bluuebunny/crossref_metadata_2025_split huggingface dataset:
NCMP-25. THE EFFECTS OF POLYPHARMACY IN PATIENTS WITH PRIMARY BRAIN TUMORS
Authors: Hyde Allison , Hernandez Juliana 
Published: November 2022

Abstract
Polypharmacy has been described as the use of five or more medications. With the effects of polypharmacy, patients may report difficulty with adherence to therapy, adverse drug-drug interactions, adverse drug-disease interactions, and cost. The development of cancer treatments for brain cancer is accomplished through clinical trials and the unfortunate truth is that most glioblastoma patients will have died in the time it can take to test a new treatment with more than half dying within the first 15 months of diagnosis. Upon completion, participants will be able to describe the effects of polypharmacy in patients with primary brain tumors in the outpatient setting. Additionally, participants will be able to identify the knowledge, skills, and attitudes necessary in the provision of nursing care to the patient with primary brain tumors. A working group comprised of two registered nurses in specialty neuro-oncology was formed. A knowledge, skills, ability framework was used to develop a survey to assess nurses' knowledge, skills, and attitudes regarding the effects of polypharmacy in patients with primary brain tumors. Two nurses were surveyed. Mean scores were calculated and ranked. The nurses reported important knowledge includes understanding of medication adverse and side effects, epidemiology and disease states including tumor histology. Important skills include neurological exam, triage, critical thinking, and patient education. The goal is to investigate the possibility of prioritizing care to include both a balance between treating the disease, use of concomitant medications and their associated adverse events. And in doing so encourage the individual to report an adverse event. In so doing this the patient is provided a wholistic treatment plan tailoring care to the individual. There was a stronger desire to better understand and manage these events.
NCOG-01. CLINICAL DETERMINANTS IMPACTING OVERALL SURVIVAL OF PATIENTS WITH OPERABLE BRAIN METASTASES FROM NON-SMALL CELL LUNG CANCER
Authors: Piffko Andras , Asey Benedikt , Dührsen Lasse , Ristow Inka , Salamon Johannes , Wikman Harriet , Maire Cecile , Lamszus Katrin , Westphal Manfred , Sauvigny Thomas , Mohme Malte 
Published: November 2022

Abstract
The incidence of brain metastases (BM) in non-small cell lung cancer (NSCLC) patients is continuously increasing. The recent improvements of systemic treatment in NSCLC necessitate continuous updates on prognostic subgroups and factors determining overall survival. In order to improve clinical decision-making, we investigated the clinical determinants affecting survival in patients with resectable NSCLC BM. A retrospective analysis was conducted of NSCLC patients with surgically resectable BM treated in our institution between 01/2015 and 12/2020. Relevant clinical factors affecting survival identified by univariate analysis where included in a multivariate logistic regression model. Overall, 264 patients were identified, with a mean age of 62.39 ± 9.98 years at initial diagnosis of NSCLC BM and overall survival (OS) of 23.22 ± 1.71 months. Factors that significantly affected overall survival from time of primary tumor diagnosis included the systemic metastatic load (mean: 45.9 ± 9.7 vs. 58.9 ± 9.4 months, p = 0.021) as well as a number of BM &lt; 2 (mean: 25.5 ± 4.4 vs. 57.4 ± 7.8 months, p = 0.014). When adjusted for survival time after neurosurgical intervention, a significant survival benefit was found in patients &lt; 60 years (32.5 ± 4.3 vs. 28.5 ± 5.2 months, p = 0.036) and patients without any concurrent systemic metastases at time of NSCLC BM diagnosis (mean 32.4 vs. 34.1, p = 0.032). Our data shows that the number of BM (singular/solitary), gender and age, but not localization (infra-/supratentorial), mass-edema index or time to BM occurrence impact overall survival in NSCLC BM patients.Additionally, our study shows that patients in prognostically favorable clinical subgroups have an overall survival, which differs significantly from current statements in literature. The described clinically relevant factors may improve the understanding of the risks and the course of this disease and aid future clinical decision making in tumor boards.
NCOG-05. A BRAIN METASTASES SURVIVAL MODEL USING AN ENSEMBLE TREE APPROACH
Authors: Shumway John , Tan Xianming , Drossopoulos Peter , Torras Marina , File Madison , Joshi Tushar , Ruhashya Ashley , Yanagihara Theodore , Shen Colette 
Published: November 2022

Abstract

PURPOSE/OBJECTIVE(S)
The primary purpose of this study is to determine whether a machine learning approach can estimate survival in patients with brain metastases undergoing stereotactic radiosurgery or fractionated stereotactic radiotherapy (SRS/SRT). The secondary purpose is to identify covariates of importance.

MATERIALS/METHODS
Data were collected for 377 SRS/SRT treatments in 291 patients done between the years 2008-2021. If a patient was treated with more than one course of SRS/SRT within 30 days, they were counted only once. Twenty-five clinically-relevant variables were identified as covariates and the primary outcome of time from brain metastasis diagnoses to death was used to build a random survival forest model. Brain metastasis location was categorized as infratentorial, supratentorial, or both. An 80/20 split was used for training (n = 302) and test (n = 75) sets. Missing data points were imputed using a just-in-time adaptive tree approach. Minimal depth and variable importance (VIMP) approaches were used to identify prognostic factors. Model performance was assessed using time-dependent area under the receiver operating characteristics curve (tAUC).

RESULTS
Median survival time was 16 months. The most important variables according to minimal depth analysis (depth threshold 5.23) were Karnofsky Performance Status (KPS), extracranial status, age, insurance status, metastases volume, histology, number of metastases, and location. Error rate on the test set was 0.38. tAUC was found to increase continuously over time and at 6, 12, 24, and 36 months was 0.56, 0.63, 0.74, and 0.84 respectively.

CONCLUSION
An ensemble tree approach can provide good survival prediction for patients with brain metastases undergoing SRS/SRT. Model performance, as measured by tAUC, increases over time suggesting better predictive capability at longer time intervals. Future directions include collecting more data to increase model performance, comparing to other models, and validating with external data.
NCOG-09. RADIATION INDUCED CEREBRAL VOLUME LOSS AND CEREBROVASCULAR DISEASE RISK IN SURVIVORS OF GRADE 2 AND 3 GLIOMAS
Authors: Gardner Melissa , Winter Sebastian , Dietrich Jorg , Gerstner Elizabeth , Sherman Janet , Shih Helen , Parsons Michael 
Published: November 2022

Abstract

INTRODUCTION
Cranial irradiation with protons (PRT) as compared with photons (PHT) reduces radiation exposure to healthy brain tissue and may mitigate early- and late-delayed complications. Prior work in our group has demonstrated that PRT results in less brain atrophy over 2 years post-treatment as compared with PHT. It is unknown whether individual factors, such as cerebrovascular disease risk (CVDR; known to be important in post-RT brain changes), interacts with treatment type to affect brain volume change.

METHODS
Patients treated with PRT for grade 2 or 3 gliomas were meticulously matched to patients treated with PHT using an eleven-tiered criterion (i.e., age, sex, tumor type, tumor location, laterality, IDH mutation status, 1p19q deletion status, concurrent chemotherapy, adjuvant chemotherapy, total Gy dose, and number of fractions). Brain volume changes were evaluated by measuring changes in ventricular size in the contralesional hemisphere (to reduce impact of tumor-related changes on volumetric measurements). A CVDR score was created, incorporating history of hypertension, hyperlipidemia, smoking, and diabetes. Correlation and multiple regression analyses examined the relationship between CVDR and brain volume loss over 2 years.

RESULTS
Mann-Whitney tests of independence showed no significant differences in CDVR between PHT and PRT treatment groups. Cerebral volume loss correlated significantly with CVDR (r =.404, p =0.02) and treatment type (r=-.366, p =0.036). Age and gender were unrelated to volume loss. A multiple regression analysis that included treatment type (PHT, PRT) and CVDR accounted for 23% of the variance in volume loss, F(2, 32) = 4.383, p &lt; .021.

CONCLUSION
The current study demonstrates that neurotoxicity of radiation therapy is related to both CVDR and radiation treatment type. Longitudinal data, including a larger sample size, are warranted to confirm these preliminary findings. Inclusion of routine neuropsychological outcome data will be critical to understand the functional significance of these results.
NCOG-11. EXTENT OF RESECTION OF CONTRAST-ENHANCING AND NON-ENHANCING TUMOR: DIFFERENT IMPACTS ON SURVIVAL ACCORDING TO TYPES OF ADULT-TYPE DIFFUSE GLIOMAS IN 2021 WHO CLASSIFICATION
Authors: Park Yae Won , Ahn Sung Soo , Kim Eui Hyun , Kim Jinna , Kang Seok-Gu , Chang Jong Hee , Kim Se Hoon , Lee Seung-Koo 
Published: November 2022

Abstract

BACKGROUND
To evaluate the impact of extent of resection (EOR) of contrast-enhancing (CE) and nonenhancing (NE) tumors in the types of adult-type diffuse gliomas according to the 2021 WHO classification.

METHODS
Total 1,196 adult-type diffuse glioma patients diagnosed between 2001 and 2021 from a single institution were enrolled (183 patients with isocitrate dehydrogenase [IDH]-mutant and 1p/19q codeleted oligodendroglioma [herein oligodendroglioma], 211 patients with IDH-mutant astrocytoma, and 802 patients with IDH-wildtype glioblastoma). Analyses were performed within each type to assess predictors of overall survival, including clinical, imaging data, histological grade, O6-methylguanine-methyltransferase (MGMT) promoter methylation status, adjuvant treatment, and EOR of CE and NE tumors. Subgroup analyses were performed in patients with CE tumor.

RESULTS
Among 1,196 patients, 926 (77.4%) patients had CE tumors. In oligodendrogliomas, gross total removal (GTR) of CE tumor was associated with survival (hazard ratio [HR]=0.09, P&lt; 0.001), whereas GTR of NE tumor was not associated with survival (HR=0.41, P=0.088). In 81 (43.3%) oligodendroglioma patients with CE tumor, GTR of CE tumor was the only independent predictor of survival (HR=0.20, P=0.092) in multivariable analysis. GTR of CE and NE tumors was independently associated with better survival in IDH-mutant astrocytoma and IDH-wildtype glioblastoma (all Ps&lt; 0.05).

CONCLUSIONS
GTR of both CE and NE tumors may significantly improve survival within all types of adult-type diffuse gliomas except oligodendrogliomas. In oligodendrogliomas, the EOR of CE tumor may be crucial in survival; aggressive GTR of NE tumor may be unnecessary, whereas GTR of the CE tumor is recommended.
NCOG-13. BEVACIZUMAB IN IDH WILD TYPE ADULT PATIENTS WITH RECURRENT GLIOBLASTOMA: A REAL WORD STUDY IN CHINA
Authors: Cui Run , Guo Chengcheng , Yang Qunying , Mou Yonggao 
Published: November 2022

Abstract

OBJECTIVE
To investigate the efficacy, safety and application mode of bevacizumab in IDH wild-type adult patients with relapsed GBM.

METHODS
The clinical data of IDH wild-type adult patients with recurrent GBM who received bevacizumab monotherapy or combined chemotherapy in Sun Yat-sen University Cancer Center from 2011 to 2020 were retrospectively analyzed. The enrolled patients had recurred for the first time or multiple times after received surgery, radiotherapy and temozolomide. The objective curative effect was evaluated according to the evaluation criteria of response assessment in neuro-oncology(RANO). Kaplan-Meier method was used for survival analysis, Log-Rank test and Cox regression model were used for prognosis analysis. Adverse reactions were evaluated according to CTC 5.0 standard.

RESULTS
81 patients were enrolled, the objective response rate was 62.9%, the disease control rate was 80.2%, the median progression-free survival (PFS) was 4.4 months (95%CI: 4.0-4.8), and the median overall survival (OS) was 7.8 months (95%CI: 6.8-8.8). Univariate analysis showed that the number of recurrences, the dose of bevacizumab, and whether combined with chemotherapy had no effects on OS. Patients with disseminated tumors, KPS score ≥ 60, MGMT promoter methylation, and ki-67 &lt; 30% had prolonged OS. Multivariate analysis showed that KPS score and MGMT promoter status were independent prognostic factors affecting OS. Major adverse events were mostly grade 1 to 2, including: myelosuppression, hypertension, elevated transaminases, nausea/vomiting, and constipation. No grade 4-5 adverse events occurred.

CONCLUSION
Bevacizumab therapy can improve the survival of IDH wild type adult patients with recurrent GBM and was well tolerated. Early or delayed use of bevacizumab after relapse, low-dose or high-dose usage, and whether combined with chemotherapy had no effect on the OS of patients. KPS score and MGMT methylation status were independent prognostic factors affecting OS.
NCOG-14. INTRAOPERATIVE COGNITIVE-LINGUISTIC MAPPING GUIDED BY VISUALIZATION OF GAMMA BAND MODULATION ELECTROCORTICOGRAMS: PROOF OF CONCEPT IN A PATIENT WITH LEFT TEMPORAL AND OCCIPITAL LOW-GRADE ASTROCYTOMA
Authors: Noll Kyle , Asman Priscella , Connelly Katherine , Tasnim Israt , Swamy Chandra , Ene Chibawanye , Sudhakar Tummala , Grasu Roxana , Liu Ho-Ling , Kumar Vinodh , Muir Matthew , Prinsloo Sarah , Michener Hayley , Wefel Jeffrey , Ince Nuri , Prabhu Sujit 
Published: November 2022

Abstract

OBJECTIVE
Determine the feasibility and preliminary utility of a novel approach to intraoperative brain mapping guided by visualization of electrocorticography (ECoG) heat maps.

METHODS
A 39-year-old male with a biopsy-proven left posterior temporal and occipital WHO grade II IDH-mutant astrocytoma underwent awake craniotomy with intraoperative language mapping. Language mapping utilized a dual iPad stimulus presentation system (NeuroMapper) coupled to a portable real-time neural signal processing system capable of both recording cortical activity and delivering direct cortical stimulation in a closed-loop fashion. An ECoG grid (4x8 with 1cm pitch) which covered the majority of the left temporal lobe was used to assess oscillatory cortical activity during administration of language paradigms including object, action, auditory descriptive, and written descriptive naming. ECoG recording and cortical stimulation were synchronized with stimulus presentation via a photosensor attached to the patient-facing tablet. Gamma band modulations in response to language paradigms at each electrode were processed in real-time and visualized as heat maps in MATLAB/Simulink. Following recording and visualization, bipolar direct cortical stimulation from the grid was conducted for each neighboring electrode pair (up to an intensity of 6 mA) during administration of language tasks.

RESULTS
Despite mild fluent aphasia, a large set of reliable baseline stimuli were obtained for the language mapping paradigms. All naming paradigms resulted in strongest heat map activation at electrode 12 located in the anterior to mid superior temporal gyrus. During stimulation, consistent speech arrest was observed across all paradigms when stimulating electrode pair 11-12, indicating good correspondence with ECoG heat map recordings. Additionally, this region corresponded well with posterior language network representation via resting-state fMRI.

CONCLUSION
Intraoperative real-time visualization of task-based ECoG gamma band modulation is feasible and may help identify targets for direct cortical stimulation. If validated, this may improve the efficiency and accuracy of intraoperative language mapping.
NCOG-16. REAL-WORLD ANALYSIS OF OUTCOMES OF PATIENTS RECEIVING BEVACIZUMAB FOR RECURRENT GLIOBLASTOMA
Authors: Chahal Manik , Harrison Rebecca , Mhurchu Elaine Ni , Thiessen Brian 
Published: November 2022

Abstract
Bevacizumab has been publicly funded in British Columbia (BC) since 2011 for treatment of recurrent glioblastoma (rGBM). We performed a retrospective analysis of patients with rGBM treated with bevacizumab to evaluate treatment practices and outcomes. 245 patients with rGBM treated at BC Cancer centers with bevacizumab between January 2011 and December 2019 were reviewed. Patient demographics, tumor characteristics, treatment regimens, and dates and type of radiographic progression and death were collected. Kaplan-Meier method was used to assess overall survival from time of bevacizumab initiation (BevOS), and comparisons were made using the log-rank test. Median OS was 7 months (CI95 = 6.28-7.73) from bevacizumab initiation. 66% of patients on corticosteroids prior to bevacizumab reduced their dose, and performance status was the same or improved in 84% of patients shortly after initiation, suggesting improvement in quality of life. Patients started on bevacizumab &lt; 6 months from chemoradiation (prior to completion of adjuvant temozolomide) had improved BevOS compared to those who started bevacizumab later (p = 0.019), but there was no association between extent of treatment prior to bevacizumab and outcomes (p = 0.417). Additionally, patients who had local progression prior to bevacizumab initiation had improved BevOS compared to those who had distant progression (p = 0.004), suggesting that pseudoprogression may have prompted the therapeutic switch. Furthermore, though there were no differences in baseline characteristics for patients treated at high volume centers vs. low volume centers, patients treated at high volume centers had improved BevOS (p = 0.004), potentially due to differences in expertise between centers or other social determinants of health not captured in baseline demographics. Together, these data highlight the need for optimization of patient selection and bevacizumab administration in high and low volume centers.
NCOG-17. THE CROSS-SECTIONAL AND LONGITUDINAL ASSOCIATION BETWEEN EXECUTIVE FUNCTIONING AND MULTILAYER CENTRALITY OF THE FRONTOPARIETAL NETWORK IN GLIOMA PATIENTS
Authors: van Lingen Marike , Breedt Lucas , Geurts Jeroen , Hillebrand Arjan , Kouwenhoven Mathilde , Kulik Shanna , Reijneveld Jaap , Stam Cornelis , De Hamer Philip Witt , Zimmermann Mona , Santos Fernando , Douw Linda 
Published: November 2022

Abstract

BACKGROUND
Many patients with glioma suffer from poorly understood executive functioning deficits before and/or after tumor resection. In the past decade, it has become increasingly clear that there is a complex interplay between glioma and both local and global functional activity and connectivity. Moreover, multilayer network integration of the frontoparietal network across multiple modalities has recently been found to explain individual differences in executive functioning in healthy subjects.

OBJECTIVE
To test whether multilayer frontoparietal network integration relates to individual differences in executive functioning before and after glioma resection.

METHODS
Patients with glioma (n = 37) underwent neuropsychological tests assessing word fluency, inhibition, and set shifting as components of executive functioning, and resting-state magnetoencephalography at T1 (at diagnosis, before resection) and T2 (1 year after resection). We constructed binary multilayer networks comprising six layers, with each layer representing frequency-specific functional connectivity between source-localized time series of 78 cortical regions. Average frontoparietal network multilayer eigenvector centrality, a measure for network integration, was calculated at both time points. Regression analyses were used to investigate associations with executive functioning.

RESULTS
At T1, lower multilayer integration (p = .017) and having epilepsy (p = .006) associated with poorer set shifting. Decreasing multilayer integration (p = .022) between T1 and T2 and not undergoing chemotherapy at T2 (p = .004) related to deteriorating set shifting. No significant associations were found for word fluency or inhibition.

CONCLUSION
As hypothesized, our results establish multilayer integration of the frontoparietal network as a cross-sectional and longitudinal correlate of executive functioning in glioma patients, further building upon the idea that glioma impacts the whole brain network and general cognitive functioning. However, multilayer integration did not significantly predict postoperative changes in executive functioning, limiting the direct clinical relevance of this measure.
NCOG-22. TIGER PRO-ACTIVE STUDY: INVESTIGATING DAILY ACTIVITY, SLEEP AND NEUROCOGNITIVE FUNCTIONING IN GLIOBLASTOMA PATIENTS APPLYING TTFIELDS THERAPY IN GERMANY IN ROUTINE CLINICAL CARE
Authors: Glas Martin , Tabatabai Ghazaleh , Fietkau Rainer , Goldbrunner Roland , Bähr Oliver 
Published: November 2022

Abstract
Based on the EF-14 trial, Tumor Treating Fields (TTFields) therapy is recommended in treatment guidelines for newly diagnosed glioblastoma (GBM). However, real-world data are limited. The non-interventional TIGER study (NCT03258021) will give insight into patients’ therapy decision, TTFields therapy duration and usage, quality of life, overall survival, and adverse events (AEs) in the real-world setting. Subsequently, we have now established the TIGER PROgram, a collaborative national network of neurooncology centers, that will allow us to use previously established administrative structures for new real-world investigations. Also, it will enable a basic data set across different trials and thereby facilitate meta-analyses across different populations. Here we report on the first study that we initiated within this program, the TIGER PRO-Active Study (NCT04717739), a prospective, an ongoing non-interventional, multicenter study in Germany investigating changes in daily activity, sleep, neurocognitive functioning as potential quality of life parameter in GBM patients whilst receiving TTFields therapy. Furthermore, TTFields therapy usage and serious AEs will be evaluated. Based on the planned subgroup analysis (MGMT and age), the experiences with the ongoing TIGER trial, the expected dropout rate and in consideration of the Central Limit Theorem (sufficiently large group size of n ≥ 30) we will recruit approximately 500 adult patients with newly diagnosed GBM over the course of 2 years. Data on physical activity and sleep will be collected via specific smartphone apps. Neurocognitive functioning will be assessed using the MoCA (Montreal Cognitive Assessment) interview test and quality of life with the EORTC QLQ-C30 and -BN20 questionnaires. Data will be collected over a time period of at least 12 months. First results are expected in 2024.