scholarly journals PS1 - 188 Rehabilitation Consultation: An Integrated Model for Addressing Rehabilitation Concerns in the Primary Brain Tumor Population

2016 ◽  
Vol 43 (S4) ◽  
pp. S9-S10
Author(s):  
I. Lax ◽  
M. Daniels ◽  
C. Kanter ◽  
W. Mason ◽  
K. Edelstein
Keyword(s):  
Brain Tumor ◽  
Brain Tumors ◽  
Disease Process ◽  
Primary Brain Tumor ◽  
Rehabilitation Services ◽  
Face To Face ◽  
Primary Brain Tumors ◽  
Common Diagnosis ◽  
Consultation Model ◽  
Oncology Treatment

Individuals with primary brain tumors experience a range of physical, cognitive and psychosocial sequelae which impact their independence, safety and quality of life. These impairments may be addressed through rehabilitation intervention. Despite acknowledgement that timely rehabilitation services over the course of the disease process is of benefit, few outpatient neuro-oncology treatment teams include a rehabilitation professional. Purpose: The aims are: (1) to describe a rehabilitation consultation model of care integrated into outpatient neuro-oncology treatment for individuals with primary brain tumors; and (2) to describe the characteristics of individuals referred for rehabilitation services. Methods: This retrospective descriptive study examined data from 200 individuals that received rehabilitation consultation from January 2015 to March 2016 at Princess Margaret Hospital, Pencer Brain Tumor Centre. Information on patient demographics, referral characteristics, and number of patient care visits was collected. Descriptive statistics were calculated. Preliminary Results: Of all patients, (n=195), the most common diagnosis is glioblastoma, 39% (n=76), and 50% are 50-69 years of age (M=55, SD=15.0). The most common reason for initial referral was decline in physical functioning, strength and balance (41%). In 77% of cases, patients were seen immediately at the time of referral. In total, 540 consultations were completed (face-to-face=230, telephone=310) with 2.78 on average (SD=4.0) per patient. Conclusion: Given the range of symptoms that individuals with primary brain tumors experience coupled with changes in functional status as the disease progresses, integrated and timely rehabilitation consultation is feasible.

scholarly journals Fertility preservation in primary brain tumor patients

2016 ◽  
Vol 4 (1) ◽  
pp. 40-45 ◽  
Author(s):  
Jacqueline B. Stone ◽  
Joanne F. Kelvin ◽  
Lisa M. DeAngelis
Keyword(s):  
Brain Tumor ◽  
Brain Tumors ◽  
Fertility Preservation ◽  
Primary Brain Tumor ◽  
Nurse Specialist ◽  
Tumor Patients ◽  
Related Factors ◽  
Patients Âgés ◽  
Primary Brain Tumors ◽  
Significant Difference

Abstract Background Fertility preservation (FP) is an infrequently addressed issue for young adults with primary brain tumors. Given the improved prognosis and enhanced technology in reproductive medicine, more primary brain tumor patients see procreation as feasible, making the discussion of FP increasingly important. The goals of this study were to describe patients who received FP counseling by a fertility nurse specialist (FNS) and determine which sociodemographic and disease-related factors predict acceptance of referral to a reproductive specialist. Methods Institutional review board-approved retrospective review of primary brain tumor patients, ages 18 to 45, who were referred for FP counseling with a FNS from 2009 to 2013. Results Seventy patients were referred for FP counseling: 38 men, 32 women, with a median age of 32 years and median KPS of 90. Eighty-nine percent had gliomas; 58% grade III, 17% grade IV. Sixty-seven percent were referred for counseling at initial diagnosis. Of those referred, 73% accepted referral to a sperm bank (87% of men) or reproductive endocrinologist (56% of women). Patients were more likely to accept referral if they had no prior children (P = .048). There was no statistically significant difference in referral acceptance by age, race/ethnicity, marital status, religion, or tumor grade. After treatment, 3 men conceived naturally, 2 men conceived using banked sperm, and 2 women conceived naturally. Conclusions Despite the historically poor prognosis of patients with primary brain tumors, there is significant interest in FP among these patients, particularly if they have no prior children. Clinicians should develop strategies to incorporate FP counseling into practice.

THE APPLICATION OF NANOMATERIALS IN DIAGNOSIS AND TREATMENT FOR MALIGNANT PRIMARY BRAIN TUMORS

NANO ◽  
2014 ◽  
Vol 09 (01) ◽  
pp. 1430001 ◽  
Author(s):  
RUICHAO LIANG ◽  
FANG FANG
Keyword(s):  
Brain Tumor ◽  
Brain Tumors ◽  
Tumor Cells ◽  
Primary Brain Tumor ◽  
High Morbidity ◽  
Convection Enhanced Delivery ◽  
Anticancer Efficacy ◽  
Agent Based ◽  
Diagnostic Strategies ◽  
Primary Brain Tumors

Malignant primary brain tumors have a very high morbidity and mortality. Even though enormous advances have been made in primary brain tumor management, in the case of malignant primary brain tumors, current diagnostic strategies cannot identify exact infiltrating margins, surgery alone cannot achieve total mass resection, and adjuvant therapies cannot improve survivals. Therefore, there is an urgent need to explore novel strategies to diagnose and treat such infiltrating brain tumors. Nanomaterials, particularly zero-dimensional and one-dimensional platforms, can carry various compounds such as contrast agents, anticancer drugs and genes into brain tumor cells specifically. Thus, contrast agent-based nanomaterials can selectively present infiltrating tumor outlines, while anticancer agent-based nanomaterials can specifically kill malignant tumor cells. In addition, dual-targeting nanomaterials, multifunctional nanocarriers, theranostic nanovehicles as well as convection-enhanced delivery technology hold promise to increase drug accumulation in tumor tissues, which could largely improve anticancer efficacy. In this review, we will mainly focus on the application of nanomaterials in preoperative diagnosis, intraoperative diagnosis and adjuvant treatment for malignant primary brain tumors.

scholarly journals Neuroinflammation in Autoimmune Disease and Primary Brain Tumors: The Quest for Striking the Right Balance

2021 ◽  
Vol 15 ◽  
Author(s):  
Dana Mitchell ◽  
Jack Shireman ◽  
Elizabeth A. Sierra Potchanant ◽  
Montserrat Lara-Velazquez ◽  
Mahua Dey
Keyword(s):  
Brain Tumor ◽  
Brain Tumors ◽  
Primary Brain Tumor ◽  
Primary Brain Tumors ◽  
Neuroinflammatory Disease ◽  
Pathological Conditions ◽  
The Central Nervous System ◽  
The Right ◽  
The Brain ◽  
Cns Malignancies

According to classical dogma, the central nervous system (CNS) is defined as an immune privileged space. The basis of this theory was rooted in an incomplete understanding of the CNS microenvironment, however, recent advances such as the identification of resident dendritic cells (DC) in the brain and the presence of CNS lymphatics have deepened our understanding of the neuro-immune axis and revolutionized the field of neuroimmunology. It is now understood that many pathological conditions induce an immune response in the CNS, and that in many ways, the CNS is an immunologically distinct organ. Hyperactivity of neuro-immune axis can lead to primary neuroinflammatory diseases such as multiple sclerosis and antibody-mediated encephalitis, whereas immunosuppressive mechanisms promote the development and survival of primary brain tumors. On the therapeutic front, attempts are being made to target CNS pathologies using various forms of immunotherapy. One of the most actively investigated areas of CNS immunotherapy is for the treatment of glioblastoma (GBM), the most common primary brain tumor in adults. In this review, we provide an up to date overview of the neuro-immune axis in steady state and discuss the mechanisms underlying neuroinflammation in autoimmune neuroinflammatory disease as well as in the development and progression of brain tumors. In addition, we detail the current understanding of the interactions that characterize the primary brain tumor microenvironment and the implications of the neuro-immune axis on the development of successful therapeutic strategies for the treatment of CNS malignancies.

EPID-17. COMPARATIVE EPIDEMIOLOGY OF PRIMARY BRAIN TUMORS AMONG ADOLESCENTS AND YOUNG ADULTS (AYA)

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi89-vi89
Author(s):  
Nayan Lamba ◽  
Bryan Iorgulescu
Keyword(s):  
Brain Tumor ◽  
Brain Tumors ◽  
Cox Regression ◽  
Adolescent And Young Adult ◽  
Lower Grade ◽  
Diffuse Glioma ◽  
Tumor Type ◽  
Primary Brain Tumors ◽  
Diffuse Gliomas ◽  
Hiv Aids

Abstract INTRODUCTION We utilized national registry data to evaluate the unique epidemiology of primary adolescent and young adult (AYA) brain tumors according to the WHO2016 classification. METHODS AYA patients (15≤age≤39) presenting between 2004-2017 with a brain tumor were identified by ICD-O-3 coding from the National Cancer Database (comprising >70% of newly-diagnosed cancers in the U.S.), and compared to pediatric and adult populations. Epidemiology and overall survival (estimated by Kaplan-Meier techniques and multivariable Cox regression) were assessed by WHO2016 tumor type. RESULTS 108,705 AYA brain tumor patients were identified (56.9% female), compared to 23,928 pediatric (46.8% female) and 748,272 adult (55.6% female) patients. Among the 69.4% of AYA brain tumors with pathological diagnosis, diffuse gliomas (31.4%), sellar tumors (19.2%), and meningiomas (15.3%) predominated in both sexes. Diffuse glioma (31.4%), sellar (19.2%), cranial nerve (7.3%), and mesenchymal non-meningothelial (4.1%) tumors represented a greater proportion of AYA brain tumors than in either pediatric or adult populations. A majority of all intracranial GCTs (59.2%) and neuronal & mixed neuronal-glial tumors (51.6%) presented during AYA. Although the prevalence of diffuse gliomas was similar between AYAs and adults, AYA gliomas were more likely to be grade 2-3 astrocytomas (38.9% vs 14.3%) and oligodendrogliomas (19.3% vs 4.3%) than in adults. GBMs represented 76.0% of adult diffuse gliomas vs. only 25.7% of AYA diffuse gliomas, but with a similar prevalence of MGMT promoter methylation (40.8% vs 38.4%). Notably, 50.7% of AYA PCNSLs were associated with HIV/AIDS, vs only 7.1% in adults (p< 0.001). CONCLUSIONS The distribution, epidemiology, and survival outcomes of primary brain tumors in the AYA population are distinct from their pediatric and adult counterparts. Notably, AYA infiltrative gliomas were more often of lower grade than adults and AYA PCNSL were far more likely to be associated with HIV/AIDS. Primary brain tumors in AYA patients require specialized management.

scholarly journals BRAF Mutations and the Utility of RAF and MEK Inhibitors in Primary Brain Tumors

Cancers ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 1262 ◽  
Author(s):  
Karisa C. Schreck ◽  
Stuart A. Grossman ◽  
Christine A. Pratilas
Keyword(s):  
Brain Tumors ◽  
Poor Prognosis ◽  
Primary Brain Tumor ◽  
High Grade ◽  
Braf Mutations ◽  
Mek Inhibitors ◽  
Primary Brain Tumors ◽  
The Poor ◽  
Oncogenic Mutations ◽  
Tumor Types

BRAF mutations have been identified as targetable, oncogenic mutations in many cancers. Given the paucity of treatments for primary brain tumors and the poor prognosis associated with high-grade gliomas, BRAF mutations in glioma are of considerable interest. In this review, we present the spectrum of BRAF mutations and fusion alterations present in each class of primary brain tumor based on publicly available databases and publications. We also summarize clinical experience with RAF and MEK inhibitors in patients with primary brain tumors and describe ongoing clinical trials of RAF inhibitors in glioma. Sensitivity to RAF and MEK inhibitors varies among BRAF mutations and between tumor types as only class I BRAF V600 mutations are sensitive to clinically available RAF inhibitors. While class II and III BRAF mutations are found in primary brain tumors, further research is necessary to determine their sensitivity to third-generation RAF inhibitors and/or MEK inhibitors. We recommend that the neuro-oncologist consider using these drugs primarily in the setting of a clinical trial for patients with BRAF-altered glioma in order to advance our knowledge of their efficacy in this patient population.

scholarly journals GENE-03. SPECIFIC SIGNATURES OF microRNA IN CEREBROSPINAL FLUID OF PATIENTS WITH PRIMARY BRAIN TUMORS AND METASTASES

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi98-vi98
Author(s):  
Radim Jancalek ◽  
Martin Smrcka ◽  
Alena Kopkova ◽  
Jiri Sana ◽  
Marek Vecera ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Czech Republic ◽  
Brain Tumor ◽  
Brain Tumors ◽  
Brain Metastases ◽  
Independent Set ◽  
Low Grade ◽  
Primary Brain Tumors ◽  
Csf Analysis ◽  
Different Levels

Abstract Cerebrospinal fluid (CSF) baths extracellular environment of the central nervous system, and thus, it is ideal source of tumor diagnostic biomarkers like microRNAs (miRNAs), short non-coding RNAs involved in the pathogenesis of many cancers. As dysregulated levels of brain tumor specific miRNAs have been already observed in CSF, analysis of CSF miRNAs in brain tumor patients might help to develop new diagnostic platform. Next-Generation sequencing (NGS) was performed for analysis of small RNAs in 89 CSF samples taken from 32 glioblastomas (GBM), 14 low-grade gliomas (LGG), 11 meningiomas, 13 brain metastases and 19 non-tumor donors. Subsequently, according to NGS results levels of 10 miRNAs were measured in independent set of CSF samples (41 GBM, 44 meningiomas, 12 brain metastases and 20 non-tumor donors) using TaqMan Advanced miRNA Assays. NGS analysis revealed 22, 12 and 35 CSF miRNAs with significantly different levels in GBM, meningiomas, and brain metastases (adj.p < 0.0005, adj.p < 0.01, and adj.p < 0.005) respectively, in comparison with non-tumor CSF samples. Subsequent validation of selected CSF miRNAs has confirmed different levels of 7 miRNAs in GBM, 2 in meningiomas, and 2 in brain metastases compared to non-tumors. Panel of miR-30e-5p and miR-140-5p was able to distinguish brain metastases with 65% sensitivity and 100% specificity compared to non-tumor samples (AUC = 0.8167); panel of miR-21-3p and miR-196-5p classified metastatic patients with 78% sensitivity and 92 % specificity in comparison to GBM (AUC = 0.90854) and with 75% sensitivity and 83% specificity compared to meningiomas (AUC = 0.84848). We have observed that CSFs from patients with various primary brain tumors and metastases are characterized by specific miRNA signatures. This work was supported by the Ministry of Health, Czech Republic grant nr. NV18-03-00398 and the Ministry of Education, Youth and Sports, Czech Republic under the project CEITEC 2020 (LQ1601).

scholarly journals Podoplanin expression in primary brain tumors induces platelet aggregation and increases risk of venous thromboembolism

Blood ◽  
2017 ◽  
Vol 129 (13) ◽  
pp. 1831-1839 ◽  
Author(s):  
Julia Riedl ◽  
Matthias Preusser ◽  
Pegah Mir Seyed Nazari ◽  
Florian Posch ◽  
Simon Panzer ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Venous Thromboembolism ◽  
Platelet Aggregation ◽  
High Risk ◽  
Brain Tumors ◽  
Tumor Patients ◽  
Primary Brain Tumors ◽  
Key Points ◽  
Podoplanin Expression ◽  
Very High

Key Points Brain tumor patients have a very high risk of VTE. Podoplanin expression by primary brain tumors induces platelet aggregation and is associated with hypercoagulability and a high risk of VTE.

The New Approaches to Brain Tumor Therapy (NABTT) CNS Consortium: Organization, Objectives, and Activities

1998 ◽  
Vol 5 (2) ◽  
pp. 107-114 ◽  
Author(s):  
Stuart A. Grossman ◽  
Joy D. Fisher ◽  
Steven Piantadosi ◽  
Henry Brem
Keyword(s):  
Brain Tumor ◽  
Brain Tumors ◽  
Clinical Research ◽  
Tumor Therapy ◽  
Laboratory Research ◽  
Primary Brain Tumors ◽  
Large Numbers ◽  
Neuro Imaging ◽  
Important Drug

Background: Despite advances in neuro-imaging, neurosurgery, radiation therapy, and chemotherapy, limited progress has been made in the treatment of patients with high-grade astrocytomas. The National Cancer Institute has attempted to speed advances in this field by funding CNS consortia to conduct innovative clinical trials in this patient population since 1994. Methods: The NABTT CNS Consortium is composed of a consortium headquarters and nine member institutions with outstanding multidisciplinary expertise, clinical and laboratory research capabilities, and access to large numbers of patients with brain tumors. Results: The objectives of the NABTT Consortium are to improve the therapeutic outcome for adults with primary brain tumors, to conduct basic science and clinical research, and to improve the care and quality of life of adults with primary brain tumors. NABTT's clinical studies have discovered important drug interactions between anticonvulsant and antineoplastic agents, defined the activity of paclitaxel and 9-aminocamptothecin in glioblastoma multiforme, tested a novel dose escalation strategy for brain tumor trials, and established new protocol “classes” to expedite and standardize clinical research in this field. Conclusions: Significant progress in the care of patients with primary brain tumors is likely to result from the highly focused and multidisciplinary efforts of the NIH-funded CNS consortia.

scholarly journals Study Protocol for a Randomized Controlled Trial Evaluating the Efficacy of an Evidence-Based iPad-App for Cognitive Rehabilitation in Patients with Primary Brain Tumors

Neurosurgery ◽  
2018 ◽  
Vol 85 (2) ◽  
pp. 273-279 ◽  
Author(s):  
Sophie Dorothee van der Linden ◽  
Margriet Maria Sitskoorn ◽  
Geert-Jan Maria Rutten ◽  
Karin Gehring
Keyword(s):  
Randomized Controlled Trial ◽  
Brain Tumor ◽  
Brain Tumors ◽  
Cognitive Rehabilitation ◽  
Controlled Trial ◽  
Rehabilitation Program ◽  
Control Group ◽  
Tumor Patients ◽  
Primary Brain Tumors ◽  
Randomized Controlled

Abstract BACKGROUND Many patients with primary brain tumors suffer from cognitive deficits, which negatively impact their quality of life. However, cognitive rehabilitation programs for these patients are scarce. We developed an iPad-based cognitive rehabilitation program for brain tumor patients, which was based on our effective face-to-face cognitive rehabilitation program. After successful completion of a feasibility study, a randomized controlled trial has been started. OBJECTIVE To evaluate the immediate and long-term effects of the iPad-based program on cognitive performance and patient-reported outcome measures (PROMs) in patients with primary brain tumors in an early stage of the disease. METHODS Prior to surgery, patients with presumed low-grade glioma and meningioma are included. Before surgery and 3 mo after surgery, neuropsychological assessments are conducted. After the second neuropsychological assessment, patients are assigned to the intervention group or waiting-list control group. The intervention consists of psychoeducation, compensation training, and retraining. Patients are advised to spend 3 h per week on the program for 10 wk. Immediately after completion of the program and a half-year thereafter, postintervention assessments take place. Patients in the control group are offered the opportunity to follow the program after all study assessments. EXPECTED OUTCOMES We expect that early cognitive rehabilitation has beneficial effects on cognitive performance and PROMs in brain tumor patients. DISCUSSION The iPad-based program allows brain tumor patients to follow a cognitive rehabilitation program from their homes. Forthcoming results may contribute to further improvement of supportive care for brain tumor patients.

scholarly journals Brain tumors risk factors - current state of knowledge review

2021 ◽  
Vol 11 (9) ◽  
pp. 101-107
Author(s):  
Zygmunt Siedlecki ◽  
Małgorzata Szafrańska ◽  
Emilia Główczewska-Siedlecka ◽  
Maciej Śniegocki
Keyword(s):  
Risk Factors ◽  
Brain Tumor ◽  
Ionizing Radiation ◽  
Brain Tumors ◽  
Poor Prognosis ◽  
Primary Brain Tumor ◽  
Evidence Based ◽  
Raw Meat ◽  
The Public ◽  
Current State

Brain tumors cause widespread apprehension in society, associated with poor prognosis and death. Laymen most often associate them with glioblastoma multiforme which is in fact the most common malignant primary brain tumor (formerly it was considered the most common primary brain tumor, now it is thought that meningiomas are the most common). The interest of both the public and physicians is aroused by potential brain tumors risk factors. The only evidence based risk factor is ionizing radiation of head and neck. Other risk factors are also under consideration, however are not conclusive and different studies give different results. Given the widespread apprehension of brain tumors, knowledge of the risk factors seems obvious. In this manuscript, we have reviewed the current state of knowledge aboutf risk factors based on research. They confirm that apart from ionizing radiation, the existence of other risk factors is considered: cell phones, electromagnetic field, occupational exposure to raw meat, viruses. However, all these risk factors are not confirmed by reference results.

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