bluuebunny/crossref_metadata_2025_split huggingface dataset:
10085-RT-2 TREATMENT RESULTS OF AVAGAMMA THERAPY FOR RECURRENT GLIOBLASTOMA COMBINED WITH GAMMA KNIFE AND BEVACIZUMAB
Authors: Sato Kenichi , Asanome Taku , Ishida Yuuki , Yoshihara Ryuunosuke , Sugio Hironori , Takanashi Masami , Nakamura Hirohiko 
Published: December 2023

Abstract

PURPOSE
We report the treatment results of AVAgamma therapy combining gamma knife (GK) and bevacizumab (Bev) for recurrent glioblastoma.

SUBJECTS
From August 2013 to July 2023, 64 patients with recurrent glioblastoma treated with AVAgamma therapy as salvage therapy at the time of relapse after initial treatment. The average age is 64.2 years, with 38 men and 26 women. The tumor volume is 150 ml or less, and KPS is 40% or more as the indication of AVAgamma therapy. The mean therapeutic borderline dose was 24.2 Gy. Bevacizumab was administered 10 mg / kg or 15 mg / kg 1 to 10 times after GK. [Methods]: Median progression-free survival (mPFS) and median survival (mOS) from AVAgamma treatment, and mOS and 5-year survival rate from initial treatment were compared with historical controls (GK group: 30 patients) who received only GK at the time of recurrence.

RESULTS
The mPFS from AVAgamma therapy was 6 months, PFS-6m was 39%, OS-6m was 76%, and mOS was 10 months. The mOS from initial treatment was 25 months, which was prolonged compared to 21 months in the GK group (p=0.07). The 5-year survival rate for recurrent glioblastoma was 5% in the GK group and 22% in the AVAgamma group (p=0.07). The 5-year survival rate for glioblastoma with KPS greater than 70% at recurrence was 0% in the GK group and 29% in the AVAgamma group (p=0.09).

DISCUSSION
Combined use of Bev with GK was considered to provide local control of recurrent lesions and prolong life prognosis in patients with good KPS at the time of recurrence.

CONCLUSION
AVAgamma therapy is thought to prolong the survival of recurrent glioblastoma and play an important role as salvage treatment.
10089-CO-4 DEVELOPMENT OF A PHYSICIAN SUPPORT SYSTEM FOR ANALYSIS OF GENETIC MUTATIONS IN BRAIN TUMORS AND SELECTION OF CLINICAL TRIALS USING LARGE-SCALE LANGUAGE MODELS (LLMS) WITH RETRIEVER
Authors: Takahashi Satoshi , Hana Taijyun , Koyama Tkafumi , Takasawa Ken , Kouno nobuji , Ishidu Kenichi , Hamamoto Ryuji 
Published: December 2023

Abstract
In the management of brain tumors, comprehensive genomic profiling testing is used to identify genetic mutations and understand their clinical significance to facilitate optimal therapeutic strategies. However, the test can identify non-standard mutations for brain tumor classification, and accurately presenting their clinical relevance is challenging. Providing accurate clinical trials per patient requests based on these results can also be time-consuming, creating the need for a physician support system. Large Language Models (LLMs) such as GPT, which are used for general conversation, question answering, and text generation, have limitations when used in specialized domains such as medicine. The information derived only from training data results in the inability of the LLM to handle specialized knowledge queries and verify certain facts, increasing the risk of generating incorrect information. To overcome these challenges, we developed a system that integrates a retriever with LLM. The retriever acts as an external memory, allowing LLM to access information beyond the training data. Because the retriever uses human-verified information, it mitigates the potential for incorrect information generation by LLM.In this presentation, we will discuss the use of this system in actual brain tumor diagnosis and treatment, and evaluate its accuracy and reliability. We believe that this system can help diagnose and treat patients with various genetic mutations, not limited to brain tumors.
10094-MPC-8 MOLECULAR PATHOLOGICAL ANALYSIS OF RADIATION-INDUCED GLIOBLASTOMA AFTER PEDIATRIC CEREBELLAR MEDULLOBLASTOMA TREATMENT
Authors: Ohe Naoyuki , Okubo Takafumi , Shoda Kenji , Yamada Tetsuya , Suzui Natsuko , Nakayama Noriyuki , Miyazaki Tatsuhiko 
Published: December 2023

Abstract

INTRODUCTION
The number of long-term survivors of pediatric medulloblastoma has been increasing due to improved treatment options. However, secondary cancer can be an issue for long-term survivors. We report the molecular pathological evaluation of two cases of radiation-induced glioblastoma. Patients: Of the 27 patients with cerebellar medulloblastoma treated at our institution, two who were 3 years old and 11 years old at the time of medulloblastoma diagnosis and both were girls, developed cerebellar glioblastomas after the initial treatment at five years and 11 months and 22 years and eight months, respectively. These two cerebellar glioblastomas were clinically diagnosed as radiation-induced secondary cancer.

RESULTS
Both of the two cases we clinically diagnosed as radiation-induced glioblastoma had negative IDH-1, EGFR expression and positive p53 expression in immunohistochemistry.

DISCUSSION
It has been reported that EGFR expression is negative as a molecular feature of radiation-induced glioblastoma, and the two cases we experienced were consistent with radiation-induced secondary cancers. In general, primary glioblastoma is positive for EGFR expression in the supratentorial region and negative in the infratentorial region. Therefore, in the case of supratentorial glioblastoma, it is useful to evaluate EGFR expression to distinguish primary glioblastoma from secondary glioblastoma.
10103-GMC-7 RETROSPECTIVE ANALYSIS ABOUT BEVACIZUMAB THERAPY FOR 10 YEARS AFTER AUTHORIZATION FOR MALIGNANT GLIOMAS IN OUR DEPARTMENT
Authors: Hashiba Tetsuo , Ueda Saori , Iwamura Haruka , Ueno Katsuya , Yamamura Natsumi , Miyata Mayuko , Lee Ichi , Kamei Takamasa , Yoshimura Kunikazu , Tenjin Hiroshi , Nonaka Masahiro , Asai Akio 
Published: December 2023

Abstract
In the treatment of malignant gliomas, drug therapy options are limited, and the Stupp regimen is still the standard treatment, In 2013, bevacizumab (BEV) was approved and became an option. Although BEV is not considered to prolong survival, it is currently used in many cases. We conducted a retrospective review of the use of BEV in our department 10 years after its approval. Of the 83 cases treated at our department, 70 were treated from the initial treatment to death or transfer to BSC. 70 cases consisted of 39 males and 31 females with a mean age of 63 years. Pathology was obtained in 69, and the diagnosis was made according to the WHO classification at each treated time. In the 21 cases where BEV was initially used, biopsy was performed in 13 cases and partial excision in 3 cases, indicating that BEV tended to be used from the time of initial presentation if there was residual disease. Of the 38 cases used at recurrence, 29 were treated with BEV alone, 8 with surgery followed by BEV for residual disease, and 6 of the 70 cases were still being followed. Of the remaining 64 patients, 55 died and 9 were transferred to BSC. The average number of times was 9.6 times, and the reasons for termination were invalidity in 45 cases, side effects in 10 cases, BSC transfer in 6 cases, patient request in 2 cases, and unknown in 1 case. In the 55 patients who died, the average overall survival was 21.4 months, the average survival time from the start of BEV to death was 8.9 months, and the average survival time from the end of BEV to death was 3.3 months. Based on 10 years of experience, it is necessary to find more efficient ways to use BEV.
10109-COT-13 LONG-TERM FOLLOW-UP OF FLAIR HIGH LESION IN THE BRAIN
Authors: Fujita Shohei , ohno Makoto , takahashi Masamichi , Yanagisawa Shunsuke , osawa sho , tsuchiya Takahiro , narita yoshitaka 
Published: December 2023

Abstract

AIM
Incidental FLAIR (Fluid Attenuated Inversion Recovery) high-intensity lesion in the brain can be considered as IDH-mutant low-grade glioma (LGG). Differential diagnosis includes trauma, ischemic changes, demyelinating diseases, and other inflammatory diseases. The biopsy is sometimes high risk for a young patient or an asymptomatic patient with a lesion in the brain stem, motor or language area. Imaging intervals vary among hospitals and the method for regular follow-up for these cases has not been established.

METHODS
We have studied 26 patients with FLAIR high lesion from 2012 to 2022. In cases of suspected LGG, the biopsy was performed, when necessary, after consultation with the patient and family. Our neurosurgery team protocol was to perform PET-MRI at the first consultation, and if there was negative, we have scheduled MRI examination at the next visit in one month. Then, MRI was performed every 2-3 months for the first year and every 3-6 months thereafter. The clinical features of these FLAIR high lesion and their differentiations from LGG in our cases are examined.

RESULTS
Biopsy was performed in 5 cases, but no tumor was found. The male-to-female ratio was 7:19, which was more common in female. The median age at onset was 44 years (15-47 years), showing a bimodal distribution with peaks in younger and older individuals. Among 26 cases, 14 cases had been unchanged for more than 5 years. The median maximum lesion diameter was 17 mm (8-47 mm). An annual average increase of LGG has been reported to be 3-5 mm in (Pallud, 2010). There were no cases diagnosed as glioma in cases where no expansion was seen after 5 years or more.

CONCLUSION
In this study, the possibility of glioma was considered to be low for cases in which no expansion on MRI was seen after 5 years or more.
10121-BT-8 CLINICOPATHOLOGICAL ANALYSIS OF CENTRAL NERVOUS SYSTEM GERM CELL TUMORS -387CASES IN THE JCCG COHORT AND THE IGCT CONSORTIUM COHORT
Authors: Yoshimoto Shoko , Takami Hirokazu , Kimura Yui , Hibiya Yuko , Nakano Yoshiko , Matsushita Yuuko , Yakayanagi Shunsaku , Tanaka Shota , Saito Nobuhito , Hirato Junko , Yoshioka Takako , Kato Miho , Takimoto Tetsuya , Nakazato Yoichi , Suzuki Tomonari , Mukasa Akitake , Kazuhiko Sugiyama , Kanamori Masayuki , Nakada Mitsutoshi , Maehara Taketoshi , Nishikawa Ryo , Ichimura Koichi 
Published: December 2023

Abstract

BACKGROUND
Central nervous system germ cell tumors (CNS GCTs) are rare primary tumors that tend to occur in East Asian boys. In Japan, the Japan Children's Cancer Group (JCCG) and the CNS GCT Genome Analysis Consortium (iGCT Consortium) have been accumulating clinical and pathological data on CNS-GCT cases.

METHODS
Statistical analyses were performed on 178 cases in the JCCG's Solid Tumor Observational Study (2016-2022) and 209 cases in the iGCT Consortium (2011-2021) for age, gender, site of origin, and pathological diagnosis.

RESULTS
There were 306 primary cases and 44 recurrent cases, 296 (77%) males and 90 (23%) females, with a median age of 13 years, 11 years for JCCG and 16 years for iGCT Consortium, with differences between these two cohorts. The most common pathological diagnosis was germinoma in 200 cases (52%). Non-germinomatous germ cell tumors (NGGCTs) in 167 cases (43%), of which 69 cases (18%) were mixed GCT with germinoma, 34 cases were immature teratoma, mature teratoma in 32 cases (8%), yolk sac tumor in 20 cases (5%), mixed GCT without germinoma in 5 cases (1%), choriocarcinoma in 5 cases (1%), embryonal carcinoma in 2 cases (0.5%). The median age of patients with germinoma was 15 years, while with other histological types was 12 years. The pineal gland was the most common site (208 cases, 56%) and 114 cases (31%) occurred in the neurohypophysis. 38 cases of them were bifocal. Tumor development in the basal ganglia occurred in 40 cases (11%), and multiple lesions were seen in 37 cases (10%). In the neurohypophysis, the male-to-female ratio was 1:1, while in the pineal region was 11:1. In the neurohypophysis, 67% had germinoma and 9% had teratoma, whereas, in the pineal regions, 50% had germinoma and 19% had teratoma.

CONCLUSIONS
CNS GCT is closely correlated with age, sex, site of origin, and histology.
10127-COT-15 REGIONAL MEDICAL DISPARITIES AND RESPONSES TO THE INCREASING COMPLEXITY OF GLIOBLASTOMA TREATMENT
Authors: Momii Yasutomo , Hata Nobuhiro , Fujiki Minoru 
Published: December 2023

Abstract
Glioblastoma remains a poor prognosis, but with the approval of bevacizumab (BEV) and the alternating tumor treating fields therapy (TTF), combined treatment can now be expected to expand patients' ADL and extend prognosis. However, the shortening of the intervals between patient visits and the unipolarization of treatment are worryingly increasing the unevenness of treatment opportunities, depending on the social circumstances of the patients. In rural areas in particular, it is possible that the disparity in medical care by place of residence is becoming more serious, as transportation conditions make it more difficult for patients to receive regular medical examinations. In this study, we analyzed differences in treatment and prognosis by patient's area of residence, and examined the effects of unipolarization of multidisciplinary medical care in rural areas. Based on the results, we examined what measures should be taken to correct regional disparities. Method: Of 129 consecutive glioblastoma patients initially treated at the hospital between 2010 and 2021, 75 patients who continued treatment after recurrence were included in the study, and were divided into two groups according to their place of residence: a group in the neighborhood of the hospital (59 patients) and a remote group (16 patients). The relationship between overall survival, duration of maintenance therapy visits, and BEV use was also examined. Result: Although no significant differences were found, there was an increase of about 3 months in both median survival and duration of maintenance therapy visits in the neighboring areas. Conclusion: Compared to patients living in the proximity of our facility, patients living in remote areas tended to have shorter maintenance therapy visits and poorer survival. We must strive to be close to such patients and provide them with the best possible quality and appropriate medical care.
10150-GGE-16 INTRAOPERATIVE INTEGRATED DIAGNOSTIC SYSTEM FOR MALIGNANT CENTRAL NERVOUS SYSTEM TUMORS
Authors: Hayashi Takahiro , Ooshima Akito , Honma Hirokuni , Sugino Kyoka , Uchiyama Kaho , Kato Miyui , Takayama Yutaro , Sonoda Masaki , Iwashita Hiromitsi , Yamanaka Shoji , Fujii Masashi , Yamamoto Tetsuya , Tateishi Kensuke 
Published: December 2023

Abstract

INTRODUCTION
As the most of adult malignant brain tumors are gliomas and primary central nervous system lymphomas (PCNSL)., differentiating between PCNSL and glioma during surgery is crucial for determining the treatment strategy. Also, the WHO CNS5 criteria indicates common genetic alterations according to tumor types. Thus, intraoperatively identifying these genomic abnormalities could aid diagnosis, which may contribute in more personalized therapeutic approaches. Here, we report an intraoperative integrated diagnostic system (i-ID system) that combines frozen section (FS) diagnosis with quantitative PCR (qPCR) based genotyping.

MATERIAL & METHODS
Rapid histopathological diagnosis by FS was performed for all cases. For cases requiring differentiation from PCNSL, rapid immunohistochemical staining (R-IHC) for CD20 and GFAP was performed. qPCR genotyping was used for the rapid evaluation of IDH1R132H, IDH2R172K, TERTC228T, C250T, BRAFV600E, H3F3AK27M, MYD88L265P, and CDKN2A copy number alteration. The diagnostic accuracy for adult diffuse glioma and PCNSL using i-ID system was examined.

RESULTS
i-ID system was required 100 min to obtain complete information. After retrospectively analyzing of 151 cases for setting diagnostic algorithm, 101 cases were prospectively assessed for diagnostic potential. The matched ratios for IDH1/2, TERT, BRAF, H3F3A, and CDKN2A evaluations using qPCR were 100%, 98.8%, 100%, 100%, and 93.9%, respectively. In cases of glioblastoma, astrocytoma, and oligodendroglioma, the sensitivity of FS was low, with values of 0.18, 0.17, and 0.00, respectively. On the other hand by combining genotyping, the sensitivity improved up to 0.94, 1.00, and 0.88, respectively. The sensitivity for PCNSL improved from 0.47 (genotyping alone) to 0.95 with combination of R-IHC. Overall, i-ID based intraoperative diagnosis was matched to the permanent diagnosis in 80/82 (97.6%) patients with glioma and 18/19 (94.7%) PCNSL patients, respectively.

CONCLUSIONS
The i-ID system provides rapid and reliable integrated diagnosis of adult malignant CNS tumors.
10154-PEDT-6 RETROSPECTIVE STUDY OF 12 PEDIATRIC EPENDYMOMAS TREATED AT OUR HOSPITAL
Authors: Shiba Yoshiki , Yamaguchi Junya , Takido Yuhei , Shimizu Daiki , Kibe Yuji , Maeda Sachi , Nishikawa Tomohide , Ohka Fumiharu , Motomura Kazuya , Saito Ryuta 
Published: December 2023

Abstract
Ependymoma is an important disease in pediatric brain tumors, but reports with a large number of cases are scarce. In this study, we investigated the clinical course of 12 cases of ependymoma in children treated at our hospital.The median age was 2.5 years (0-15 years), and 10 had posterior fossa and 2 had supratentorial onset. Surgery was performed in all cases, and total resection was achieved in 9 cases (75%). Five cases were diagnosed as ependymoma, Grade II, and seven cases were diagnosed as anaplastic ependymoma, Grade III, according to the WHO revised 4th edition. Adjuvant therapy was administered in 8 patients, 6 with radiotherapy and 2 with combination chemotherapy and radiotherapy. Recurrence was seen in 6 cases, 4 of which were local recurrences and 2 of which were dissemination. The 2-year and 5-year progression-free survival rates were both 60%, and the 2-year and 5-year survival rates were 100% and 66.6%. Progression-free survival/overall survival analysis was performed, and the above results were considered to be equivalent to the published data of 27 cases (Peralia et al. Cell 2022). Progression-free survival tended to be favorable in patients with complete resection (HR = 0.18, 95% CI: 0.025-1.28) and patients with supratentorial disease (HR = 0.18, 95% CI: 0.030-1.11). No difference was seen by WHO grade (HR = 1.022, 95% CI: 0.20-5.24). Our cohort also yielded the same results regarding prognostic factors as previously reported, and WHO grade did not correlate with prognosis. The WHO 5th edition classification adopts molecular diagnosis and further subclassifies ependymoma. Since molecular diagnostics require advanced analytical techniques, there is a problem that it is difficult to put them into practical use, but surrogate markers that can be applied clinically have also been reported. This time, we will reclassify pediatric ependymoma using surrogate markers and compare it with the old classification.
10157-BOT-1 DISCRIMINATION OF EPENDYMOMA AND MEDULLOBLASTOMA BY RAMAN SPECTROSCOPY
Authors: Kawamoto Yuki , Okita Yoshiko , Tenma Kenta , Nakagawa Kanji , Utsugi Reina , Murakami Koki , Kuroda Hideki , Tachi Tetsuro , Hirayama Ryuichi , Kijima Noriyuki , Kagawa Naoki , Fujita Katsumasa , Kishima Haruhiko 
Published: December 2023

Abstract

Introduction
Ependymoma and medulloblastoma are difficult to diagnose by imaging and histology. Since the treatment strategies differ between the two, an accurate and prompt diagnosis is required. Raman spectroscopy can measure tissue-specific molecular vibrations. It shows extract biomolecular information characteristic of tumor tissue. We observed the tissues of ependymoma and medulloblastoma by Raman spectroscopy, and attempted to establish a new differentiation method.

Methods
The subjects were 13 patients with ependymoma and 5 patients with medulloblastoma who underwent resection from July 2017 to June 2023 at our institution. Their formalin-fixed paraffin-embedded (FFPE) section were observed by Raman spectroscopy. Raman spectra were collected using a line-illumination Raman microscopy developed at the department of Applied Physics, Osaka University. 532 nm excitation light was focused on the sample by an objective lens (Nikon 25x, NA1.1, CFI75). Excitation intensity and measurement time were 3 (mW/um2 ) and 5 seconds, respectively.

Results
We observed a Raman peak at 1240 cm-1 (Amide II3) that was significantly different in both ependymoma and medulloblastoma, and a similar tendency was observed for each specimen. It can suggest differences in amino acids, proteins, and lipids within tumor tissue.

Discussion and conclusion
We investigated whether it is possible to make a differential diagnosis between ependymoma and medulloblastoma using Raman spectroscopy. It was suggested that we can detect the molecular difference between the two using FFPE sections. Raman spectroscopy is a label-free measurement technique that does not require staining of biological samples, allowing simple and rapid evaluation. In the future, we plan to verify the validity of the differential method using specimens collected during surgery and frozen specimens.
10162-STMO-8 A SINGLE CENTER RETROSPECTIVE ANALYSIS OF AWAKE CRANIOTOMY FOR BRAIN METASTASIS.
Authors: Yanagisawa Shunsuke , Ono Makoto , Takahashi Masamichi , Osawa Sho , Tuchiya Takahiro , Fujita Syohei , Miyakita Yasuji , Narita Yoshitaka 
Published: December 2023

Abstract

BACKGROUND/AIM
Awake surgery is often used for resecting glioma, but it is controversial whether it should be performed for brain metastasis, because brain tumor is rather demarcated than glioma. However, a small number of hospitals can perform awake craniotomy by limitation of hospital capacity. Here we show a single center retrospective analysis of awake craniotomy for brain metastasis to examine the safety and efficacy of awake craniotomy.

MATERIAL/METHOD
We analyzed consecutive 50 cases from January 2016 to May 2023 in our hospital. Rehabilitation staff evaluated their neurological status within a week before and after surgery.

RESULT
Patients characteristics were as follow. Median age was 62 (16-81). Left side tumor were 43 (86.0%). Frontal lobe was 36 (72.0%),temporal lobe 8 (16.0%), parietal lobe 5 (10.0%), occipital lobe 1 (2.0%). Primary cancer was lung 26 (52.0%), gastrointestinal lesion 7 (14.0%), breast 6 (12.0%), soft tissues 4 (8.0%), uterus 1 and malignant melanoma 1, respectively. Radiation necrosis after stereotactic radiosurgery for brain metastases was 5 (10.0%). Preoperative KPS 100-90 was 25 (50.0%), KPS 80 was 10 (20.0%) and less than or equal to KPS 70 was 15 (30.0%). Gross total removal was 43, partial removal was 7. MMSE of before and after surgery was mean 27.1 and median 29. Median OS was 18.8 months (95%CI: 11.2-526).

DISCUSSION/CONCLUSION
We selected most awake craniotomy for a tumor on left frontal lobe and each evaluationg scales showed no deterioration. Awake craniotomy for brain metastasis is probed to be performed without deteriorating patient's neurological function.