bluuebunny/crossref_metadata_2025_split huggingface dataset:
QOL-34. The relationship between Psychological Flexibility, Quality-of-Life and psychological health in young people who have experienced a brain tumour
Authors: Airdrie Jac , Geagan Chloe , Davies Nicholas , Powers Katie , Wright Ingram , Borrill Heather , Gibson Faith , Clifford Steve , Lowis Stephen , Bailey Simon , Limond Jennifer , Owen Ray , Grundy Richard , Lemon James , Hayes Louise , Malins Sam , Thomas Sophie 
Published: June 2022

Abstract
Despite increasing survival rates in young people who have experienced a brain tumour, this patient group have the poorest reported quality-of-life (QoL) of all cancer survivors. QoL is defined as an individual’s perception of their position in life in relation to their goals, expectations and standards. QoL can be influenced by physical functioning but one of its strongest predictors is psychological health. A concept that has a large impact on psychological health is Psychological Flexibility (PF). PF refers to the ability to recognise and adapt to situations, shift cognitive and behavioural repertoires which are impacting negatively on personal and social functioning and commit to behaviours that are in line with strongly held values. Studies have demonstrated a relationship between PF and QoL in other patient populations such as chronic pain and breast cancer survivors. In this study we explored the relationship between PF and QoL at baseline in a sample of young people enrolled in a randomised controlled trial of Acceptance and Commitment Therapy (ACT) for young people who have experienced a brain tumour. We found that higher PF was associated with higher QoL in both 11-15 year olds (R2 = .69, p &lt; .05) and 16 – 24 year olds (R2 = .29, p &lt; .01). We also found higher PF was associated with lower levels of mental health difficulties (R2s ≥ .24, ps &lt; .01) which was also associated with higher levels of QoL (R2 = .49 , p &lt; .01). The results suggest assessing and providing support to increase PF is important for young people who have experienced a brain tumour. It highlights that interventions found to increase PF, such as ACT, could be helpful in improving psychological health in this population.
QOL-35. School reentry of children and adolescents with a brain tumor: can we improve family-school-hospital cooperation? An analysis of supportive and inhibiting factors as a result of a pilot project
Authors: Leiss Ulrike , Krottendorfer Kerstin , Pletschko Thomas , Peyrl Andreas , Azizi Amedeo , Wekerle Karoline , Schneider Fee , Rosenmayr Verena , Sanin Lisa , Weiler-Wichtl Liesa Josephine , Kutschera Andrea 
Published: June 2022

Abstract
OBJECTIVE: School reentry support focusing on providing information to schools and communication between patient/family-hospital-school is defined as a psychosocial standard of care in pediatric oncology (Thompson et al., 2015). This is critical for students with brain tumors (BT) - although it is not yet universally implemented - especially during follow-up, as they are a risk group for late effects. Due to long distances between family-hospital-school, limited personnel capacities and since 2020 Covid-19 restrictions, an online-event (OE) for teachers from external schools was designed, with the aim of: (1) strengthening cooperation, (2) breaking down barriers and (3) increasing level of knowledge.
METHODS: 54 teachers participated in each of two OEs. Content was presented by an interdisciplinary team (clinician, clinical/neuropsychologist, social worker, teacher), followed by time for sharing experience. Two months after event 2, participants were asked to complete an evaluation in an anonymous online survey. Supportive and inhibiting factors for successful school reintegration were included in the survey and statistically analyzed.
RESULTS: 54% of 23 respondents (70% teaching &gt; 10 years) felt that their training before the event did not prepare them adequately for a teaching setting with seriously ill children (1-3 points on a 10-point Likert-scale). 92% rated their knowledge greater after the event. All interdisciplinary inputs were rated very useful and practical (79-88%: 8-10 points). 38% felt relieved to got to know contact persons. 33% rated teaching a student with BT as fundamentally challenging and felt more confident after the event.
CONCLUSION: The results of this pilot project indicate that an online-information-event can increase knowledge and cooperation. Resulting promoting and inhibiting factors for school reintegration will be incorporated into future concept improvement. The findings further highlight the great importance of ongoing support in the form of a reintegration teacher and interdisciplinary input for schools to appropriately support students with BT.
SURG-03. Durability of an Early Management Strategy Facilitating Endoscopic Removal of Recurrent Choroid Plexus Carcinoma
Authors: Guadix Sergio , Garman Tyler , Pisapia David , Souweidane Mark 
Published: June 2022

Abstract
BACKGROUND: Choroid plexus carcinoma (CPC) is a rare, primarily intraventricular neoplasm with a dismal prognosis. Extent of surgical removal is correlated with improved outcomes but is frequently limited due to tumor vascularity and size. Information related to surgical management and molecular drivers of tumor recurrence is currently limited. Here we characterize a case of multiply recurrent CPC treated solely with sequential endoscopic tumor removals over a 10-year period and highlight its genomic properties. METHODS: We performed a retrospective review of a 16-year-old female treated for CPC with local and distal recurrences undergoing repeat excision with minimally invasive neuro-endoscopy. We describe technical nuances associated with neuro-endoscopic intervention, mean hospital stay, complications, and perioperative MRI. Whole exome sequencing (WES), targeted sequencing, and methylation profiling results over time are reviewed. RESULTS: Five years after standard treatment, the patient was evaluated for a distant intraventricular recurrence. A total endoscopic resection was performed given the local, non-disseminated recurrence pattern. WES results included NF1, PER1, and GLI3 mutations as well as FGFR3 gain, and was negative for TP53 alterations. Repeat sequencing on a recurrence 4 years later showed persistent NF1 and FGFR3 alterations. Methylation profiling was consistent with “plexus tumor, subclass pediatric B”. Overall, short-term surveillance neuroimaging detected four isolated recurrences, all treated with complete endoscopic resections at 5 years, 6.5 years, 9 years, and 10 years after initial CPC diagnosis. Mean hospital stay for all recurrences was 1 day with no complications from treatment. CONCLUSION: We describe a patient with 4 isolated recurrences of CPC over a decade, each treated with complete endoscopic removal, and identify an unusual set of molecular alterations that persisted over time. These outcomes support a strategy encompassing frequent neuroimaging surveillance to facilitate a minimally invasive endoscopic surgical approach at early detection and relatively low tumor mutagenicity.
SURG-06. Management outcome (5years or more) of paediatric vertebral haemangiomas presenting with myelopathy
Authors: Singh Pankaj , Chandra Sarat , Kale Shashank 
Published: June 2022

Abstract
INTRODUCTION: Vertebral hemangiomas are very rare in pediatric age group. In this study we analysed the outcomes of patient treated at department of neurosurgery , All india institute of medical sciences New Delhi since may 2010 to January 2022 with at least 5 year follow up. MATERIALS AND METHOD: All patients up to 18 years age of vertebral haemangioma treated at our hospital from may 2010 to january 2022 with at least 5 year follow up. All had features of myelopathy.Patients demography, clinical details and follow up and complications were retrieved from hospital records. Functional clinical outcomes were measured using ASIA score. Mean age was 14.21 years with range of 12 years to 18 years. All patients had magnetic resonance imaging and computed tomography of spine in preoperative and postoperative period. Mean follow up was 78 months with range from 60 month to 144 months. RESULTS: There were 6 male and 8 female patients with sex ratio of 3:4. All were located in dorsal spine with single level involvement . Upper dorsal spine involvement was more common (10 cases 71.43%) than lower dorsal spine involvement (4 case 28.57%). All patients had weakness of lower limbs with features of myelopathy, urinary bladder symptoms were present in 6 patients local site pain in 1. D1 involvement was present in 1, D3 in 2, D4 in 2, D5 in 2, D6 in 3 , D8 in 1,D10 in 1,D11 in 1 and D12 in 1. All patients have improvement in power of both lower limbs after surgery. Bladder symptom and pain resolved in all patients. CONCLUSION: Good postoperative results can be achieved in pediatric symptomatic vertebral hemangioma with minimal complications. Individualization of treatment for each patient should be done with avoidance of selecting more blood loss procedures like corpectomies.
SURG-12. Endoscopic evaluation of ventricular dissemination in primary central nervous system (CNS) germ cell tumors (GCTs)
Authors: Yan Rachel , Lin Tong , Carnevale Joseph , Bhatia Aashim , Shaw Dennis , MacDonald Shannon , Murphy Erin , Leary Sarah , Bartels Ute , Khatua Soumen , Fouladi Maryam , Gajjar Amar , Dhall Girish , Fangusaro Jason , Onar-Thomas Arzu , Souweidane Mark 
Published: June 2022

Abstract
INTRODUCTION: Endoscopic third ventriculostomy and endoscopic tumor biopsy have become integral to the surgical management of children with primary CNS GCTs. Observing ependymal tumor dissemination at the time of endoscopic surgery has been anecdotally reported. The incidence and impact of this finding in CNS GCT has not been reported. METHODS: Baseline neurosurgery data capture forms and operative reports from the Children’s Oncology Group (COG) ACNS1123 study were reviewed for ventriculoscopic findings of suspected tumor dissemination. The association between these findings and relapse was determined using Fisher’s exact test for each stratum and the Cochran-Mantel-Haenszel test for the entire cohort. Progression-free survival (PFS) was defined as time from enrollment to relapse, progression, death, or last follow-up; and survival probabilities were estimated using the Kaplan-Meier method with log-rank tests for outcome comparisons. RESULTS: 110/244 patients (45.1%) underwent endoscopic neurosurgery. Twelve patients (10.9%) had a documented observation suggestive of metastatic disease within the ventricular compartment. Ten were in the third ventricle and two were in the lateral ventricle. Nine of 12 were nongerminomatous germ cell tumors (NGGCTs) and three were germinoma. Ventriculoscopic findings of metastatic tumor were not significantly associated with relapse in NGGCT (p=0.4091), germinoma (p=0.1832), or overall (p=0.1540); odds ratio 2.57 (95%CI:0.66–10.11). PFS was not influenced in NGGCT (Log-rank test, p=0.1953) but was negatively impacted in germinoma (p=0.0250) when tumor dissemination was found during ventriculoscopy. CONCLUSIONS: Ventriculoscopic observation of tumor dissemination was reported in 10.9% of cases. This may negatively influence outcomes in children with germinoma, though due to the small number of relapses, more data is needed to verify these findings. Ventriculoscopic observation of tumor dissemination may contribute toward more accurate staging and influence future therapy, but a larger sample size is needed. Prospective studies should routinely integrate documentation of endoscopic observation in the study protocol.
SURG-13. The COMBAT Project - Core post operative morbidity set for paediatric brain tumours
Authors: Trichinopoly Krishna Sandhya , Millward Christopher , Mallucci Conor , Gamble Carrol , Jenkinson Michael , Pizer Barry 
Published: June 2022

Abstract
BACKGROUND: Brain tumours are associated with high morbidity both from the tumour and the medical and surgical interventions used to treat them. Post operative morbidity reporting following surgery for paediatric brain tumours is poor due to the lack of a common language when reporting harms. One solution is to develop a core adverse outcome set to stipulate the minimum post operative harms that should be reported. The COMBAT (Core post operative morbidity set for paediatric brain tumours) Project will develop a core adverse outcome set that can be applied to post operative paediatric brain tumour patients to harmonise how harms are measured and reported, enabling comparison between different trials, studies and clinical services. We aim to generate interest in the COMBAT Project and invite collaboration with healthcare professionals and researchers experienced in paediatric neuro oncology surgery. METHODS AND ANALYSIS : A systematic review will identify harms reported in post operative paediatric brain tumour patients and how they are measured. We will engage with national and international stakeholders including healthcare professionals, researchers, patients and their carers. Qualitative interviews with patients and carers will identify any important harms not extracted in the systematic review. A Delphi survey will be created from the harms identified. An international consensus meeting will be held to finalise the core adverse outcomes set. The final core adverse outcome set will be published and disseminated to encourage uptake. DISCUSSION: There is a clear need for a common language to harmonise measurement and reporting of harms following surgery for paediatric brain tumour patients. The core adverse outcome set will be developed with collaboration with key stakeholder groups to ensure it is representative. It will be used to standardise surgical morbidity outcome measurement and reporting in trials, studies and clinical practice and will inform future research in this field.
SURG-15. A Case Series of Pediatric Patients with Brain Tumors and Perioperative COVID-19 Infection
Authors: Emmanuel Torio John , Baticulon Ronnie , Alcasabas Anna Patricia 
Published: June 2022

Abstract
INTRODUCTION: Surgery in patients diagnosed with COVID-19 is associated with increased risk of morbidity and mortality, especially within 6 weeks of SARS-CoV-2 infection. Furthermore, most studies have focused on adults, and little is known about perioperative outcomes in children with COVID-19. METHODS: We reviewed the operative census of the Division of Neurosurgery of Philippine General Hospital from March 2020 until December 2021. We identified all pediatric patients with brain tumors and confirmed COVID-19 infection within two weeks of their neuro-oncologic surgery. Their clinical course and outcomes are described herein. RESULTS: Four patients were included in this case series: three had tumors in the cerebellum, one in the pineal region. All of them were boys, with ages ranging from 4 months to 13 years. All tumors were malignant, and two were confirmed to be medulloblastoma after tumor resection. COVID-19 infection was diagnosed by the presence of SARS-CoV-2 RNA through a nasopharyngeal swab. Three patients acquired the virus post-operatively, likely from nosocomial transmission. In the remaining patient, it was community-acquired. All the patients had chest radiographs consistent with pneumonia but none had marked elevation of serum inflammatory markers. No patient received remdesivir or tocilizumab. At the time of their presentation, either the COVID-19 vaccine was not yet available in the country, or the patient was not yet eligible for vaccination. One patient died because of brain herniation from tumor progression, two were discharged and eventually underwent adjuvant therapy, and one remained in-hospital as of this writing. DISCUSSION: COVID-19 infection resulted in delays in the management of patients with pediatric CNS tumors. Given the high risk of these patients for potential complications, consensus guidelines must be established to achieve good outcomes and prolong survival.
SURG-17. Impact of introduction of sagittal dimensions to predictive model of post-operative cerebellar mutism (CMS): A report of the Nottingham CMS Workshop
Authors: Walker David , Liu Jo-Fen , Dineen Rob A , Thomale Ulrich-Wilhelm , Driever Pablo Hernáiz 
Published: June 2022

Abstract
BACKGROUND: The Nottingham-Liverpool risk stratification tool for predicting post-operative cerebellar mutism syndrome (CMS) requires further refinement. Previous smaller studies identified tumours arising in cerebellar hemispheres (CH+ve) as very low risk and proposed that larger sagittal dimensions may be associated with a higher CMS risk. METHODS: An international multi-centre workshop assembled clinical, imaging and surgical data from 242 posterior fossa tumour patients from 9 centres (age 2-23.8, mean 8.23 years; histology 122 medulloblastoma, 75 pilocytic astrocytoma, 25 ependymoma, 18 other tumour types, 2 not known). Post-operative CMS developed in 0/66 CH+ve and 40/176 CH-ve patients (23%, range 13-33%) and. Tumour measurements in the sagittal plane were incorporated into the predictive model. RESULTS: In CH-ve tumours, CMS was associated higher D-Sag (CMS+ve 3.91±1.08 vs CMS-ve 3.01±1.56 cm p=0.001), d-Sag (CMS+ve 0.63±0.27 vs CMS-ve 0.44±0.31 cm p=0.001) and D-Sag*d-Sag (CMS+ve 2.60±1.36 vs CMS-ve 1.65±1.45 cm2 p=0.001). The Rotterdam model identified CMS rates for CH-ve tumours for low, intermediate and high risk groups as: 4% (2/45), 20% (16/79) and 42% (22/52), respectively. CONCLUSIONS: Incorporating D-sag and d-Sag estimates of tumour size, proposed, and adopted by the Beijing and Rotterdam groups, respectively, enhanced the objectivity and supports the model’s CMS predictive capacity for the purposes of consent and future trials. Higher CMS risk, associated with larger sagittal dimensions, may account for variability in CMS rates between cohorts and, as a new finding, may have broader clinical implications around the timing of diagnosis.
NURS-01. Development and Implementation of a MEK Inhibitor Targeted Therapy Standardized Educational Curriculum for Pediatric Oncology Patients, Caregivers, and Clinical Staff
Authors: Rangan Kasey , Bira Kimberly , Bryant Lauren , Waters Kaaren 
Published: June 2022

Abstract
Molecular targeted therapies have become a fundamental treatment regimen within pediatric oncology practice, yet these medications are not without side effects, which often require interruption, dose reduction, or early discontinuation of treatment. Existing chemotherapy education curriculums focus on the side effect profile of traditional chemotherapy regimens and do not include standardized instruction on toxicities related to targeted therapies, resulting in a knowledge gap for caregivers and the clinical team. The purpose of this project was to development and implement a standardized teaching curriculum to educate patients, caregivers and clinical staff on common toxicities related to MEK inhibitors including anticipated side effects, symptom management, and toxicity surveillance. The education was presented to patients and families by a neuro-oncology nurse or nurse practitioner at the initiation of MEK inhibitor therapy. The cohort consisted of 11 patients over a 12-month period with a diagnosis of plexiform neurofibromas and neurofibromatosis type 1. Additionally, the education curriculum was presented to clinical staff during an in-service and included a pre-post intervention survey to assess effectiveness of the education curriculum. The results demonstrated that increasing patient and family knowledge at initiation of MEK inhibitor therapy likely leads to fewer dose reductions, drug interruptions, and early therapy discontinuations. Greater than 90% of the patient cohort were able to complete the treatment regimen without early termination due to toxicity, with only 18% requiring dose reduction and 9% requiring interruption of therapy. Surveys evaluating the effectiveness of the staff educational curriculum demonstrated an increased knowledge in the identification and treatment of MEK inhibitor side effects with a 26% improvement in survey results post-intervention. This project is a feasible educational approach for preventing and treating toxicities associated with MEK inhibitors and can be initiated at pediatric oncology practices to standardize MEK inhibitor education to clinicians, patients, and caregivers.
OTHR-11. The effects of the COVID-19 Pandemic on the time to diagnosis in pediatric patients with Primary central nervous system tumors
Authors: Canova Tyler , McNinch Neil , Judd Alexis , Rush Sarah , Wright Erin 
Published: June 2022

Abstract
Primary central nervous system (CNS) tumors are a leading cause of death and disability amongst pediatric cancer patients. The early identification of symptom onset is critical in preventing diagnostic delays. In 2018, Akron Children’s Hospital published data on our response time to brain tumor diagnosis and launched educational programs in an effort to decrease diagnostic delays. The goal was to reduce the total diagnostic interval (TDI) in our patient population and reduce tumor- and treatment-related morbidities for these patients. Our post intervention group (2018-2021) was drastically affected by the numerous hospital changes secondary to the COVID-19 pandemic. We sought to examine the impact of COVID-19 related changes on TDI and attempted to identify groups at potential increased risk for diagnostic delays due to the unique pandemic constraints. A retrospective chart review was performed on patients at Akron Children’s Hospital to evaluate both for pre- (diagnosed Jan 1, 2018-February 29, 2020) and post-COVID-19 (diagnosed Mar 1, 2020-June 8, 2021) groups. Both subsets were evaluated statistically and were similar in all respects including demographics, symptomatology, tumor location, tumor type, and survival. The pre-COVID-19 group demonstrated a median TDI of 43.5 days, while the post-COVID-19 group demonstrated a 30-day median. The TDI for low-grade lesions increased from 32 to 59 days and for high-grade lesions decreased from 60 to 27.5 days in the post-pandemic cohort. Overall, this demonstrates a maintained average time to diagnosis for patients despite the pandemic restrictions in place. In addition, the differences in low vs. high-grade lesions suggest that tumors with a more subtle onset of symptoms were disproportionately affected, and highlight a population for intervention during the continued pandemic.