Biomarkers, Diagnostic Tools, Treatment Outcomes, and Late Complications in Neuro-Oncology

A special issue of Cancers (ISSN 2072-6694).

Deadline for manuscript submissions: closed (31 March 2023) | Viewed by 9892

Special Issue Editors


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Guest Editor
1. Department of Women’s and Children’s Health, Karolinska Institutet, 171 64 Stockholm, Sweden
2. Pediatric Oncol-ogy, Karolinska University Hospital, 171 64 Stockholm, Sweden
Interests: pediatric neuro-oncology; diffuse midline glioma; neuroinflammation; late complications

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Guest Editor
Department of Women's and Children's Health, Karolinska Institutet, 171 64 Stockholm, Sweden
Interests: neonatal brain injury; irradiation; behavior; brain; cerebral palsy; EMF

E-Mail Website
Guest Editor
Department of Women's and Children's Health, Karolinska Institutet, 171 64 Stockholm, Sweden
Interests: pediatric neuro-oncology; neuroinflammation

Special Issue Information

Dear Colleagues, 

Neuro-oncology has seen major advances in diagnostics and targeted therapies, particularly in pediatric brain tumors. Classification of tumors has changed dramatically, and the community is adapting to a wide range of pharmacological agents not previously used in oncology. It is important that biomarkers and diagnostic tools are developed and used to assess and predict treatment outcomes and, for long-term survivors, late complications, also called late effects.

The topic of this Special Issue is the advancement of biomarkers and diagnostic tools to complement the classical tools at hand, thereby hopefully providing a better basis for treatment decisions, when to start, what to use, and for how long. The same biomarkers and diagnostic tools may also provide important information on the risk of developing so-called late effects, nowadays more commonly termed late complications, and their severity. There is a great lack of research in this field, where the aim is to understand why late complications occur, and how they can be prevented, or even reversed. The goal must be to not only ensure patients survive, but also retain their quality of life.

The aim of this issue is, on the one hand, to promote investigations on biomarkers and diagnostic tools that enable better treatment decisions and, on the other hand, to promote investigation into the other end of the spectrum—the quality of life of long-term survivors, particularly in pediatric neuro-oncology.

Prof. Dr. Klas Blomgren
Dr. Adamantia Fragopoulou
Dr. Lena-Maria Carlson
Guest Editors

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Keywords

  • neuro-oncology
  • brain tumors
  • biomarkers
  • diagnostic tools
  • late effects
  • late complications

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Published Papers (4 papers)

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17 pages, 5693 KiB  
Article
Are Thalamic Intrinsic Lesions Operable? No-Man’s Land Revisited by the Analysis of a Large Retrospective, Mono-Institutional, Cohort
by Paolo Ferroli, Francesco Restelli, Giacomo Bertolini, Emanuele Monti, Jacopo Falco, Giulio Bonomo, Irene Tramacere, Bianca Pollo, Chiara Calatozzolo, Monica Patanè, Silvia Schiavolin, Morgan Broggi, Francesco Acerbi, Alessandra Erbetta, Silvia Esposito, Elio Mazzapicchi, Emanuele La Corte, Ignazio Gaspare Vetrano, Giovanni Broggi and Marco Schiariti
Cancers 2023, 15(2), 361; https://doi.org/10.3390/cancers15020361 - 5 Jan 2023
Cited by 2 | Viewed by 2311
Abstract
Thalamic gliomas represent a heterogeneous subset of deep-seated lesions for which surgical removal is advocated, although clear prognostic factors linked to advantages in performance status or overall survival are still lacking. We reviewed our Institutional Cancer Registry, identifying patients who underwent surgery for [...] Read more.
Thalamic gliomas represent a heterogeneous subset of deep-seated lesions for which surgical removal is advocated, although clear prognostic factors linked to advantages in performance status or overall survival are still lacking. We reviewed our Institutional Cancer Registry, identifying patients who underwent surgery for thalamic gliomas between 2006 and 2020. Associations between possible prognostic factors such as tumor volume, grade, the extent of resection and performance status (PS), and overall survival (OS) were evaluated using univariate and multivariate survival analyses. We found 56 patients: 31 underwent surgery, and 25 underwent biopsy. Compared to biopsy, surgery resulted positively associated with an increase in the OS (hazard ratio, HR, at multivariate analysis 0.30, 95% confidence interval, CI, 0.12–0.75). Considering the extent of resection (EOR), obtaining GTR/STR appeared to offer an OS advantage in high-grade gliomas (HGG) patients submitted to surgical resection if compared to biopsy, although we did not find statistical significance at multivariate analysis (HR 0.53, 95% CI 0.17–1.59). Patients with a stable 3-month KPS after surgery demonstrated to have a better prognosis in terms of OS if compared to biopsy (multivariate HR 0.17, 95% CI, 0.05–0.59). Age and histological grades were found to be prognostic factors for this condition (p = 0.04 and p = 0.004, respectively, chi-square test). Considering the entire cohort, p53 positivity (univariate HR 2.21, 95% CI 1.01–4.82) and ATRX positivity (univariate HR 2.69, 95% CI 0.92–7.83) resulted associated with a worse prognosis in terms of OS. In this work, we demonstrated that surgery aimed at tumor resection might offer a stronger survival advantage when a stable 3-month KPS after surgery is achieved. Full article
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12 pages, 286 KiB  
Article
Post-Compulsory Education in Teenagers and Young Adults Treated for Brain Tumors in Childhood: A Swedish Nationwide Registry-Based Study
by Malin Lönnerblad, Maria Åberg, Klas Blomgren and Eva Berglund
Cancers 2023, 15(1), 255; https://doi.org/10.3390/cancers15010255 - 30 Dec 2022
Viewed by 1558
Abstract
The risk of late complications after a brain tumor in childhood is high. Both the tumor itself and the treatments give rise to sequelae that affect daily life activities. In this registry study, we explored post-compulsory education, i.e., further education following the nine [...] Read more.
The risk of late complications after a brain tumor in childhood is high. Both the tumor itself and the treatments give rise to sequelae that affect daily life activities. In this registry study, we explored post-compulsory education, i.e., further education following the nine compulsory years in school, in 452 cases born 1988–1996 and diagnosed with a brain tumor before their fifteenth birthday. They were compared with 2188 individual controls who were not treated for cancer. Significantly fewer teenagers and young adults treated for brain tumors in childhood attended high school or university compared with controls, especially individuals treated for embryonal tumors or optic pathway gliomas. A significantly larger proportion of subjects treated for embryonal tumors and craniopharyngiomas attended folk high schools, a type of post-compulsory school with a more accessible learning environment. For both cases and controls, we observed a positive correlation between parental education levels and attendance in high school and university. In our previous studies we have shown that children treated for brain tumors, as a group, tend to perform worse during their last year of compulsory school compared with their peers, and the current study confirms that these differences remain over time. Full article
14 pages, 3204 KiB  
Article
Optical Coherence Tomography Identifies Visual Pathway Involvement Earlier than Visual Function Tests in Children with MRI-Verified Optic Pathway Gliomas
by Urszula Arnljots, Maria Nilsson, Ulrika Sandvik, Ida Hed Myrberg, Daniel Martin Munoz, Klas Blomgren and Kerstin Hellgren
Cancers 2022, 14(2), 318; https://doi.org/10.3390/cancers14020318 - 9 Jan 2022
Cited by 5 | Viewed by 2727
Abstract
This study investigates whether optical coherence tomography (OCT) could add useful information in the examination of children with optic pathway glioma (OPG) at high risk of developing vision loss. For this purpose, the relationship between ganglion cell-inner plexiform layer (GC-IPL) thickness and visual [...] Read more.
This study investigates whether optical coherence tomography (OCT) could add useful information in the examination of children with optic pathway glioma (OPG) at high risk of developing vision loss. For this purpose, the relationship between ganglion cell-inner plexiform layer (GC-IPL) thickness and visual function, evaluated with tests of visual acuity (VA) and visual field (VF), as well as tumor site according to magnetic resonance imaging (MRI), were examined in a geographically defined group of children with OPG. Methods: Children aged <18 years with OPG underwent ophthalmic examination including VA, VF (Zeiss HFA perimetry) and OCT imaging (Zeiss Cirrus HD-OCT). Results: Out of 51 patients included, 45 provided 77 eyes with MRI-verified OPG, and 19 patients provided 25 eyes without OPG. Significant correlations were found between GC-IPL, VF and VA (p < 0.001). The GC-IPL pattern loss corresponded in 95% to VF defects and in 92% to MRI findings. Conclusions: Our study indicates that GC-IPL measures could serve as an early marker of vision-threatening changes related to OPG and as a valuable link between MRI and visual function tests. Thinning of GC-IPL and differences in topography between eyes are strong indicators of and predictive of vision loss related to OPG. Full article
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13 pages, 494 KiB  
Systematic Review
Sexual Dysfunction of Patients with Diffuse Low-Grade Glioma: A Qualitative Review of a Neglected Concern
by Arnaud Lombard and Hugues Duffau
Cancers 2022, 14(12), 3025; https://doi.org/10.3390/cancers14123025 - 20 Jun 2022
Cited by 10 | Viewed by 2492
Abstract
Diffuse low-grade gliomas (LGG) commonly affect young adults and display a slow evolution, with a life expectancy that can surpass 15 years, thanks to multimodal therapeutic management. Therefore, preservation of quality of life (QoL), including sexual health, is mandatory. We systematically searched available [...] Read more.
Diffuse low-grade gliomas (LGG) commonly affect young adults and display a slow evolution, with a life expectancy that can surpass 15 years, thanks to multimodal therapeutic management. Therefore, preservation of quality of life (QoL), including sexual health, is mandatory. We systematically searched available medical databases of Pubmed, Cochrane, and Scopus for studies that reported data on sexual activity or dysfunction (SD) in LGG patients. We analyzed results to determine incidence of SD and its association with QoL in this population. Three studies focused on SD incidence in patients presenting specifically LGG, or brain tumors including LGG. They comprised 124 brain tumor patients, including 62 LGG, with SD incidence ranging from 44 to 63%. SD was reported by more than 50% of interrogated women in the three studies. Regarding QoL, two out of the three studies found significant associations between SD and alterations of QoL parameters, particularly in the field of social and functional wellbeing. Finally, we discussed those results regarding methods of evaluation, inherent biases, and therapeutic implications regarding antiseizure medications and also planning of surgery, chemo-, and radiotherapy. Our review showed that SD is highly prevalent but still poorly studied in LGG patients. As those patients are usually young and enjoy an active life, there is a need to assess more systematically the occurrence of SD in clinical routine, in order to adapt cancer treatments accordingly, to manage actively these troubles, and finally to improve patients’ QoL in the long run. Full article
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