bluuebunny/crossref_metadata_2025_split huggingface dataset:
QOL-03. PATIENT-PARTNER RELATIONSHIPS AND QUALITY OF LIFE IN BRAIN TUMOR PATIENT
Authors: Boccia Maria , Fonkem Ekokobe , Frye Nick , Murillo Jennifer , Anyanda Elizabeth , Tamimi Adam , Bradshaw Eva 
Published: November 2023

Abstract
As cancer treatment has advanced, quality of life (QoL) has become a significant consideration in patient and survivor care. The 2005 Institute of Medicine Cancer Survivorship Care Planning guide requires the inclusion of information on the possible effects of cancer on relationship satisfaction and sexual functioning associated with QoL. Guided by the cognitive-transactional model of chronic illness, this study explored the extent to which relationship satisfaction and sexual dysfunction was associated with QoL. Thirty patients and their partners were recruited from a neuro-oncology practice and given a QoL questionnaire (FACT-Br) and measures of relationship satisfaction (Couple Satisfaction Index) and sexual functioning. Women were given the Female Sexual Function Index (FSFI). Men were given scales to assess premature ejaculation (PE), and erectile dysfunction (ED). In addition, information about site and type of tumor and treatment (surgery, radiation, chemotherapy) was collected. Descriptive statistics as well as T-tests and regression models were used to analyze the data. Relationship satisfaction varied across participants and was significantly related to QoL for patients. There was significant sexual dysfunction as was previously reported by our team. QoL and relationship satisfaction were correlated with sexual dysfunction. Our capacity to address the relationships of patients is dependent on our understanding the types of difficulties encountered. Specifically, partners are often also engaged in the role of primary caregiver, understanding these relationships and how to ensure their health can be critical for QoL and outcomes for brain tumor patients.
QOL-04. CHANGES IN FUNCTIONAL CONNECTIVITY AFTER SURGERY ARE ASSOCIATED WITH DECLINE IN FUNCTIONAL INDEPENDENCE IN PATIENTS WITH ELOQUENT GLIOMA
Authors: Noll Kyle , Bradshaw Mariana , Chen Henry , Wefel Jeffrey , Sullaway Catherine , Thomas Ashley , Kumar Vinodh , Prabhu Sujit , Liu Ho-Ling 
Published: November 2023

Abstract
It is unknown whether patient independence following resection of eloquent glioma is associated with postoperative functional connectomic changes. Fifteen patients with left perisylvian glioma underwent resting-state fMRI and neuropsychological evaluation before and about 1 month after resection. Functional independence was measured with the Physical Self-Maintenance Scale (PSMS) and the Instrumental Activities of Daily Living scale (IADL). Manual dexterity testing (Grooved Pegboard; N = 13), neurologic motor exam (N = 12), and performance status (KPS; N = 14) were also obtained. Graph theoretical analysis was used to calculate functional brain network properties. Postoperative need for assistance in at least 1 activity on the IADL increased from baseline in 80% of patients, most commonly in Transportation (67%), followed by Shopping (60%), Financial Management (47%), Cooking (47%), Medication Management (33%), and Phone Use (33%). Overall need for assistance (Total IADL score) significantly increased postoperatively (Mdn change = 4, p = .006). Need for assistance on the PSMS only increased in 27% of patients, with rates less than 15% across all functions. Total PSMS scores did not differ pre- and postoperatively (Mdn change = 0). KPS scores worsened in 40% of patients. None had gross motor worsening, though fine manual dexterity declined in 7% for the left and 23% for the right hand. Increased connectomic properties were significantly associated (Spearman ρ) with greater need for assistance on the IADL [Local Efficiency: Total (.72), Shopping (.71), Cooking (.64), Financial Management (.64); Clustering Coefficient: Phone Use (.63); Betweenness Centrality: Phone Use (.63); all p &lt; .01]. PSMS and IADL ratings were not associated with KPS, manual dexterity, pre/postoperative FLAIR volume, or extent of resection. This study demonstrated that increases in certain functional connectomic properties after surgery are associated with greater need for assistance in instrumental activities in the postoperative period. Connectivity increases have also been associated with poorer cognitive outcome in this population, though specific properties involved may differ.
QOL-05. EXPLORATORY ANALYSIS OF COGNITIVE BEHAVIORAL THERAPY FOR INSOMNIA (CBT-I) AMONG PATIENTS WITH PRIMARY BRAIN TUMOR: EFFECTS ON DEPRESSION, ANXIETY, AND LIFE QUALITY
Authors: Lanoye Autumn , Fox Amber , Willis Kelcie , Zukas Alicia M , Loughan Ashlee 
Published: November 2023

Abstract

BACKGROUND
Sleep disturbance is among the most common complaints endorsed by patients with a brain tumor diagnosis, yet the delivery of behavioral insomnia treatment is not standard practice in neuro-oncology. Our pilot trial of a 6-session group-based telehealth CBT-I program among primary brain tumor patients demonstrated clinically significant improvements in self-reported insomnia, fatigue, and sleep quality. In other cancer patient samples, CBT-I is also associated with improvements in psychosocial outcomes beyond sleep; thus, the aim of this exploratory analysis was to examine change in depression, anxiety, and life quality among primary brain tumor patients enrolled in CBT-I.

METHODS
This was a single-arm ORBIT Model Phase IIa proof-of-concept trial. N = 40 cognitively-intact participants (Mage = 52.4 + 12 years; 50.0% female) with a primary brain tumor and insomnia enrolled in a 6-week group-based telehealth CBT-I intervention with weekly 90-minute sessions led by graduate students in clinical psychology. Questionnaires (PHQ-9, GAD-7, EORTC-QLQ-30) were completed at baseline and 6 weeks. Within-person clinically significant improvement was calculated for intervention completers (n = 34) based on established cutoffs.

RESULTS
Approximately one-third of participants experienced clinically significant improvements in symptoms of depression (n = 12, 35.3%) and generalized anxiety (n = 11, 32.3%) following CBT-I, with 0 participants experiencing a clinically significant worsening of symptoms. Thirty-two of thirty-four participants (94.1%) reported clinically significant improvement in at least 1 domain of life quality spanning physical, role, emotional, and/or social functioning.

CONCLUSIONS
Findings suggest that a brief behavioral intervention for insomnia, CBT-I, may improve depression, anxiety, and life quality in addition to sleep among primary brain tumor patients.

RESULTS
from this proof-of-concept trial suggest proceeding to a test of CBT-I in comparison to a control group in order to bolster internal validity. In addition, future studies will examine sleep and related psychosocial outcomes over a longer follow-up period to assess maintenance of intervention effects.
QOL-13. MEASURING FEAR OF CANCER RECURRENCE IN PATIENTS WITH PRIMARY BRAIN TUMORS
Authors: Braun Sarah , Mladen Samantha , Langbein Jenna , Verter Jacob , Lanoye Autumn , Loughan Ashlee , Simard Sébastien 
Published: November 2023

Abstract

BACKGROUND
Fear of cancer recurrence (FCR) differs for those living with primary brain tumor compared to other cancers due to poorer prognosis, neurologic symptoms, and often lifelong treatment. The gold-standard instrument used to assess FCR–the FCR Inventory (FCRI)–has not been validated in patients with PBT. The present study explored the psychometric properties of the FCRI in patients with brain tumors, with items added assessing brain tumor-specific distress.

METHODS
Adult patients with brain tumors (n = 87) completed the FCRI and other psychological medical, and demographic questionnaires. Exploratory factor analysis (EFA) was conducted on the FCRI with five additional items informed by neuro-oncology patients and professionals assessing brain tumor-specific hypervigilance (e.g., interpreting headache or cognitive difficulties as possible tumor growth) and one item assessing tendency to research treatments—for a total of 48 items. Correlations investigated convergent/discriminant validity and relationships with relevant medical and demographic variables.

RESULTS
After iteration, EFA revealed a seven-factor model with 24 retained items, accounting for 68.19% of variance, with factor correlations between .12 and .65. The seven-factor model echoed but did not fully replicate the original FCRI. FCRI-Brain factors were: Triggers, Psychological Distress, Functional Impairments, Insight, Reassurance, Emotion-Focused Coping, and Problem-Focused Coping (Total: Cronbach’s a = .92). The resultant FCRI-Brain demonstrated good convergent validity with measures of depression (r = .57), anxiety (r = .71), and death anxiety (r = .81; ps&lt; .05). Lack of correlation with education (p &gt; .05) supported discriminant validity. There was no relationship with time since diagnosis (p &gt; .05).

CONCLUSIONS
These data represent the initial validation of an FCR measure in patients with brain tumors. Factor analysis identified a theoretically similar; yet unique seven-factor model for the FCRI-Brain. Item-level exploration will be presented, including further discussion of factor iteration and construction. Future work will build on this data in larger samples and inform intervention development.
QOL-14. INTEGRATING A TECHNOLOGY-ENABLED PLATFORM FOR PATIENT REPORTED OUTCOMES INTO A NEURO-ONCOLOGY PRACTICE
Authors: Mahotz Mariah , Nguyen Minhdan , George Renee , Swisher Christine , Weinreb Jason , Tang Yiqing , Mauritson Emmaline , Wagle Naveed , Carrillo Jose , Martin Neil , Kesari Santosh , Sharma Akanksha 
Published: November 2023

Abstract

BACKGROUND
Neuro-oncology (NOC) patients experience various symptoms from disease and treatment which are deleterious to function and quality of life (QOL). Evidence demonstrates the use of electronic patient-reported outcomes (ePROs) improves health-related QOL, mental functioning, patient-provider communication, and overall survival. Despite this knowledge, uptake across cancer services has been slow. In this pilot study, we sought to understand the utility of an electronic symptom monitoring platform (ESMP) in this population.

METHODS
We implemented an ESMP at a NOC practice and conducted a preliminary analysis of ePROs over 7-month period. Patients were prompted to report their symptoms at least 3 times/week through multiple-choice questions targeting 19 distinct symptoms and their severity (tiered 1-4). The care team was automatically notified through the electronic medical record predefined symptom severities.

RESULTS
During a 7-month period, 28 neuro-oncology patients were enrolled and monitored for a total of 660.7 patient-weeks or an average of 23.6 weeks per patient. In total, 314 questionnaires were completed; each patient completed 0.6 per week on average. We found questionnaire compliance to be the highest initially, declining in subsequent weeks. Symptoms were reported in 42.8% of questionnaires; the most frequent of which were peripheral neuropathy (16.6%), fatigue (11.5%) and headache (10.5%). Alerts were sent to the care team for 103 (32.8%) questionnaires, 38 resulted in additional interventions for the patient.

CONCLUSION
Our results support the hypothesis that technology-enabled integration of ePROs enables monitoring followed by automated alerts and customized responses to NOC patients. We note that peak usage was at the beginning of active treatment which occurred concurrently with onboarding. Opportunities and challenges involve the continuous promotion of patient engagement and optimization of workflow to encourage discussions and utilization. Future work also includes determining if this platform can lead to improved clinician efficiency and patient outcomes in this patient population.
QOL-15. THE PIVOTAL TRIDENT STUDY OF TUMOR TREATING FIELDS (TTFIELDS) THERAPY WITH CHEMORADIATION, FOLLOWED BY MAINTENANCE TTFIELDS THERAPY/TEMOZOLOMIDE (TMZ), IN NEWLY DIAGNOSED GLIOBLASTOMA (NDGBM)
Authors: Shi Wenyin , Glas Martin , Roberge David , Kleinberg Lawrence , Jeyapalan Suriya , Goldlust Samuel , Nagpal Seema , Lustgarten Leonardo , Combs Stephanie , Nishikawa Ryo , Reardon David , Grossman Rachel 
Published: November 2023

Abstract
INTRODUCTION: TTFields are electric fields which act to disrupt processes necessary for cancer cell division and tumor progression. TTFields therapy is a noninvasive, locoregional treatment with US FDA approval for ndGBM and recurrent GBM, as well as pleural mesothelioma. TTFields therapy concomitant with maintenance TMZ is standard of care in ndGBM after chemoradiation based on the pivotal EF-14 study (NCT00916409) reporting significant improvements in progression-free survival (PFS) and overall survival (OS) vs TMZ alone. Preclinical and pilot clinical studies subsequently demonstrated that concomitant TTFields therapy also enhanced the therapeutic effect of radiotherapy (RT). TRIAL DESIGN: TRIDENT (EF-32, NCT04471844) is a pivotal multicenter study investigating TTFields therapy (200 kHz) concomitant with RT/TMZ in adult patients with histologically confirmed ndGBM. Eligibility criteria include life expectancy (≥ 3 months) and Karnofsky performance status (≥ 70). Patients (n≈950) stratified by MGMT promoter methylation status and extent of resection are randomly assigned 1:1 to receive TTFields therapy from the first day of chemoradiation (experimental arm), or approximately 4 weeks after completion of chemoradiation (control arm). All patients will receive TTFields therapy uninterrupted for 24 months, or until second disease progression (PFS2). The primary endpoint is median OS and other endpoints include survival rates at 1 and 2 years, PFS (overall, PFS2, and rates at 6 and 12 months), overall radiological response, safety, quality of life and dependence of OS on TTFields dose. The sample size is powered for a hazard ratio of &lt; 0.8 (5% type I error). A stratified log-rank test will be used to test the hypothesis that OS is significantly improved with first line TTFields therapy/RT/TMZ vs RT/TMZ. This global study is open at sites in 11 countries.
QOL-19. TUMOR TREATING FIELDS (TTFIELDS) THERAPY IN GLIOBLASTOMA (GBM): RELATIONSHIP BETWEEN PATIENT EXPERIENCE, GLOBAL REGION, AND AGE
Authors: Shockley Shermona , Gage Gwyn P , Adams Renae , Batzianouli Eleni , Johnson Heather , Abdullah Huda Ismail 
Published: November 2023

Abstract

BACKGROUND
TTFields therapy is a noninvasive, locoregional anticancer treatment approved for newly diagnosed and recurrent GBM based on efficacy and safety results in 2 global, randomized pivotal studies, supported by real-world evidence.

METHODS
In 2022, 2 questionnaires (mail or online) surveyed the real-world experiences of patients with GBM receiving TTFields therapy (NovoTTF-200A; Novocure®, GmBH) and their caregivers in Germany, Austria, and Switzerland (DACH), and the USA.

RESULTS
545/1197 surveys were returned in DACH (46%); 1332/5031 in the USA (26%). Most respondents indicated satisfaction/high satisfaction with TTFields (in patients starting therapy, 82% [DACH] and 58% [USA]; in patients with &gt;6 months use, 67% [DACH] and 72% [USA]). The following data pertain to patients with &gt;6 months of TTFields use (n = 114 DACH; n = 375 USA). 63% in DACH reported that daily life was changed “much”/“very much”, and 35% “hardly at all”; in the USA, 17% indicated they were able to live as they did before therapy, 61% had to make adjustments but had returned to a normal routine, and 23% said therapy had markedly impacted daily life. 74% (DACH) and 73% (USA) would recommend to other patients. Common reasons for low satisfaction included skin irritation and device handling. To assess any impact of age, responses from patients aged ≥70 years ( &gt;6 months use) from the USA (n = 82 [22%]) were analyzed (there were not enough elderly patients with &gt;6 months use in DACH [n = 8] to analyze). As with the overall population, elderly patients in the USA reported they were satisfied/very satisfied (67%). 66% of elderly patients (USA) were very likely to recommend TTFields to someone else.

CONCLUSIONS
Surveys of patient/caregivers in DACH and the USA who used TTFields for GBM identified a high degree of satisfaction, including elderly patients. Most respondents would recommend TTFields to others.
QOL-22. USE OF TUMOR TREATING FIELDS THERAPY WITH ADJUVANT TEMOZOLOMIDE AND IMMUNOTHERAPY FOR NEW DIAGNOSED GLIOBLASTOMA (NDGBM)
Authors: Cheng Samantha , Hormigo Adilia 
Published: November 2023

Abstract

BACKGROUND
Treatment options for GBM remain limited, and novel approaches are required. One of them, Tumor Treating Fields (TTFields) therapy, is a non-invasive treatment modality that delivers low intensity, intermediate frequency, alternating electrical fields and increases survival through multiple mechanisms, including disrupting cell mitosis, triggering tumor cell death, and expanding CD8+ cytotoxic lymphocytes.

METHODS
In this prospective study, adult patients with ndGBM underwent standard-of-care treatment with maximal resection, followed by radiotherapy and temozolomide. Use of TTFields therapy, with a recommended daily use of ≥ 18 hours/day, throughout adjuvant temozolomide treatment and with immunotherapy, was investigated.

RESULTS
Eight patients received TTFields therapy. Use of TTFields was 2, 5, 6, 6, 8, 8, 10, and 16 months with an average of 10.2 months. The patient with the lowest use developed a grade 1 papulopustular scalp rash and discontinued use. Monthly average daily use ranged from 0% to 87%. Average daily use over treatment was 39%, 47%, 48%, 53%, 67%, 69%, 78%, and 83%. None of the patients achieved the goal for daily use every month. Four patients had a daily use ≥ 80% for at least one month of treatment. Except for one patient, whose daily use increased from 72% in the first month to 79% in the last month, all other patients down-trended in TTFields use. Six patients completed EORTC-QLQ-C30 surveys throughout the study. 3/8 had an overall increase in their global quality of life scale, 3 patients had a decrease, and 2 patients did not complete the survey.

DISCUSSION
In this study, the use of TTFields was suboptimal. We presume that with multiple treatments in the adjuvant phase including 6 cycles of temozolomide and optional TTFields use, patients did not recognize the potential therapeutic benefit of continued TTField therapy use and opted to remain only in the immunotherapy treatment.
QOL-27. EXPLORING DYADIC CHANGES IN ANXIETY AND DEPRESSION SYMPTOMS FOR PRIMARY BRAIN TUMOR PATIENTS AND THEIR FAMILY CAREGIVERS
Authors: Bacharz Kelsey , Body Anjelica , Ernster Alayna , Hanvey Grace Ann , Rahman Maryam , Mitchell Duane , Wilborn Adaixa , Pereira Deidre , Ghiaseddin Ashley 
Published: November 2023

Abstract
A primary brain tumor (PBT) diagnosis impacts not only the diagnosed person but their family caregivers. Prior research has established that the psychosocial outcomes (i.e., fear of cancer recurrence, quality of life) of individuals with a PBT and their caregivers are interrelated. Actor-partner interdependence modeling (APIM) can account for this interdependence and be used to assess for dyadic changes over time or different variables. The purpose of the present study was to assess longitudinal dyadic changes in anxiety and depressive symptoms for PBT patients and their caregivers. 38 PBT patient/caregiver dyads completed assessments of anxiety and depressive symptoms during routine oncology clinic visits. All dyads completed at least two assessments, at least 8-weeks apart utilizing the PROMIS anxiety and depression short forms. APIM analyses via mixed linear modeling revealed significant actor effects for both depression and anxiety symptoms (i.e., how the same person’s scores are related from baseline to follow-up) but non-significant partner effects (i.e., how one person’s score at the first timepoint is related to the other person’s score at the second timepoint). Specifically, a one-point increase in T-score at the first timepoint was associated with the same person having a 0.58 increase in their PROMIS depression T-score and 0.50 increase in their PROMIS anxiety T-score, respectively, at the second timepoint (p &lt; .001). There were no significant partner effects detected for depression (p = .168) or anxiety (p = .998). Despite the lack of significant relationship between patient and caregiver outcomes in these results (possibly influenced by small sample size), it is notable that, overall, there was an increase in psychological distress over time for both depression and anxiety symptoms for both patients and caregivers. Thus, future research should continue to focus on how to reduce distress and ensure that both patients and caregivers are supported throughout the disease trajectory.
RBIO-04. INHIBITING THE SHH PATHWAY AND PARP1 IN COMBINATION ENHANCES THE RADIATION SENSITIVITY OF PEDIATRIC SONIC HEDGEHOG MEDULLOBLASTOMA
Authors: Price Laura , Lau Bonnie 
Published: November 2023

Abstract
Medulloblastoma accounts for 20-25% of all pediatric brain tumors. These patients undergo craniospinal and focal radiation therapy during their treatment, resulting in negative long-term consequences such as bone and tissue hypoplasia and decreased neurocognitive functioning. One of the most concerning effects is the significantly increased risk for secondary radiation induced cancers later in life. Thus, there is a critical need for novel approaches to radiation therapy that can effectively target and kill tumor cells while minimizing long lasting toxic effects. Here, we investigate a novel approach to radiation therapy that relies on the combination of two classes of therapeutic agents, Sonic Hedgehog (SHH) inhibitors and Poly (ADP-ribose) Polymerase (PARP) inhibitors. The SHH pathway plays a key role in medulloblastoma tumorigenesis and affects the radiation sensitivity of various cancer types such as basal cell carcinoma. The PARP family, specifically PARP1, plays a key role in DNA damage repair and affects the radiation sensitivity of pediatric brain cancers such as high-grade glioma and medulloblastoma. We hypothesize that combining these approaches by inhibiting Smo and Gli1 in the SHH pathway, and PARP1 simultaneously, will enhance medulloblastoma tumor cell killing following radiation therapy. We found that in vitro treatment with Sonidegib, GANT61, and Veliparib alone and in combination with was sufficient to significantly decrease tumor cell viability and self-renewal as measured by clonogenic survival assays (p &lt; 0.01). 24 hours following these targeted treatments, 2 Gy of radiation was administered which resulted in a greater degree of decreased cell viability and self-renewal (p &lt; 0.01), as well as in increased cell death. Together, this data suggests that inhibition of Smo, Gli1, and PARP1 either alone as single agents, or in combination is a promising therapeutic strategy for increasing the radiation sensitivity of pediatric SHH medulloblastoma.