bluuebunny/crossref_metadata_2025_split huggingface dataset:
QOL-25. DIGITAL PHENOTYPING OF PERIOPERATIVE MOBILITY METRICS IN PATIENTS UNDERGOING SURGICAL RESECTION OF SKULL BASE TUMORS
Authors: Hong Christopher , Gudde Niels , Magnusson David , Gerstl Jakob , Kilgallon John , Onnela J P , Smith Timothy 
Published: November 2024

Abstract
Current methods to assess quality of life and recovery after surgery for skull base tumors are limited and often biased by subjective patient-reported assessments, while objective, in-situ assessments are lacking. Smartphone-based digital phenotyping has been increasingly studied across pathologies, utilizing built-in technologies to measure behavioral patterns pertaining to sleep, physical mobility, social interactions, and cognitive functioning, among others. Here, we report our initial experience with smartphone-based digital phenotyping in patients who underwent resection of skull base lesions. Patients seen at our multi-disciplinary skull base center were enrolled under an institutional board-approved protocol and installed the Beiwe application, which passively collected GPS data 20 days pre- and up to 140 days post-surgery. Variables measured included time spent at home, number of separate significant places visited outside home, daily walking time, and daily number of steps taken. 26 patients were enrolled, comprised of 14 pituitary adenomas, 8 meningiomas, and 4 vestibular schwannomas. All patients demonstrated increased time spent at home, fewer number of significant locations visited, decreased walking time, and decreased total steps in the immediate post-operative period. For pituitaries, mean return to baseline for these variables was 25.7, 24.3, 80.2, and 88.9 days, respectively. For meningiomas, return to baseline was 56.5, 214.4, 45.0, and 45.6 days, respectively. For vestibular schwannomas, return to baseline was 219, 39.9, 35.1, and 36.4 days, respectively. This study demonstrates initial efficacy of digital phenotyping for a cohort of patients undergoing surgical resection of skull base lesions, based on passively collected smartphone GPS data during the peri-operative period. This is part of a larger, ongoing study enrolling surgical patients as well as non-operative controls for comparison. Such peri-operative mobility metrics may potentially be refined to predict postoperative outcomes following surgery such as improvement of neurological symptoms, postoperative CSF leak, infection, dysnatremia, and hospital length of stay.
QOL-26. GLIOMA PATIENTS’ COGNITION AND THEIR CAREGIVERS: THE GOOD, THE BAD, AND THE BURDEN
Authors: Zarrella Giuliana , Fox Amber , Loughan Ashlee , Lanoye Autumn , Aslanzadeh Farah , Sherwood Paula , Braun Sarah 
Published: November 2024

Abstract

BACKGROUND
Cognitive decline, common in patients with gliomas, can contribute to reduced independence in daily functioning. Patients with gliomas often rely on informal caregivers for functional support, evidenced to cause distress in other caregiver populations (e.g., Alzheimer’s, terminal cancer, dementia). Few studies have investigated this relationship in neuro-oncology; thus, we explored whether patients’ neurocognitive function was associated with aspects of caregiver burden.

METHODS
Patients with glioma underwent neurocognitive testing including Auditory Verbal Learning Test-Delayed Recall (AVLT), Trail Making Test-Part B (TMT-B), Stroop Color-Word Interference (CWI), Controlled Oral Word Association Test (COWA), and the Grooved Pegboard (GPB). Caregiver burden was assessed using the schedule burden and self-esteem subscales of the Caregiver Reaction Assessment (CRA). Hierarchical regressions and independent samples t-tests evaluated whether neurocognitive performance predicted caregiver burden and differences in caregiver burden between patients with intact versus impaired (AVLT; ≥ -1.5 SD) memory.

RESULTS
Seventy-eight dyads were included for analyses (Patient: Mage=53.4, 65.4% male, 97.4% Non-Hispanic/White; Caregiver: Mage =52.5, 71.8% female, 96.2% Non-Hispanic/White). AVLT performance was significantly related to both caregiver schedule burden (β = -.63, p =.003) and self-esteem (β =.26, p =.046). Performance on TMT-B, COWA, GPB, and CWI and patient age were not related to caregiver burden in any model (ps&gt;.05). There was a significant difference in caregiver schedule burden between those with (M=15.17, SD=5.84) and without memory impairment (M=18.50, SD=5.60) [t(72)=-2.44, p=.017] but not for self-esteem (p&gt;.05).

CONCLUSIONS
Patient performance on verbal memory was sensitive to the changes that may contribute to increased caregiver burden. An amnestic profile may be the most salient cognitive predictor of strain on neuro-oncology caregivers. Our findings speak to the interdependence of patient outcomes and caregiver quality of life. Supporting patients’ neurocognitive capabilities, such as implementing individualized cognitive rehabilitation programs, may improve caregiver burden.
QOL-27. PATIENT REPORTED OUTCOME AND PREFERENCE AFTER CRANIOTOMY AND LASER THERMAL ABLATION: A PILOT STUDY
Authors: Pino Isabela Peña , Bartek Jiri , Chen Clark 
Published: November 2024

Abstract

BACKGROUND
Laser interstitial thermal therapy (LITT) is a minimally invasive procedure that allows cytoreduction in the treatment of brain tumors and can be considered by both surgeons and patients as an alternative to craniotomy.

OBJECTIVE
We surveyed 27 patients who underwent both craniotomy and LITT during distinct stages of their oncology journey to assess patient reported outcomes comparing both procedures.

METHODS
A nine question survey was developed and validated to assess patient reported post-operative recovery, pain level, narcotic use, and procedure preference. The survey was administered to patients with WHO II-IV gliomas who underwent both craniotomy and LITT.

RESULTS
The survey was reviewed by independent surgeons, patient advocates, and patients in terms of face validity and showed &gt;90% correlation in test-retest reliability. Our cohort had a mean age of 57 (+/- 12 years), 78% had glioblastoma. There was no significant difference in symptomatic improvement post-craniotomy or post-LITT (30% versus 4%, p=0.17). Similarly, no significance was detected in patient-reported recovery time from craniotomy (time required to return to pre-operative state, 4.3 +/- 9.1 weeks, median 2 weeks) or LITT (2 ± 2.3 weeks, median 1 week)(p=0.21). Notably, post-surgical pain (1-10 pain scale) and need for narcotic use in the first week (yes/no) after the procedure were significantly lower post-LITT (average pain score 1.7 versus 5 points, narcotic use 4% versus 81%, p&lt;0.0005 for both comparisons). When asked which procedure they would choose – having experienced both craniotomy and LITT, surveyed patients overwhelmingly chose LITT over craniotomy (89% versus 11%, p&lt;0.0005). Of note, the patients who preferred craniotomy experienced improved neurologic function post-craniotomy or suffered new deficits post-LITT.

CONCLUSION
In this pilot study, patients reported less pain and narcotic use post-LITT relative to craniotomy and generally preferred the former procedure if given the choice. Validation of these results in future studies can help inform decision making in clinical scenarios where there is equipoise between LITT and craniotomy.
QOL-28. CANCER-RELATED DISTRESS IN NEURO-ONCOLOGY: PATIENTS INFORM PROGRAM DEVELOPMENT FOR ENHANCING QUALITY OF LIFE
Authors: Fox Amber , Zarrella Giuliana V , Loughan Ashlee R , Lanoye Autumn , Palesh Oxana , Moeller F Gerard , Braun Sarah E 
Published: November 2024

Abstract

BACKGROUND
Brain tumor diagnosis and treatment result in significant negative sequelae, including cognitive decline, fatigue, and psychosocial symptoms. This study aimed to identify brain tumor patients’ sources of cancer-related distress and examine their interest in various treatment modalities targeting cognitive decline to inform program development for this underserved population.

METHODS
In pursuit of program development, patients with both primary and secondary brain tumors completed an anonymous survey. They reported demographics, tumor characteristics, subjective cognitive functioning; and, rated sources of cancer-related symptom distress (i.e., cognitive changes, fatigue, physical symptoms, motor functioning, balance, mood, and relationship) and interest in treatments targeting cancer-related cognitive decline (i.e., cognitive rehabilitation, mindfulness-based practices, psychotherapy, and medication). Descriptive statistics, t-tests, chi-square, and linear regressions were conducted.

RESULTS
Among participants (N=137, Mage=49.6±15.8, 58.1% female, 84.8% White), 50.4% endorsed subjective cognitive functioning below the mean (MFACT-Br-CI=22.6±7.5). Nearly half reported significant distress due to cancer-related fatigue (49.6%) and cognitive change (48.9%). Patients’ mean severity of distress due to cognitive decline was significantly greater relative to all other cancer-related symptoms (ps&lt;.001), except fatigue (p&gt;.05). Age, gender, or time since diagnosis were not significant predictors (ps&gt;.05) of distress due to cognitive decline. Most patients with distress due to cognitive change were interested in cognitive rehabilitation (63.6%) and mindfulness-based practices (61.6%), and only 40.4% were interested in medication. Interest in cognitive rehabilitation was not predicted by symptom distress, subjective cognitive functioning, age, gender, or time since diagnosis (ps&gt;.05). Gender was the only significant predictor of interest in mindful movement (b=.18, p=.041), with greater interest among women (χ2(1)=4.65, p=.031).

CONCLUSIONS
Fatigue and cognitive decline were the most distressing cancer-related symptoms for neuro-oncology patients. These findings emphasize the need for integrated interventions, including cognitive rehabilitation and mindfulness, as well as multi-targeted and individualized treatments for fatigue and cognitive decline in neuro-oncology.
QOL-29. PREVALENCE, MANAGEMENT, AND OUTCOMES OF PROCARBAZINE-ASSOCIATED HYPERSENSITIVITY REACTIONS IN PATIENTS RECEIVING PCV FOR LOW-GRADE GLIOMA
Authors: Knott Jack , Liebling Simon , Reed-Guy Lauren , Croteau Desiree , Phillips Richard , Desai Arati , Bagley Stephen 
Published: November 2024

Abstract
Procarbazine is an alkylating agent commonly used to treat low-grade gliomas as part of the PCV regimen. The use of procarbazine is frequently limited by the development of hypersensitivity reactions (HSRs), which often require dose reduction or cessation of procarbazine therapy prior to the completion of a planned treatment course. The prevalence, clinical characteristics, and potential predictors of these reactions are not well defined. We conducted a retrospective cohort study of patients with low-grade glioma who received PCV between January 2016 and January 2024 at a tertiary academic hospital. Data on patient demographics, tumor type, clinical characteristics, treatment course, and hypersensitivity reactions were collected and analyzed. 61 total patients were included. The overall prevalence of HSRs was 60.7% (95% CI: 48.4% - 72.9%). The median cycle during which HSRs occurred was cycle 3 (IQR: 2-4, Range: 1-5). All HSRs involved the development of rash, with 86.5% being pruritic and 21.6% involving the face. Treatments for HSRs included antihistamines (62.2%), topical corticosteroids (35.1%), and systemic corticosteroids (27.0%). Three patients with HSRs presented to the emergency department with concern for anaphylaxis, and one required treatment with epinephrine. Out of six patients rechallenged with procarbazine after experiencing HSRs, one patient redeveloped a diffuse, pruritic rash that resolved with systemic corticosteroids. A multiple logistic regression analysis was performed to assess the association between HSRs and gender, age at PCV C1D1, elevated liver enzymes, and concomitant anticonvulsant use, but no significant correlation was observed. In summary, our study provides a contemporary and comprehensive analysis of the prevalence and severity of HSRs to procarbazine in patients with low-grade glioma. The high rate of HSRs in this population, including a relatively high rate of suspected anaphylaxis, should be considered carefully by clinicians in choosing chemotherapy for low-grade glioma and warrants routine counseling and close monitoring.
QOL-31. RESULTS OF A TELEHEALTH-BASED PSYCHOLOGICAL INTERVENTION FOR CAREGIVERS OF PATIENTS WITH PRIMARY MALIGNANT BRAIN TUMORS: A MODERATION ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL
Authors: Willis Kelcie , Horick Nora , Strander Sumita , Whitman Jessica , Chiu Daniel , Pintro Kedie , Corveleyn Amy , El-Jawahri Areej , Greer Joseph , Temel Jennifer , Jacobs Jamie , Forst Deborah 
Published: November 2024

Abstract

BACKGROUND
In a recent randomized controlled trial, caregivers of patients with primary malignant brain tumors (PMBT) who received NeuroCARE—a six-session, telehealth-based psychological intervention—demonstrated improved anxiety and depression symptoms, coping, and self-efficacy at 11-weeks compared to usual care (UC) participants. We now explore how sociodemographic variables, disease-specific factors, and baseline mood symptoms moderate intervention effects on anxiety and depression symptoms.

METHODS
We examined data from 120 enrolled caregivers (Mage=53 years; 83% female, 92% White, 70% spouses/partners) of PMBT patients (84% glioblastoma). Eligible caregivers had elevated anxiety (Generalized Anxiety Disorder-7 ≥ 5). Participants were randomized 1:1 to NeuroCARE or UC and completed baseline sociodemographic questionnaires and the Hospital Anxiety and Depression Scale at baseline and 11-weeks. We used linear regression to evaluate whether selected sociodemographic characteristics (gender, age, relationship to patient), tumor characteristics (tumor location/laterality, IDH mutation status), and baseline mood symptoms moderated intervention effects on anxiety and depression symptoms. We report the group-by-moderator (b) effects, using a 0.20 significance level.

RESULTS
The beneficial effects of NeuroCARE on reducing 11-week anxiety symptoms were greater in women compared to men (b=-2.63, CI: -6.17, 0.91, p=0.14) and greater in caregivers who reported higher baseline anxiety symptoms (b=-0.43, CI: -0.78, -0.08, p=0.02) and depression symptoms (b=-0.56, CI: -0.96, -0.17, p=0.01). The beneficial effects of NeuroCARE on reducing 11-week depression symptoms were greater in caregivers of patients with IDH-wildtype tumors compared to caregivers of patients with IDH-mutant tumors (b=2.49, CI: -0.26, 5.24, p=0.08). Caregiver age, relationship to patient, and tumor location/laterality did not significantly moderate NeuroCARE effects on mood.

CONCLUSIONS
The positive effects of NeuroCARE were particularly salient for caregivers with elevated anxiety and/or depression symptoms and those caring for patients with IDH-wildtype tumors. Content may be further tailored to account for the unique needs of men and caregivers of patients with IDH-mutant tumors.
RBIO-08. INVESTIGATING THE EFFICACY AND MECHANISMS OF TUMOR TREATING FIELDS IN RADIATION-RESISTANT GLIOBLASTOMA MODELS
Authors: Schanel Taylor , Pandit Rhea , Anderson Joshua , Alrefai Hasan , Jones Amber , Hicks Patricia , Hjelmeland Anita , Willey Christopher 
Published: November 2024

Abstract
Glioblastoma (GBM) is an aggressive malignant brain tumor with poor prognosis despite current treatment regimens involving surgical resection, radiation, temozolomide, and the newly approved use of Tumor Treating Fields (TTFields; a noninvasive, transdermal, administration of alternating low-intensity, intermediate-frequency electrical fields). Acquired radiation resistance, thought to be partially driven by brain tumor-initiating cells (BTICs), underscores therapeutic challenges in GBM. While clinical evidence supports the therapeutic benefit of TTFields, its precise mechanisms of action are poorly understood, and TTFields impact on radiation-resistant GBM is unknown. To better understand the effect and mechanism of TTFields in radiation-resistant GBM, we utilized patient-derived xenolines (PDX) and their acquired radio-resistant pairs to assess changes in viability and molecular signaling. PDX were previously developed by subcutaneous implantation of patient GBM cells into immunodeficient (nu/nu) mice. Acquired radiation-resistant PDX were generated through serial in vivo radiation. TTFields were administered with the Novocure inovitroTM device in a cooling incubator to maintain 37oC sample temperature in the ceramic well plates of the device. PDX were cultured on geltrex-coated coverslips under serum-free conditions. Cytotoxicity was quantified 72h post TTFields with crystal violet. Molecular signaling was captured with PamChip peptide-based kinase activity arrays and RayBiotech proteomic arrays. We found that TTFields inhibit cell growth in both parental and acquired radiation-resistant PDX. Differences in molecular signatures between the PDX lines suggest molecular mechanisms of TTFields sensitivity signatures and interactions with acquired radio-resistant PDX. We are currently trying to generate TTFields-resistant PDX lines through serial treatment with plans to examine BTIC populations relative to TTFields efficacy. We also plan to explore targetable TTFields-induced alterations in the future.
RBIO-10. RADIATION FRACTION SIZE DIFFERENTIALLY AFFECTS MYELOID-DERIVED SUPPRESSOR CELL (MDSC) SUBSETS IN WHO GRADE 1 MENINGIOMA
Authors: Boorsma Bergerud Kyra , Berkseth Matthew , Golden Lydia , Sando Nicole , Chen Liam , Venteicher Andrew , Sloan Lindsey 
Published: November 2024

Abstract
Meningiomas are often cured after focal therapy with surgical resection and/or radiotherapy (RT); however, a small proportion still recur. RT dose can be used to modulate anti-tumor immune responses, potentially through regulating immunosuppressive MDSCs. Here, we investigate the effect of a single fraction of RT (2Gy vs. 15Gy) on frequency and activation status of MDSC subsets in patients with WHO grade 1 meningioma. We hypothesize that 2Gy will promote immunosuppressive MDSC activity more than 15Gy. Fresh tumor cells from patients with a presumed diagnosis of meningioma were digested into primary cell cultures and treated with a single fraction of 2 or 15 Gy or were sham irradiated using a XRAD 320 Biological Irradiator. Cells were incubated for 18hrs prior to flow cytometric analysis. MDSC populations were identified as Live/Dead-CD11b+CD33+HLA-DR-. MDSC subsets were then divided into M-MDSC (CD14+CD15-) or G-MDSC (CD15+CD14-). Five WHO grade 1 meningiomas were analyzed. The total frequency of MDSCs in tumors increased from 3% with sham RT to 4% after irradiation with 2Gy (p=0.03). This was driven by a 2-fold increase in frequency of total M-MDSCs, as G-MDSCs decreased by half after 2Gy (p=0.03). After irradiation with 15Gy, M-MDSC frequency was nearly half that of 2Gy. The frequency of TGF-β+MDSCs increased after 15 Gy (p=0.02). The frequency of IL-10+G-MDSCs increased in response to 2Gy (p =0.03) but decreased 4-fold after 15Gy. 18hrs after 2Gy, IFN-γ+M-MDSCs increased compared to sham (p=0.01). In this small cohort of grade 1 meningiomas, a 2Gy fraction of RT appeared to support expansion of the M-MDSC subset. RT at both fraction sizes increased immunosuppressive cytokine producing-MDSCs: M-MDSC-IL-10; G-MDSC-TGF-β. These findings indicate the need for further studies to understand the subset-specific impact of RT on MDSC, a key immune cell type in brain cancers.
SURG-01. INTRAOPERATIVE FLUORESCENCE ACTIVITY OF 5-AMINOLEVULINIC ACID IN BRAIN METASTASIS OF LUNG CANCER IS ASSOCIATED WITH THE GENETIC ALTERATION OF CELL CYCLE REGULATION
Authors: Kim Young Zoon , Go Kyeong-O 
Published: November 2024

Abstract
With advancement of technology in brain tumor surgery, fluorescence image, such as 5-Aminolevulinic Acid (5-ALA), can help detect the residual tumor during surgery. Recently, genetic alteration of cancer is additionally considered as prognostic factor with being added into traditional prognostic system, such as Graded Prognostic Assessment (GPA) scoring system. The primary objective of this study was to investigate the association of certain genetic alterations and intraoperative fluorescent activity of 5-ALA in brain metastasis (BM) of lung adenocarcinoma. A retrospective cohort study was conducted among 72 patients who underwent surgical resection of BM of lung adenocarcinoma at our institute for five years. Cancer cell infiltration was estimated by the intraoperative fluorescent activity of 5-ALA, and genetic alterations were analyzed by next-generation sequencing (NGS). Total 72 patients were eligible for analysis. Strong fluorescence was obtained in 56 (77.8%) patient during surgery. The sensitivity and specificity for detecting cancer cell infiltration using 5-ALA were 87.5% and 96.4%, respectively. In the NGS data of BM, genetic alteration of cell cycle regulation, DNA repair, tumorigenesis, proliferation, epigenetic regulation, and cancer immunology were detected in 73.6%, 44.4%, 56.9%, 66.7%, 30.6%, and 2.8%, respectively. Genes associated with cell cycle regulation (p = 0.003) and cell proliferation (p = 0.044) were significantly associated with positive fluorescence activity of 5-ALA in the adjacent brain tissue. Genetic alterations in cell cycle regulation and cell proliferation were also associated with shorter recurrence-free survival (p = 0.013 and p = 0.042, respectively) and overall survival (p = 0.026 and p = 0.042, respectively) in the multivariate analysis. Additionally, age, KPS, status of NSCLC, RPA class, GPA score, modality of adjuvant treatment were associated with PFS and OS.The results suggest that genetic alterations in cell cycle regulation and cell proliferation are associated with positive fluorescence activity of 5-ALA in the adjacent infiltrative brain tissue and influence the clinical outcome of BM of lung adenocarcinoma.
SURG-06. IMPACT OF LASER INTERSTITIAL THERMAL THERAPY VERSUS RESECTION FOR METASTASES ASSOCIATED WITH THE MOTOR CORTEX
Authors: Jackson Joshua , Haskell-Mendoza Aden , Flusche Ann Marie , Woo Joshua , Reason Ellery , Gonzalez Ariel , Srinivasan Ethan , Lerner Emily , Edwards Ryan , Huie David , Calabrese Evan , Fecci Peter 
Published: November 2024

Abstract

BACKGROUND
For brain metastases (BM), resection remains a mainstay for the upfront management of large, symptomatic lesions, while laser interstitial thermal therapy (LITT) has become a key treatment for radiographically progressive BM following stereotactic radiosurgery (SRS). Compared to LITT, resection-associated morbidity may delay systemic therapies. We evaluated functional outcomes for resection versus LITT to primary motor cortex (PMC)-associated metastases.

METHODS
Patients receiving resection or LITT for BM radiographically associated with the PMC from 2015-2023 were retrospectively reviewed. Demographic and survival data were collected, with patient Karnofsky Performance Status (KPS) or modified Rankin Scale (mRS) scores assessed out to 1-year by independent raters.

RESULTS
Forty-one patients underwent resection and 30 underwent LITT to a PMC-associated lesion. Median age was 67 (range 38 – 80) vs 65 (44 – 80) for resection vs LITT; median pre-operative KPS (70 vs 80, P = 0.1) or mRS (2 vs 2, P = 0.66) did not differ between groups. Lung was the most common primary (56.1% resections vs 56.7% LITTs). Resected lesions were of larger median diameter than LITT, 2.8 vs 1.9 cm, P = 0.0001. For resections, length of stay was longer, median 2 vs 1 day, P = 0.0002, and ICU use more frequent (75.6% versus 20.0%, P &lt; 0.0001). At 1-month post-op, 66.7% of resection patients and 51.7% of LITT patients had stable or improved symptoms from pre-op, P = 0.21, with parity at 3-months (65.7% vs 62.9%) and therafter. Further, there was no significant decrement in KPS or mRS score out to a year for either intervention.

CONCLUSIONS
While there is a short-term increased risk of post-operative neurologic worsening due to LITT-associated edema, our data shows that, relative to resection, this is a transient and clinically limited phenomenon. With careful patient selection, LITT to lesions involving the PMC is feasible.