Objective: To test whether the presence of patient- and imaging-level characteristics (1) are associated with clinically meaningful changes in mobility among patients with late-stage cancer with metastatic brain involvement, and (2) can predict their risk of near-term functional decline.
Design: Prospective nested cohort study.
Setting: Quaternary academic medical center.
Participants: The study population consisted of a nested cohort of the patients with imaging-confirmed brain metastases (n=66) among a larger cohort of patients with late-stage lung cancer (N=311).
Interventions: Not applicable.
Main Outcome Measures: Functional evaluations with the Activity Measure for Post-Acute Care Computer Adaptive Test (AM-PAC-CAT) and symptom intensity ratings were collected at monthly intervals for up to 2 years.
Results: In exploratory univariate models, whole brain radiation therapy (WBRT) and imaging findings of cerebellar or brainstem involvement were associated with large AM-PAC-CAT score declines reflecting worsening mobility (-4.55, SE 1.12; -2.87, SE, 1.0; and -3.14, SE 1.47, respectively). Also in univariate models, participants with new neurologic signs or symptoms at imaging (-2.48; SE .99), new brain metastases (-2.14, SE .99), or new and expanding metastases (-2.64, SE 1.14) declined significantly. Multivariate exploratory mixed logistic models, including WBRT, cerebellar/brainstem location, presence of new and expanding metastases, and worst pain intensity, had excellent predictive capabilities for AM-PAC-CAT score declines of 7.5 and 10 points (C statistics ≥0.8).
Conclusions: Among patients with lung cancer and brain metastases, cerebellar/brainstem location, new and expanding metastases, and treatment with WBRT may predict severe, near-term mobility losses and indicate a need to consider rehabilitation services.
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http://dx.doi.org/10.1016/j.apmr.2016.08.473 | DOI Listing |
J Exp Clin Cancer Res
January 2025
Beijing Neurosurgical Institute, Capital Medical University, Beijing, 100070, China.
Background: Bone-invasive Pituitary Neuroendocrine Tumors (BI PitNETs) epitomize an aggressive subtype of pituitary tumors characterized by bone invasion, culminating in extensive skull base bone destruction and fragmentation. This infiltration poses a significant surgical risk due to potential damage to vital nerves and arteries. However, the mechanisms underlying bone invasion caused by PitNETs remain elusive, and effective interventions for PitNET-induced bone invasion are lacking in clinical practice.
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January 2025
Department of Radiology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, 441000, Hubei, China.
Brain metastases (BM) are the most prevalent intracranial malignancies. Approximately 30-40% of cancer patients develop BM at some stage of their illness, presenting with a high incidence and poor prognosis. Our clinical findings indicate a significant disparity in the efficacy between non-enhanced and enhanced lung cancer BM.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Gastroenterology, First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou, Fujian, China.
This study investigated the relationship between the frailty index and all-cause and cause-specific mortality in patients with depression. We recruited 2,669 participants with depression from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018 and quantified their frailty status using a 53-item frailty index. Cox proportional hazards models were used to estimate hazard ratios (HR) and their 95% confidence intervals (CI).
View Article and Find Full Text PDFCell Death Dis
January 2025
State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Department of Immunology, Fourth Military Medical University, Xi'an, Shaanxi Province, China.
Glioblastoma (GBM) is the most common malignant primary brain cancer with poor prognosis due to the resistant to current treatments, including the first-line drug temozolomide (TMZ). Accordingly, it is urgent to clarify the mechanism of chemotherapeutic resistance to improve the survival rate of patients. In the present study, by integrating comprehensive non-coding RNA-seq data from multiple cohorts of GBM patients, we identified that a series of miRNAs are frequently downregulated in GBM patients compared with the control samples.
View Article and Find Full Text PDFAppl Nurs Res
February 2025
Institute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan; Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, UK. Electronic address:
Aim: Compare the convergent and divergent viewpoints of early-stage postoperative patients with glioblastoma and their caregivers on end-of-life care planning in Taiwan.
Background: Decision-making capacity in patients with glioblastoma may be compromised as disease progresses, making early future care planning essential to ensure that the provided care aligns with patients' goals. However, within many Asian cultures, the tendency to avoid discussions about death can lead patients to feel hesitant about addressing end-of-life care options.
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