bluuebunny/crossref_metadata_2025_split huggingface dataset:
NCMP-03. SHORT AND LONG TERM EFFICACY OF BEVACIZUMAB THERAPY FOR RADIATION NECROSIS IN BRAIN METASTASES
Authors: Nobel Hila , Ofer Jonathan , Yust-Kayz Schlomit , Borenstein Sara , Sigal Tali , Kaner Andrew , Laviv Yossef , Limon Dror , Gal Omer , Elihaou Ruth , Amiel Alexandra 
Published: November 2023

Abstract

PURPOSE
Brain radionecrosis (RN) is a frequent, and often life devastating complication of stereotactic radiotherapy (SRS) for brain metastases. There is no standard treatment for RN. Bevacizumab is often proposed although data regarding its efficacy is limited. We performed a retrospective study to evaluate the short and long-term efficacy of bevacizumab in RN.

METHODS
We included all the patients who received bevacizumab for RN developed after treatment with SRS for brain metastases. Patients treated in our institution between 31/07/2018 and 31/07/2022 were enrolled into the study. Clinical and radiographic evaluations, immediately, 6, 12 and 24 months after completion of bevacizumab were evaluated. Response was assessed using RANO criteria. Changes in volume lesion were calculated using Brain Lab navigator system.

RESULTS
24 patients were included in the study. Median time from diagnosis of RN to treatment with bevacizumab was 5.1 months. According to RANO criteria first MRI performed after completion of treatment with bevacizumab showed a partial or complete response in 34 % of the patient and a stable disease in 41% of the patient. Volumetric measurements demonstrated significant (above 25%) diminution in the volume of the lesion in 66% of patients. Clinical improvement in neurological symptoms was revealed in 41 % of patients and steroid dosage was reduced in 50% of patients. Among the patients with a stable disease in the first MRI after bevacizumab, 27% demonstrated partial or complete response at the following 6 months MRI. During the entire follow-up period, a regrowth of RN occurred in 45% of patients who demonstrated a partial or complete response in the first MRI after bevacizumab.

CONCLUSION
Bevacizumab is an effective therapy for of RN, with high response rate within the first 6 first months after treatment. However regrowth of radionecrosis is occurs frequently during long term follow-up.
NCMP-11. ASSESSING SURVIVAL OUTCOMES OF PCV-BASED AND TEMOZOLOMIDE-BASED ADJUVANT THERAPY IN OLIGODENDROGLIOMA PATIENTS
Authors: Begley Sabrina , Chen Adrian , Schulder Michael , Goenka Anuj 
Published: November 2023

Abstract

INTRODUCTION
When treating oligodendroglioma, choosing between temozolomide (TMZ) and procarbazine, lomustine, and vincristine (PCV), with concurrent radiotherapy still poses a challenge. Given the commonality of tumor recurrence, optimizing progression-free survival while minimizing adverse effects is crucial to improving quality of life. We compare survival and adverse effects of patients treated for oligodendroglioma with PCV-based vs TMZ-based adjuvant therapy.

METHODS
87 patients treated for oligodendroglioma between 1994-2022 were retrospectively reviewed. Progression-free survival (PFS) and overall survival (OS) from initial resection were compared between PCV-based or TMZ-based treatment groups using Kaplan-Meier and multi-variable Cox survival analysis.

RESULTS
The median age at diagnosis was 41 years and 62% were male. After initial resection, 42.8% received PCV-based treatment and 57.2% received TMZ-based treatment. Treatment groups were balanced in the following variables: age, tumor genetic profiling, extent of resection, and KPS score. However, more patients in the TMZ-based group received concurrent radiation. The entire cohort had a 6.3-year PFS and 21.0-year OS. The median time to recurrence was significantly longer in those treated with PCV (12 years) compared to those treated with TMZ (4.7 years). PFS [HR = 0.46, p = 0.04] and OS [HR = 0.26, p = 0.04] were significantly longer in those receiving PCV-based treatment compared to TMZ-based treatment (Fig. 1). After adjusting for aforementioned variables, Cox regression analysis revealed no difference in OS between PCV- and TMZ-based treatment. The overall adverse effect rate did not significantly differ between PCV-based and TMZ-based treatment (25% vs. 28.1%, p &gt; 0.99).

CONCLUSIONS
PCV treatment confers longer progression-free survival than TMZ treatment for oligodendroglioma patients, noting that most patients in our series received concurrent radiation with TMZ, and those receiving PCV not having received upfront radiation. Pending clinical trial results, our findings suggest PCV-based therapy warrants consideration as the preferred therapeutic option for oligodendroglioma patients.
NCMP-17. IMPROVEMENT IN CRANIAL NEUROPATHIES FOLLOWING STEREOTACTIC RADIOTHERAPY ALONE FOR SKULL BASE MENINGIOMAS
Authors: Hafazalla Karim , Lan Matthews , Piper Keenan , Carey Preston , Khanna Omaditya , Andrews David , Evans James , Judy Kevin , Farrell Christopher 
Published: November 2023

Abstract
Cranial neuropathies are a common presenting symptom in skull base meningiomas. Many of these tumors are not amenable to surgical resection; for these patients, stereotactic radiotherapy (SRT) is a viable option. Our study sought to investigate the efficacy of SRT for improving cranial neuropathies and identify predictors that portend favorable response. A single-institution retrospective analysis was performed for patients with skull base meningiomas causing cranial neuropathies who received SRT as sole treatment from 2001 to 2021. Clinical variables were collected and analyzed for predictors of improvement. Subgroup analysis for each type of cranial neuropathy was also performed. Overall 101 patients were included, of which 51 (50.4%) had an improvement in cranial neuropathy following SRT. There was no difference in gender or age between patients with and without improvement. The most common tumor location was cerebellopontine angle (n=38), followed by cavernous sinus (n=27) and optic canal (n=25). Cranial nerve II was most frequently affected (n=34), followed by VI (n=28) and V (n=27). There was no significant difference in tumor volume, radiation dose, location, or specific cranial nerve affected between patients with and without improvement. Median time to improvement was 8 months (IQR 3-15). In subgroup analysis, patients with optic neuropathy who experienced improvement after SRT were significantly younger (50.7 vs. 60.1 years, p=0.03), while patients with trigeminal neuropathy who experienced improvement were significantly older (69.6 vs. 58.7 years, p=0.03). For patients with extraocular movement neuropathies or vestibulocochlear dysfunction, there were no significant factors associated with improvement. Half of patients with cranial neuropathy from skull base meningiomas experience symptomatic improvement following sole SRT. Age may play a role in predicting improvement, with younger patients more likely to have improved vision and older patients more likely to experience improvement in trigeminal neuropathy.
NCMP-24. RECURRENT BOUTS OF SCURVY DURING GLIOBLASTOMA REMISSION
Authors: Bonm Alipi , Katherine Hicks , Graber Jerome 
Published: November 2023

Abstract
Various nutritional deficiencies are more common in patients with cancer, including thiamine, iron and vitamin B12 deficiences, and can be associated with metabolic stress, treatments given and reduced nutritional intake or absorption. Vitamin C deficiency and scurvy have also been reported as a rare complication in cancer patients, but are not frequently seen in the developed countries. We report a 29 year old woman who underwent partial resection of a bifrontal isocitrate dehydrogenase, methylated glioblastoma followed by radiation and temozolomide four years prior. Her tumor remained stable since that time, but she had ongoing decreased appetite and sensitivity to food smells and tastes, which restricted her diet substantially. She had mild chronic anemia and was underweight, but had remained stable. She presented to us with acutely worsening fatigue, lower limb edema and a new rash that was superficially petechial in appearance. She had gingival hyperplasia and friability, and a jaundiced appearance. No deep venous thrombosis was found and liver tests were normal, giving a picture of scurvy. Her serum vitamin C level was undetectable, B12 was 75, folate 3.4, hemoglobin 6.1, albumin 3.2 and vitamin D 11.5. She was given intravenous and oral ascorbic acid as well as other supplementation and had immediate resolution of limb swelling and greatly improved appetite and energy. One year later, with glioblastoma still stable off treatment, she had recurrent worsening fatigue, appetite and gingivitis, and typical petechia-like rash appeared within minutes of IV placement for MRI contrast in the associated vein. She declined repeat serum testing but symptoms resolved on resuming high dose oral vitamin supplementation. Vitamin C has been studied as a supplement in glioblastomas, but also shown to reduce etoposide toxicity. Vitamin C and other nutritional deficiencies may be more common in brain tumor patients, but under-diagnosed.
NCOG-06. BEVACIZUMAB ALONE VERSUS BEVACIZUMAB PLUS IRINOTECAN IN PATIENTS WITH RECURRENT GLIOBLASTOMA: A NATIONWIDE POPULATION-BASED STUDY
Authors: Lee Yeonhu , Roh Tae Hoon , Kim Se-Hyuk 
Published: November 2023

Abstract

INTRODUCTION
There is no established treatment for recurrent glioblastoma. For the treatment of recurrent glioblastoma, the antiangiogenic antibody, bevacizumab, is used either alone or in combination with Irinotecan. This study aimed to compare the survival of patients receiving bevacizumab monotherapy (BEV) and those receiving bevacizumab plus irinotecan combination therapy (B+I) in recurrent glioblastoma (GBM), using a nationwide population-based dataset.

METHODS
Patients matching the ICD code C71.x were screened from the national database. From January 2008 to November 2021, 846 patients who had undergone surgery or biopsy and received concurrent chemoradiotherapy with Temozolomide were included. Of these, 450 received BEV, while 396 received B+I. The patients' demographic characteristics, inpatient stay duration, prescription frequency, and survival outcomes were compared between the two groups.

RESULTS
The median overall survival from initial surgery was 22.60 months (9% CI: 20.50 – 24.21) and 20.44 months (95% CI: 18.55 – 22.60) in the BEV and B+I groups, respectively (p=0.5079, log rank test). The BEV group was older and had a higher percentage of females compared to the B+I group. Younger age, female gender, and having surgery rather than biopsy were associated with better prognosis.

CONCLUSION
This study found no significant difference in overall survival between bevacizumab alone versus bevacizumab plus irinotecan combination therapy in patients with recurrent GBM. Considering the additional potential toxicity associated with irinotecan, bevacizumab monotherapy may be a suitable treatment option.
NCOG-07. HUB-RELATED GRAPH METRICS AS MARKER FOR COGNITIVE OUTCOMES IN ADULT GLIOMA SURVIVORS AFTER MULTIMODAL THERAPY
Authors: De Roeck Laurien , Blommaert Jeroen , Sunaert Stefan , Dupont Patrick , Clement Paul , De Vleeschouwer Steven , Sleurs Charlotte , Lambrecht Maarten 
Published: November 2023

Abstract

BACKGROUND
Although cognitive impairment is a prevalent long-term side effect in glioma survivors, predictive imaging-based markers remain inconsistent to date. Structural brain network topology could be altered by both the tumor and its’ treatment through reorganization of hubs (i.e. highly interconnected nodes). Here, we explored the role of nodal hub-related graph metrics in cognitive functioning.

METHODS
48 WHO grade 2-3 adult glioma survivors ( &gt; 1y post-therapy) and 42 matched controls, underwent a cognitive assessment. Cognitive scores were transformed into w-scores, corrected for age and education. Weighted nodal graph metrics were calculated based on diffusion weighted imaging. Hubs were calculated based on 4 nodal metrics. Significant differences in nodal graph metrics between patients and controls, and hubs versus non-hubs were tested in a repeated measures ANOVA, using Bonferroni correction for multiple testing. Significant group differences in nodal graph metrics were correlated to cognitive scores per domain.

RESULTS
In controls, 12/78 nodes were defined as hubs. In survivors, the left superior-parietal region and left putamen had a significantly lower likelihood of being a hub (p&lt; .001). These areas showed assortativity to be positively correlated with attention, language and executive function (r(90) &gt; .51,p&lt; .001) and characteristic path length to be negatively correlated with all cognitive domains (r(90) &gt; .51, p&lt; .001). Nodal metrics of clustering coefficient, characteristic path length, local efficiency and assortativity were significantly different between groups in both hub and non-hub regions (p&lt; .001). Except for betweenness centrality, all nodal metrics strongly correlated with cognitive outcomes, occurring more often in hubs (33-50%) than intermediate hubs (10-33%) or non-hubs (4-12%).

CONCLUSION
Reorganization of hubs is frequently observed in this cohort of glioma survivors. Hub connectivity seems to be important in cognitive functioning, more than for non-hub regions. Therefore, structural nodal hub-related graph metrics might be important in predicting cognitive outcomes.
NCOG-20. WEARABLE DEVICE DATA QUANTIFY DISEASE PROGRESSION IN HIGH GRADE GLIOMA AND MAY PROVIDE NOVEL OUTCOME MEASURES
Authors: Dadhania Seema , Williams Matthew 
Published: November 2023

Abstract

BACKGROUND
Functional status is a prognostic measure of survival in high grade glioma (HGG). Real-time monitoring between clinical encounters can extend the reach of care and provide actionable insights to drive more personalized and proactive care. We present data from the completed BrainWear Study, a highly novel study evaluating if data captured via a wrist-worn wearable device in patients with HGG can be used to explain, influence and/or predict cancer-related outcomes. Materials and

METHODS
All participants agreed to wear a wrist-worn Axivity AX3 triaxial accelerometer changed at 14-day intervals. Raw accelerometer data was processed using the UKBiobank Accelerometer analysis package v6.2.3 for Python and inclusion of high-quality wear time selected as ≥72 hours of data over 7-days. We analysed variation in activity by patient demographics and MRI result utilising the Response Assessment in Neuro-Oncology (RANO) criteria. Patient reported outcomes (PROs) were completed at planned study timepoints. Wilcoxin-signed rank test was used to compare participant activity at timepoints of stable or progressive disease (PD). Mixed-effects models were used to evaluate changes in activity.

RESULTS
12512 days of accelerometer data were recorded from 56 patients (36 male; 20 female) with a median age of 60 years. 80% of the data were characterised as high-quality. Mean acceleration(mg) and time spent walking daily(h/day) correlated positively with the global health QOL and physical functioning scores and inversely with the fatigue score from PROs. In the 6-weeks surrounding an MRI scan, patients with PD walked on average 1856 steps less per day than those with stable disease, and spent 22 minutes less walking (p=0.0403). Several wearable data daily physical activity measures demonstrated statistically significant change at the time of PD.

CONCLUSION
Remote monitoring data can complement snapshots of health gathered during clinical visits. Collection of digital data hold promise for novel HGG trial outcome measure development.
NCOG-23. ASSESSMENT OF NON-MEASURABLE DISEASE IN HIGH-GRADE GLIOMA: RANO-BASED 2D VS. 3D VOLUMETRICS
Authors: Farhat Maguy , Chen Melissa , Gule Maria , Talpur Wasif , Langshaw Holly , White Victoria , Chung Caroline 
Published: November 2023

Abstract
Non-measurable disease (NMD) in High grade glioma (HGG), defined as "longest perpendicular dimension of less than 10 mm”, is a limitation of RANO criteria that limits trial enrollment and biases trial populations to exclude patients with smaller tumors that eventually become measurable. Volumetric (3D) measurements may improve sensitivity and precision for measuring HGG of all sizes, however there is limited data comparing volumetric to 2D RANO measurements. AIMS: To investigate the correlation between RANO-based bidimensional 2D and 3D volumetric measurements in the postoperative setting of patients with HGG, including patients with NMD. METHODS: Contrast-enhanced (CE) postoperative and radiotherapy planning MRIs were utilized for 2D RANO measurements by neuroradiologists and volumetric (3D) measurements extracted from segmentations of CE disease. Pearson’s correlation between the 2D and 3D measurements were evaluated at each time point. The percentage of NMD based on RANO criteria and the range of tumor volumes for the NMD cases were reported. RESULTS: For 59 patients, there was lower concordance in the 2D and 3D measures at the postoperative MRI time point (Pearson =0.46) compared to the treatment planning MRI time point (Pearson=0.81). Interestingly, the postoperative time point had a higher percentage of NMD of 38% with the mean tumor volume of 13 cm3 (range: 0-21 cm3) compared to the treatment planning MRI with percentage NMD of 8% and mean tumor volume of 9 cm3 (range: 6-13cm3). CONCLUSION: In this study, higher rate of agreement was observed between RANO-based 2D and 3D volumetric tumor measurements at the time point of MR simulation when there was lower rate of NMD, suggesting NMD may contribute to the discrepancy between 2D and 3D measurements. Volumetric measurement tools may be a superior approach to improve the assessment especially of NMD in the postoperative period, improving trial enrollment for these patients.
NCOG-30. ENVIRONMENTAL ENRICHMENT AND HEALTH OUTCOMES AFTER RADIATION
Authors: Figuracion Karl Cristie , McGranahan Tresa , Lewis Frances , Donald Christine Mac , Hunt David , Rockhill Jason , Halasz Lia , Goldberg Myron , Thompson Hilaire 
Published: November 2023

Abstract
Individuals treated with brain radiation (RT) are at a disproportionately increased risk of accelerated aging and symptom burden. The aim of this abstract is to describe the health outcomes experienced by brain tumor (BT) survivors who received Photon (XRT) and Proton-Beam (PBRT) in relation to levels of environmental enrichment (EE). The study employed a cross-sectional cohort design among persons with glioma (WHO Grade 2 and 3) treated with RT approximately 5 years following diagnosis. EE consists of social network/engagement, physical activity, and employment status/financial stability measured by the Berkman-Syme Social Network Index, International Physical Activity Questionnaire, Vocational Index Scale, and two Socioeconomic Questions, respectively. EE level is classified into low, moderate, or high tertile. Montreal Cognitive Assessment measured cognitive function. Cortical atrophy is measured using temporal brain MRI images from the time of diagnosis, 3 years after, and at the time of enrollment. Images were processed using FreeSurfer. MD Anderson Symptom Inventory – BT module was used to measure functional status. Two-Way ANOVA described the health outcomes among individuals who received XRT and PBRT. Thirty-nine participants, 18 with astrocytoma and 19 with oligodendroglioma, completed the study protocol. Eighteen individuals received XRT (5 were categorized into Low EE, 10 to Moderate EE and 3 had High levels of EE) and 21 received PBRT (8 were categorized into Low EE, 7 had Moderate EE and 6 had High EE). Individuals who received XRT and had High levels of EE had higher scores in MoCA, lower cortical atrophy rate, and lower symptom burden than individuals who had Moderate and Low EE. BT survivors are at an increased risk of accelerated aging and progressive neurological decline. Providing an enriched environment may serve to reduce symptom burden, promote healthy brain aging, and improve cognitive and functional status in BT survivors receiving radiation.
NCOG-39. DOSE-EFFECT RELATIONSHIP OF DEXAMETHASONE ON OUTCOMES OF PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA
Authors: White Jessica , Webb Lauren , Neth Bryan , Sener Ugur , Mustafa Rafid 
Published: November 2023

Abstract

BACKGROUND
Dexamethasone is commonly used for symptomatic management in primary central nervous lymphoma (PCNSL). The optimal dosing scheme for dexamethasone is unknown and practice patterns widely vary among clinicians. In this study, we explored the dose-effect relationship of dexamethasone on PCNSL outcomes to better influence quality care for these patients.

METHODS
We retrospectively identified 24 Mayo Clinic patients (1/1/2018 – 12/31/2022) with pathologically confirmed PCNSL who received dexamethasone. All patients otherwise received standard oncologic care including methotrexate-based systemic chemotherapy and/or radiotherapy. The association between dexamethasone dosing regimens and clinical outcomes (performance status, clinical and radiographic response, survival) in addition to potential adverse effects were evaluated in the acute phase of presentation and at first post-treatment oncology follow up.

RESULTS
Nine patients received less frequent dexamethasone dosing (4 mg twice daily or less), while 15 received more frequent dexamethasone dosing (4 mg four times daily). Fourteen patients received dexamethasone prior to biopsy, 2 of which (1 in each cohort) had a non-diagnostic biopsy and required a second procedure 3 weeks to 3 months later to confirm PCNSL diagnosis. There were no statistically significant differences in time to diagnosis from presentation or clinical and radiographic improvement including Karnofsky Performance Status, reduction in seizures, or survival between the two cohorts. Additionally, there were no differences in the frequency of adverse events (e.g., hyperglycemia, hypertension, infection, psychosis) between the two dosing regimens.

CONCLUSIONS
These results suggest that more frequent dexamethasone dosing is not associated with better clinical outcomes in the symptomatic management of PCNSL. Twice daily or less frequent dosing can be considered without compromising patient outcomes.