bluuebunny/crossref_metadata_2025_split huggingface dataset:
10066- MET-7 RISK FACTORS FOR THE EPILEPSY IN PATIENTS WITH BRAIN METASTASES
Authors: Sasaki Takahiro , Nakai Yasuo , Fukai Junya , Nakao Naoyuki 
Published: November 2024

Abstract
In accordance with the progress of cancer treatment, there is a need for long-term control of epilepsy that develops in metastatic brain tumors. In this study, we examined risk factors for the development of epilepsy in metastatic brain tumors. We retrospectively analyzed 200 patients with metastatic brain tumors treated between January 2010 and December 2023 for clinical information such as tumor site, imaging features, genetic mutations, and treatment details. Overall, median age was 67 years, 112 (56%) were male, and the major primary sites were non-small cell lung cancer (55%), breast cancer (12.5%), and small cell lung cancer (11.5%). Epilepsy occurred in 42 patients (21%). In univariate analysis, maximum tumor size, peritumoral edema, intratumoral hemorrhage, surgical treatment, and nonuse of molecularly targeted drugs were significantly associated with the development of epilepsy. Current guidelines do not recommend prophylactic administration of antiepileptic drugs for metastatic brain tumors. However, with the availability of antiepileptic drugs that have fewer side effects and fewer interactions with chemotherapy, prophylactic administration of antiepileptic drugs in high-risk groups for the development of epilepsy may warrant reconsideration.
10099- MET-10 A PROPENSITY SCORE-MATCHED ANALYSIS OF STEREOTACTIC RADIOTHERAPY FOR METASTATIC BRAIN TUMORS USING THE LEKSELL GAMMA KNIFE ICON MASK SYSTEM: A SINGLE-CENTER RETROSPECTIVE COMPARATIVE STUDY OF CASES MEETING AND NOT MEETING THE JLGK0901 CRITERIA
Authors: Oi Yuta , Kawabe Takuya , Ogawa Takahiro , Taniyama Ichita , Yamanaka Takumi , Takahashi Yoshinobu , Sato Manabu , Hashimoto Naoya 
Published: November 2024

Abstract

OBJECTIVE
Stereotactic radiosurgery (SRS) for metastatic brain tumors (METs) has previously been considered to be indicated only for cases with a few lesions with small sizes. Expansion of the indication of SRS for METs is mainly due to the JLGK0901 study. Furthermore, since introduction of the Leksell Gamma knife Icon, both single irradiation and fractionated irradiation has become possible using a mask fixation system. The purpose of this study was to evaluate our own institutional experience in order to reexamine the limitations on the number and volume of lesions established in the JLGK0901 study.

METHODS
The study period was 6.5 years from the start of operations using the Leksell Gamma Knife Icon at Rakusai Shimizu Hospital (2017/09-2024/02). A retrospective study was conducted in 1043 patients who had undergone initial treatment with Gamma Knife Icon and had at least one post-treatment follow-up report. A comparison was made between cases that did (Group A) and did not (Group B, extended indication) meet JLGK0901 criteria. Propensity score matching was used to establish matched cases. Neurological death was the primary endpoint. Functional outcomes and imaging changes were secondary endpoints.

RESULTS
Of 1043 cases, 673 were in Group A and 370 were in Group B. The median survival time after Gamma Knife Icon radiotherapy was shorter in Group B (19.7 vs. 10.6 months, p&lt;0.01), but the incidence of neurological death did not differ significantly between the two groups (p=0.635). There were also no significant differences in the rates of poor local control (p=0.381) and new intracranial lesions (p=0.925), or in neurological deterioration (p=0.738) and severe radiation-induced adverse events (p=0.994).

CONCLUSIONS
The results support expansion of the indication for Leksell Gamma Knife Icon for METs from that in JLGK0901 based on the absence of an influence of the number of metastases and tumor volume on outcomes.
10183- MET-14 SALVAGE SURGERY FOR LOCAL PROGRESSION AFTER RADIATION THERAPY OF BRAIN METASTASES
Authors: Arita Hideyuki , Umehara Toru , Takano Koji , Okita Yoshiko , Kinoshita Manabu 
Published: November 2024

Abstract
Recent advancement in cancer treatments have prolonged survival after the onset of brain metastases (BM), and this trend increases the risk of local progression (LP) after radiotherapy (RT)of BM. Salvage options include surgical resection, re-irradiation and medical therapies, but there is no standard management for this clinical setting. This study aimed to evaluate the outcome of salvage surgery. We performed surgical resection for intracranial metastases in 221 cases in a single institution between Apr 2014 and Mar 2024. Of those, the data of the cases underwent initial surgery after irradiation for BM were extracted. After excluding duplicated cases and those underwent surgery within one month after irradiation, we finally analyzed 49 cases. Overall survival (OS) and local progression free survival (LPFS) were evaluated by Kaplan Meier method. All but two cases had a history of stereotactic radiosurgery/radiotherapy for BM. Histopathological diagnosis of surgical specimens was tumor recurrence in 33 cases and radiation necrosis (RN) in 16 cases. RN cases showed longer duration between radiation and LP, when comparing with recurrent cases (median 42.3. vs. 9.3 months). OS was longer in RN cases than in tumor recurrent cases (median 68.5 vs. 26.9 months). In the recurrent cases, preoperative poor KPS (under 70), active state of extracranial lesions and RPA class were associated with shorter OS. Extent of resection, postoperative chemotherapy and local irradiation did not have significant impact on OS. Twenty cases experienced local recurrence after salvage surgery, and LPFS was 7.0 months. Any of extent of removal, postoperative chemotherapy and RT were not associated with LPFS. Relative long survival after salvage surgery for local failure of BM after irradiation was observed. Salvage surgery should be considered especially in patients with good extracranial control and performance status.
10093- MNG-4 PREDICTION MODEL FOR TUMOR GROWTH BY QUANTITATIVE IMAGE ANALYSIS FOR INCIDENTALLY DISCOVERED MENINGIOMAS
Authors: Oi Yuta , Taniyama Ichita , Minamoto Haruki , Fukuzawa Masayuki , Ogawa Takahiro , Yamanaka Takumi , Takahashi Yoshinobu , Hashimoto Naoya 
Published: November 2024

Abstract

PURPOSE
Most factors identified in prior studies on meningioma enlargement are qualitative, with limited quantitative evaluation. Predicting future tumor growth from initial imaging of incidentally discovered meningiomas could inform treatment decisions. This study quantitatively evaluates imaging data at diagnosis to identify characteristics associated with tumor enlargement.

METHODS
We compared MRI T2 features from the initial imaging of 10 patients in a clearly enlarged group with 10 in a non-enlarged group. Using 3D Slicer and Slicer Radiomics plug-ins, we created a program to set regions of interest (ROIs) in the tumor and calculate various features. Additional ROIs were placed in the outer tumor edge, brain, and white matter contralateral to the tumor. Inter-ROI ratios of features were calculated and compared using PyRadiomics software. We analyzed 107 features across seven classifications: one-dimensional statistics, shape features, Gray Level Co-occurrence Matrix, Gray Level Run Length Matrix, Gray Level Size Zone Matrix, Gray Level Dependence Matrix, and Neighbouring Gray Tone Difference Matrix. A t-test was conducted to identify significant predictors.

RESULTS
Twenty-four features showed significant differences (p&lt;0.05), including 10 one-dimensional statistics, 1 shape feature, 5 Gray Level Co-occurrence Matrix, 6 Gray Level Run Length Matrix, 1 Gray Level Size Zone Matrix, and 1 Gray Level Dependence Matrix.

CONCLUSIONS
We identified potential quantitative predictors of incidentally discovered meningioma growth. Future analysis with a larger sample size will refine these predictors and support the development of a predictive formula and corresponding program.
10085- BT-4 MEDULLOBLASTOMA WITH INTRATUMORAL HEMORRHAGE
Authors: Yamaki Yusuke , Suzuki Tomonari , Sato Masaya , Fukuoka Masayoshi , Ehara Takuro , Takayanagi Shunsaku , Shirahata Mitsuaki , Fujimaki Takamitsu , Mishima Kazuhiko 
Published: November 2024

Abstract

INTRODUCTION
Medulloblastoma, a malignant pediatric brain tumor, is classified into four molecular subtypes: WNT, SHH, Group 3, and Group 4, according to the 2021 WHO classification. Reports indicate that WNT-type medulloblastomas have a higher incidence of intratumoral hemorrhage compared to other subtypes. This study investigates the correlation between intratumoral hemorrhage and molecular classification in medulloblastoma cases treated at our institution, supplemented by a literature review.

METHODS
We included patients diagnosed with medulloblastoma from January 2011 to July 2024. Intratumoral hemorrhage was identified using CT and MRI, and molecular diagnoses along with clinical findings were retrospectively reviewed and evaluated.

RESULTS
The study comprised 21 medulloblastoma cases with an average age of 12.2 years and a male-to-female ratio of 3:2. The molecular subtypes included 7 WNT, 5 SHH, 1 Group 3, and 7 Group 4. Intratumoral hemorrhage was observed in 3 cases, all of which were WNT-type. The average age of WNT-type cases was 10.1 years, with a male-to-female ratio of 4:3. There were no significant differences in treatment outcomes between hemorrhagic and non-hemorrhagic cases.

DISCUSSION
WNT-type medulloblastomas may cause blood-brain barrier dysfunction due to β-catenin mutations, leading to intratumoral hemorrhage. Our findings support previous reports showing a higher incidence of intratumoral hemorrhage in WNT-type medulloblastomas. Hemorrhagic medulloblastomas on imaging are likely WNT-type, making intratumoral hemorrhage an important factor in treatment strategy planning.

CONCLUSION
Our analysis of medulloblastoma cases at our institution confirmed a significantly higher incidence of intratumoral hemorrhage in WNT-type tumors. Intratumoral hemorrhage can aid in preoperative molecular diagnosis of medulloblastomas.
10210- CS-11 A CASE OF DIFFUSE HEMISPHERIC GLIOMA WITH H3 K27M MUTATION, NEC
Authors: Sumi Takuma , Uzuka Takeo , Matsuda Hadzki , Akutsu Hiroyoshi 
Published: November 2024

Abstract
Reports of diffuse glioma with H3 K27M mutation occurring in non-midline regions are rare. We report a case of diffuse hemispheric glioma with H3 K27M mutation (DHG) that infiltrated both temporal lobes without involvement of midline structures. The patient was a 50-year-old man who was found to have intracranial lesions during a brain checkup. MRI showed diffuse FLAIR high signal lesions in the right temporal lobe-hippocampus-insular cortex and the medial contralateral temporal lobe. A partial resection of the right temporal lobe was performed, and pathology showed moderately dense infiltrating atypical glial cells on HE staining. Immunostaining was positive for p53 and H3 K27M, negative for ATRX and H3K27me3, and Ki67 was 25.7% at a hot spot. Cancer panel test confirmed H3 K27M and TP53 mutations, as well as PDGFRA amplification. Based on these findings, the patient was diagnosed with diffuse hemispheric glioma, H3 K27M mutation, not elsewhere classified (NEC). The patient underwent postoperative radiation therapy (60 Gy/30 fractions) with concomitant and 12 courses of maintenance temozolomide therapy. At 18 months post-surgery, MRI showed progression of the FLAIR lesion and the appearance of some enhancing lesions, so gamma knife surgery was performed. The patient is currently under observation 21 months after surgery. Including this case, 12 cases of DHG, have been reported, with a median age of 44 years, older than diffuse midline glioma, H3 K27M mutant (DMG). Additionally, MAPK pathway alteration was observed in 42% of cases, and three patients had an overall survival of more than two years, indicating the presence of long-term survivors. Although the differences between DHG and DMG are unclear, DHG may exhibit clinical and molecular biological characteristics from DMG. Further accumulation of cases and studies is necessary to clarify these differences.
10048- COT-5 DEVELOPMENT OF A DIAGNOSTIC MODEL FOR GLIOMAS USING SERUM MICRO RNA
Authors: Osawa Sho , Ohno Makoto , Matsuzaki Juntaro , Mishima Kazuhiko , Nagane Motoo , Narita Yoshitaka 
Published: November 2024

Abstract

BACKGROUND
MicroRNAs (miRNAs) are non-coding RNAs consisting of approximately 20 base pairs. Several studies have reported the usefulness of serum miRNAs in the diagnosis of gliomas. However, the results differ among studies, and reproducibility remains an issue. In this study, we investigated the usefulness of serum miRNAs in the diagnosis of gliomas using prospectively collected samples with strictly defined procedures. Furthermore, we integrated the data set with retrospectively collected samples stored at the same temperature and constructed a diagnostic model.

MATERIALS AND METHODS
Fifty-eight gliomas and 273 healthy controls from prospective cohort, and 17 gliomas from retrospective cohort were included in the study. First, 58 gliomas from prospective cohort and 273 healthy subjects were divided into two groups: training set and validation set. Serum miRNAs were comprehensively analyzed, and a diagnostic model for gliomas was constructed. Second, 100 miRNAs useful for diagnosis of gliomas were extracted from both cohorts, and the diagnostic model was constructed based on the 45 miRNAs commonly extracted from both cohorts.

RESULTS
A diagnostic model for gliomas was generated using 24 miRNAs in the prospective cohort. The AUC was 0.818 and 0.925 for the prospective and retrospective cohorts, respectively. However, the miRNAs used in the model did not include miRNAs that have been reported to be useful in the diagnosis of gliomas. The expression profiles of miRNAs differed between the prospective and retrospective cohorts. The integrated analysis using both prospective and retrospective datasets constructed diagnostic model using seven miRNAs. The AUC was 0.810 for both datasets.

CONCLUSION
The serum miRNA profiles are greatly affected by conditions from sample collation to storage. Although interpretation of the results should be done with caution, the diagnostic model using miRNAs that are stably expressed under different conditions is expected to be useful for screening gliomas.
10123- COT-13 TREATMENT RESULTS OF TUMOR TREATING FIELD IN OUR HOSPITAL: EXAMINATION OF EARLY DROPOUT CAESE
Authors: Yamashita Shinji , Ogasawara Natsuki , Kawano Tomoki , Tamura Mitsuru , Okuyama Hironobu , Matsumoto Fumitaka , Ohta Hajime , Yokogami Kiyotaka , Okita Yoshiko 
Published: November 2024

Abstract

BACKGROUND/PURPOSE
Tumor treating field therapy (Novo-TTF) is a new treatment for glioblastoma that suppresses tumor growth by generating an alternating electric field in the brain. We have treated 21 cases since September 2019,and experienced a certain number of cases that dropped out of this treatment early. In this study, we examined TTF treatment at our hospital, with a particular focus on cases of early dropout.

SUBJECTS/METHODS
Nineteen patients with glioblastoma who underwent TTF at our hospital from September 2019 to July 2024 and were observed for at least 6 months. Patient information and outcome were analyzed retrospectively.

RESULTS
The median age of the patients was 64 years (33-72 years). Fourteen patients were males and five were females. The mean duration of TTF treatment was 9.9 months (0-55 months), and the mean usage rate was 41.0% (0-96.9%). Survival analyses showed that mPFS was 9 months and mOS was 23 months. Seven of 19 patients (37%) dropped out of treatment within 3 months (early dropout group). Compared to other patients (maintenance group), early dropout group included significantly more patients who had left cerebral lesions (71.4% vs. 16.7%, p=0.017) and fewer patients that KPS was 90 or higher (14.3% vs. 50.0%, p=0.144). Prognosis was significantly worse in the early dropout group compared to the maintenance group for both PFS and OS (p&lt;0.01 for both PFS and OS), and multivariate analysis in PFS showed that early dropout was an independent poor prognostic factor (p=0.001).

CONCLUSION
In TTF treatment, the presence of patients who drop out early is a major factor that worsens the outcome of treatment. It is important to obtain the patient’s understanding and motivation for treatment in order to avoid early dropout. Tumor localization (left cerebellum) and low KPS may be potential disincentive factor for continue treatment.
10160- COT-18 DIFFERENCES IN 5-ALA FINDINGS AND BRIGHTNESS ON SECOND SURGERY
Authors: Kon Takashi , Kobayashi Yusuke , Sato Yosuke , Shimizu Katsuyoshi , Mizutani Tohru 
Published: November 2024

Abstract
We report cases of malignant brain tumor that underwent multiple surgeries, followed by postoperative radiation therapy and chemotherapy, and discuss the 5-ALA findings, changes in brightness, and factors that affect them. We report four cases, (case 1) anaplastic astrocytoma diagnosed by initial surgery, second surgery was done 18 months after, and the diagnosis was radiation necrosis. 5-ALA was negative at first surgery, and strongly positive at second surgery. (case 2) anapestic astrocytoma with 5-ALA negative findings at first surgery, and strongly positive at second surgery. histopathological findings were same. (case 3) Glioblastoma with 5-ALA strongly positive on both surgery, and they were histologically same. (case 4) breast cancer metastasis. 5-ALA brightness were strongly positive on initial and second surgery, and those were histopathologically same. We considered the malignant transformation of the tumor as the reason for the difference in 5-ALA findings, but one case was radiation necrosis, and three cases had the same pathological findings. It is possible that radiation, chemotherapy, etc. may have had some effect on the change in brightness, and we report here, together with a literature review, on factors that lead to differences in 5-ALA positive findings and brightness.
100310- COT-27 UNDERSTANDING THE BURDEN OF MIDH1/2 DIFFUSE GLIOMA AND THE COMPLEXITY OF NAVIGATING THE PATIENT PATHWAY: INSIGHTS FROM PATIENTS AND CAREGIVERS
Authors: Gatellier Laureline , Oliver Kathy , Burton Mary , Cardinal Craig , LaHay Shannon , Leon Bernard , Mallett Rebecca , Rogers Sarah , Tse Chris 
Published: November 2024

Abstract
Diffuse gliomas with mutations in isocitrate dehydrogenase 1/2 (mIDH1/2) are characterized by a slow-progressing, yet life-limiting, disease predominantly in young people. Herein, we report interim findings from a qualitative study to describe the mIDH1/2 diffuse glioma patient pathway, experience of the disease, and treatment approaches. Patients, caregivers, and patient-association group (PAG) representatives undertook individual interviews, with patients also completing standardized exercises as pre-work. Materials were developed in collaboration with the International Brain Tumour Alliance. Patients were aged ≥12 years with mIDH1/2 glioma, had their last resection ≥6 months before enrollment, and were either undergoing active observation or receiving chemotherapy/radiotherapy. Caregivers were living with the patient. PAG representatives were active members of a brain tumor PAG. From November 2023 to March 2024, 30 patients (Australia: n=10; China: n=6; France/UK: n=5 each; Canada/Japan: n=2 each), two caregivers (China/Australia: n=1 each) and one PAG (UK) participated. Median age of patients was 41.5 years. There were 17 astrocytoma and 13 oligodendroglioma diagnoses. Presentation symptoms, circumstances of diagnosis and treatment, access to care, and navigation in the healthcare system differed per patient and within countries. Surgical resection was perceived as a crucial stage, both feared and desired. A second opinion was more often sought for surgery than for subsequent treatment approaches. Patients undergoing chemotherapy/radiotherapy (n=17) or active observation (n=13) expressed substantial physical, socioeconomic, financial, and psychological burden. Patients receiving active observation experienced strong and ongoing anxiety, as the uncertainty of tumor recurrence took a toll on their emotional wellbeing in the long term. The experience of people living with mIDH1/2 diffuse glioma is heterogeneous regarding their pathway and complexity navigating the healthcare system, with a substantial psychological and socioeconomic impact. Improved education, as well as facilitating early navigation and prioritizing shared decision-making along the disease pathway, will better support people living with mIDH1/2 diffuse glioma.
IL-3 NOVEL SYNNOTCH-CAR-BASED T-CELL THERAPY FOR BRAIN TUMORS
Authors: Okada Hideho 
Published: November 2024

Abstract
The development of safe and effective chimeric antigen receptor (CAR)T therapy for malignant gliomas, such as glioblastoma (GBM), must overcome multiple challenges, including on-target off-tumor toxicity, heterogeneity of antigen expression, and exhaustion of CART cells. To this end, we adopted a novel synthetic Notch (synNotch) receptor system and developed innovative T cell circuits that recognize tumor cells based on the “prime-and-kill” strategy. In this system, the first antigen, which is expressed exclusively on GBM cells (e.g., EGFRvIII), primes the T cells to induce expression of a CAR that recognizes IL-13Rα2 and EphA2, thereby eradicating GBM cells expressing either EphA2 or IL-13Rα2. We reported that EGFRvIII-synNotch-primed EphA2/IL-13Rα2 CAR (E-SYNC) are effectively but restrictedly activated by EGFRvIII as the GBM-specific signal, thereby leading to complete eradication of orthotopic patient-derived xenografts with heterogeneous EGFRvIII expression, without attacking EphA2/IL-13Rα2-positive cells outside of the central nervous system (CNS) (Choe J, Watchmaker PB et al. Sci. Transl. Med 2021; PMID: 33910979). To extend the utility of synNotch-CART-cells to patients whose tumors do not express EGFRvIII, such as pediatric brain tumors, we developed a new concept of priming the synNotch-CAR circuit by antigens that are restrictedly expressed on CNS cells but not on cells of non-CNS systemic organs. This should be safe because, within the CNS, EphA2 and IL-13Rα2 are expressed only on tumor cells, but not normal CNS cells. Through screening, we have found Brevican (BCAN), a proteoglycan localized to the neuronal and glial cell surface, as the most promising priming antigen. A single IV infusion of T-cells engineered with the α-BCAN synNotch → CAR (B-SYNC) circuit showed complete remission in both PDX and immunocompetent mouse models without attacking CAR antigen-positive cells outside of CNS with superior efficacy and CNS-homing compared to conventional, constitutively expressed CART-cells (Simic M., Watchmaker PB, et al. Science in press). These synNotch-CART cells were more efficacious than conventional EphA2/IL-13Rα2 CART cells, associated with excellent persistence, and more juvenile in phenotype than conventional CART cells. We recently opened the phase I study evaluating the E-SYNC T-cells in patients with GBM (NCT06186401).
The Challenges of Constructing the Supreme Court by the Numbers: A Review Article
Authors: Gerhardt Michael J 
Published: November 2024

Abstract
This review article discusses the strengths and possible limitations of the new book, Making the Supreme Court: The Politics of Appointments, 1930–2020 by Charles M. Cameron and John P. Kastellec. The book, which provides the most extensive empirical analysis of the political construction of the Supreme Court yet written, including conventional and creative analyses of political influences shaping the Supreme Court. The book raises but does not resolve several important questions. While it illuminates some possible answers, a more nuanced analysis is needed in the future to capture the connection between the composition and direction of the Court, particularly in light of unforeseen developments in the law that challenge conventional notions of liberal and conservative jurists.