Diagnosis and management of complications from the treatment of primary central nervous system tumors in adults

Author:

Weller Michael1ORCID,Le Rhun Emilie12,Van den Bent Martin3,Chang Susan M4,Cloughesy Timothy F5,Goldbrunner Roland6,Hong Yong-Kil7,Jalali Rakesh8,Jenkinson Michael D9,Minniti Giuseppe1011,Nagane Motoo12ORCID,Razis Evangelia13,Roth Patrick1,Rudà Roberta14,Tabatabai Ghazaleh15ORCID,Wen Patrick Y16,Short Susan C1718,Preusser Matthias19ORCID

Affiliation:

1. Department of Neurology, University Hospital and University of Zurich , Zurich , Switzerland

2. Department of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich , Zurich , Switzerland

3. The Brain Tumour Center at the Erasmus MC Cancer Institute , Rotterdam , The Netherlands

4. Department of Neurological Surgery, University of California , San Francisco, California , USA

5. Department of Neurology, David Geffen School of Medicine at UCLA , Los Angeles, California , USA

6. Center of Neurosurgery, Department of General Neurosurgery, University of Cologne , Cologne , Germany

7. Brain Tumor Center, Hallym University Sacred Heart Hospital , Anyang , South Korea

8. Neuro Oncology Cancer Management Team, Apollo Proton Cancer Centre , Chennai , India

9. Department of Neurosurgery, The Walton Centre NHS Foundation Trust & University of Liverpool , Liverpool , UK

10. Department of Medicine, Surgery and Neurosciences, University of Siena, Policlinico Le Scotte , Siena , Italy

11. IRCCS Neuromed , Pozzilli, IS , Italy

12. Department of Neurosurgery, Kyorin University Faculty of Medicine , Tokyo , Japan

13. Third Department of Medical Oncology, Hygeia Hospital , Marousi, Athens , Greece

14. Division of Neuro-Oncology, Department of Neuroscience, City of Health and Science and University of Turin , Turin , Italy

15. Department of Neurology & Neuro-Oncology, Hertie Institute for Clinical Brain Research, Center for Neurooncology, Comprehensive Cancer Center, German Cancer Consortium (DKTK), Partner site Tübingen, University Hospital Tübingen, Eberhard Karls University Tübingen , Tübingen , Germany

16. Center for Neuro-oncology, Dana-Farber Cancer Institute and Harvard Medical School , Boston, Massachusetts , USA

17. Leeds Institute of Medical Research, University of Leeds , Leeds , UK

18. Department of Clinical Oncology, Leeds Teaching Hospitals NHS Trust , Leeds , UK

19. Division of Oncology, Department of Medicine 1, Medical University , Vienna , Austria

Abstract

AbstractCentral nervous system (CNS) tumor patients commonly undergo multimodality treatment in the course of their disease. Adverse effects and complications from these interventions have not been systematically studied, but pose significant challenges in clinical practice and impact function and quality of life, especially in the management of long-term brain tumor survivors. Here, the European Association of Neuro-Oncology (EANO) has developed recommendations to prevent, diagnose, and manage adverse effects and complications in the adult primary brain CNS tumor (except lymphomas) patient population with a specific focus on surgery, radiotherapy, and pharmacotherapy. Specifically, we also provide recommendations for dose adaptations, interruptions, and reexposure for pharmacotherapy that may serve as a reference for the management of standard of care in clinical trials. We also summarize which interventions are unnecessary, inactive or contraindicated. This consensus paper should serve as a reference for the conduct of standard therapy within and outside of clinical trials.

Publisher

Oxford University Press (OUP)

Subject

Cancer Research,Neurology (clinical),Oncology

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