bluuebunny/crossref_metadata_2025_split huggingface dataset:
QOLP-17. GROUP MEDICAL PLAY EFFECTIVELY IMPROVES HOSPITALIZATIONADAPTABILITY OF PEDIATRIC PATIENTS WITH NEUROTUMOR
Authors: Zhang Xing , Zhang Fuqiang , Lai Mingyao , Li Juan , Zhang Yangqiong , Zhou Cheng , Shan Changguo , Cai Linbo 
Published: December 2020

Abstract

OBJECTIVE
To explore the effect of group medical games on the hospitalization adaptability of pediatric patients with neuro tumor.

METHODS
pediatric patients with neuro tumor (age:6 to 13 years) who were treated in hospital from June to December 2019 and were hospitalized for 1 month to 2 months. 29 pediatric patients(mean age:9y) were selected as the control group and treated as usual; 26 pediatric patients(meanage:8y) were selected as the experimental group for group therapeutic play intervention. Interventions last Monday, Wednesday and Friday of each week, with an average duration of one hour. Group medical play include: medical picture book education, medical preview game, emotional games, social table games. Two groups completed self-made questionnaires at the time of admission and two weeks after admission, including: diet, sleep, compliance, and social status, hospital adaptation and other related issues, two groups completed a satisfaction questionnaire after two weeks of admission, recorded analysis and compared the difference of questionnaire data and satisfaction of the two groups of pediatric patients.

RESULTS
There was no statistical difference in age and sex between the two groups, and there was no significant difference in baseline RESULTS: The re-test results showed that the experimental group was significantly better than the control group in terms of social status, hospital adaptation, compliance and family satisfaction(p＜0.05).

CONCLUSION
Group medical games can effectively improve the adaptability, compliance and family satisfaction of pediatric with neuro tumor.
QOLP-19. INSOMNIA IN BRAIN TUMOR PATIENTS: ASSESSING NEEDS IN NEURO-ONCOLOGY
Authors: Willis Kelcie , Ravyts Scott , Lanoye Autumn , Loughan Ashlee 
Published: December 2020

Abstract

BACKGROUND
Insomnia is a prevalent consequence of cancer diagnosis and treatment. In primary brain tumor (PBT) patients specifically, insomnia has been rated as one of the most severe symptoms and linked with other negative side effects, such as increased fatigue and emotional distress. Despite these findings, research has consistently omitted PBT patients in understanding the detailed effects and treatment for insomnia.

METHODS
Adult PBT patients (N=74) completed anonymous surveys at routine neuro-oncology appointments at an NCI-designated academic medical center. The surveys included validated measures of insomnia (ISI & PSQI), fatigue (BFI), and other original items (e.g., How would you describe your feelings towards medication treatment for insomnia?). The current investigation aimed to assess: 1) the prevalence of clinically elevated symptoms of insomnia, 2) the relationship between sleep disturbance and daytime fatigue and distress, and 3) patients’ preferences for pharmacological and non-pharmacological treatment for insomnia in PBT patients.

RESULTS
Of the sampled PBT patients, 38% reported significant sleep disturbance as measured by the PSQI. Moreover, 23% endorsed clinically elevated, moderate-severe symptoms of insomnia as measured by the ISI. Excessive worrying (r =.31) and bad dreams (r =.29, p&lt; .05) were both associated, though not predictive of insomnia severity (p &gt;.05). Insomnia symptoms predicted increased fatigue severity, F(1,72) =52.60, β=.65, p&lt; .001, R2 =.42. Of the patients with clinical insomnia, 59% felt that their symptoms were not well-managed by their medical team; 53% expressed interest in pharmacological treatment and 47% in non-pharmacological treatment.

CONCLUSIONS
The prevalence and consequences of insomnia identified in PBT patients are similar to that of other cancers, yet the majority of PBT patients with insomnia reported their symptoms were poorly managed. Though there was slight preference for pharmacological treatment, the sizeable proportion of those interested in non-pharmacological treatments warrants investigations into such therapies (e.g., CBT-I) in medical settings
QOLP-22. POSTTRAUMATIC GROWTH IN NEURO-ONCOLOGY
Authors: Kovalchick Laurel , Willis Kelcie , Brechbiel Julia , Lanoye Autumn , Husain Mariya , Aslanzadeh Farah , Braun Sarah , Parker Kyra , Loughan Ashlee 
Published: December 2020

Abstract

BACKGROUND
Posttraumatic Growth (PTG) refers to the positive psychological change following a trauma and may include a heightened appreciation for life, greater value in meaningful relationships, and/ or spiritual development. A brain cancer diagnosis may be experienced as a traumatic event given the high risk of tumor progression, lack of curative treatments, and ultimately unexpected disheartening prognosis; however, there is limited research on PTG in neuro-oncology. The aim of this study was to determine the profile of PTG in patients diagnosed with primary brain tumors (PBTs).

METHODS
Patients with PBTs (N = 53, Mage = 48.17, 52.8% male) completed the Post Traumatic Growth Inventory (PTGI) during routine neuro-oncology clinic visits. Descriptive statistics and frequencies for the five factors of the PTGI and PTGI total were calculated.

RESULTS
PTG was evident across all domains with the most growth reported in appreciation for life and the least growth in new possibilities. Most patients endorsed low levels of growth across the five factors; 29-49% of patients endorse moderate-to-high severity in at least one PTG domain. Lastly, the average total score (M = 46.10) of this sample met the established cutoff for moderate-to-high PTG (&gt; 46).

CONCLUSIONS
The results suggest that patients with PBTs may perceive positive psychological growth following the traumatic event of a brain tumor diagnosis. Specifically, patients may experience a greater appreciation for life but relatively less growth in new possibilities, perhaps due to the poor prognosis of many PBTs. In non-CNS cancer populations, patients with higher PTG reported better quality of life and lower distress. Further research to expand our knowledge of PTG and the associated factors, including the demographic, medical, and psychological correlates, will better equip providers to promote positive change in PBT patients.
RADT-18. LONG-TERM FOLLOW-UP OF PATIENTS TREATED WITH GAMMA KNIFE® STEREOTACTIC RADIOSURGERY (GK-SRS) FOR VESTIBULAR SCHWANNOMA (VS)
Authors: Retzlaff Amber , Straza Michael , Bovi Joseph , Siker Malika , Friedland David , Harris Michael , Zwagerman Nathan , Albano Katherine , Wu Ruizhe , Banerjee Anjishnu , Schultz Christopher 
Published: December 2020

Abstract

PURPOSE
GK-SRS is an accepted definitive treatment option for appropriately selected patients with VS. To assess long-term outcomes in VS patients treated with GK-SRS, we retrospectively evaluated all patients treated at our institution from 2007-2019.

METHODS
For VS patients treated with GK-SRS from 2007-2019, clinical data (symptoms, physical exams, audiograms, and imaging) was collected via retrospective chart review at pre-treatment and standard follow-up intervals (6 weeks, 6 months, 12 months, then annually). Descriptive analyses, including the proportions of patients in different grades of clinical parameters, are reported. For each clinical parameter, only patients with both pre- and post-treatment data were included in the evaluation set used for analysis.

RESULTS
Of 177 patients identified, 46 were excluded from the evaluable set (age &lt; 18 years, prior resection, NF-2, or no follow-up). Among the remaining 131, median follow-up was 42 months (6 weeks to 11 years), and 36.6% completed 5+ years of follow-up. At time of treatment, median age was 61 years, and median Karnofsky Performance Score was 90. 58.0% of lesions were left-sided, and 42.0% were right-sided. The majority were Koos grade II (37.4%) or III (38.2%); the remainder were grade I (13.0%) or IV (11.5%). Pre-treatment central necrosis and ventriculomegaly were present in 39.7% and 4.6%, respectively. Following treatment, audiogram analysis with Gardner-Robertson Hearing Score demonstrated no change in 48.9%, some level of decline in 47.8%, and improvement in 3.3% at last follow-up. 97.7% had House-Brackmann scores of I at diagnosis; the remainder were House-Brackmann II. House-Brackmann scores remained unchanged at last follow-up for 96.9%, improved for 1.6%, and worsened for 1.6%. Salvage therapy in the form of surgery (n=5) or repeat GK-SRS (n=2) was necessary in 5.3% (n=6 for progression; n=1 for trigeminal symptoms).

CONCLUSION
Long-term follow-up demonstrates that GK-SRS remains a well-tolerated, primary definitive treatment for VS.
RADT-20. HISTOPATHOLOGIC FINDINGS IN MALIGNANT PERIPHERAL NERVE SHEATH TUMOR ARE BOTH PROGNOSTIC FOR OVERALL SURVIVAL AND PREDICTIVE FOR RESPONSE TO RADIATION THERAPY
Authors: Vasudevan Harish N , Lucas Calixto-Hope G , Chen William , Magill Stephen , Braunstein Steve , jacques Line , Dahiya Sonika , Rodriguez Fausto , Horvai Andrew , Perry Arie , Pekmezci Melike , Raleigh David 
Published: December 2020

Abstract

BACKGROUND
Malignant peripheral nerve sheath tumor (MPNST) is an aggressive neoplasm associated with neurofibromatosis type 1 (NF1). Despite multimodal therapy, clinical outcomes remain poor. To elucidate markers of MPNST treatment response, we retrospectively reviewed the medical records of MPNST patients at a single institution and performed histopathological and immunohistochemical (IHC) analysis for predictive and prognostic features.

METHODS
We identified 54 consecutive patients treated at University of California San Francisco between 1990 and 2018 that met diagnostic criteria for MPNST on pathologic review with sufficient tissue available for histology and immunohistochemistry (IHC) assays. IHC was performed for Ki-67, EGFR, p53, H3K27me3, neurofibromin, S100, p75NTR, SOX10, p16, and SOX2. Overall survival (OS), metastasis free survival (MFS), and locoregional failure free rate (LFFR), were estimated using the Kaplan-Meier method. Log-rank test, Cox Proportional Hazards regression, and hierarchical clustering were performed in R.

RESULTS
With a median follow up of 19.2 months, the 5-year OS, MFS, and LFFR were 58%, 68%, and 66%, respectively, with no significant differences between NF1 associated (n=32) and sporadic tumors (n=22). Radiation therapy significantly improved 5-year LFFR (80% versus 49%, p=0.05), but not OS or MFS. Tumor grade was associated with worse OS by Fédération Nationale des Centres de Lutte Contre Le Cancer (FNCLCC) grading (p=0.02). Furthermore, elevated Ki-67 index was associated with worse 5-year OS (39% versus 73% for Ki-67 index ³ 60 and Ki-67 index &lt; 60, p=0.01). Finally, hierarchical clustering of IHC data identified a predictive signature defined by elevated Ki-67 and EGFR expression associated with improved responses to radiation therapy (5-year OS 86% versus 10%, p=0.004).

CONCLUSIONS
Our data provide insights into the diagnosis and treatment of MPNST. Additional investigation is needed to understand the biologic mechanisms and generalizability of the signatures uncovered in our analysis.
RADT-26. LASER INTERSTITIAL THERMAL THERAPY FOR RECURRENT GLIOBLASTOMA: POOLED ANALYSES OF AVAILABLE LITERATURE
Authors: Munoz Casabella Amanda , Rahman Masum , Alvi Mohammed , Brown Desmond 
Published: December 2020

Abstract

INTRODUCTION
Laser Interstitial Thermal Therapy (LITT) is a novel treatment modality that has been used for an array of intracranial pathology. In the current manuscript, we sought to conduct a systematic review and meta-analysis to summarize all available literature to date, on outcomes of patients with recurrent GBM (r-GBM) undergoing LITT, pooling together quantitatively the overall survival and progression-free survival data.

METHODS
A comprehensive literature search was performed to retrieve all studies investigating overall survival, post-procedure survival, and progression-free survival outcomes of patients with r-GBM undergoing LITT. All statistics were pooled together by the meta-analysis of the mean using a weighted random-effects (RE) or fixed-effect (FE) model.

RESULTS
Eleven studies were included in the final cohort, representing a total of 134 patients with rGBM. The pooled mean age of the cohort at the time of recurrence diagnosis was found to be 56.7 ± 4.56 while 41% of the cohort were females. For the delivery of LITT, two studies utilized neodymium-yttrium aluminum-garnet laser (Neodp-YAG Laser), three studies utilized the Visualase system, five studies utilized the Neuroblate system, and one study used both the Neuroblate and the Visualase system. A total of eight studies with 107 patients had available data for overall median survival. The pooled overall survival was found to be 18.6 months (95%CI 16.2-21.1). A total of six studies with 93 patients had available data for post-LITT survival. The pooled post-LITT survival was found to be 10.1 months (95%CI 8.8-11.6). A total of eight studies with 119 patients had available data for progression-free survival. The pooled progression-free survival was found to be 6 months (95%CI 5.3-6.7).

CONCLUSION
LITT is a novel minimally invasive procedure which, when used with optimal adjuvant therapy, may confer survival benefit for patients with r-GBM.
RADT-28. RADIATION DOSE-DEPENDENT LONG-TERM NEUROCOGNITIVE DECLINE IN LOW GRADE GLIOMA PATIENTS: RESULTS OF A CROSS-SECTIONAL STUDY
Authors: Sinnige Peter , van der Weide Hiske , Kramer Miranda , Enting Roelien , Bosma Ingeborg , Rakers Sandra , Huitema Rients , Buunk Anne , Spikman Jacoba , Langendijk Johannes 
Published: December 2020

Abstract

BACKGROUND
Radiotherapy is a well-known risk factor for neurocognitive decline in glioma patients. Advanced radiotherapy techniques enable more selective brain irradiation. However, limited data exists on which brain regions are most relevant to avoid. The aim of this study was to explore the dose-effect relationship between brain subvolumes and neurocognitive performance.

METHODS
In this cross-sectional study, patients with grade II or III glioma treated with radiotherapy who were free of progression for at least one year were eligible. Patients underwent a neurocognitive test battery, including Rey Auditory Verbal Learning Test; (RAVLT), Trail Making Test (TMT), Copy of Rey’s Complex Figure Test (RCFT), Single Digit Modalities Test (SDMT) and Verbal Fluency tests (letters and categories). Test scores were correlated to radiation dose distributions in brain subvolumes using non-parametric tests.

RESULTS
The study was composed of 17 right-handed patients with grade II (n= 14) and grade III (n= 3) gliomas. The mean follow up after radiotherapy was 42 months, and the mean age 47 years. Performance on all tests was significantly worse for patients compared to healthy matched controls. Correlations were found between: 1) dose to the left hippocampus and performance on the RAVLT (Delayed Recall) (r= -0.60; p= 0.011); 2) dose to the supratentorial brain and performance on the TMT-A (r= 0.54; p= 0.025) and 3) dose to the left hemisphere and SDMT (r= -0.64; p= 0.006) and verbal fluency tests (for letters score: r= -0.73; p= 0.001).

CONCLUSIONS
We found significant correlations between radiation dose to the left hippocampus and hemisphere and neurocognitive performance. In this small sample we could not account for the effect of tumor location as a confounder. Reducing radiation dose to the left hippocampus and hemisphere by using advanced radiotherapy techniques may give superior neurocognitive outcomes.
RADT-30. COPLANAR AND NON-COPLANAR VMAT ARC SETTING FOR GLIOBLASTOMA MULTIFORME – DOSIMETRIC AND RADIOBIOLOGICAL COMPARISONS
Authors: Moldoveanu Vanessa , Dumitrache Mihai , Bacinschi Xenia , Serbanescu Luiza , Anghel Rodica 
Published: December 2020

Abstract

OBJECTIVES
To evaluate three different arc arrangements in glioblastoma multiforme (GBM) treatment planning.

METHODS
Eighteen GBM patients were replanned by using one full arc (1FA), two full coplanar arcs (2FA), and three full non- coplanar arcs (3FA). Dose-volume histograms (DVHs) were used to calculate conformity (CI), homogeneity (HI) and gradient indices (GI), the dose received by 5% (D5%) and 95% (D95%) of the planning target volume (PTV) and maximum (Dmax) and minimum (Dmin) absorbed dose for organs at risk (OARs), including normal brain (brain excluding PTV). General equivalent uniform dose (gEUD) for both PTV and OARs and EUD based tumor control probability (TCP) and normal tissue control probability (NTCP) were calculated as radiobiological parameters. Monitor units (MUs) were also computed and compared.

RESULTS
All three plans resulted in similar conformity, while 2FA resulted in a better homogeneity than 1FA (0.06vs. 0.07, p=0.007). 2FA vs. 1FA dose analysis for PTV revealed a lower D5% (61.28 vs. 61.37 Gy, p=0.014), a higher D95% (58.7 vs. 58.47 Gy, p=0.008) and a higher TCP (37.73 vs.37.38%, p=0.008). The utilization of 3FA did not significantly change the outcome of PTV but managed to decrease GI in comparison to both 1FA and 2FA (4.11 vs. 5.19 and 5.49, p&lt; 0.05). Regarding NB, 1FA scored a higher Dmax than 2FA (62.32 vs. 61.98 Gy, p=0.005), while 3FA scored a higher Dmin than 1FA and 2FA (2.52 vs. 1.08 and 1.10 Gy, p&lt; 0.05). No difference in NB NTCP was noted between techniques. Furthermore, 3FA yielded more MUs when compared to coplanar patters (566.74 vs. 486.78, p= 0.015 for 1FA and 495.98, p=0.019 for 2FA).

CONCLUSION
Although all three approaches resulted in clinical admissible outcome, the utilization of complex non-coplanar arrangement resulted in a stepper dose fall off but did not improve PTV results and increased machine MUs.
RADT-32. NATIONAL TRENDS IN RADIATION DOSE FOR LOW GRADE GLIOMAS
Authors: Wegner Rodney , Horne Zachary , Abel Stephen , Xu Linda , Yu Alexander , Ranjan Tulika , Karlovits Stephen 
Published: December 2020

Abstract

BACKGROUND
Adjuvant radiation is used in patients with low grade gliomas (LGG) with high risk characteristics. Randomized trials have examined dosing schemes ranging from as low as 45 Gy to higher than 60 Gy, with no difference in outcome. We used the National Cancer Database (NCDB) to see which doses were used in this patient population, and if any difference were seen in outcome.

METHODS
We queried the NCDB for patients with WHO Grade 2 brain tumors treated with surgery and adjuvant radiotherapy. We divided the cohort into dose groups: 45-50 Gy, 50.4-54 Gy, and &gt;54 Gy. Multivariable logistic regression was used to identify predictors of low and high dose radiation. Propensity matching was used to account for indication bias.

RESULTS
We identified 1,437 patients meeting the above criteria. Median age was 45 years. Forty-eight percent had astrocytoma subtype and 70% had subtotal resection. The majority of patients (69%) were treated to between 50.4-54 Gy. Half of all patients were treated with radiation alone. 1p19q status was recorded in 32% of patients, and 13% overall were co-deleted. Predictors of high dose radiation were increased income, astrocytoma subtype, chemotherapy receipt, and treatment in 2014. Patients treated to a dose of &gt;54 Gy had a median survival of 73.5 months and was not reached in those treated to a lower dose (p=0.0041). Subset analysis of patients with astrocytoma subtype showed median survivals of 79.0 and 51.2 months for low and high dose, respectively (p=0.13). When limited to oligodendrogliomas corresponding 5 year survival rates were 86% and 65%, in favor of lower doses (p=0.0004).

CONCLUSIONS
This analysis shows that 50.4-54 Gy is the most widely used radiation regimen for ow grade gliomas. There appeared to be no benefit to higher doses, although factors not recorded are likely confounding the RESULTS:
RADT-35. POSTOPERATIVE RADIOTHERAPY FOR WHO GRADE II–III INTRACRANIAL EPENDYMOMA IN ADULTS: AN INTERGROUP COLLABORATIVE STUDY (KROG 18-06/KNOG 18-01)
Authors: Woo Wee Chan , Kim Il Han , Park Chul-Kee , Lim Do Hoon , Nam Do-Hyun , Yoon Hong In , Suh Chang-Ok , Chang Jong Hee , Chung Woong-Ki , Jung Tae-Young , Park Shin-Hyung , Kim Chae-Yong , Kim Young Zoon , Gwak Ho Shin , Cho Kwan Ho , Kim Jin Hee , Im Jung Ho , Kim Woo Chul , Kim Sung-Hwan , Kim In Ah 
Published: December 2020

Abstract

BACKGROUND
To evaluate the impact of adjuvant postoperative radiotherapy (PORT) in adult WHO grade II–III intracranial ependymoma (IEPN).

METHODS
A total of 172 pathologically confirmed adult grade II–III IEPN patients from 12 institutions were eligible. Of them, 106 (61.6%) and 66 (38.4%) patients were grade II and III, respectively. For grade II and III IEPNs, 51 (48.1%) and 59 (89.4%) patients received PORT, respectively. The median dose to the primary tumor bed was 54.0 Gy and 59.4 Gy for grade II and III patients, respectively. The prognostic impact of sex, age, performance, WHO grade, location, size, surgical extent, and PORT on local control (LC), progression-free survival (PFS), and overall survival (OS) were evaluated by univariate and multivariate analysis.

RESULTS
The median follow-up period for survivors was 88.1 months. The 5-/10-year LC, PFS, and OS rates were 64.8%/54.0%, 56.4%/44.8%, and 76.6%/71.0%, respectively. On multivariate analysis, adjuvant PORT significantly improved LC (P=0.002), PFS (P=0.002), and OS (P=0.043). Older age (P&lt; 0.001), WHO grade III (P&lt; 0.001), larger tumor size (P=0.004), and lesser surgical extent (P&lt; 0.001) were also negative factors for OS. Adjuvant PORT also improved LC (P=0.010), PFS (P=0.007), and OS (P=0.069) on multivariate analysis for grade II IEPNs.

CONCLUSION
This multicenter retrospective study supports the role of adjuvant PORT in terms of disease control and survival in adult grade II–III IEPNs. Prospective randomized trials focused on individualized treatment based on molecular subtypes is warranted.
RBIO-06. IMPLEMENTATION OF HUMAN INDUCED PLURIPOTENT STEM CELL DERIVED CEREBRAL ORGANOIDS TO MODEL NORMAL TISSUE RADIORESPONSE
Authors: Bronk Lawrence , Singh Sanjay , Thomas Riya , Parkitny Luke , Maletic-Savatic Mirjana , Mohan Radhe , Lang Frederick , Grosshans David 
Published: December 2020

Abstract
Treatment-related sequelae following cranial irradiation have life changing impacts for patients and their caregivers. Characterization of the basic response of human brain tissue to irradiation has been difficult due to a lack of preclinical models. The direct study of human brain tissue in vitro is becoming possible due to advances in stem cell biology, neuroscience, and tissue engineering with the development of organoids as novel model systems which enable experimentation with human tissue models. We sought to establish a cerebral organoid (CO) model to study the radioresponse of normal human brain tissue. COs were grown using human induced pluripotent stem cells and a modified Lancaster protocol. Compositional analysis during development of the COs showed expected populations of neurons and glia. We confirmed a population of microglia-like cells within the model positive for the makers Iba1 and CD68. After 2-months of maturation, COs were irradiated to 0, 10, and 20 Gy using a Shepard Mark-II Cs-137 irradiator and returned to culture. Subsets of COs were prepared for immunostaining at 30- and 70-days post-irradiation. To examine the effect of irradiation on the neural stem cell (NSC) population, sections were stained for SOX2 and Ki-67 expression denoting NSCs and proliferation respectively. Slides were imaged and scored using the CellProfiler software package. The percentage of proliferating NSCs 30-days post-irradiation was found to be significantly reduced for irradiated COs (5.7% (P=0.007) and 3.4% (P=0.001) for 10 and 20 Gy respectively) compared to control (12.7%). The reduction in the proliferating NSC population subsequently translated to a reduced population of NeuN-labeled mature neurons 70 days post-irradiation. The loss of proliferating NSCs and subsequent reduction in mature neurons demonstrates the long-term effects of radiation. Our initial results indicate COs will be a valuable model to study the effects of radiation therapy on normal and diseased human tissue.