P14.45 The incidence of major subtypes of primary brain tumours in adults in England 1995–2017

2021 ◽  
Vol 23 (Supplement_2) ◽  
pp. ii46-ii47
Author(s):  
H Wanis
Keyword(s):  
Brain Tumour ◽  
Brain Tumours ◽  
Incidence Rates ◽  
Diagnostic Tools ◽  
Cancer Registration ◽  
Molecular Testing ◽  
Malignant Tumours ◽  
Primary Brain Tumours ◽  
Primary Brain Tumour ◽  
European Standard Population

Abstract BACKGROUND Primary brain tumours are a complex heterogenous group of benign and malignant tumours. Reports on their occurrence in the English population by sex, age, and morphological subtype and on their incidence are currently not available. Using data from the National Cancer Registration and Analysis Service (NCRAS), the incidence of adult primary brain tumour by major subtypes in England will be described. METHODS Data on all adult English patients diagnosed with primary brain tumour between 1995 and 2017, excluding spinal, endocrinal and other CNS tumours, were extracted from NCRAS. Incidence rates were standardised to the 2013 European Standard Population. Results are presented by sex, age, and morphological subtype. RESULTS Between 1995 and 2017, a total of 133,669 cases of adult primary brain tumour were registered in England. Glioblastoma was the most frequent tumour subtype (31.8%), followed by meningioma (27.3%). The age-standardised incidence for glioblastoma increased from 3.27 per 100,000 population per year in 1995 to 7.34 in men in 2013 and from 2.00 to 4.45 in women. Meningioma incidence also increased from 1.89 to 3.41 per 100,000 in men and from 3.40 to 7.46 in women. The incidence of other astrocytic and unclassified brain tumours declined between 1995 and 2007 and remained stable thereafter. CONCLUSION Part of the increase in the incidence of major subtypes of brain tumours in England could be explained by advances in clinical practice including the adoption of new diagnostic tools, classifications and molecular testing, and improved cancer registration practices.

scholarly journals Brain Tumours: Rise in Glioblastoma Multiforme Incidence in England 1995–2015 Suggests an Adverse Environmental or Lifestyle Factor

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Alasdair Philips ◽  
Denis L. Henshaw ◽  
Graham Lamburn ◽  
Michael J. O’Carroll
Keyword(s):  
Glioblastoma Multiforme ◽  
Brain Tumour ◽  
Brain Tumours ◽  
Age Groups ◽  
Diagnostic Techniques ◽  
Incidence Rates ◽  
Lifestyle Factor ◽  
Lower Grade ◽  
Incidence Data ◽  
European Standard Population

Objective. To investigate detailed trends in malignant brain tumour incidence over a recent time period. Methods. UK Office of National Statistics (ONS) data covering 81,135 ICD10 C71 brain tumours diagnosed in England (1995–2015) were used to calculate incidence rates (ASR) per 100k person–years, age–standardised to the European Standard Population (ESP–2013). Results. We report a sustained and highly statistically significant ASR rise in glioblastoma multiforme (GBM) across all ages. The ASR for GBM more than doubled from 2.4 to 5.0, with annual case numbers rising from 983 to 2531. Overall, this rise is mostly hidden in the overall data by a reduced incidence of lower-grade tumours. Conclusions. The rise is of importance for clinical resources and brain tumour aetiology. The rise cannot be fully accounted for by promotion of lower–grade tumours, random chance or improvement in diagnostic techniques as it affects specific areas of the brain and only one type of brain tumour. Despite the large variation in case numbers by age, the percentage rise is similar across the age groups, which suggests widespread environmental or lifestyle factors may be responsible. This article reports incidence data trends and does not provide additional evidence for the role of any particular risk factor.

scholarly journals Non-coplanar VMAT plans for postoperative primary brain tumour to reduce dose to Hippocampus, temporal lobe and cochlea: a planning study

BJR|Open ◽  
2021 ◽  
pp. 20210009
Author(s):  
Eva Yi Wah Cheung ◽  
Kevin Ho Yuen Lee ◽  
Wilson Tin Long Lau ◽  
Amy Pik Yan Lau ◽  
Pak Ying Wat
Keyword(s):  
Brain Tumour ◽  
Temporal Lobe ◽  
Brain Tumours ◽  
Contralateral Side ◽  
Plan Quality ◽  
Planning Study ◽  
Primary Brain Tumours ◽  
Primary Brain Tumour ◽  
Dose Constraints

Objectives: This study aimed to compare radiotherapy plan quality of coplanar VMAT (CO-VMAT) and non-coplanar VMAT (NC-VMAT) for postoperative primary brain tumour. Methods: A total of 16 patients who were treated for primary brain tumours were retrospectively selected for this study. For each patient, identical CT sets with structures were used for both CO-VMAT and NC-VMAT planning. For CO-VMAT, one full arc and two coplanar half arcs were used. For NC-VMAT, one full coplanar and two non-coplanar half arcs with couch rotation of 315° or 45°. Dose constraints were adhered to the RTOG0614 and 0933. Dose volumetric parameters were collected for statistical analysis. Results: There were no significant differences for the PTV, HI, CN and μ between the CO-VMAT and NC-VMAT. For the brainstem, Dmean of CO-VMAT and NC-VMAT were 6.04 ± 3.94 Gy and 4.69 ± 2.56 Gy respectively (p < 0.05). For the ipsilateral OARs including temporal lobe, TM joint and cochlear, Dmean of CO-VMAT and NC-VMAT were 31.80 ± 12.78 Gy and 25.51 ± 17.54 Gy (p < 0.01) ; 14.12 ± 8.6 Gy and 3.35 ± 4.12 Gy (p < 0.001); 11.96 ± 11.68 Gy and 6.62 ± 9.74 Gy (p < 0.01) respectively. For contralateral OARs including hippocampus, temporal lobe, TM joint, Optic nerve, lens, eyeball and cochlear, the Dmean of CO-VMAT and NC-VMAT were 6.16 ± 2.44 Gy and 4.49 ± 2.00 Gy (p < 0.01) ; 6.48 ± 2.76 Gy and 3.68 ± 1.76 Gy (p < 0.0001); 11.96 ± 11.68 Gy and 6.62 ± 9.74 Gy (p < 0.01) respectively. Conclusion: The proposed NC-VMAT showed more favourable plan quality than the CO-VMAT for primary brain tumours, in particular to OARs located to the contralateral side-of tumours. Advances in knowledge: For primary brain tumours RT, NC-VMAT can reduce doses to the brainstem, ipsilateral temporal lobe, TM joint and cochlear, as well as OARs located to the contralateral side-of tumours.

scholarly journals Mortality due to primary brain tumours in China and detection rate in people with suspected symptoms: a nationally representative cross-sectional survey

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Bin Jiang ◽  
Hongmei Liu ◽  
Dongling Sun ◽  
Haixin Sun ◽  
Xiaojuan Ru ◽  
...  
Keyword(s):  
Brain Tumour ◽  
Brain Tumours ◽  
Detection Rate ◽  
Epidemiological Data ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Detection Rates ◽  
Primary Brain Tumours ◽  
Symptom Screening ◽  
Nationally Representative

Abstract Background and purpose Epidemiological data on primary brain tumours (PBTs) are lacking due to the difficulty in case ascertainment among the population. Thus, we aimed to estimate mortality due to PBTs in China nationwide and the detection rate in people with suspected symptoms. Methods A multistage, complex sampling survey regarding mortality due to PBTs in Chinese individuals was carried out by reviewing all causes of death within a year. The detection rates in people with suspected symptoms were estimated based on PBT symptom screening and neurologist reviews and compared between groups by logistic regression analysis. Results Weighted mortality due to PBT was 1.6 (0.8–3.3) per 100,000 population in Chinese individuals, 1.8 (0.7–4.6) per 100,000 population in men, and 1.5 (0.5–4.5) per 100,000 population in women. Among 14,990 people with suspected symptoms, the PBT detection rate was 306.9 (95% CI 224.7–409.3) per 100,000 population in the total population, 233.0 (95% CI 135.7–373.1) per 100,000 population in men, and 376.9 (95% CI 252.4–546.3) per 100,000 population in women. People with an unsteady gait (OR 2.46; 95% CI 1.09–5.51; P=0.029), visual anomalies (3.84; 1.88–7.85; P<0.001), and headache (2.06; 1.10–3.86; P=0.023) were more likely to have a brain tumour than those without corresponding symptoms, while people with dizziness/vertigo were less likely to have a brain tumour than those without corresponding symptoms (0.45; 0.23–0.87; P=0.017). Conclusions Mortality due to PBT in China was low, with a nationwide estimate of 21,215 (10,427–43,165) deaths attributable to PBTs annually. However, the detection rate of PBTs can be greatly improved based on symptom screening in the population.

scholarly journals Mobile phone use and incidence of brain tumour histological types, grading or anatomical location: a population-based ecological study

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e024489 ◽  
Author(s):  
Ken Karipidis ◽  
Mark Elwood ◽  
Geza Benke ◽  
Masoumeh Sanagou ◽  
Lydiawati Tjong ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Brain Tumour ◽  
Brain Tumours ◽  
Ecological Study ◽  
Population Based ◽  
Incidence Rates ◽  
Anatomical Location ◽  
Mobile Phone Use ◽  
Registration Data ◽  
Relative Risks

ObjectiveSome studies have reported increasing trends in certain brain tumours and a possible link with mobile phone use has been suggested. We examined the incidence time trends of brain tumour in Australia for three distinct time periods to ascertain the influence of improved diagnostic technologies and increase in mobile phone use on the incidence of brain tumours.DesignIn a population-based ecological study, we examined trends of brain tumour over the periods 1982–1992, 1993–2002 and 2003–2013. We further compared the observed incidence during the period of substantial mobile phone use (2003–2013) with predicted (modelled) incidence for the same period by applying various relative risks, latency periods and mobile phone use scenarios.SettingNational Australian incidence registration data on primary cancers of the brain diagnosed between 1982 and 2013.Population16 825 eligible brain cancer cases aged 20–59 from all of Australia (10 083 males and 6742 females).Main outcome measuresAnnual percentage change (APC) in brain tumour incidence based on Poisson regression analysis.ResultsThe overall brain tumour rates remained stable during all three periods. There was an increase in glioblastoma during 1993–2002 (APC 2.3, 95% CI 0.8 to 3.7) which was likely due to advances in the use of MRI during that period. There were no increases in any brain tumour types, including glioma (−0.6, –1.4 to 0.2) and glioblastoma (0.8, –0.4 to 2.0), during the period of substantial mobile phone use from 2003 to 2013. During that period, there was also no increase in glioma of the temporal lobe (0.5, –1.3 to 2.3), which is the location most exposed when using a mobile phone. Predicted incidence rates were higher than the observed rates for latency periods up to 15 years.ConclusionsIn Australia, there has been no increase in any brain tumour histological type or glioma location that can be attributed to mobile phones.

scholarly journals Using surgical and oncology workload to plan brain tumour trial recruitment in England

2019 ◽  
Vol 21 (Supplement_4) ◽  
pp. iv11-iv12
Author(s):  
Kerlann Le Calvez ◽  
Peter Treasure ◽  
Matt Williams
Keyword(s):  
Clinical Trials ◽  
Brain Tumour ◽  
Brain Tumours ◽  
Adult Patients ◽  
Trial Recruitment ◽  
Trade Off ◽  
Primary Brain Tumour ◽  
Rational Planning ◽  
The Brain ◽  
Over Time

Abstract Introduction Access to clinical trials is a common request for patients with brain tumours. However, opening clinical trials requires additional work per centre opened. We have previously shown that surgical and oncology workload varies between centres, and fluctuates over time. There is a trade-off between offering access to clinical trials and increasing costs associated with opening trials in centres that treat few patients. Methods We used two separate datasets from England covering 3 years – one for neurosurgical workload and one for radiotherapy. We only included adult patients and calculated cumulative proportions of the malignant primary brain tumour population (C71) by number of centres. We investigated stability by checking how many patients would have to be added/ removed from a centre to change their rank. Results There were 7061 surgical and 5060 radiotherapy patients. To capture 25% of patients, we would need to open trials in 4 surgical/5 radiotherapy centres; for 50%, 9 surgical/ 13 radiotherapy centres; for 75%, 16 surgical/ 24 radiotherapy centres. Centre rank was fluid: adding 16 surgical/9 radiotherapy patients would change the rank of a centre. Discussion These are the first data to allow for rational planning of trials in brain tumour patients. We have shown that we can reach 75% of the brain tumour population by opening trials in ~50% of surgical and radiotherapy centres. Centre rank alters over year, so we should be cautious about being too prescriptive. Nonetheless, these data should allow some rational planning of trial centre inclusion.

scholarly journals Developing guidelines for the management of brain tumour related epilepsy

2021 ◽  
Vol 23 (Supplement_4) ◽  
pp. iv3-iv4
Author(s):  
Elizabeth Vacher ◽  
Miguel Rodriguez Ruiz ◽  
Jeremy Rees
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Brain Tumour ◽  
Brain Tumours ◽  
Current Evidence ◽  
Low Grade ◽  
Clinical Nurse Specialists ◽  
Primary Brain Tumours ◽  
Low Incidence

Abstract Aims Brain Tumour Related Epilepsy (BTRE) has a significant impact on Quality of Life with implications for driving, employment and social and domestic activities. Management of BTRE is complex due to the higher incidence of pharmacoresistance and the potential for interaction between anti-cancer therapy and anti-epileptic drugs (AEDs). Neurologists, oncologists, palliative care physicians and clinical nurse specialists treating these patients would benefit from up-to-date clinical guidelines. We aim to review the current evidence to adapt current NICE guidelines for Epilepsy and to outline specific recommendations for the optimal treatment of BTRE, encompassing both primary and metastatic brain tumours. Method A comprehensive search of the literature from the past 20 years on BTRE was carried out in three databases: Embase, Medline and EMCARE. A broad search strategy was used and the evidence was evaluated and graded based on the Oxford Centre for Evidence-Based Medicine Levels of Evidence. Results All patients with BTRE should be treated with AEDs. There is no proven benefit for the use of prophylactic AEDs, although there are no randomised trials testing newer agents. Seizure frequency varies between 10-40% (Class 2a evidence) in patients with Brain Metastases (BM) and from 30% (high-grade gliomas) to 90% (low-grade gliomas) (Class 2a evidence) in patients with Primary Brain Tumours (PBT). In patients with BM, risk factors include number of BM and melanoma histology (Class 2b evidence). In patients with PBT, risk factors include frontal and temporal location, oligodendroglial histology, IDH mutation and cortical infiltration (Class 2b evidence). There is a low incidence of seizures (13%) after stereotactic radiosurgery for BM (Class 2b evidence). Non-enzyme inducing AEDs are recommended as first line treatment for BTRE, but up to 50% of patients with BTRE due to PBT remain resistant (Class 2b evidence). Conclusion The review has highlighted the relative dearth of high quality evidence for the management of BTRE, and provides a framework for further studies aiming to improve seizure control, quality of life, and indications for AEDs.

scholarly journals Missed opportunities for diagnosing brain tumours in primary care: a qualitative study of patient experiences

2019 ◽  
Vol 69 (681) ◽  
pp. e224-e235 ◽  
Author(s):  
Fiona M Walter ◽  
Clarissa Penfold ◽  
Alexis Joannides ◽  
Smiji Saji ◽  
Margaret Johnson ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Brain Tumour ◽  
Brain Tumours ◽  
Help Seeking ◽  
Patient Experiences ◽  
Missed Opportunities ◽  
North West ◽  
Primary Brain Tumour ◽  
Symptom Appraisal ◽  
Poor Outcomes

BackgroundBrain tumours are uncommon, and have extremely poor outcomes. Patients and GPs may find it difficult to recognise early symptoms because they are often non-specific and more likely due to other conditions.AimTo explore patients’ experiences of symptom appraisal, help seeking, and routes to diagnosis.Design and settingQualitative study set in the East and North West of England.MethodIn-depth interviews with adult patients recently diagnosed with a primary brain tumour and their family members were analysed thematically, using the Model of Pathways to Treatment as a conceptual framework.ResultsInterviews were carried out with 39 patients. Few participants (n = 7; 18%) presented as an emergency without having had a previous GP consultation; most had had one (n = 15; 38%), two (n = 9; 23%), or more (n = 8; 21%) GP consultations. Participants experienced multiple subtle ‘changes’ rather than ‘symptoms’, often noticed by others rather than the patient, which frequently led to loss of interest or less ability to engage with daily living activities. The most common changes were in cognition (speaking, writing, comprehension, memory, concentration, and multitasking), sleep, and other ‘head feelings’ such as dizziness. Not all patients experienced a seizure, and few seizures were experienced ‘out of the blue’. Quality of communication in GP consultations played a key role in patients’ subsequent symptom appraisal and the timing of their decision to re-consult.ConclusionMultiple subtle changes and frequent GP visits often precede brain tumour diagnosis, giving possible diagnostic opportunities for GPs. Refined community symptom awareness and GP guidance could enable more direct pathways to diagnosis, and potentially improve patient experiences and outcomes.

scholarly journals Soluble PD-L1 is associated with local and systemic inflammation markers in primary and secondary brain tumours

ESMO Open ◽  
2020 ◽  
Vol 5 (6) ◽  
pp. e000863
Author(s):  
Maximilian J Mair ◽  
Sahra Pajenda ◽  
Aysegül Ilhan-Mutlu ◽  
Ariane Steindl ◽  
Barbara Kiesel ◽  
...  
Keyword(s):  
Brain Tumour ◽  
Systemic Inflammation ◽  
Brain Tumours ◽  
Death Receptor ◽  
Immunohistochemical Analysis ◽  
Tumour Microenvironment ◽  
Clinical Activity ◽  
Lower Grade ◽  
Protein Levels ◽  
Primary Brain Tumours

BackgroundImmune-modulatory treatments have so far shown limited clinical activity in primary brain tumours. We aimed to investigate soluble programmed death receptor ligand 1 (sPD-L1) as systemic inflammation parameter in patients with brain tumour.MethodsEDTA plasma was collected from 81 glioma (55 glioblastoma (GBM), 26 lower-grade glioma (LGG)), 17 meningioma and 44 brain metastasis (BM) patients and 24 controls. sPD-L1 concentrations were determined by ELISA. Correlations with the local tumour microenvironment were assessed by immunohistochemical analysis for PD-L1, CD3 and CD8.ResultssPD-L1 was detected in 62 out of 166 (37.7%) patients (glioma: 41/81, 50.6%; meningioma: 5/17, 29.4%; BM: 7/44, 15.9%; controls: 9/24, 37.5%; p=0.002). sPD-L1 concentrations were lower in BM than in LGG (p=0.003) or GBM (p<0.001). Membranous PD-L1 expression on tumour cells was not associated with sPD-L1 concentrations (p=0.953). sPD-L1 concentration was inversely correlated with the density of CD8+ (r=−0.713, p=0.001) and CD3+ (r=−0.484, p=0.042) tumour-infiltrating lymphocytes in LGG. sPD-L1 is correlated with neutrophil counts (r=−0.318, p=0.045) and C reactive protein levels (r=−0.363, p=0.008) in GBM. sPD-L1+ patients had longer overall survival in GBM (p=0.006) and worse OS in LGG (p=0.028).ConclusionssPD-L1 is detectable in a fraction of patients with brain tumour. Although it is not correlated with tissue PD-L1 expression, correlations with other local and systemic inflammation parameters could be detected in LGG and GBM.

scholarly journals Subcortical contributions to higher cognitive function in tumour patients undergoing awake craniotomy

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Rex E Jung ◽  
Christopher J Wertz ◽  
Shannan J Ramey ◽  
Ron L Mims ◽  
Ranee A Flores ◽  
...  
Keyword(s):  
Cognitive Functioning ◽  
Brain Tumours ◽  
Cognitive Outcome ◽  
Subcortical Structures ◽  
Cavernous Malformations ◽  
Emotional Quality ◽  
Primary Brain Tumours ◽  
Primary Brain Tumour ◽  
Prior Literature ◽  
Temporal Structures

Abstract Primary brain tumours often occur near eloquent regions, affecting language, motor and memory capacity, with awake mapping and tailored resection designed to preserve higher cognitive functioning. The effects of such tumours on subcortical structures, including the thalamus and basal ganglia, have been largely unexplored, in spite of the known importance of such structures to higher cognitive functioning. We sought to explore the effects of volume changes of subcortical structures on cognition, in 62 consecutive patients diagnosed with primary brain tumour and cavernous malformations, referred to our neurosurgical practice. We found right caudate to be highly predictive of intelligence, left pallidum of total neuropsychological function and right hippocampus of mood. Our study is the largest of its kind in exploring subcortical substrates of higher cognition in consecutive patients with brain tumours. This research supports prior literature, showing subcortical structures to be related to higher cognitive functioning, particularly measures of memory and executive functioning implicated in fronto-subcortical circuits. Furthermore, involvement of right mesial temporal structures in mood, further strengthens the central role of Papez circuit in emotional quality of cognition. Attention to subcortical integrity is likely to be important in discussing postsurgical cognitive outcome with patients and their families.

scholarly journals Ex Vivo Raman Spectrochemical Analysis Using a Handheld Probe Demonstrates High Predictive Capability of Brain Tumour Status

Biosensors ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. 49 ◽  
Author(s):  
Danielle Bury ◽  
Camilo Morais ◽  
Katherine Ashton ◽  
Timothy Dawson ◽  
Francis Martin
Keyword(s):  
Gold Nanoparticles ◽  
Brain Tissue ◽  
Brain Tumour ◽  
Sensitivity And Specificity ◽  
Brain Tumours ◽  
Ex Vivo ◽  
Diagnostic Tools ◽  
Low Grade ◽  
Normal Brain ◽  
Raman Probe

With brain tumour incidence increasing, there is an urgent need for better diagnostic tools. Intraoperatively, brain tumours are diagnosed using a smear preparation reported by a neuropathologist. These have many limitations, including the time taken for the specimen to reach the pathology department and for results to be communicated to the surgeon. There is also a need to assist with resection rates and identifying infiltrative tumour edges intraoperatively to improve clearance. We present a novel study using a handheld Raman probe in conjunction with gold nanoparticles, to detect primary and metastatic brain tumours from fresh brain tissue sent for intraoperative smear diagnosis. Fresh brain tissue samples sent for intraoperative smear diagnosis were tested using the handheld Raman probe after application of gold nanoparticles. Derived Raman spectra were inputted into forward feature extraction algorithms to build a predictive model for sensitivity and specificity of outcome. These results demonstrate an ability to detect primary from metastatic tumours (especially for normal and low grade lesions), in which accuracy, sensitivity and specificity were respectively equal to 98.6%, 94.4% and 99.5% for normal brain tissue; 96.1%, 92.2% and 97.0% for low grade glial tumours; 90.3%, 89.7% and 90.6% for high grade glial tumours; 94.8%, 63.9% and 97.1% for meningiomas; 95.4%, 79.2% and 98.8% for metastases; and 99.6%, 88.9% and 100% for lymphoma, based on smear samples (κ = 0.87). Similar results were observed when compared to the final formalin-fixed paraffin embedded tissue diagnosis (κ = 0.85). Overall, our results have demonstrated the ability of Raman spectroscopy to match results provided by intraoperative smear diagnosis and raise the possibility of use intraoperatively to aid surgeons by providing faster diagnosis. Moving this technology into theatre will allow it to develop further and thus reach its potential in the clinical arena.

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