Depression in brain cancer patients is a common but often overlooked condition, and oncologists should regularly screen tumor patients for depression, according to an article by Pranckeviciene and Bunevicius in CNS Oncology. The authors, both of the Lithuanian University of Health Sciences, also propose that more studies be completed to explore the efficacy of antidepression treatments, as well as the value of depression biomarkers for future brain tumor research.

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“Psychological distress is an important complication in patients with brain tumors but often remains undiagnosed and untreated,” said Adomas Bunevicius MD, PhD. “Methodologically rigorous studies aiming to identify the most optimal depression screening tools for patients with brain tumor are lacking. As a consequence, to date there are no evidence-based depression diagnostic algorithms.”

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Among patients undergoing surgery for a brain tumor, low T3 (triiodothyronine) syndrome has been found to be predictive of unfavorable clinical outcomes and depressive symptoms.

 

Low T3 syndrome is a term used to describe the finding of low blood serum concentrations of T3, which can be accompanied by abnormal T4 (thyroxine) to T3 conversion and high concentrations of reverse T3 (rT3) without any obvious sign of thyroid disease. Previous reports have shown that the finding of low levels of T3 in critically ill patients and in patients undergoing surgery for some disorders is widespread and associated with unfavorable clinical outcomes.

 

This association of low T3 and poor outcomes was investigated in patients undergoing brain tumor surgery by Adomas Bunevicius, MD, PhD, of Lithuanian University of Health Sciences and colleagues there and at the University of North Carolina at Chapel Hill. They performed perioperative thyroid function tests and also examined whether there was an association between low T3 syndrome and symptoms of anxiety and depression. These are common complications in patients harboring brain tumors and are associated with poor prognoses.

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Low triiodothyronine (T3) syndrome appears to be a biomarker of poor clinical outcomes and symptoms of depression in patients undergoing surgery for brain tumor. That is the conclusion of a pilot study now available online ahead of print in the Journal of Neurosurgery.

 

“No one else has looked at low T3 syndrome in brain cancer patients,” said lead study author Adomas Bunevicius, MD, PhD, a neuroradiology fellow at the University of North Carolina at Chapel Hill and neurosurgery resident at Lithuanian University of Health Sciences. “There are data from hospitalized critical care and cardiac patients indicating that the syndrome is important for long-term outcomes in these populations, so we tried to look at it in neurosurgical brain tumor patients.”

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In a study of 90 patients undergoing surgery for brain tumor, researchers in Lithuania (Lithuanian University of Health Sciences) and the United States (University of North Carolina at Chapel Hill and Brigham & Women's Hospital, Harvard University) have discovered that the finding of low T3 (triiodothyronine) syndrome is predictive of unfavorable clinical outcomes and depressive symptoms. Details of this study are furnished in the article "Low triiodothyronine syndrome as a predictor of poor outcomes in patients undergoing brain tumor surgery: a pilot study. Clinical article," by Adomas Bunevicius, M.D., Ph.D., and colleagues, published today online, ahead of print, in the Journal of Neurosurgery.

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Nors smegenų vėžys laikomas reta liga, ši diagnozė, ko gera, gąsdina kur kas labiau nei, pavyzdžiui, kur kas dažnesnis krūties vėžys. Pasak statistikos, dėl kai kurių smegenų auglių metus išgyvena vos 30 proc. pacientų.
 

Ligos eiga taip pat nieko gera nežada – žmogus gali būti paralyžiuotas, trinka jo intelektiniai gebėjimai, aptemsta sąmonė. Lietuvos tyrėjai kartu su Harvardo mokslininkais bandė patyrinėti, nuo ko priklauso vienokia ar kitokia ligos eiga, ir atrado vilties teikiančių dalykų.
 

Vienas iš Kauno klinikų Neurochirurgijos klinikoje atlikto tyrimo, kurio rezultatai buvo publikuoti prestižiškiausiame Neurochirurgijos žurnale „Jornal of Neurosurgery“, dalyvių, keletą metų JAV praleidęs Kauno klinikų Neurochirurgijos klinikos rezidentas Adomas Bunevičius, patvirtino, kad dauguma piktybinių smegenų auglių turi blogas pasekmes. Net taikant šiuo metu esamą veiksmingiausią gydymą, pacientų išgyvenamumas labai mažas, kadangi augliai nuolat atauga.

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