Fertility preservation in primary brain tumor patients

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.

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

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2016.355 ◽

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.

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

Blood ◽

10.1182/blood-2016-06-720714 ◽

2017 ◽

Vol 129 (13) ◽

pp. 1831-1839 ◽

Cited By ~ 67

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.

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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 ◽

10.1093/neuros/nyy254 ◽

2018 ◽

Vol 85 (2) ◽

pp. 273-279 ◽

Cited By ~ 4

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.

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COT-15 LITERATURE REVIEW ON THE DECISION MAKING OF THE BRAIN TUMOR PATIENT

Neuro-Oncology Advances ◽

10.1093/noajnl/vdz039.195 ◽

2019 ◽

Vol 1 (Supplement_2) ◽

pp. ii43-ii43

Author(s):

Tatsuya Kishi ◽

Naoya Sakurada ◽

Mayumi Horikawa ◽

Haruaki Ohkubo ◽

Kazumi Ishii ◽

...

Keyword(s):

Decision Making ◽

Brain Tumor ◽

Brain Tumors ◽

End Of Life ◽

End Of Life Care ◽

Primary Brain Tumor ◽

Life Care ◽

Tumor Patients ◽

The Family ◽

The Brain

Abstract BACKGROUND Patients with primary brain tumors find it difficult to make decisions during the advanced disease stage and experience decreased consciousness. It is important for patients to receive supported decision-making early. Medical staff should know what to do and when to do it,but there are no clear guidelines. Therefore,we reviewed the literature for supported decision-making for primary brain tumor patients,particularly to provide information for understanding trends reported in previous research. METHOD On January 1,2019,we conducted a search using keywords,such as “brain tumor”and “decision-making,” via PubMed and “Igakuchuo-zashi” in Japan. We extracted literature about treatment decision support and end-of-life care for patients with primary brain tumors. Furthermore,we studied and chose the documents for information provision. RESULT Upon observing 7 studies,we found: 1) about 50% of the patients want more prognostic information; 2) patients with brain tumor tend to be anxious,but they want more information to develop a good understanding of the disease and to lower their anxiety; 3) about half of the brain tumor patients in end-of-life care are unable to make decisions sooner owing to impaired consciousness,and hence are unable to share treatment preferences with their doctors; 4) when medical professionals provide information,such as adding video tools about end-of-life care to oral explanations,it facilitates supported decision-making; and 5) when the caregiver intends to notify patients,the family feels conflicted. DISCUSSION The results suggested that if the timing of the end-of-life conversation is late,it becomes difficult for the patient to make decisions and the burden of decision-making falls on the family. It is necessary to examine effective supported decision-making tools for patients by assessing and comprehending information needs and anxiety levels of primary brain tumor patients.

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SWK-02. WEAVING COMFORT AND SUPPORT FOR CHILDREN WITH BRAIN TUMORS AND THEIR FAMILIES IN AN OUTPATIENT CLINIC

Neuro-Oncology ◽

10.1093/neuonc/noaa222.819 ◽

2020 ◽

Vol 22 (Supplement_3) ◽

pp. iii464-iii465

Author(s):

Ria Hawks ◽

Jane Bloom ◽

Maurine Packard ◽

Sonia Lugo ◽

Nadine Ulysses ◽

...

Keyword(s):

Brain Tumor ◽

Brain Tumors ◽

Outpatient Clinic ◽

Low Vision ◽

Medical Center ◽

Primary Brain Tumor ◽

Childhood Brain Tumor ◽

Tumor Patients ◽

Neurologic Disability

Abstract Parents of children diagnosed with brain tumors report high levels of stress at diagnosis and feelings of “being lost” on transition to outpatient follow-up care (Jackson AC, et al, 2007). Ssori is a Japanese form of free-style weaving that encourages people facing life-limiting challenges to discover inner strengths. We report our experience with Saori weaving with brain tumor patients and their families in a pediatric oncology outpatient clinic at a major university medical center. During 2019, we offered weaving sessions twice a week. We had a total of 151 encounters with hematology/oncology patients (age 5–18 years), siblings, or parents. Among these patients there were 20 with primary brain tumor diagnoses. Weaving was offered in the art therapy area of the clinic. After creating a fabric, the weavers had the opportunity to have their work sewn into functional objects, such as pillows, bags, purses, or healing pouches filled with beans that can be heated or cooled for comfort. Brain tumor patients readily engaged in weaving, despite various degrees of neurologic disability including hemiparesis or low vision. In the words of an 8 y/o weaver. “This is so cool. Daddy, can we always come when the weavers are here, so I can weave?” And from a mother: “This is great. She’s focused and busy!” Case studies, including a presentation of Legacy work, will be reported. In conclusion, Saori weaving can be an impactful intervention for childhood brain tumor patients and their families in an outpatient clinic setting.

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Measurement of the peritumoral edema and tumor volume ratio in differentiating malignant primary and metastatic brain tumor

GSC Biological and Pharmaceutical Sciences ◽

10.30574/gscbps.2020.13.2.0295 ◽

2020 ◽

Vol 13 (2) ◽

pp. 055-061

Author(s):

Aulia Hanum ◽

Achmad Bayhaqi Nasir Aslam ◽

Yuyun Yueniwati ◽

Diah Prabawati Retnani ◽

Nanik Setjowati

Keyword(s):

Brain Tumor ◽

Brain Tumors ◽

Volume Ratio ◽

Peritumoral Edema ◽

Volume Data ◽

Metastatic Brain Tumors ◽

Cross Sectional ◽

Primary Brain Tumors ◽

Tumor Group ◽

Significant Difference

Malignant primary and metastatic brain tumors are group of malignancies radiologically difficult to distinguish between one another. Meanwhile, the treatment regimens between the two entities are very different. The right regimen can maintain patient’s survival. MRI is the modality of choice for diagnosing brain tumors; although, malignant primary brain tumors and solitary metastases appear similar on conventional MRI. The difference in the pathophysiology of peritumoral edema in malignant primary and metastatic brain tumors has the potential for differentiation of the two entities. In malignant primary brain tumors, tumor cell infiltration occurs in the edema area, meaning that the peritumoral edema is narrower than that of the metastases. This study analyzed the ratio of peritumoral edema volume to tumor (EP/T volume ratio) in malignant primary and metastatic brain tumors by means of MRI examination with a cross-sectional design, using MRI data on FLAIR and T1WI sequences with contrast in malignant brain tumor of patients that have been pathologically proven. Then, volume contouring was performed on peritumoral edema (EP) and tumor (T), and comparation was done to obtain the EP/T volume ratio. The ratio of EP/T volume data in both groups was analyzed using the Mann–Whitney test with the SPSS 22 software. The results of statistical analysis revealed that the EP/T volume ratio of the malignant primary brain tumor group was smaller with a median value (max-min) of 1.1 (5.65-0.17) and in the metastatic group, 2.3 (64.03-0.09). There was a significant difference in the EP/T volume ratio between the two groups, which the brain metastatic tumor group have a double ratio of EP/T with a value of p=0.008 (p<0.05).

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

NANO ◽

10.1142/s1793292014300011 ◽

2014 ◽

Vol 09 (01) ◽

pp. 1430001 ◽

Cited By ~ 4

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.

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

Frontiers in Cellular Neuroscience ◽

10.3389/fncel.2021.716947 ◽

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.

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Genetic variants and cognitive functions in patients with brain tumors

Neuro-Oncology ◽

10.1093/neuonc/noz094 ◽

2019 ◽

Vol 21 (10) ◽

pp. 1297-1309 ◽

Cited By ~ 5

Author(s):

Denise D Correa ◽

Jaya Satagopan ◽

Axel Martin ◽

Erica Braun ◽

Maria Kryza-Lacombe ◽

...

Keyword(s):

Oxidative Stress ◽

Cell Cycle ◽

Dna Repair ◽

Brain Tumor ◽

Brain Tumors ◽

Cell Cycle Regulation ◽

Cognitive Outcome ◽

Cholesterol Transport ◽

Tumor Patients ◽

Cycle Regulation

AbstractBackgroundPatients with brain tumors treated with radiotherapy (RT) and chemotherapy (CT) often experience cognitive dysfunction. We reported that single nucleotide polymorphisms (SNPs) in the APOE, COMT, and BDNF genes may influence cognition in brain tumor patients. In this study, we assessed whether genes associated with late-onset Alzheimer’s disease (LOAD), inflammation, cholesterol transport, dopamine and myelin regulation, and DNA repair may influence cognitive outcome in this population.MethodsOne hundred and fifty brain tumor patients treated with RT ± CT or CT alone completed a neurocognitive assessment and provided a blood sample for genotyping. We genotyped genes/SNPs in these pathways: (i) LOAD risk/inflammation/cholesterol transport, (ii) dopamine regulation, (iii) myelin regulation, (iv) DNA repair, (v) blood–brain barrier disruption, (vi) cell cycle regulation, and (vii) response to oxidative stress. White matter (WM) abnormalities were rated on brain MRIs.ResultsMultivariable linear regression analysis with Bayesian shrinkage estimation of SNP effects, adjusting for relevant demographic, disease, and treatment variables, indicated strong associations (posterior association summary [PAS] ≥ 0.95) among tests of attention, executive functions, and memory and 33 SNPs in genes involved in: LOAD/inflammation/cholesterol transport (eg, PDE7A, IL-6), dopamine regulation (eg, DRD1, COMT), myelin repair (eg, TCF4), DNA repair (eg, RAD51), cell cycle regulation (eg, SESN1), and response to oxidative stress (eg, GSTP1). The SNPs were not significantly associated with WM abnormalities.ConclusionThis novel study suggests that polymorphisms in genes involved in aging and inflammation, dopamine, myelin and cell cycle regulation, and DNA repair and response to oxidative stress may be associated with cognitive outcome in patients with brain tumors.

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