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.

Neuropsychiatric aspects of CNS tumours in adults

2020 ◽  
pp. 229-244
Author(s):  
Alex J. Mitchell ◽  
Audrey Hopwood
Keyword(s):  
Quality Of Life ◽  
Brain Tumour ◽  
Cancer Diagnosis ◽  
Brain Tumours ◽  
Presenting Symptoms ◽  
Primary Brain Tumours ◽  
Neuropsychiatric Complications ◽  
Cns Tumours ◽  
Psychiatric Complications

A brain tumour is the most feared cancer diagnosis by the general public. Primary brain tumours account for about 1.5% of all new cases of cancer, and 2.5% of all cancer deaths. However, most brain tumours are, in fact, metastases from other cancer sites. Brain tumours cause considerable psychological and psychiatric complications, as well as a burden for caregivers, and hence a reduction in overall quality of life. Around 90% of patients will suffer neuropsychiatric complications, and in around 20%, these are the presenting symptoms. Neuropsychiatric complications often improve following brain tumour treatment, such as radiotherapy, but can also deteriorate. New therapeutic techniques have improved survival and are gradually improving quality of life. However, this is only effective if neuropsychiatric complications are recognized and addressed.

Type‐D personality and quality of life in patients with primary brain tumours

2020 ◽  
Author(s):  
Sung Reul Kim ◽  
Ju‐Hee Nho ◽  
Hye Young Kim ◽  
Eun Ko ◽  
Shin Jung ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Brain Tumours ◽  
Type D Personality ◽  
Primary Brain Tumours ◽  
Type D

Health-related quality of life among paediatric survivors of primary brain tumours and acute leukaemia

2010 ◽  
Vol 19 (2) ◽  
pp. 191-198 ◽  
Author(s):  
Monika Pogorzala ◽  
Jan Styczynski ◽  
Andrzej Kurylak ◽  
Robert Debski ◽  
Magdalena Wojtkiewicz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Acute Leukaemia ◽  
Brain Tumours ◽  
Health Related Quality ◽  
Primary Brain Tumours ◽  
Related Quality ◽  
Health Related

scholarly journals QOL-32. THE PROMOTE STUDY: HEALTH-RELATED QUALITY OF LIFE COMMUNICATION NEEDS OF CHILDREN, ADOLESCENTS, AND THEIR FAMILIES ATTENDING OUTPATIENT CONSULTATIONS AFTER TREATMENT FOR A BRAIN TUMOUR

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii437-iii437
Author(s):  
Shelly Stubley ◽  
Anita Freeman ◽  
Christina Liossi ◽  
Anne-Sophie Darlington ◽  
Martha Grootenhuis ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Brain Tumour ◽  
Brain Tumours ◽  
Emotional Health ◽  
Health Related Quality ◽  
Childhood Brain Tumours ◽  
Related Quality ◽  
Health Related ◽  
Communication Needs

Abstract BACKGROUND Childhood brain tumours and their treatment can reduce health-related quality of life (HRQoL) and cause anxiety and depression, withdrawal, and social isolation. Improved communication within outpatient consultations may allow early identification and treatment of these issues. We explored family communication needs in survivors of childhood brain tumours receiving six-monthly follow-up outpatient review within the English NHS. METHODS Semi-structured interviews were conducted with 18 families whose child aged 8–17 years had finished treatment for a brain tumour within the preceding five years. Thematic analysis used the Framework Method. RESULTS Adjusting to change and finding a “new normal” was the overarching theme to emerge. HRQoL issues included fatigue, coping with physical changes, challenges at school, isolation, and adjusting to changes in abilities. Survivors described a need for greater knowledge about and more support with changes in cognitive functioning. Parents spoke about the impact on the wider family and their changed role in supporting the child’s HRQoL. Communication barriers included short-term memory loss, shyness, and the need to suppress or regulate emotions evoked by these issues. Communication needs included more information regarding recovery and rehabilitation and/or help managing anxiety or emotional health. CONCLUSION The above communication needs and barriers should be addressed. Having a digital record to document and monitor this information systematically could improve service planning and provide patients and their families with the resources to reach their full potential and experience a better HRQoL.

scholarly journals Fragility Fractures: Risk Factors and Management in the Elderly

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1119
Author(s):  
Filippo Migliorini ◽  
Riccardo Giorgino ◽  
Frank Hildebrand ◽  
Filippo Spiezia ◽  
Giuseppe Maria Peretti ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Fragility Fractures ◽  
The Elderly ◽  
Scientific Investigation ◽  
Current Evidence ◽  
Diagnostic Tools ◽  
Socioeconomic Impact ◽  
New Ideas

Given the progressive ageing of Western populations, the fragility fractures market has a growing socioeconomic impact. Fragility fractures are common in the elderly, negatively impacting their quality of life, limiting autonomy, increasing disability, and decreasing life expectancy. Different causes contribute to the development of a fractures in frail individuals. Among all, targeting fragile patients before the development of a fracture may represent the greatest challenge, and current diagnostic tools suffer from limitations. This study summarizes the current evidence on the management of fragility fractures, discussing risk factors, prevention, diagnosis, and actual limitations of the clinical therapeutic options, putting forward new ideas for further scientific investigation.

Surgical techniques in the management of intrinsic tumours

2019 ◽  
pp. 163-172
Author(s):  
Shawn Hervey-Jumper ◽  
Mitchel Berger
Keyword(s):  
Quality Of Life ◽  
Surgical Resection ◽  
Brain Tumours ◽  
Surgical Techniques ◽  
Extent Of Resection ◽  
Current Evidence ◽  
Tumour Resection ◽  
Direct Stimulation ◽  
Functional Neuronavigation

Surgical resection plays a central role in the management of intrinsic brain tumours, and there is a growing body of evidence concerning the value of extent of resection to improve patient outcome and quality of life. Maximal resection can be difficult to achieve due to tumour proximity to eloquent structures and uncertainty as to tumour margins. Direct stimulation mapping, functional neuronavigation, intraoperative MRI, and fluorescence-guided surgery are all useful tools to improve the extent of tumour resection while minimizing morbidity. Current evidence suggests that a more extensive surgical resection is associated with longer survival and improved quality of life for patients with either low- or high-grade gliomas. This chapter emphasizes the evidence supporting the role of surgery for intrinsic brain tumours, their surgical neuroanatomy, and techniques to maximize the extent of resection while minimizing morbidity.

scholarly journals The Quality of Life of Patients after Surgical Treatment of Brain Tumours and the Location of the Tumour

2020 ◽  
Vol 9 (3) ◽  
pp. 91-96
Author(s):  
Agnieszka Królikowska ◽  
◽  
Piotr Zieliński ◽  
Marek Harat ◽  
Renata Jabłońska ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Frontal Lobe ◽  
Brain Tumour ◽  
Postoperative Period ◽  
Brain Tumours ◽  
Early Postoperative Period ◽  
Tumour Location ◽  
Eortc Qlq ◽  
The Brain

Introduction. The location of intracranial neoplasms and the process of treating these lesions itself can significantly affect the quality of life of patients. Hence, the aim of the study was to investigate the impact of the location of the brain tumour on the quality of life of surgically treated patients. Aim. The aim of the study was to investigate the influence of the location of the brain tumour on the quality of life of surgically treated patients. Material and Methods. The study included 236 patients with brain tumours operated at the Department of Neurosurgery of the 10th Military Clinical Hospital with the SP ZOZ Polyclinic in Bydgoszcz. Patients with different tumour locations were included: in the temporal lobe, in the frontal lobe, in the parietal lobe, in the ventricles of the brain and in the extra-cerebral locations. The following questionnaires were used to assess the quality of life: EORTC QLQ-C30 and EORTC QLQ-BN20, in which the patients were tested three times: on the day of admission to the Clinic, on the fifth day after brain tumour surgery and 30 days after the surgery. Results. Patients’ quality of life decreased in the early postoperative period in all groups in terms of tumour location, especially in patients with tumours of the frontal lobe (-0.104) and ventricular neoplasms (-0.109) (p > 0.05). On the 30th day, however, an improvement in the quality of life was achieved in all groups, the highest improvement was obtained in patients with tumours located extra-cerebrally (0.115) and tumours of the temporal lobe (0.097) (p > 0.05). Conclusions. There was no effect of the location of the brain tumour on the quality of life of the studied patients. In the early postoperative period, the quality of life decreased, while it improved 30 days after the surgery. (JNNN 2020;9(3):91–96) Key Words: brain tumour, quality of life, tumour location

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 Acceptance and commitment therapy for young brain tumour survivors: study protocol for an acceptability and feasibility trial

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e051091
Author(s):  
Sam Malins ◽  
Ray Owen ◽  
Ingram Wright ◽  
Heather Borrill ◽  
Jenny Limond ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Young People ◽  
Brain Tumour ◽  
Acceptance And Commitment Therapy ◽  
Brain Tumours ◽  
Link Type ◽  
Commitment Therapy ◽  
Acceptance And Commitment

IntroductionSurvivors of childhood brain tumours have the poorest health-related quality of life of all cancer survivors due to the multiple physical and psychological sequelae of brain tumours and their treatment. Remotely delivered acceptance and commitment therapy (ACT) may be a suitable and accessible psychological intervention to support young people who have survived brain tumours. This study aims to assess the feasibility and acceptability of remotely delivered ACT to improve quality of life among these young survivors.Methods and analysisThis study is a two-arm, parallel group, randomised controlled trial comparing ACT with waitlist control at 12-week follow-up as the primary endpoint. Seventy-two participants will be recruited, who are aged 11–24 and have completed brain tumour treatment. Participants will be randomised to receive 12 weeks of ACT either immediately or after a 12-week wait. The DNA-v model of ACT will be employed, which is a developmentally appropriate model for young people. Feasibility will be assessed using the proportion of those showing interest who consent to the trial and complete the intervention. Acceptability will be assessed using participant evaluations of the intervention, alongside qualitative interviews and treatment diaries analysed thematically. A range of clinical outcome measures will also assess physical and mental health, everyday functioning, quality of life and service usage at 12-week follow-up. The durability of treatment effects will be assessed by further follow-up assessments at 24 weeks, 36 weeks and 48 weeks.Ethics and disseminationEthical approval was given by East Midlands, Nottingham 1 Research Ethics Committee (Reference: 20/EM/0237). Study results will be disseminated in peer-reviewed journals, through public events and relevant third sector organisations.Trial registrationISRCTN10903290; NCT04722237.

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