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Neurosurgical Review Jun 2023Maintaining the integrity of crucial fiber tracts allows functional preservation and improved recovery in patients with glioma resection. Diffusion tensor imaging (DTI)... (Meta-Analysis)
Meta-Analysis Review
Maintaining the integrity of crucial fiber tracts allows functional preservation and improved recovery in patients with glioma resection. Diffusion tensor imaging (DTI) and intraoperative subcortical mapping (ISM) are commonly required for pre- and intraoperative assessment of white matter fibers. This study investigated differences of clinical outcomes in glioma resection aided by DTI or ISM. A comprehensive literature retrieval of the PubMed and Embase databases identified several DTI or ISM studies in 2000-2022. Clinical data, including extent of resection (EOR) and postoperative neurological deficits, was collected and statistically analyzed. Heterogeneity was regressed by a random effect model and the Mann-Whitney U test was used to test statistical significance. Publication bias was assessed by Egger test. A total of 14 studies with a pooled cohort of 1837 patients were included. Patients undergoing DTI-navigated glioma surgery showed a higher rate of gross total resection (GTR) than ISM-assisted surgical resection (67.88%, [95% CI 0.55-0.79] vs. 45.73%, [95% CI 0.29-0.63], P = 0.032). The occurrence of early postoperative functional deficit (35.45%, [95% CI 0.13-0.61] vs. 35.60% [95% CI 0.20-0.53], P = 1.000), late postoperative functional deficit (6.00%, [95% CI 0.02-0.11] vs. 4.91% [95% CI 0.03-0.08], P = 1.000) and severe postoperative functional deficit (2.21%, [95% CI 0-0.08] vs. 5.93% [95% CI 0.01-0.16], P = 0.393) were similar between the DTI and ISM group, respectively. While DTI-navigation resulted in a higher rate of GTR, the occurrence of postoperative neurological deficits between DTI and ISM groups was comparable. Together, these data indicate that both techniques could safely facilitate glioma resection.
Topics: Humans; Diffusion Tensor Imaging; Databases, Factual; Glioma; Postoperative Period; White Matter
PubMed: 37380888
DOI: 10.1007/s10143-023-02058-5 -
Journal of Rehabilitation Medicine Jun 2015To systematically review the literature for studies on cognitive functioning in patients with low-grade glioma to evaluate assessment methods and prevalence of cognitive... (Review)
Review
OBJECTIVE
To systematically review the literature for studies on cognitive functioning in patients with low-grade glioma to evaluate assessment methods and prevalence of cognitive dysfunction.
DATA SOURCES
A search was made in PubMed, Embase, and PsycINFO for articles published between January 2002 and June 2012 using cognition, memory, attention, executive functioning, and low-grade glioma as search terms.
STUDY SELECTION
Two reviewers independently performed the study selection and data extraction. Inclusion criteria were: studies including at least 10 adult patients, with suspected or confirmed low-grade glioma and cognitive functioning as outcome measure.
DATA EXTRACTION
A standard data extraction form was used, with items regarding study quality, patient characteristics, type of measurement instruments, cognitive domain, definition of cognitive dysfunction, and reported prevalence.
DATA SYNTHESIS
Of the 312 articles screened on title/abstract, 69 were screened on full-text and, finally, 17 were included. A total of 46 different measurement instruments were found for the assessment of cognitive functioning; 5 of these were used 5 or more times. There was variability in the definition of cognitive dysfunction. The reported prevalence of cognitive dysfunction ranged from 19% to 83%.
CONCLUSION
Many patients with low-grade glioma experience cognitive dysfunction. However, there is no consensus on how to assess cognitive functioning in these patients.
Topics: Brain Neoplasms; Cognition Disorders; Glioma; Humans; Neuropsychological Tests; Prevalence
PubMed: 25994416
DOI: 10.2340/16501977-1975 -
Journal of Neuro-oncology Jan 2009The translational value of experimental therapeutic neuroscience research to clinical practice is highly variable. This has been particularly well demonstrated in the... (Review)
Review
What is the translational efficacy of chemotherapeutic drug research in neuro-oncology? A systematic review and meta-analysis of the efficacy of BCNU and CCNU in animal models of glioma.
INTRODUCTION
The translational value of experimental therapeutic neuroscience research to clinical practice is highly variable. This has been particularly well demonstrated in the field of neuroprotective agents following either head injury or stroke. In this study we evaluate the efficacy of systemic BCNU and CCNU in experimental glioma models and how the experimental data has translated into clinical practice.
METHODS
A systematic review of the efficacy of BCNU and CCNU, against experimental rodent and murine in vivo glioma models was conducted. Selected articles were graded on a 15 point scale for scientific methodology. A stratified meta-analysis based on median-survival data and effect sizes was performed to generate global-efficacy estimates for BCNU and CCNU, and to produce 'weighted-mean effect-sizes' for individual sub-categories of selected study-characteristics.
RESULTS
Fourteen papers satisfied search criteria and encompassed 231 treatment comparisons in 2256 animals. The median methodology score was 9 (range 7-12/15). Global-efficacy estimates were BCNU 0.194 (95% CI -0.538 to 0.927) and CCNU 0.432 (95% CI -0.392 to 1.256), with CCNU being significantly more effective than BCNU. Because of these wide confidence intervals a beneficial or detrimental effect of either agent could not be confirmed. Most selected study-design characteristics (e.g. glioma cell line, drug dosage, drug scheduling, mode of drug administration, timing of therapy after glioma implantation but not animal used) significantly influenced the efficacy-results obtained. The methodological score did not influence efficacy-estimate.
CONCLUSION
This review has found (i) experimental-design influenced the efficacy-data obtained and (ii) that there is highly variable outcome data for the efficacy of both BCNU and CCNU in experimental in vivo rodent and murine glioma models. In many ways these findings are analagous to the use of nitrosoureas in human malignant glioma. The statistically significant small beneficial effect of nitrosoureas in combination with other chemotherapeutic agents in human glioma was only noted after a meta-analysis of human randomized controlled trials.
Topics: Animals; Antineoplastic Agents, Alkylating; Carmustine; Disease Models, Animal; Drug Evaluation; Glioma; Humans; Lomustine; Meta-Analysis as Topic
PubMed: 18813876
DOI: 10.1007/s11060-008-9697-z -
Annals of Palliative Medicine Dec 2021At present, the use of arterial spin-labeling (ASL) imaging to assess the recurrence of gliomas and post-treatment radiation effect (PTRE) is limited, and the results of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
At present, the use of arterial spin-labeling (ASL) imaging to assess the recurrence of gliomas and post-treatment radiation effect (PTRE) is limited, and the results of studies on ASL are quite different. To date, no multi-center, large-scale studies have been conducted to confirm its diagnostic efficacy. This study sought to systematically evaluate the diagnostic value of ASL imaging in distinguishing between glioma recurrence and PTRE.
METHODS
Databases, including Medline, Cochrane Library, Pub Med, Web of Science, Embase, China National Knowledge Infrastructure, Wan Fang, were searched to retrieve studies that used ASL imaging to diagnose glioma recurrence and radiation-induced brain injury. The search deadline was August 31, 2021. Two reviewers independently screened the literature according to set literature inclusion and exclusion criteria, extracted basic data from the literature, and evaluated the quality of the literature. Revman 5.3 software was used to analyze the included research data.
RESULTS
Ten studies, comprising 216 patients with glioma recurrence and 152 patients with PTRE, were included in the meta-analysis. The results showed that cerebral blood flow [mean difference (MD) =1.67, 95% confidence interval (CI): 0.89-2.46, P=0.000], relative cerebral blood flow (MD =1.20, 95% CI: 0.91-1.49, P=0.000), and relative cerebral blood volume (MD =1.29, 95% CI: 0.98-1.59, P=0.000); this 3 indicators between glioma recurrence and PTRE were significantly different.
DISCUSSION
ASL imaging has high diagnostic value in distinguishing between glioma recurrence and PTRE.
Topics: Brain; Brain Neoplasms; Cerebrovascular Circulation; Glioma; Humans; Magnetic Resonance Imaging; Spin Labels
PubMed: 35016424
DOI: 10.21037/apm-21-3319 -
Neuro-oncology Apr 2022Detailed prevalence estimates of BRAFV600 mutations and BRAF inhibitor (BRAFi) treatment responses in V600-mutant glioma will inform trial development.
BACKGROUND
Detailed prevalence estimates of BRAFV600 mutations and BRAF inhibitor (BRAFi) treatment responses in V600-mutant glioma will inform trial development.
METHODS
Our systematic review analyzed overall prevalence of BRAFV600 mutations in glioma and BRAFi treatment response.
RESULTS
Based on 13 682 patients in 182 publications, the prevalence of BRAFV600 in epithelioid glioblastoma (eGBM) was 69% [95% CI: 45-89%]; pleomorphic xanthoastrocytoma (PXA): 56% [48-64%] anaplastic pleomorphic xanthoastrocytoma (aPXA): 38% [23-54%], ganglioglioma (GG): 40% [33-46%], and anaplastic ganglioglioma (aGG): 46% [18-76%]. Prevalence in astroblastoma was 24% [8-43%], desmoplastic infantile astrocytoma (DIA): 16% [0-57%], subependymal giant cell astrocytoma (SEGA): 8% [0-37%], dysembryoplastic neuroepithelial tumor (DNET): 3% [0-11%], diffuse astrocytoma (DA): 3% [0-9%], and pilocytic astrocytoma (PA): 3% [2-5%]. We reviewed 394 V600-mutant gliomas treated with BRAFi from 130 publications. One hundred and twenty-nine pediatric low-grade gliomas showed 4 (3.1%) complete response (CR); 53 (41.1%) partial response (PR); 64 (49.6%) stable disease (SD) and 8 (6.2%) progressive disease (PD). 25 pediatric high-grade gliomas showed CR; PR; SD; PD in 4 (16.0%); 10 (40.0%), 4 (16.0%); and 7 (28.0%) respectively. Thirty-nine adult low-grade gliomas showed CR; PR; SD; PD of 4 (10.3%); 17 (43.6%); 16 (41.0%) and 2 (5.1%) respectively. Ninety-seven adult high-grade gliomas showed CR; PR; SD; PD of 6 (6.2%); 31 (32.0%); 27 (27.8%); and 33 (34.0%) respectively.
CONCLUSIONS
BRAFV600 prevalence is highest in eGBM, PXA, aPXA, GG, aGG, and lower in astroblastoma, DIA, SEGA, DNET, DA, and PA. Our data provide the rationale for adjuvant clinical trials of BRAFi in V600-mutant glioma.
Topics: Adult; Astrocytoma; Brain Neoplasms; Child; Glioma; Humans; Mutation; Prevalence; Proto-Oncogene Proteins B-raf
PubMed: 34718782
DOI: 10.1093/neuonc/noab247 -
Journal of Neuroimaging : Official... Jan 2022Diffuse hemispheric gliomas, H3 G34-mutant (DHGs-G34m), are newly recognized malignant brain tumors characterized by histone gene mutations. However, the neuroradiologic... (Review)
Review
BACKGROUND AND PURPOSE
Diffuse hemispheric gliomas, H3 G34-mutant (DHGs-G34m), are newly recognized malignant brain tumors characterized by histone gene mutations. However, the neuroradiologic characteristics of these tumors require elucidation. We reviewed the demographic, clinical, and neuroradiological features of DHGs-G34m.
METHODS
Data were extracted using a database search in MEDLINE, SCOPUS, and Google Scholar in June 2021. Studies assessing pathologically proven DHGs-G34m with each patient's information and neuroradiological findings were included. After screening and reviewing 332 abstracts, 12 articles including 56 cases met the criteria. We also added the findings for three patients evaluated in our hospital. Two board-certified radiologists reviewed all demographic, clinical, and neuroradiological findings of each study. One board-certified pathologist reviewed all pathological data of each study. Kaplan-Meier analyses with log-rank tests were performed to compare the survival between patients with different tumor margin characteristics (well-delineated and ill-defined).
RESULTS
The median patient age at diagnosis was 19 years (range, 6-66 years), and 31/59 patients (52.5%) were men. Supratentorial tumors were observed in all patients (59/59, 100%). Frequent contact with leptomeninges (92.3%) and ependymal regions (87.5%) was observed. The 1- and 2-year survival rates after initial surgery were 66.7% and 40.0%, respectively. DHGs-G34m with ill-defined and well-delineated margins showed significant differences in survival (p = .04).
CONCLUSIONS
DHGs-G34m occur most often in the supratentorial regions of adolescents. Prognosis varies among patients. Evaluation of tumor margins may provide prognostic value.
Topics: Adolescent; Brain Neoplasms; Glioma; Histones; Humans; Male; Mutation; Neuroimaging
PubMed: 34632671
DOI: 10.1111/jon.12939 -
Drugs Feb 2022Gliomas represent most common primary brain tumors. Glioblastoma (GBM) is the most common subtype and carries a poor prognosis. There is growing interest in the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Gliomas represent most common primary brain tumors. Glioblastoma (GBM) is the most common subtype and carries a poor prognosis. There is growing interest in the anti-glioma properties of statins. The aim of this study was to conduct a systematic review of the preclinical literature and to meta-analyze existing clinical studies to determine what benefit, if any, statins may confer in the context of glioma.
METHODS
The PubMed, Embase, Cochrane, and Web of Science libraries were queried in May 2021. Preclinical studies were included if they investigated the anti-cancer effects of statins in glioma in vitro and in vivo. Clinical studies were included if they reported incidence rates of glioma by statin use, or mortality outcomes among GBM patients by statin use. Pooled point estimates were calculated using a random-effects model.
RESULTS
In total, 64 publications, 51 preclinical and 13 clinical, were included. Preclinical studies indicated that statins inhibited glioma cell proliferation, migration, and invasion. These effects were time- and concentration-dependent. Synergistic anti-glioma effects were observed when statins were combined with other anti-cancer therapies. Clinical observational studies showed an inverse, albeit non-statistically significant, association between statin use and incidence rate of glioma (HR = 0.84, 95% CI 0.62-1.13, I = 72%, p-heterogeneity = 0.003, 6 studies). Statin use was not associated with better overall survival following GBM surgery (HR = 1.05, 95% CI 0.85-1.30, I = 30%, p-heterogeneity = 0.23, 4 studies).
CONCLUSION
Statins were potent anti-cancer drugs that suppressed glioma growth through various mechanisms in vitro; these effects have translated into the clinical realm, clinically but not statistically, in terms of glioma incidence but not GBM survival.
Topics: Antineoplastic Agents; Glioma; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors
PubMed: 35122635
DOI: 10.1007/s40265-021-01668-x -
BioMed Research International 2019Different microRNAs (miRs) have been demonstrated to relate with the outcome of glioma patients, while the conclusions are inconsistent. We perform a meta-analysis to... (Meta-Analysis)
Meta-Analysis
PURPOSE
Different microRNAs (miRs) have been demonstrated to relate with the outcome of glioma patients, while the conclusions are inconsistent. We perform a meta-analysis to clarify the relationship between different miRs and prognosis of glioma.
METHODS
Related studies were retrieved from PubMed, Embase, and Cochrane Library. Pooled hazard ratios (HRs) of different miRs expression for survival and 95% confidence intervals (CIs) were calculated using random-effects model.
RESULTS
A total of 15 miRs with 4708 glioma patients were ultimately included. Increased expression of miR-15b (HR, 1.584; 95% CI, 1.199-2.092), 21 (HR, 1.591; 95% CI, 1.278-1.981), 148a (HR, 1.122; 95% CI, 1.023-1.231), 196 (HR, 1.877; 95% CI, 1.033-3.411), 210 (HR, 1.251; 95% CI, 1.010-1.550), and 221 (HR, 1.269; 95% CI, 1.054-1.527) or decreased expression of miR-106a (HR, 0.809; 95% CI, 0.655-0.998) and 124 (HR, 0.833; 95% CI, 0.729-0.952) was correlated with poor outcome of glioma patients.
CONCLUSIONS
miR-15b, 21, 148a, 196, 210, 221, 106a, and 124 are valuable biomarkers for the prognosis of glioma which might be used in clinical settings.
Topics: Biomarkers, Tumor; Disease-Free Survival; Gene Expression Regulation, Neoplastic; Glioma; Humans; MicroRNAs; Prognosis; Survival Analysis
PubMed: 31032345
DOI: 10.1155/2019/4015969 -
Neuro-oncology Jul 2015There is growing evidence that antitumor treatment contributes to better seizure control in low-grade glioma patients. We performed a systematic review of the current... (Review)
Review
There is growing evidence that antitumor treatment contributes to better seizure control in low-grade glioma patients. We performed a systematic review of the current literature on seizure outcome after radiotherapy and chemotherapy and evaluated the association between seizure outcome and radiological response. Twenty-four studies were available, of which 10 described seizure outcome after radiotherapy and 14 after chemotherapy. All studies demonstrated improvements in seizure outcome after antitumor treatment. Eight studies reporting on imaging response in relation to seizure outcome showed a seizure reduction in a substantial part of patients with stable disease on MRI. Seizure reduction may therefore be the only noticeable effect of antitumor treatment. Our findings demonstrate the clinical relevance of monitoring seizure outcome after radiotherapy and chemotherapy, as well as the potential role of seizure reduction as a complementary marker of tumor response in low-grade glioma patients.
Topics: Brain Neoplasms; Glioma; Humans; Seizures; Treatment Outcome
PubMed: 25813469
DOI: 10.1093/neuonc/nov032 -
Journal of Neuro-oncology Sep 2014Malignant glioma (MG) is a devastating neurological disease with a uniformly poor prognosis and a clinical course characterized by progressive functional and cognitive... (Review)
Review
Malignant glioma (MG) is a devastating neurological disease with a uniformly poor prognosis and a clinical course characterized by progressive functional and cognitive impairment. A small body of literature addresses patients' and caregivers' prognostic awareness (PA), or understanding of prognosis in patients with cancer. Studies that examine PA and desire for prognostic information among patients with MG are limited. We sought to review the existing literature on PA and communication of prognostic information to patients with MG. Fourteen studies examining PA or experience and preferences regarding communication of prognostic information were included. The definition and measurement of PA across studies varied, and the prevalence of accurate PA ranged from 25 to 100 % of participants. There is likely a subset of patients who do not desire accurate prognostic information, although the patient and disease characteristics that predict this preference are currently unknown. This review suggests that patients with MG desire prognostic information communicated in a manner that preserves hope. Systematic investigation to define communication needs for prognostic information in the unique clinical setting of MG is needed.
Topics: Attitude to Health; Awareness; Brain Neoplasms; Communication; Glioma; Humans; Physician-Patient Relations; Prognosis
PubMed: 24874468
DOI: 10.1007/s11060-014-1487-1