Volume 03 Issue 05-2023
24
American Journal Of Biomedical Science & Pharmaceutical Innovation
(ISSN
–
2771-2753)
VOLUME
03
ISSUE
05
Pages:
24-36
SJIF
I
MPACT
FACTOR
(2021:
5.
705
)
(2022:
5.
705
)
(2023:
6.534
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
Limitations in trial design, accrual, and data reporting impact efficient and reliable drug evaluation in cancer clinical
trials. These concerns have been recognized in neuro-oncology but have not been comprehensively evaluated. We
conducted a semi- automated survey of adult interventional neuro-oncology trials, examining design, interventions,
outcomes, and data availability trends. Trials were selected programmatically from ClinicalTrials.gov using primary
malignant CNS tumour classification terms. Regression analyses assessed design and accrual trends; effect size
analysis utilized survival rates among trials investigating survival.
KEYWORDS
Primary Central Nervous System malignancies; clinical trial design trends; trial accrual; treatment effect size
assumptions; leveraging of trial registry data. Interdisciplinary; Iran; NOSC; brain tumours; neuro-oncology.
Research Article
AWARENESS AMONG PEOPLE BASED ON NEURO ONCOLOGY
Submission Date:
May 09, 2023,
Accepted Date:
May 14, 2023,
Published Date:
May 19, 2023
Crossref doi:
https://doi.org/10.37547/ajbspi/Volume03Issue05-04
Mirkhamidova Sevara Mirmakhmudovna
Assistant Of The Department Of The Public Health And Management, Tashkent Medical Academy, Uzbekistan
Muyassarova Mukhabbat Mukhammadiyevna
Senior Teacher Of The Department Of Public Health And Management, Tashkent Medical Academy, Uzbekistan
Abdurashitova Sharafat Abdumajidovna
Senior Teacher Of The Department Of Public Health And Management, Tashkent Medical Academy, Uzbekistan
Karimbayev Shakhrambay Dexkanbayevich
Associate Professor (Phd) Of The Department Of Public Health And Management, Tashkent Medical Academy,
Uzbekistan
Tanisha Rahim
Student Foreign Faculty Tashkent Medical Academy, Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ajbspi
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 03 Issue 05-2023
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American Journal Of Biomedical Science & Pharmaceutical Innovation
(ISSN
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2771-2753)
VOLUME
03
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05
Pages:
24-36
SJIF
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MPACT
FACTOR
(2021:
5.
705
)
(2022:
5.
705
)
(2023:
6.534
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
INTRODUCTION
Despite important advances in the molecular
understanding of malignant primary CNS tumours and
efforts to translate these advances into clinical benefit,
there has been limited progress in treatments across
neuro-oncology. Therapeutic drug development in
neuro- oncology is complicated by a unique set of
challenges including vast inter- and intra-tumoral
heterogeneity, complex interactions of the tumour
with the neuronal and tumour microenvironments, the
existence of the blood-brain/tumour barrier which
limits the penetrability of compounds, a distinct and
isolated immunologic locale, and the inability of
preclinical models to recapitulate this complexity.
Beyond scientific challenges, past studies have pointed
to shortcomings in clinical trial design (including a lack
of randomization, absence of controls, overly
restrictive eligibility criteria, and low accrual) as
contributing to the translation failure of potentially
promising therapies.
discussions have highlighted the need to address
design challenges through novel trial designs that the
scope of our survey included past, ongoing, and
planned trials assessing interventions on any malignant
CNS tumour diagnoses; we evaluated trial design
characteristics, estimated treatment effect size
assumptions implied by the trial designs, overviewed
the extent of data availability, and summarized
reported efficacy and toxicity of interventions.
Research and practice of neuro-oncology compiles
clinical neuroscience expertise from neurosurgery,
radiation oncology, neuroradiology, medical oncology,
neuropathology and related disciplines to optimize
planning and therapy in central nervous system
malignancies. Such an interdisciplinary context
prompted health-care providers from all related
disciplines to establish the Neuro-Oncology Scientific
Club (NOSC) in Iran and let it flourish since 3 years ago.
With the advent of advanced technologies and
through continued share of experience, NOSC
members have tried to provide more integrated
diagnoses and therapeutic care to brain tumour
patients across the country. NOSC activities revolve
around some key tenets including dissemination of
education and updates, facilitation of institutional
collaborations; data registry and patients' awareness.
By virtue of recent insights on molecular
characterization of brain tumours such as codeletion of
chromosomes 1p and 19q in anaplastic gliomas and O6-
methylguanine-DNA
methyltransferase
(MGMT)
promoter methylation in glioblastoma, a range of
translational research is being followed within NOSC.
The most recent NOSC meeting which was held in
Tehran, recapitulated main advances and dealt with
the current debates on functional neurosurgery,
biological markers and neuroimaging, risk prediction
models in high grade gliomas and clinical issues in
Volume 03 Issue 05-2023
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(ISSN
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VOLUME
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SJIF
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(2021:
5.
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(2022:
5.
705
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(2023:
6.534
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
paediatric neuro-oncology. This article gives an
overview of current hotspots in neuro-oncology
research and practice which are pursued within NOSC
[1].
Survivorship has become a significant topic within
oncologic care. The tools and means by which the
provision of survivorship care can be implemented and
delivered are in development and are the focus of
significant research oncology-wide. These tools and
methods include innovations of survivorship care
delivery, survivorship care plans, and improving
communication among all stakeholders in an individual
patient's care as the means to elevate health-related
quality of life. The merits of these survivorship care
provisions in the field of neuro-oncology and its
patients' exigent need for more patient-centric care
focused on living with their illness are discussed. Brain
metastases occur commonly in patients with advanced
solid malignancies. Yet, less is known about brain
metastases than cancer-related entities of similar
incidence. Advances in oncologic care have heightened
the importance of intracranial management. Here, in
this consensus review supported by the Society for
Neuro-Oncology (SNO), we review the landscape of
brain metastases with particular attention to
management approaches and ongoing efforts with
potential to shape future paradigms of care [2].
Adolescents and young adults (AYA) comprise a
specific group of oncology patients with a distinct
biological and epidemiological spectrum of central
nervous system neoplasms. It has been well
documented that they differ clinically, especially in
relation to prognosis and chemotherapy tolerance;
however, the underlying reasons for this are unclear.
Recent advances in the genomics of both childhood
and adult brain tumors have provided new
explanations and insights into the previously described
age-dependent heterogeneity. Herein, we summarize
the current state of the AYA population in neuro-
oncology, specifically how biological advances can help
personalize therapy for this unique group of patients.
The management of brain tumors developed in
adolescents and young adults (AYAs) is challenging
because of their histological heterogeneity and low
incidence. The brain tumor and its treatment
interventions can negatively affect neurological,
neurocognitive, and endocrinological function, and
dramatically affect the circumstances of AYA patients
progressing to further education, employment, and
marriage. Specific support is thus necessary to
maintain the quality of life (QOL) of AYA brain tumor
patients. AYA patients and survivors require active
intervention and support for returning to school or
work, progressing to further education, finding
employment, and preserving fertility. Recent cancer
genome profiling revealed that AYA gliomas include
pediatric- and adult-type genetic alteration. Insights
into the biology underlying the distribution of tumors
in AYAs may influence the development of prospective
trials. A more individualized view of brain tumors may
Volume 03 Issue 05-2023
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(2023:
6.534
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OCLC
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1121105677
Publisher:
Oscar Publishing Services
Servi
influence stratification of patients' in future clinical
studies as well as selection for molecular targeted
therapy.[3]
Selection and measurement of appropriate outcomes
in clinical trials is critical. A trial or study outcome is a
measurable variable examined in response to a
treatment or intervention, to assess effectiveness or
harm. Traditional measures of response or time-
dependent metrics are important (Eg., radiological
tumor response or survival), but are somewhat limited
because they fail to characterize the functional or
symptomatic effect of the tumor on the person.
Outcomes should measure, either directly or indirectly,
how patients feel, function, and survive. Patients want
to live longer, but not necessarily at the expense of
quality of life.
The US Food & Drug Administration (FDA) describe
four categories of clinical outcome assessment (COA):
patient-reported (eg, health-related quality of life by
questionnaire), clinician-reported (eg, performance
status), observer-reported (eg, informal caregivers), or
performance
outcomes
(eg,
neurocognitive
tests).Brain tumor clinical trials increasingly include the
measurement of patient-reported outcomes, but the
level of reporting may be suboptimal.
COS should only be developed for neuro-oncology if
there is a clearly identified need and future uptake is
anticipated. Examples of need include standardizing
outcomes to allow meta-analysis and generation of
new knowledge, or identifying outcomes of core
importance to patients that are not currently
measured in clinical trials
—
a scenario which may result
in treatment recommendations that are not
acceptable to patients. COS are increasingly being
developed for routine practice which may also justify
need. Future uptake requires broad engagement of
healthcare professionals conducting neuro-oncology
research. The COS should be widely disseminated
through conference presentations, publications, and
communication with policy makers, charities, and
patient organizations [4].
The Core Outcome Measures in Effectiveness Trials
(COMET) initiative brings together people interested in
the development and application of COS. New COS
projects should be registered, and if the same COS are
listed as under development by another research
group or if overlap exists, COMET facilitates
communication between research groups to promote
collaboration and prevent duplication of effort and
research waste [6].
The existence of a COS with similar scope to one
planned
does
not
constitute
an
absolute
contraindication to its development, and may be
beneficial within neuro-oncology. Consider the
hypothetical situation of a disease-specific COS being
developed for pediatric medulloblastoma, and a
researcher developing a broader COS defining
outcome measures for clinical trials of surgically
managed posterior fossa tumors. The disease-specific
COS may include outcomes highly relevant to
Volume 03 Issue 05-2023
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American Journal Of Biomedical Science & Pharmaceutical Innovation
(ISSN
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VOLUME
03
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SJIF
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FACTOR
(2021:
5.
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)
(2022:
5.
705
)
(2023:
6.534
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
medulloblastoma key stakeholders, eg, disease-
specific
treatments
such
as
adjuvant
chemoradiotherapy. However, a broader COS that
reflects surgical intervention for a particular
anatomical location (ie, posterior fossa), will identify
adverse events associated with surgery that will be
relevant to other key stakeholders, including those
invested in medulloblastoma. The combination of a
disease-specific and treatment-specific COS will cover
outcomes of relevance to all key stakeholders [7].
CNS tumors are the most common solid tumor in those
aged 0
–
19 years, represent 6% across all ages, and are
the most common cause of cancer death in this
population. Pediatric brain tumors are associated with
high morbidity which may have lifelong consequences
for survivors, both from the disease and treatment.
Classifying and reporting postoperative morbidity in
pediatric brain tumors is challenging. The disease area
is highly heterogeneous, anatomically distributed, and
associated with location-specific morbidity. Pathology
may also dictate the aggressiveness of surgical intent
and the level of postoperative morbidity which is
acceptable to achieve adequate disease control. In
addition, presurgical neurological condition and co-
morbidity status can be variable at diagnosis and may
contribute to cumulative postoperative morbidity.
Finally, many children will go on to have systemic
therapies or radiotherapy which also affect tumor-
associated morbidity. Transparent and reproducible
morbidity reporting helps to manage patient and
parent expectations, provides a standardized way to
compare adverse events in clinical or research studies
and provides a benchmark to compare clinical services.
The application of existing morbidity tools to report
pediatric brain tumor surgery harms is inadequate. The
COMBAT project will develop a core set of adverse
outcomes for children undergoing tumor biopsy and/or
resection which are determined to be of importance to
all key stakeholders [5].
Neuro-oncology and palliative care: a challenging
interface Palliative care is defined by the World Health
Organization as “an approach that improves the
quality of life of patients and their families facing the
problems associated with life-threatening illness,
through the prevention and relief of suffering by
means of early identification and impeccable
assessment and treatment of pain and other problems,
physical, psychosocial and spiritual.” Palliative care
encompasses symptom control and provision of
practical support to patients and their carers
—
from
first referral through terminal care and death and into
bereavement.
The goal of palliative care is to maximize quality of life,
drawing on the skills of a multidisciplinary team to help
the patient live as actively as possible whilst neither
hastening nor postponing death. Palliative care can
play an important role in the management of
malignant and nonmalignant conditions, in both
inpatient and outpatient settings [6].
MATERIALS AND METHODS
Volume 03 Issue 05-2023
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SJIF
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(2021:
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(2022:
5.
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(2023:
6.534
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OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
This study used an online google forms questionnaire
as the instruments. Invitation to people in this survey
was sent through via email and among social media
platforms. It was sent this way because everyone
nowadays are on social media platforms it would be
easy to spread awareness in this way. Therefore, using
Google form to reach each participant is the best
choice.
The target respondents are the young people of
Tashkent, Uzbekistan and India under the age of 25
because the young people ratio are more in this area
and they need a good awareness among them . The
questions in the developed questionnaire were
distributed for this pilot to test the awareness of public
on neuro-oncology. The population of this survey was
102 members. This work is done to create awareness
among people on neuro oncology. The search for
literary sources was carried out using the bibliographic
databases Web of Science, Scopus, DBLP, PubMed.
When selecting sources, they paid attention to
experimental articles, literary reviews, the number of
their citations over the past year.
RESULTS
The survey were conducted using information and
communication technologies, booklets, brochures,
presentations, etc. All were asked to answer using a
specially designed public awareness on neuro-
oncology questionnaire. The table below show the
results of the survey. People of about 102 were under
survey. Among them, Male (40.8%), Female (59.2%) and
Others (0%)
MALE
59%
FEMALE
41%
GENDER
Volume 03 Issue 05-2023
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SJIF
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(2021:
5.
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(2022:
5.
705
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(2023:
6.534
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OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
The age of the participants was from 18-25 years old (78.4%), from 26-40years old (13.7%), from 41-60 years old (7.8%)
and from 60 and above (0%). The respondents are mostly under 25 because my survey reached to most of the young
people whom I’m in contact with. Even
-though , I also received response from middle-aged people through my family
members and relations in India .
Most of the participants of the survey responded the correct answer ‘No’(78%).
So the result tells that the disease is not contagious by the people. Even-though, some people are not aware that it is
not infectious and answered as ‘Yes’ (11%)
Under 18
20%
from 25-30
78%
above 45
2%
AGE
yes
11%
no
78%
Don’t know
11%
Do you think its infectious or non infectious?
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(2021:
5.
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(2022:
5.
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(2023:
6.534
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
So more than half (55%) of the people in my survey are suffering from any kind of brain related diseases. So this
portrays that these diseases are becoming familiar in our life cycle nowadays.
Nowadays Headache (37%) became an usual symptom among teenagers and adults because of lots of stress they go
through in this era. Due to this the cycle continues as Weakness (35%) ,Change in personality (12%) ,Nausea (9%) and
goes on.
Most of the people doesn’t know about Neuro
-oncology and they are not aware about this disease.
yes
55%
no
36%
maybe
9%
Are you suffering from any brain diseases or any type of
tumours or brain cancer?
weakness
35%
seizures
2%
Difficulty in walking
5%
changes in
personality
12%
Nausea
9%
Headaches
37%
Are you going through any of these symptoms?
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(2021:
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(2022:
5.
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(2023:
6.534
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OCLC
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1121105677
Publisher:
Oscar Publishing Services
Servi
It’s not a prevalent disease in this era because people never share that they have any oncology disease (69%).
Yes
30%
No
69%
Maybe
1%
Have you seen people suffering from this around you?
yes
42%
No
58%
Are you awarre about Neuro oncology?
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(2022:
5.
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(2023:
6.534
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OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
MRI Scan are becoming very common but even then people
get fear while performing those tests so they don’t prefer
to take tests even though they have the related symptoms so that we got the answer mostly as ‘no’(69%)
yes
30%
no
69%
maybe
1%
Have you gone through any test or MRI/scannings?
Yes
16%
no
84%
Did you consult a doctor ?
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5.
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(2023:
6.534
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OCLC
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1121105677
Publisher:
Oscar Publishing Services
Servi
Moving to Neurologist now is not usual because most of the people said ‘no’ (84%)
. They move only if the general
doctor gives an expert opinion.
No relevant disease observed so ultimately they prefer no (90%) medications. Very rare case are prevalent so they
might take medications (10%).
yes
10%
no
90%
Are you taking medications?
26.20%
62.10%
11.70%
Do you think major death cases are due to cancers?
Yes
no
maybe
Volume 03 Issue 05-2023
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SJIF
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OCLC
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1121105677
Publisher:
Oscar Publishing Services
Servi
In this survey we can see most of the people knew
about neuro oncology and its common symptoms.
Tumors, brain cancers is a common neurological
disorder characterized by recurrent headaches.
Typically, the associated symptoms affects a person so
much as it’s all basic signs a p
erson can suffer from
nausea, difficulty in walking, headaches, changes in
personality etc. The pain is generally made worse by
physical activity during an attack, although regular
physical exercise may prevent future attacks. Up to
one-third of people affected have aura: typically, it is a
short period of visual disturbance that signals or
harmful radiation will effect it. Occasionally, aura can
occur with little or no following symptoms ,but not
everyone has this symptoms.
DISCUSSION
When analyzing the efficiency of knowledge
assimilation, the compared options, in contrast to the
analysis of minimizing costs are characterized by
greater or lesser, but not equivalent, efficiency.
In this regard, it is important to assess the degree of
feasibility of the analysis, depending on the level of
reliability of the data. The test results were expressed
in points Participants' results were calculated using
Microsoft Excel software. The assessment of the
effectiveness of the assimilation of knowledge was
calculated based on the application of the proposed
methodological recommendation in practice Thus,
each participant of the survey, on average. Increased
his theoretical and practical level of knowledge in the
field of Neuro Oncology and it's prevention by almost
half.
CONCLUSION
Its concluded from my survey also that many people
nowadays are going through common symptoms but
weren’t aware about it. Now after participating in my
survey they would have got more awareness than
before. If people are receiving any kind of symptom
they should obviously consult the doctor as soon as
possible. They shouldn’t take risk in it because the
death rate in this case are literally very high and no
proper medication can work if the condition goes out
of hand .
RECOMMENDATION
➢
Avoid environmental hazards such as smoking and
excessive radiation exposure
➢
Manage stress
➢
Relaxation techniques like meditation, yoga and
mindful breathing can help
➢
Eat on a regular schedule
➢
Drink lots of fluids
➢
Get plenty of rest
➢
Get regular moderate exercise
➢
Ask your doctor about preventive medicines if you
get
➢
Try getting lots of oxygen
REFERENCES
1.
Haddad P, Shazadi S, Samiei F, Kharrazi HH,
Tabatabaeefar M, Rakhsha A, Faranoosh M,
Torabi-Nami M, Dadras A, Liaghi A, Nafarieh L.
Volume 03 Issue 05-2023
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MPACT
FACTOR
(2021:
5.
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)
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5.
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6.534
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Publisher:
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Servi
An overview of neuro-oncology research and
practice in Iran, three years with the NOSC
initiative. Int J Clin Exp Med. 2015 Mar
15;8(3):3946-55. PMID: 26064296; PMCID:
PMC4443130.
2.
Aizer AA, Lamba N, Ahluwalia MS, Aldape K,
Boire A, Brastianos PK, Brown PD, Camidge DR,
Chiang VL, Davies MA, Hu LS, Huang RY,
Kaufmann T, Kumthekar P, Lam K, Lee EQ, Lin
NU, Mehta M, Parsons M, Reardon DA,
Sheehan J, Soffietti R, Tawbi H, Weller M, Wen
PY. Brain metastases: A Society for Neuro-
Oncology (SNO) consensus review on current
management and future directions. Neuro
Oncol. 2022 Oct 3;24(10):1613-1646. doi:
10.1093/neuonc/noac118.
PMID:
35762249;
PMCID: PMC9527527.
3.
Armstrong
TS.
Survivorship
in
Neuro-
Oncology.
Neuro
Oncol.
2018
Nov
9;20(suppl_7):vii4-vii5.
doi:
10.1093/neuonc/noy173.
PMID:
30412259;
PMCID: PMC6225750.
4.
Мирхамидова С. М., Динмухаммадиев Н. А.
Особенности
распространенности
онкологических заболеваний //Молодой
ученый. –
2016.
–
№. 20.
–
С. 84
-87.
5.
Levin VA. Drug discovery in neuro-oncology:
challenges in the path forward. Neuro Oncol.
2018
Mar
27;20(4):435-436.
doi:
10.1093/neuonc/noy004.
PMID:
29538691;
PMCID: PMC5909643.
6.
Millward CP, Armstrong TS, Barrington H,
Brodbelt AR, Bulbeck H, Byrne A, Dirven L,
Gamble C, Grundy PL, Islim AI, Javadpour M,
Keshwara SM, Krishna ST, Mallucci CL, Marson
AG, McDermott MW, Meling TR, Oliver K, Pizer
B, Plaha P, Preusser M, Santarius T,
Srikandarajah N, Taphoorn MJB, Watts C,
Weller M, Williamson PR, Zadeh G, Zamanipoor
Najafabadi AH, Jenkinson MD. Opportunities
and challenges for the development of "core
outcome sets" in neuro-oncology. Neuro
Oncol. 2022 Jul 1;24(7):1048-1055. doi:
10.1093/neuonc/noac062. PMID: 35287168;
PMCID: PMC9248398.
7.
Lin E, Rosenthal MA, Le BH, Eastman P. Neuro-
oncology and palliative care: a challenging
interface. Neuro Oncol. 2012 Sep;14 Suppl 4:iv3-
7.
doi:
10.1093/neuonc/nos209.
PMID:
23095828; PMCID: PMC3480249.
