Surveillance imaging in children with medulloblastoma (posterior fossa PNET)

被引:13
作者
Roebuck, DJ
Villablanca, JG
Maher, K
Nelson, MD
机构
[1] Great Ormond St Hosp Children, Dept Radiol, London WC1N 3JH, England
[2] Childrens Hosp Los Angeles, Dept Radiol, Los Angeles, CA 90027 USA
[3] Childrens Hosp Los Angeles, Dept Pediat, Los Angeles, CA 90027 USA
关键词
D O I
10.1007/s002470000235
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Background. The use of surveillance imaging in children with medulloblastoma has been criticised. The aim of this study was to determine what proportion of relapses are detected by surveillance and whether these are found at a relatively favourable stage. Methods. This study was a retrospective review of the medical charts and imaging studies of 89 patients treated at a single children's cancer centre. Relapse was defined as evidence of an increase in volume of residual tumour of greater than 25 % or the presence of metastases, or new onset of positive CSF cytology. Relapse was termed symptomatic if it was diagnosed by tests performed because of new symptoms that occurred in the interval between surveillance examinations. Asymptomatic relapse was diagnosed solely on the basis of surveillance imaging. Survival time to relapse was calculated from the date of the first surgical procedure. Results. Surveillance imaging detected 17 (71%) of the 24 relapses that occurred later than 6 months after diagnosis. All seven patients who presented with symptoms between scans have died, with a median survival from relapse of 5 months. Median survival from relapse in the patients detected by surveillance was 44 months, and four remain alive at 44-75 months. The patients detected by surveillance tended to have less advanced disease, which was more amenable to salvage therapy. Conclusion. This type of study cannot prove that surveillance imaging improves survival in children with medulloblastoma because of the effects of lead time and length biases. Despite this, surveillance does appear to be effective in detecting potentially curable medulloblastoma relapses and should be offered to all patients.
引用
收藏
页码:447 / 450
页数:4
相关论文
共 21 条
[1]   MAMMOGRAPHY - CONTRARY VIEW/CY [J].
BAILAR, JC .
ANNALS OF INTERNAL MEDICINE, 1976, 84 (01) :77-84
[2]   MEDULLOBLASTOMA - FREEDOM FROM RELAPSE LONGER THAN 8 YEARS - A THERAPEUTIC CURE [J].
BELZA, MG ;
DONALDSON, SS ;
STEINBERG, GK ;
COX, RS ;
COGEN, PH .
JOURNAL OF NEUROSURGERY, 1991, 75 (04) :575-582
[3]   High dose chemotherapy with autologous stem cell rescue for patients with medulloblastoma [J].
Dunkel, IJ ;
Finlay, JL .
JOURNAL OF NEURO-ONCOLOGY, 1996, 29 (01) :69-74
[4]   Will high dose chemotherapy followed by autologous bone marrow transplantation supplant cranio-spinal irradiation in young children treated for medulloblastoma? [J].
DupuisGirod, S ;
Hartmann, O ;
Benhamou, E ;
Doz, F ;
Mechinaud, F ;
Bouffet, E ;
Coze, C ;
Kalifa, C .
JOURNAL OF NEURO-ONCOLOGY, 1996, 27 (01) :87-98
[5]   THE TREATMENT OF MEDULLOBLASTOMA - RESULTS OF A PROSPECTIVE RANDOMIZED TRIAL OF RADIATION-THERAPY WITH AND WITHOUT CCNU, VINCRISTINE, AND PREDNISONE [J].
EVANS, AE ;
JENKIN, RDT ;
SPOSTO, R ;
ORTEGA, JA ;
WILSON, CB ;
WARA, W ;
ERTEL, IJ ;
KRAMER, S ;
CHANG, CH ;
LEIKIN, SL ;
HAMMOND, GD .
JOURNAL OF NEUROSURGERY, 1990, 72 (04) :572-582
[6]   MEDULLOBLASTOMA IN VERY YOUNG-CHILDREN - OUTCOME OF DEFINITIVE CRANIOSPINAL IRRADIATION FOLLOWING INCOMPLETE RESPONSE TO CHEMOTHERAPY [J].
GAJJAR, A ;
MULHERN, RK ;
HEIDEMAN, RL ;
SANFORD, RA ;
DOUGLASS, EC ;
KOVNAR, EH ;
LANGSTON, JA ;
JENKINS, JJ ;
KUN, LE .
JOURNAL OF CLINICAL ONCOLOGY, 1994, 12 (06) :1212-1216
[7]   High-dose chemotherapy with autologous stem-cell rescue in patients with recurrent and high-risk pediatric brain tumors [J].
Graham, ML ;
Herndon, JE ;
Casey, JR ;
Chaffee, S ;
Ciocci, GH ;
Krischer, JP ;
Kurtzberg, J ;
Laughlin, MJ ;
Longee, DC ;
Olson, JF ;
Paleologus, N ;
Pennington, CN ;
Friedman, HS .
JOURNAL OF CLINICAL ONCOLOGY, 1997, 15 (05) :1814-1823
[8]   STAGING AND SURVEILLANCE OF CHILDREN WITH CENTRAL-NERVOUS-SYSTEM NEOPLASMS - RECOMMENDATIONS OF THE NEUROLOGY AND TUMOR IMAGING COMMITTEES OF THE CHILDRENS CANCER GROUP [J].
KRAMER, ED ;
VEZINA, LG ;
PACKER, RJ ;
FITZ, CR ;
ZIMMERMAN, RA ;
COHEN, MD .
PEDIATRIC NEUROSURGERY, 1994, 20 (04) :254-262
[9]  
KUN LE, 1985, CANCER-AM CANCER SOC, V56, P1818, DOI 10.1002/1097-0142(19851001)56:7+<1818::AID-CNCR2820561320>3.0.CO
[10]  
2-9