Palliative care and end-of-life care in adults with malignant brain tumors

Background This systematic review provides updated insights, from the published literature in the past 5 years, based on the 2017 European Association of Neuro-Oncology (EANO) guidelines for palliative care in adults with malignant brain tumors. It provides an overview of palliative care options, including during the end-of-life phase for patients with malignant brain tumors. Methods A systematic literature search was conducted from 2016 to 2021 focusing on four main topics: (1) symptom management, (2) caregiver needs, (3) early palliative care, and (4) care in the end-of-life phase. An international panel of palliative care experts in neuro-oncology synthesized the literature and reported the most relevant updates. A total of 140 articles were included. Results New insights include that: Hippocampal avoidance and stereotactic radiosurgery results in a lower risk of neurocognitive decline in patients with brain metastases; levetiracetam is more efficacious in reducing seizures than valproic acid as first-line monotherapy antiseizure drug (ASD) in glioma patients; lacosamide and perampanel seem well-tolerated and efficacious add-on ASDs; and a comprehensive framework of palliative and supportive care for high-grade glioma patients and their caregivers was proposed. No pharmacological agents have been shown in randomized controlled trials to significantly improve fatigue or neurocognition. Conclusions Since the 2017 EANO palliative care guidelines, new insights have been reported regarding symptom management and end-of-life care, however, most recommendations remain unchanged. Early palliative care interventions are essential to define goals of care and minimize symptom burden in a timely fashion. Interventional studies that address pain, fatigue, and psychiatric symptoms as well as (the timing of) early palliative care are urgently needed.Neurolog

Palliative care and end-of-life care in adults with malignant brain tumors (vol 15, noac216, 2022)

Neurolog

Visualizing Related Metabolic Pathways in Two and a Half Dimensions

We propose a method for visualizing a set of related metabolic pathways using 2 2 D graph drawing. Interdependent, two-dimensional layouts of each pathway are stacked on top of each other so that biologists get a full picture of subtle and significant di#erences among the pathways. Layouts are determined by a global layout of the union of all pathway-representing graphs using a variant of the proven Sugiyama approach for layered graph drawing that allows edges to cross if they appear in di#erent graphs