-MET in 1p/19q co-deleted gliomas showed significantly higher uptake than gliomas without 1p/19q co-deletion(p&lt;0.05).

CONCLUSION
Preoperative PET evaluation of each PET tracers may be useful for the molecular diagnosis of glioma.
NQPC-01 CURRENT STATUS AND PROBLEMS OF ADVANCE CARE PLANNING AND PALLIATIVE CARE FOR MALIGNANT BRAIN TUMOR
Authors: Aoki Tomokazu , Narita Yoshitaka , Mishima Kazuhiko , Matsutani Masao 
Published: December 2019

Abstract
Purpose Genomic medicine is in progress, but the median survival of glioblastoma is 14–16 months. It seems to have the same life prognosis as stage 4 like unresectable pancreatic cancer, lung cancer and colon cancer. Palliative care including Advance care planning (ACP) at first diagnosis of glioblastoma is important We conducted a questionnaire survey to understand the current status of Japanese oncologists. Method In July 2018, a questionnaire of 37 items was sent by e-mail to 767 members of Japanese Society of Neuro Oncology, and in August replies were received from 154 persons (20%). The same 22-item questionnaire in 2012–2013 was compared internationally with a report (Walbert T., et al., 2015) by Society of NeuroOncology and the European Association of NeuroOncology. In addition, we compared domestically with a 30-item questionnaire (Narita et al. 2009) in 2007. The Nonparametric Mann-Whitney’s U test was mainly used. Result 1 Characteristics of Japan in comparison with Western countries(p&lt;0.01): 1. The number of doctors in charge is overwhelmingly male. 2. The specialty is predominantly neurosurgeons. 3. Aging of NeuroOncologists. 4, medical treatment place: the proportion of university is low. 5, frequent regular examination of the patient. Result 2Changes compared with domestic(Japan) data 11 years ago(p&lt;0.01): 1 Explaining the condition in more detail. 2. Explaining to not only the family but also the patient. 3. Continuing chemotherapy more aggressively. 4. The place of death: decreasing at hospitals and increasing at home. 5, Frequency with a respirator decreased. 6, About 70% at the end of the period, nasal injection and gastrostomy are applied. Conclusion In the treatment of malignant brain tumors in Japan, a male neurosurgeon who has over 15 years of experience actively continues chemotherapy and appears to see it with nasal injection.
NQPC-12 SHORT-TIME INTENSIVE REHABILITATION FOR PATIENTS WITH NEWLY DIAGNOSED MALIGNANT GLIOMAS WITH SPECIAL REFERENCE TO MEDICAL COOPERATION TEAM
Authors: Maeda Takeshi , Matsutani Masao , Kato Momoka , Okamura Daijiro , Muraya Syoichi 
Published: December 2019

Abstract

PURPOSE
Many reports presented that patients with GBM had stable HRQoL during their remission time. However, there are few reports on the situation of ADL that is the basis of QOL. This prospective study was designed to evaluate the effectiveness of intensive rehabilitation for physically disabled patients with GBM after the initial treatment.

PATIENTS and METHOD
Twelve patients with newly-diagnosed glioblastoma presenting with severe physical disabilities were registered after the completion of postsurgical radiation therapy combined with TMZ. All patients were evaluated by means of a core set of clinical scales of Functional Independence Measure (FIM), Sitting Balance score, Standing Balance score, and Mini-mental State Examination (MMSE). Patients were evaluated before the beginning and at the end of rehabilitation treatment. The daily rehabilitation program consisted of individual 180-min. sessions of treatment, seven days a week, for four to six consecutive weeks. Speech therapy was included when aphasia was diagnosed.

RESULTS
Ten of 12 patients presented with mean increased FIM score of 26.6 points that reached the individual maximum point within 10 to 56 days.

CONCLUSION
A short-time intensive rehabilitation (4 to 6seeks) is effective for GBM patients during TMZ withdrawal period after the postoperative radiation therapy. This effective program requires close teamwork with the medical cooperation teams in the medical and rehabilitation hospitals: explanation to patients of the significance of the short-term rehabilitation, which is different from stroke rehabilitation, adjustment of hospitalization date considering radiotherapy and chemotherapy schedule, and adjustment of MRI imaging or bevacizumab administration schedule during rehabilitation.
NQPC-14 COMPARISON OF QOL SCALES IN PATIENTS WITH BRAIN TUMORS
Authors: Satomi Natsuko Tsushita , Miyahara Ruriko , Omura Takaki , Takahashi Masamichi , Ohno Makoto , Miyakita Yasuji , Narita Yoshitaka 
Published: December 2019

Abstract

PURPOSE
Measurement of quality of life (QOL) of patients with brain tumors is a challenge, because parameters of the established QOL scales for cancer patients are easily affected by the focal neurological deficits. Thus, simpler QOL scales which are feasible for evaluation of QOL with severe neurological deficits are required. We compared the results of four QOL scales in patients with brain tumors.

METHODS
From 2015 to 2018, we prospectively performed EORTC QLQ-C30/BN20 (C30/BN20), KPS, EQ-5D and “Distress and Impact Thermometer (DIT)” every three months.

RESULTS
2150 QOL evaluations from 710 patients were analyzed. The median age was 54 years (range 14–97). 319 glioma, 93 meningioma, 165 brain metastases and 133 other brain tumors were included. Global health status of C30/BN20 strongly correlated with QOL scores calculated by EQ-5D and DIT; it also showed correlation with KPS (correlation coefficients: 0.632, -0.675, -0.622, 0.412, respectively (p&lt;0.001)). Most items of C30/BN20 showed relatively strong correlation with QOL scores, whereas KPS strongly correlated to physical activities and DIT strongly correlated to items related to psychological status. Seizures did not corelate with any other QOL scales. In patients with KPS≤60, wide dispersion of QOL scores and DIT were observed. In these patients, KPS correlated only with items 1–3 of EQ-5D and DIT with item 5. When time course of QOL scores in malignant glioma was evaluated, it was maintained until first remission, and significantly impaired at recurrence, compared to onset (p=0.014).

CONCLUSION
QOL scores can be used as an alternative for C30/BN20, and QOL time course of glioma can be adequately evaluated with it. KPS and DIT can also be alternative scales. These two scales should desirably be used in combination in patients with low KPS. Evaluations of feasibility and validity of these QOL scales in patients who cannot answer C30/BN20 are warranted.
NQPC-15 COGNITIVE FUNCTION AND ACTIVITY OF DAILY LIFE AFTER TUMOR REMOVAL FOR PATIENTS WITH BIFRONTAL GLIOBLASTOMA
Authors: Kakuta Akiko , Nitta Masayuki , Maruyama Takashi , Muragaki Yoshihiro , Ikai Tetsuo 
Published: December 2019

Abstract

INTRODUCTION
Glioblastomas often grow in a butterfly shape in the bifrontal lobes. The aggressive removal of these contrast-enhanced lesions may cause serious cognitive dysfunction. In this study, we have analyzed changes of cognitive function, effects on ADL, as well as rehabilitation methods for patients with bifrontal glioblastoma before and after tumor removal.

SUBJECTS
In this study, 6 patients including 2 males and 4 females with a mean age of 39.8 were reviewed. All patients exhibited bifrontal glioblastoma that was surgically removed. The primary tumor location was lower-left frontal gyrus for four of the patients, the right preSMA-SMA region for one patient, and the lower-right frontal gyrus for the remaining patient.

METHOD
Patients’cognitive function and ADL evaluated after the tumor removal and at the end of postoperative chemoradiotherapy, were retrospectively analyzed. We compared and verified the features and EOR. An evaluation was performed using MMSE-J, FAB, TMT, RCPM, RBMT, BADS, and FIM.

RESULT
After completion of chemoradiotherapy, 3 patients returned home, 2 were transferred to the hospital, and 1 returned to work. MMSE score was worsen in two patients, and their tumor were located in the lower-right frontal gyrus and the lower-left frontal gyrus. Two cases in the right frontal lobe and two cases in the lower left frontal gyrus scored lower average on the TMT. In our final evaluation, ADL was not worsening after surgery.

DISCUSSION
Many patients with bifrontal glioblastoma exhibited disturbance of consciousness due to strong edema before surgery, but they recovered in about two months after the tumor removal and many of them considered back to work. Involvement of prefrontal cortex may be related to severe cognitive dysfunction. Active rehabilitation should be started as soon as possible after surgery to acquire a compensation functions for the cognitive disorders and simulation for social life and work.
BT-10 A RARE CASE OF RADIATION-INDUCED GLIOBLASTOMA 29 YEARS AFTER TREATMENTS OF GERMINOMA
Authors: Matsuo Ayaka , Kawahara Ichiro , Hiu Takeshi , Haraguchi Wataru , Ono Tomonori , Ushijima Ryujiro , Tsutsumi Keisuke 
Published: December 2019

Abstract

BACKGROUND
Germinoma is one of the most radiosensitive tumors. Although radiotherapy (RT) can lead to long term-survival, it has the possibility to cause adverse effects. One of the more serious side effects include radiation-induced tumors that can contribute to a life-long prognosis.

Case presentation
A 40-year-old man was diagnosed with left basal ganglia germinoma at the age of 11 years old. Postoperatively, he received whole-brain radiotherapy 40Gy, focal radiotherapy 9.26Gy, and craniospinal irradiation. After these treatments, he was free from tumor recurrence or a secondary tumor during the long-term follow up. However, after 29 years, he began experiencing aphasia. A Magnetic Resonance Imaging (MRI) showed a developing 4.5cm round mass in the left parietal lobe with marked surrounding edema. He underwent surgical resection of the tumor at the left partial lobe. Pathological examination showed the tumor to consist of unclear pleomorphism, and the diffuse proliferation of heterocyst. Therefore, the pathologic diagnoses concluded as glioblastoma (Ki-67 labeling index was 50%). Conclusion: The tumor developed in the previously irradiated field, and it was not present prior to the RT. He did not suffer from pathologies favoring the development of the tumor. The interval between the radiation exposure and the onset of the second tumor was approximately 29 years, and the histotype of the tumor differed from the original tumor. Considering these clinical features, we diagnosed the glioblastoma as a radiation-induced tumor. Radiation-induced malignant glioma occurs frequently in patients after the treatment for acute lymphoblastic leukemia. Therefore, the radiation-induced malignant glioma after the treatment for germinoma is rare. Regardless of age, histology, and RT dosages, the patient has the possibility to develop radiation-induced malignant glioma. In conclusion, it is necessary to have careful monitoring even after 20–30 years of RT.
CS-03 LARGE CYSTIC INTRADURAL SCHWANNOMA IN CERVICAL REGION: A CASE REPORT
Authors: Takeshima Yuki , Takezaki Tatsuya , Hamasaki Tadashi , Tajiri Seiji , Mukasa Akitake 
Published: December 2019

Abstract
Schwannomas are the most common intradural extramedullary spinal tumors. However, they are usually solid tumors, and totally cystic changes are rare. Herein, we report a case of a 46-year-old male presenting with numbness of right limbs, right hemiplegia, and posterior neck pain for one year. MRI revealed a well-defined cystic long-segment, from C1 to C6, intradural extramedullary mass. The lesion showed hypointense on T1WI, hyperintense on T2WI, hyperintense on DWI, and it was marginally enhanced on the contrast image with Gd-DTPA. C1 laminectomy and hemi-laminectomy from C2 to C6 was performed for tumor resection. The tumor was found to be totally cystic and tensed with a jelly-like content. It was completely resected with the attachment of the C3 dorsal root. Histopathological examination confirmed it to be a schwannoma. The mechanism of cyst formation in schwannoma is considered as results of ischemic necrosis associated with tumor growth, or cystosis due to degeneration of Antoni-type B region. The long-segment, totally cystic intradural cervical schwannoma is rare, bit it should be included in the differential diagnosis of a cystic mass in the spinal region. It can be difficult to distinguish cystic spinal schwannomas from other cystic lesions like arachnoid cyst, epidermoid cyst, and neurenteric cyst. Contrast enhanced MRI is useful by enhancing the margin of the tumor.
CS-06 A CASE OF GLIOBLASTOMA METASTATIC TO THE LUMBAR VERTEBRA
Authors: Matsuhashi Ako , Tanaka Shota , Nomura Masashi , Ikemura Masako , Sakai Yu , Karasawa Yasuaki , Takayanagi Shunsaku , Saito Nobuhito 
Published: December 2019

Abstract

BACKGROUND
Most cases of glioblastoma recur within one year even under the standard treatment of surgical resection, radiation therapy and chemotherapy. 60–70% of recurrences are local, and in rare cases of metastasis, most are within the CNS. Extradural metastasis is considered exceedingly rare.

CASE REPORT
We present a 21-year-old man post total resection of right parietal lobe glioblastoma, diagnosed with lumber metastasis. He originally presented with impaired consciousness and left hemiplegia at the age of 20 and underwent gross total resection of the tumor. Pathology was IDH wild type, H3F3A K34R/V wild-type glioblastoma. Radiotherapy and adjuvant temozolomide per the Stupp regimen as well as infusion of bevacizumab were conducted. 6 months after the resection of tumor, the patient presented with severe back pain. Radiographic studies showed an osteolytic mass on the first lumbar vertebrae, and needle biopsy was consistent with glioblastoma. Posterior spinal fusion, internal decompression and radiotherapy were conducted to relieve the pain. At 3 months after the diagnosis of lumbar metastasis, he is currently treated with temozolomide and bevacizumab, without the enlarging of the tumor.

DISCUSSION
As far as we investigated, there has been 30 cases of vertebral metastasis of glioblastoma reported in literature. Considering the biological obstacles that prevent glioblastomas from infiltrating outside of the CNS, it can be speculated that deposition of tumor cells into the blood stream or excision of the dura due to surgical interventions may attribute to extracranial metastasis. Due to the improvement of overall survival of glioblastoma, vertebral metastasis is suspected to be more common. Therefore, investigation of its risk factors and standardization of its treatment is necessary.

CONCLUSION
We reported a case of lumbar metastasis of glioblastoma. Extradural metastasis of glioblastoma must be included in differential diagnoses in treating patients with glioblastoma.
COT-05 A CASE OF NEPALESE IN JAPAN SUSPECTED OF NEUROCYSTICERCOSIS
Authors: Mikai Masataka , Matsuzaki Ryo , Matsuura Chie , Terazono Sayaka , Ando Shumpei , Harada Masashi , Masuda Hiroyuki , Kondo Kosuke , Harada Naoyuki , Sugo Nobuo 
Published: December 2019

Abstract

INTRODUCTION
Cystosis is the most common parasitic disease of the central nervous system. Especially in developing countries, it is one of the differential diagnosis of diseases that cause seizures. We report a case of a foreigner suspected of having neurocysticercosis.

CASE
A 36-year-old Nepalese visiting Japan for 2 years. Two days ago, she lost consciousness for a few seconds and was transferred to our hospital complaint of convulsions for about 1 minute. Head Computed Tomography (CT) revealed a mass lesion with a ring enhancement effect of about 10 mm in the right frontal lobe, with edema around it. Magnetic Resonance Imaging (MRI) shows T1WI low signal, T2WI high signal, and diffusion-weighted image with a light high signal. The ring-shaped enhancement effect was exhibited. Whole body CT showed no obvious lesions and blood tumor markers were negative. Various infections were negative, and cerebrospinal fluid cytology and culture were negative.

POSTOPERATIVE COURSE
From the surgical findings, brain abscesses such as cerebral tuberculoma were suspected, but various tests were negative. As a pathological result, the tumor had a capsule, and the inside showed necrotic tissue and fibrous granulation tissue reaction. There were no insects, and no obvious cells were identified by special staining. From the origin area, symptoms, and pathological findings, neurocysticercosis was most suspected.

CONCLUSION
We experienced a case of suspected neurocysticercosis that was difficult to diagnose from images and pathological findings. In neurocysticercosis, when the worm body dies, contrast-enhanced MRI shows a ring-like enhancement effect, and it is accompanied by surrounding edema, which may require differentiation from brain tumors.
COT-11 EFFECT OF PHYSICIAN SUPPORTS ON QUALITY CONTROL AND QUALITY ASSURANCE IN CLINICAL BRAIN TUMOR RESEARCH
Authors: Furukawa Keiko , Arakawa Yoshiki , Mineharu Yohei , Tanji Masahiro , Takaori Akifumi , Miyamoto Susumu 
Published: December 2019

Abstract

BACKGROUND
Clinical physicians have difficulties in conducting investigator-initiated-trials because of increasing clinical duties in Japan. Therefore, physician support can be one of the important factors for quality control and quality assurance. In Kyoto University Hospital, clinical research professional’s support for physician had started at November 2012. In this study, we evaluate effect of physician supports on quality control and quality assurance in clinical brain tumor research.

METHODS
Our department of Neurosurgery has been a member of Brain Tumor Study Group in Japan Clinical Oncology Group (JCOG) since 2007. The number of registered patients, the status of periodic monitoring, the occurrence of inquiries per case, and details of physicians’ support (items, frequency, methods, etc.) in each clinical trial were investigated. The factors affecting the audit results conducted by JCOG Audit Committee on January 2013 and February 2019 are examined.

RESULTS
There are seven trials have been ongoing on or started since November 2012. There are fifty patients registered in the clinical studies until July 2019. Periodic monitoring has been carried out in 214 patients of cumulative total number since 2012. Physicians’ support mainly involved the preparation of ethical review documents, CRF documentation, responses to data queries, preparation of SAE reports, study schedule check and monitoring of observation items. The audit results of site visit were acceptable, total evaluation score 68.80 on January 2013 and excellent, total evaluation score 99.9 on February 2019.

CONCLUSION
Clinical Trials Act has been implemented, and further improvement in the quality of clinical trials has been demanded. As the results of this study, we clarified the necessity for physician support and the contribution to quality improvement.