Publications by authors named "Terri Armstrong"
Article Synopsis
- Glioblastoma (GBM) is a severe brain cancer that can lead to toxic side effects during treatment, prompting this study to explore genetic and clinical factors associated with vascular toxicities such as thrombosis and hypertension in patients.
- A total of 591 Non-Hispanic White GBM patients were analyzed, with 62 experiencing thrombosis and 59 hypertension, revealing that hypertensive patients had improved survival rates compared to those without hypertension.
- The study found that genetic factors significantly predicted hypertension better than clinical data alone, while corticosteroid use was identified as a notable risk factor for thrombosis, suggesting a need for further research into these associations in cancer treatments.
Patients with myelodysplastic syndromes (MDS) or acute myeloid leukemia (AML) experience a wide range of symptoms due both to their underlying disease and the effects of treatment. Designing early phase trials to explore effective therapies in these patients should not only examine anti-tumor activity, but also consider the effects of treatments on how patients feel and function. Assessing symptomatic toxicities associated with new therapies in early phase trials from the patient perspective is best measured using patient-reported outcomes (PROs) and offers valuable insight and complementary information to the traditional adverse event reporting in cancer clinical trials.
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- Radiation therapy is a common treatment for primary brain tumors, but it may lead to significant sleep disorders that haven't been fully explored.
- A systematic review analyzed 38 studies involving nearly 2,948 patients, finding a high incidence of sleep disturbances particularly from the end of radiation to six months afterward, linked to radiation dosage.
- The review calls for more research on sleep disorders in patients with primary brain tumors and suggests that pharmacological interventions can help manage sleep symptoms, despite inconsistencies in how these symptoms are reported across studies.
Article Synopsis
- Researchers studied how different cancer patients experience symptoms in different ways!
- They looked at data from over 3,000 patients to find patterns in symptoms and created groups based on shared experiences!
- They discovered three main symptom clusters and found that lack of energy was really important for all patients, but different groups had different symptoms that needed more attention!
Article Synopsis
- - The systematic review highlights that mind-body, cognitive-behavioral, and physical activity interventions can potentially benefit brain tumor patients, but these strategies are not widely used in neuro-oncology.
- - Out of 29 studies reviewed, mind-body and physical activities showed promising results in improving mood, quality of life, and physical functioning, while cognitive-behavioral interventions had mixed results due to insufficient study power.
- - The review calls for more robust clinical trials to better confirm the effectiveness of these interventions for both physical and psychological health in brain tumor patients.
Article Synopsis
- We evaluated the extent of oncology clinical trial infrastructure in the US, focusing on neuro-oncology while also considering its broader implications for cancer research and care.
- * Over 57% of the US population does not have direct access to this trial-supporting infrastructure, with a significant concentration in urban and socioeconomically privileged areas.
- * Our findings highlight the disparities in access to oncology care and propose strategies to enhance the infrastructure's reach to underserved populations.*
Article Synopsis
- Sleep-wake disturbances are prevalent among primary brain tumor patients, and this study explores the relationship between patient-reported outcomes (PROs) and data from smart wearables like Fitbits over a 4-week period.
- Fifty-four patients participated, wearing Fitbits to track their sleep patterns and completing various PROs at the start and end of the study, showing high compliance and reliability in the data collected.
- Results indicated that while some patients experienced significant improvements in sleep disturbance, a notable correlation was found between wake after sleep onset and sleep disturbance, highlighting a need for further research into sleep mechanics in this patient population.
Background: Ependymoma (EPN) is not a uniform disease but represents different disease types with biological and clinical heterogeneity. However, the pattern of when and where different types of EPN relapse is not yet comprehensively described.
Methods: We assembled 269 relapsed intracranial EPN from pediatric (n=233) and adult (n=36) patients from European and Northern American cohorts and correlated DNA methylation patterns and copy-number alterations with clinical information.
Article Synopsis
- * A web-based study involving 158 adult patients revealed that low self-efficacy levels were linked to longer symptom durations before surgery and were influenced by factors such as gender and education.
- * The study found that individuals with lower self-efficacy experienced more severe mood-related issues, highlighting the need for tailored interventions to improve self-efficacy in cancer care.
Article Synopsis
- - Burnout in the medical field is linked to emotional exhaustion, depersonalization, and a decreased sense of achievement, and younger professionals are particularly at risk; this study focused on SNO Young Investigators to better understand their experiences.
- - An anonymous survey was conducted in 2019 among eligible SNO members, gathering data on their characteristics and using the Maslach Burnout Inventory to assess burnout levels, with analysis including various statistical methods.
- - The results showed that YI members reported higher levels of emotional exhaustion and depersonalization than the general population, with 30% classified as overextended and 15% experiencing burnout; stress was largely attributed to organizational challenges, indicating a need for systemic interventions.
Article Synopsis
- * A systematic review analyzed 48 studies out of 3006 abstracts to explore the relationship between SDOH and neurocognitive/mood-related symptoms in PBT patients, focusing on various factors like education, gender, and occupation.
- * The findings indicated that higher education correlated with fewer neurocognitive symptoms and that unemployment post-surgery linked to depressive symptoms, but overall results were inconsistent; future research should standardize SDOH data collection and focus on diverse populations.
Article Synopsis
- Cancer survival rates are improving overall, but have not increased for adolescents and young adults (ages 15-39), especially for those with brain tumors.
- The report details the unique histopathological differences of brain tumors in AYA compared to children and older adults, revealing an average incidence rate of 12.00 per 100,000 population from 2016 to 2020 and approximately 1,018 deaths annually due to primary malignant brain tumors.
- The most common brain tumors were pituitary tumors, with an incidence that varied by race and sex, showing higher rates in females and distinct patterns among different racial/ethnic groups.
Article Synopsis
- The study investigates the link between cancer-related cognitive impairment (CRCI) and anxiety in cancer patients, aiming to uncover the biological mechanisms behind their co-occurrence.
- Researchers analyzed data from 451 patients undergoing chemotherapy, categorizing them based on levels of CRCI and anxiety, and identified five disrupted neurodegenerative disease pathways.
- Key processes such as apoptosis and oxidative stress were common across these pathways, suggesting potential targets for future therapeutic interventions.
Article Synopsis
- A systematic review was conducted to analyze how outcomes of meningioma clinical trials are measured and reported, addressing the lack of agreement on these measures.
- The study reviewed 30 published articles and 18 ongoing trials, resulting in 47 clinical trials and 659 reported outcomes, which were grouped into unique terms using a standardized classification system.
- The findings highlight the need for a more consistent approach to outcome measurement, leading to plans for a consensus meeting to create a core outcome set to guide future trials.
Article Synopsis
- A systematic review was conducted to analyze how outcomes are measured in studies of patients with incidental intracranial meningioma, as inconsistent practices have hindered comparative research.
- The review included 33 published articles, resulting in 268 reported outcomes, which were refined to 178 unique outcomes categorized into 53 standardized terms and classified into 9 outcome domains.
- The goal is to create a Core Outcome Set through stakeholder consensus, improving the consistency of outcome measurements in future studies.
Purpose: Multidisciplinary tumor boards (MTBs) integrate clinical, molecular, and radiological information and facilitate coordination of neuro-oncology care. During the COVID-19 pandemic, our MTB transitioned to a virtual and multi-institutional format. We hypothesized that this expansion would allow expert review of challenging neuro-oncology cases and contribute to the care of patients with limited access to specialized centers.
View Article and Find Full Text PDFBackground: Glioblastoma (GBM) is the most aggressive primary brain malignancy with <45% living a year beyond diagnosis. Previously published investigations of long-term survivors (LTS) provided clinical data but rarely incorporated a comprehensive clinical and molecular analysis. Herein, we identify clinical, imaging, molecular, and outcome features for 23 GBM-LTS patients and compare them with a matched cohort of short-term survivors (STS).
View Article and Find Full Text PDFBackground: Gliosarcoma, an isocitrate dehydrogenase wildtype (IDH-WT) variant of glioblastoma, is defined by clonal biphasic differentiation into gliomatous and sarcomatous components. While the transformation from a glioblastoma to gliosarcoma is uncommon, the subsequent transformation to osteosarcoma is rare but may provide additional insights into the biology of these typically distinct cancers. We observed a patient initially diagnosed with glioblastoma, that differentiated into gliosarcoma at recurrence, and further evolved to osteosarcoma at the second relapse.
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- The EuroQoL EQ-5D-5L is a health-related quality of life measurement commonly used in clinical trials, but its effectiveness in showing changes in neurocognitive function after brain radiation is uncertain.
- A study analyzed data from patients with varying cognitive function and intracranial progression to assess changes in EQ-5D-5L scores and associated symptoms over time.
- Results indicated that EQ-5D-5L scores did not reflect neurocognitive changes, while visual analog scale scores showed sensitivity to intracranial progression, suggesting that EQ-5D may not be appropriate for brain metastases trials focused on cognitive health.
Article Synopsis
- - The adolescent and young adult (AYA) cancer population, specifically those aged 15-39 with primary brain tumors, faces significant challenges in their treatment, trial participation, and overall quality of life, despite being increasingly recognized.
- - A systematic literature review identified 68 relevant studies that highlighted 11 specific challenges related to clinical trials for AYAs, including issues like tumor biology, diagnostic delays, and limited trial availability.
- - The study concludes that the unique needs of AYAs with CNS cancers are often overlooked, emphasizing the necessity for more targeted research and tailored care to enhance their treatment outcomes and trial involvement.
Article Synopsis
- The study aims to find subgroups of patients who respond differently to hippocampal avoidant whole brain radiotherapy (HA-WBRT) for brain metastases, analyzing existing data from a clinical trial.
- Results show that patients who live longer than 4 months benefit significantly from HA-WBRT in terms of reducing neurocognitive function failure, while those with shorter survival show no significant benefits.
- It also highlights that patients with lower cognitive impairment scores and those with lung cancer histology experience greater neuroprotective effects from HA-WBRT compared to others.
Article Synopsis
- The study updates the incidence, prevalence, and survival statistics for 12 rare central nervous system (CNS) tumor types, focusing on their importance and potential for targeted treatments.
- It utilizes the CBTRUS database to analyze age-adjusted incidence rates from 2008-2019 and survival rates, revealing that ependymomas have the highest incidence and five-year survival rates compared to other tumor types.
- These findings help measure the effectiveness of clinical care and assess new therapies for rare CNS tumors in light of evolving medical standards.
Article Synopsis
- The study aimed to identify patient subgroups with different levels of cancer-related cognitive impairment (CRCI) and anxiety, analyzing their demographic and clinical traits alongside various stress measures.
- A total of 1,332 patients participated, completing assessments repeatedly during chemotherapy, which led to three distinct profiles: No CRCI and Low Anxiety, Moderate CRCI and Moderate Anxiety, and High CRCI and High Anxiety.
- Results indicated that as the severity of CRCI and anxiety increased, so did stress levels, revealing that patients with more severe symptoms experienced higher rates of specific stressors, which could help clinicians in tailoring interventions for high-risk individuals.
Article Synopsis
- The study aimed to categorize long-term survivors of primary central nervous system tumors (PCNST) based on health-related quality of life (HRQOL) to improve personalized survivorship care.
- Analysis of data from 298 survivors revealed two distinct HRQOL classes: one with good (61%) quality of life exhibiting few physical problems, and another with poor (39%) quality of life facing significant physical and emotional challenges.
- Factors such as older age, unemployment, presence of spine tumors, ongoing treatment, tumor recurrence, and lower performance status were linked to membership in the poor HRQOL class.
Background: Hypersomnolence is a common and disruptive side effect of cranial radiotherapy and is associated with fatigue and disturbances in mood and cognition in primary brain tumor (PBT) patients. The biological underpinnings of this effect are not understood. Our laboratory has previously found that the presence of a single nucleotide polymorphism (rs934945, G-E mutation) in the PERIOD2 (PER2) clock gene was associated with a decreased likelihood of fatigue in PBT patients.
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