bluuebunny/crossref_metadata_2025_split huggingface dataset:
QOL-19. RETURNING TO WORK AFTER A BRAIN TUMOUR – “I THOUGHT I WOULD BE BACK AT WORK THE NEXT WEEK, HOW WRONG I WAS!”
Authors: Nicklin Emma , Phang Isaac , Short Susan , Hoogendoorn Petra , Boele Florien 
Published: November 2022

Abstract

BACKGROUND
Returning to work is important for patients' and their families’ well-being, financial circumstances and quality of life. Side-effects of brain tumour (BT) treatment or clinical deterioration from BT progression often causes temporary or permanent inability to work. Aim: To explore the occupational expectations, experiences and satisfaction of BT patients (and their caregivers) following diagnosis/treatment.

METHODS
Qualitative semi-structured interviews were conducted with adults diagnosed with a primary BT, in employment/self-employed before diagnosis, currently in follow-up care; and their caregivers. Purposive sampling ensured a mixed BT sample. Participants were recruited from two UK tertiary referral hospitals. Data collection and thematic analysis are ongoing and will be completed by August 2022.

RESULTS
To date, 17 interviews (13 patient/4 caregiver) have taken place (59% female, aged 26-73,M= 43). Early findings: 1) Managing expectations: Patients underestimated the impact of surgery and how long it would take to return to work (if they had). Many would have liked more information prior to treatment about potential side-effects (e.g., extreme fatigue). 2) Prior financial support: Most patients suffered financially, often resulting in returning to work before they felt ready. Patients wanted more information prior to treatment about financial support. 3) Ongoing communication: Employers who were emotionally and practically supportive throughout the BT trajectory were highly valued. Some interviewees believed their employers needed to receive better education about BTs. 4) Flexible working: Patients returning to work with enhanced employer support (e.g., reduced hours, working from home and lighter duties) were more satisfied. 5) Better caregiver support: Many caregivers were unsupported by their employers to take carer leave, some worked more to support the family financially.

CONCLUSIONS
Preliminary findings offer novel data in an under-researched area. More knowledge around the experiences, barriers and facilitators influencing patients’ return to work will allow the planning of tailored occupational support and resources.
QOL-22. IDENTIFYING HEALTH STATUS PROFILES AMONG LONG-TERM CNS TUMOR SURVIVORS: A LATENT PROFILE ANALYSIS
Authors: Stockdill Macy , Armstrong Terri , Mendoza Tito , Miaskowski Christine , Cooper Bruce , Vera Elizabeth 
Published: November 2022

Abstract
CNS tumors are associated with a high mortality rate, quick onset, limited therapeutic options, and a devastating symptom burden that has a negative impact on general health status and results in functional limitations. While research is focused on development of new therapies, little is known about the health status of long-term survivors. We aimed to identify subgroups of CNS tumor survivors ( &gt; 5 years from diagnosis) with distinct health profiles using latent profile analysis ordinal logit estimation in Mplus V8.8. General health status was measured using the EQ-5D-3L (dimensions: mobility, self-care, usual activities, pain/discomfort, anxiety/depression). Associations with demographic/clinical characteristics were identified with Pearson’s correlations and chi-square tests. Sample median age was 48 years (range: 21-85), 54% were male, 82% Caucasian, 56% employed, and 53% had a KPS ≥ 90. Most had a high-grade glioma (60%), at least one recurrence (70%), and 17% were on active treatment. Two subgroups were identified: good health status (GHS) (n=183) and poor health status (PHS) (n=115). Most patients in the GHS ( &gt; 86%) reported no issues with mobility or usual activities and 100% had no self-care issues. However, 38% did report some problems with anxiety and depression and 21% had pain. PHS class was characterized by &gt; 94% having at least moderate issues with mobility and usual activities and over 50% having pain, self-care issues, and anxiety and depression. Older age (r=0.21), spine tumors (OR=3.3), active treatment at assessment (OR=2.9), tumor recurrence (OR=4.2), unemployment (OR=3.5), and poor KPS scores (OR=18.1) were associated with belonging in the PHS. While maintaining physical health and function may contribute to better health status in long-term survivors, patients dealing with tumor recurrence, ongoing treatments, and spine tumors may face significant challenges. These functional profiles can be used to develop survivorship care plans and supportive care interventions.
QOL-23. TOWARDS PATIENT-REPORTED OUTCOME ASSESSMENT IN THE MOLECULAR TUMOR BOARD – CANCER PATIENTS UNDER TARGETED THERAPY: APP-BASED ASSESSMENT OF PATIENT-REPORTED OUTCOMES (TRACE)
Authors: Renovanz Mirjam , Bombach Paula , Grosse Lucia , Rieger Johannes , Skardelly Marco , Rieger David , Hille Hanni , Volkmer Sebastian , Dörner Lorenz , Kurz Sylvia , Hippler Melina , Paulsen Frank , Öner Öznur , Ruhm Kristina , Beha Janina , Sundberg-Malek Holly , Möller Yvonne , Tatagiba Marcos , Wallwiener Markus , Eckert Nils , Escher Pascal , Pfeiffer Nico , Forschner Andrea , Bauer Armin , Zips Daniel , Bitzer Michael , Malek Nisar , Gani Cihan , Tabatabai Ghazaleh 
Published: November 2022

Abstract
Comprehensive genomic profiling and biomarker-based therapeutic strategies are currently used in clinical trials and in innovative health care systems including the center for personalized medicine network. Systematic assessments of patient-reported outcomes are warranted to gain insight into the perspective of patients and their relatives during biomarker-based therapies. In the present study, we focused on health-related quality of life (HRQoL), psychosocial situation, and physical symptoms in patients treated at the Center for Personalized Medicine Tübingen. First, we retrospectively evaluated symptom burden of n=265 (neuro-)oncological patients in the Molecular Tumor Board (MTB). Sixty percent of patients reported at least 1 neurological symptom, and psychosocial burden/unmet needs were high (overall 156/265; 59%, patients with malignant tumors n=86/106; 81%, Fisher’s exact, p &lt; 0.0001). We therefore developed an app by 14 expert rounds and pretesting including validated assessments of HRoL, symptom und psychological burden and tested it in a pilot study. We conducted a structured interview with users 3 months afterwards to assess the app’s usability and feasibility. The interview was transcribed and analyzed according to a qualitative content analysis. So far, a total of 10 patients and caregivers have been enrolled in this pilot study. They reported that (i) the app is compatible with their daily routine (median 9.3, range 0-10), that (ii) they are more aware of their health status, which was rated as positive, and that (iii) completing app-based questionnaires was easier compared to paper questionnaires. Two patients reported technical problems, which were resolved timely. The pilot study proved feasibility and acceptance of the app. The app might optimize symptom burden assessment, adapted to the patients’ profiles. The next step is to prospectively compare HRQoL before and after start of targeted therapy in a multicenter study.
RBIO-03. A MULTI-INSTITUTIONAL EXPERIENCE OF GAMMATILE BRACHYTHERAPY AS TREATMENT FOR RECURRENT GLIOBLASTOMAS
Authors: Chen Clark , Ferreira Clara , Dusenbery Kathryn , Hoang Kimberly , Lee Stuart , Smith Kris 
Published: November 2022

Abstract

BACKGROUND
Recurrent glioblastoma remains a disease without established standard of care. Here, we report the safety profile and survival outcome of recurrent glioblastoma patients treated with maximal safe resection followed by intraoperative placement of GammaTile (GT), a collagen tile-embedded Cs-131 brachytherapy platform.

METHODS
The study included isocitrate Dehydrogenase (IDH) wild-type glioblastoma patients who suffered tissue confirmed recurrence after concurrent temozolomide-radiation therapy. The series included consecutively patients treated at the University of Minnesota, Barrow Neurological Institute, Vidant Health, and Emory University Hospital. Survival results were stratified by methyl-guanine methyl transferase (MGMT) promoter methylation status

RESULTS
In total 48 patients were treated between 2019 and 2022 in this multi-institutional experience. The median days of hospitalization following the procedure was two (range: 1-15), with 72.5% of the GT implanted patients discharged home before postoperative day three. In terms of post-operative course, two patients suffered new-onset seizure post-surgery (4.0%). There was one (2%) 30-day mortality from intracranial hemorrhage secondary to heparinization for an ischemic limb. There were 13% readmission within 30 days, including hydrocephalus (n=2), urinary tract infection (n=1), deep venous thrombosis (n=1), failure to thrive (n=1), and infected wound (n=1). Of note, the patient with the infected wound had suffered a previous wound infection prior to the GT implantation and the pathogenic organism for both infections were the same (S. aureus). With a median follow-up of 250 days, twelve-month local control was 82%. Median overall survival (OS) from the time of diagnosis was 19 and 33 months for the MGMT unmethylated and methylated tumors, respectively. Select patients (n = 6) treated with adjuvant ketogenic diet in addition to GT and subsequent chemotherapy exhibited survival beyond expectation (&gt; 14 mo, median survival not reached).

CONCLUSION
This multi-institutional experience supports further investigation of GT brachytherapy as a treatment for recurrent glioblastomas.
RBIO-07. HIGHER CSF IL-10 CORRELATE WITH BRAIN ATROPHY AFTER WHOLE BRAIN RADIATION THERAPY IN PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA
Authors: Nagashima Hiroaki , Hori Tatsuo , Iwahashi Hirofumi , Tanaka Kazuhiro , Sasayama Takashi 
Published: November 2022

Abstract
Whole brain radiation therapy (WBRT) to primary central nervous system lymphoma (PCNSL) correlate with brain atrophy and leukoencephalopathy on serial computed tomography or MRI scans, negatively impacting cognitive function and quality of life. We retrospectively evaluated 53 patients with histologically proven PCNSL who underwent cerebrospinal fluid (CSF) examination including β2-MG, sIL2R, CXCL13, and IL-10 preoperatively. All patients were newly diagnosed and followed up every 3 months from the day they were discharged from the hospital. Follow up period is at least 1 year from last day of chemotherapy. Clinical data included patient demographics, radiological and characteristics; whole brain volume (mm2) calculated from BainLabTM automatically, Global Cortical Atrophy (GCA) for global brain atrophy, Medial Temporal Atrophy (MTA) for temporal atrophy, and Fazekas scale for white matter lesions. The unpaired t test and multivariable liner regression were used to examine the clinical, CSF and radiological characteristics of patients. The mean age at symptom onset was 65.2 years (47-85 years). Thirty three of 53 (62%) patients underwent WBRT with chemotherapy (WBRT group). In all patients, multivariable analysis revealed WBRT correlate with brain volume reduction (p=0.0005) and progression of temporal lobe atrophy (p=0.0056). In addition, Age correlated with increasing white matter lesions at 1 year after chemotherapy (p=0.0422). In WBRT group, multivariable analysis indicated that high CSF IL-10 level accelerated brain volume reduction (p=0.0122) and temporal lobe atrophy (p=0.0343) at 6 months after chemotherapy. However, there were no significant factor for influencing brain atrophy at 1 year. Higher IL-10 ( &gt; 100mg/ml) level demonstrated higher brain atrophy rate (p=0.0366) and severe temporal atrophy at 1 year (p=0.0214). In elderly patients with high preoperative CSF IL-10 levels, cerebral atrophy and toxic leukoencephalopathy may progress in short period of time after WBRT. We should consider treatment strategy that avoid WBRT, such as R-MPV chemotherapy, for PCNSL patients.
RTID-06. A RANDOMIZED CONTROLLED TRIAL USING ACCELERATOR-BASED BNCT SYSTEM FOR REFRACTORY RECURRENT HIGH-GRADE MENINGIOMA
Authors: Miyatake Shin-Ichi , Wanibuchi Masahiko , Kawabata Shinji , Furuse Motomasa , Ono Koji , Nihei Keiji , Akita Kazuhiko , Ko Naonori 
Published: November 2022

Abstract

BACKGROUNDS
Recently, nuclear reactors have been replaced with accelerator-based neutron sources (ABNS) for boron neutron capture therapy (BNCT). High-grade meningiomas (HGM) are refractory, especially recurred after some radiotherapy. We are now applying randomized controlled trial (RCT) of “A phase II clinical trial using accelerator-based BNCT system for refractory recurrent high-grade meningioma”.

STUDY DESIGN
PMDA in Japan which is a counter part of FDA in USA suggested the importance of RCT even for this exploratory clinical trial for HGM. Along to this suggestion, we prepared 2 study groups, BNCT test treatment group and control best supportive care (BSC) group. Progression free survival (PFS) was set-up as primary endpoint. Rescue BNCT is allowed for control group patients, if they showed progress disease (PD) during observation. Two-dimensional modified Macdonald criteria is adopted for assessment.

METHODS
The trial started in August 2019. Eighteen subjects were enrolled and divided in 12 and 6 subjects for BNCT and control BSC group, respectively. Cyclotron-based ABNS system was used for neutron source. Neutron-irradiation time is determined not to exceed to 7.5 Gy-Eq for scalp dose which was referencing preceding phase I trial for malignant gliomas. The last patient-in was August 2021.

INTERIM RESULTS
(as of April 30, 2022): All 6 cases of control group were judges as PD. Seven out of 11 cases of BNCT group were judged as PD. One case of BNCT group dropped out from the study with withdrawal of consent. Median PFS were 8 and 64 weeks for control group and BNCT group, respectively. Log-rank test showed marked statistical difference with p-value of 0.000401 between these 2 groups.

CONCLUSIONS
This RCT showed a marked difference of PFS between accelerator-based BNCT group and control group, so far. We will keep on observation at least next 2 years for other endpoints.
SURG-02. INTRAOPERATIVE RADIOTHERAPY FOR BRAIN METASTASES: EVALUATION OF ELECTROCORTICOGRAPHY AND PERI-OPERATIVE SEIZURE RISK
Authors: Cifarelli Christopher 
Published: November 2022

Abstract

BACKGROUND
Intraoperative radiotherapy (IORT) has emerged as a viable tool for consolidation of surgery and radiation for brain metastases into a single episode of care, but its relative novelty compared to SRS or fractionated radiotherapy warrants evaluation of its safety. While post-operative seizure risk is typically minimal with the use of anti-epileptic drugs during the peri-operative phase, the risk of intra-operative epileptiform discharge remains unknown.

METHODS
Five consecutive cases of surgically resected brain metastases treated with IORT underwent electrocorticography via direct cortical electrode recordings adjacent to the resection cavity with paddle electrodes used for mapping of phase reversal. Continuous recordings were made before, during, and after radiation delivery and analyzed for evidence of radiation-associated changes.

RESULTS
No evidence of significant electrophysiological change was noted in any of the cases, nor was there any clinical evidence of seizure in the immediate peri-operative period. These data represent the first direct cortical recordings in human subjects during the delivery of radiation.

CONCLUSIONS
In this small cohort of IORT treated resected brain metastases, the delivery of intra-operative radiation does not appear to impact cortical activity or precipitate post-operative seizures. Further studies are needed to determine the long-term incidence of treatment associated changes if they exist.
SURG-06. PREOPERATIVE NEOADJUVANT GAMMA KNIFE RADIOSURGERY IN THE TREATMENT OF LARGE BRAIN METASTASIS: AN INITIAL CASE SERIES OF SINGLE INSTITUTE
Authors: Kim Seon-Hwan , Kim Kyung Hwan , Lee Han-Joo , Kwon Hyon-Jo , Choi Seung-Won , Koh Hyeon-Song , Youm Jin-Young 
Published: November 2022

Abstract

BACKGROUND
Postoperative stereotactic radiosurgery (SRS) following the surgical resection of large brain metastasis is a promising therapeutic option to reduce local recurrence. However, there is an increased risk of radiation necrosis and leptomeningeal spreading and an issue of problematic target delineation. Neoadjuvant SRS, also called preoperative SRS, is an emerging treatment paradigm which delivers radiation in the preoperative setting. An initial series of single-institute cases treated with the neoadjuvant SRS followed by surgical resection of a large BM was reviewed. Method: Between 2019 and 2022, 5 patients underwent neoadjuvant SRS using Gamma Knife radiosurgery (GKS) unit, followed by surgical resection. Local tumor recurrence, distant tumor recurrence, leptomeningeal seeding, and overall survival were investigated. Pathologic findings and surgical gross findings were reviewed.

RESULTS
The mean age was 59 and 3 patients were female. All patients had multiple lesions, ranged 2 to 7, including a large lesion (mean tumor volume: 29.8 cc). The interval between GKS and surgery was varied between 1 to 14 days. The prescribed dose of plan-to-resect lesion was 12 Gy in four patients and 14 Gy in one patient. All patients underwent gross total resection without surgical complications and had no radiation-induced toxicity. 3 patients were died of extracranial progression during follow-up period, including 1 patient who died before the first follow-up image. Local tumor progression was noted in 1 patient 9 months after treatment. The mean overall survival was 4.5 months although two patients continued to require follow-up.

CONCLUSIONS
Neoadjuvant SRS may be safe and advantageous for the treatment of BM that require surgical intervention. Long-term investigation with larger patient cohorts and further randomized trials are essential to verify the efficacy of the approach.
SURG-10. PERMANENT CARRIER-EMBEDDED CESIUM-131 BRACHYTHERAPY FOR THE SALVAGE TREATMENT OF PREVIOUSLY IRRADIATED, RECURRENT BRAIN METASTASES
Authors: Imber Brandon , Beal Kathryn , Reiner Anne , Giantini-Larsen Alexandra , Yang Jonathan , Aramburu-Nunez David , Cohen Gil’ad , Brennan Cameron , Tabar Viviane , Young Robert , Moss Nelson 
Published: November 2022

Abstract

BACKGROUND
Salvage of recurrent, previously-irradiated brain metastases (rBrM) is a significant clinical challenge. High local failure is seen following salvage resection without adjuvant re-irradiation, while re-irradiation is associated with high radionecrosis rates. Salvage surgery plus intraoperative Cs131 brachytherapy may offer dosimetric and biologic advantages including improved local control versus observation, with reduced integral brain dose versus re-irradiation.

METHODS
A prospective registry of consecutively treated patients with post-stereotactic radiosurgery (SRS) rBrM was analyzed. Following resection, cavities were implanted with commercially-available, collagen-matrix embedded Cs131 seeds (GammaTile, GT Medical Technologies) prescribed to 60Gy at 5mm from the cavity.

RESULTS
Twenty patients underwent 24 operations with Cs131 implantation in 25 cavities. Previous SRS occurred a median of 358d preoperatively (range=56-1334). Median maximum preoperative diameter was 3.0cm (range=1.1-6.3) and enhancing volume was 9.5cm3 (range=0.6-69.7). Gross- or near-total resection was achieved in 60%. A median of 16 Cs131 seeds (range=6-30), with a median activity of 3.5U/seed were implanted. Maximal preoperative diameter and enhancing volume were weakly associated with the number of implanted seeds (correlation coefficients=0.50, 0.41, respectively). There was one postoperative wound dehiscence in a multiply resected and irradiated patient with hydrocephalus. With median follow-up of 1.6 years for survivors, 2 tumors recurred (one in-field, one marginal) resulting in 9.8% 1-year progression incidence (95%CI=0.0-23.2). Radiographic seed migration was identified in 7/25 cavities (28%) on scans ranging from 1.9-11.7 months post-implantation, without clinical sequelae.

CONCLUSIONS
With &gt;1 year of follow-up, intraoperative brachytherapy with Cs131 implants was associated with a high rate of local control and a favorable toxicity profile. Modest correlation between preoperative tumor geometry and implanted tiles with high associated cost suggests a need to optimize planning criteria. A randomized trial of salvage resection with or without Cs131 is ongoing (NCT04690348) to assess the incremental benefit of brachytherapy.
SURG-16. THALAMIC GLIOMAS AND THEIR SURGICAL STRATEGY: A SYSTEMATIC REVIEW
Authors: Levy Adam , Eatz Tiffany , Morell Alexis , Merenzon Martin , Higgins Dominique , Guyot Manuela , Patel Nitesh , Eichberg Daniel , Kader Michael , Luther Evan , Komotar Ricardo , Ivan Michael 
Published: November 2022

Abstract

INTRODUCTION
Until recent decades, thalamic gliomas had been considered largely inoperable. These lesions are deep-seated and surrounded by vital structures. However, as technology and imaging modalities have improved, so have treatment modalities. Currently, a range of surgical approaches are used, partially dependent on the location of the lesion; although no consensus has been reached regarding optimal surgical management.

OBJECTIVE
To conduct a systematic review of the literature to describe the current surgical outcomes of adult thalamic gliomas.

METHODS
Four databases were searched with keywords “‘thalamic glioma’ AND ‘surgical intervention’ OR ‘thalamic glioma’ AND ‘surgical treatment’” for articles assessing surgical techniques of adult thalamic glioma resection. Our systematic review was reported in accordance with the PRISMA guidelines. 793 full-text studies were assessed for eligibility. Ultimately, 14 studies were included.

RESULTS
The mean age was of 33.57 years (18-83). In 479/507 cases the surgical strategy used was described. The transcortical approach was the most utilized (37.8% of cases). The remaining cases employed transventricular (23.8%), transcallosal (22.8%), and trans-sylvian transinsular (2.92%) approaches, among others. Gross total resection (GTR), subtotal resection (STR), and partial resection were achieved in 36.7%, 47.4%, and 15.9%, respectively. New temporary postoperative deficits were observed in 57/507 patients and new permanent deficits in 56/507 patients. There were 18 total perioperative deaths reported. The degree of morbidity across approaches was recorded in just one study, where no significant difference was found. The mean overall survival of adult patients after surgery ranged from 11.5 to 27.39 months across studies.

CONCLUSION
There is a lack of statistically strong data that addresses which surgical approach causes less morbidity and allows a better surgical resection for thalamic gliomas. Ultimately, surgical resection of adult thalamic gliomas can increase overall survival but at the risk of operative morbidity. Transcortical approaches appear to carry a greater overall survival