Surveillance neuroimaging to detect relapse in childhood brain tumors

A Pediatric Oncology Group study

A. Y. Minn, Bradley H Pollock, L. Garzarella, G. V. Dahl, L. E. Kun, Jonathan M Ducore, A. Shibata, J. Kepner, P. G. Fisher

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Purpose: To investigate the prognostic significance of surveillance neuroimaging for detection of relapse among children with malignant brain tumors. Patients and Methods: A historical cohort study examined all children who experienced relapse from 1985 to 1999 on one of 10 Pediatric Oncology Group trials for malignant glioma, medulloblastoma, or ependymoma. Results: For all 291 patients (median age at diagnosis, 8.2 years), median time to first relapse was 8.8 months (range, 0.6 to 115.6 months). Ninety-nine relapses were radiographic, and 192, clinical; median time to relapse was 15.7 versus 6.6 months, respectively (P = .0001). When stratified by pathology, radiographic and clinical groups showed differences in median time to relapse for malignant glioma (7.8 v 4.3 months, respectively; P = .041) and medulloblastoma (23.6 v 8.9 months, respectively; P = .0006) but not ependymoma (19.5 v 13.3 months, respectively; P = .19). When stratified by early (< 8.8 months) or late (≥ 8.8 months) time to relapse, 115 early relapses were clinical, and 32, radiographic; for late relapses, 77 were clinical, and 67, radiographic (P = .001). Overall survival (OS) from relapse was significantly longer for radiographic compared with clinical detection (median, 10.8 months; 1-year OS, 46% v median, 5.5 months; 1-year OS, 33%; P = .002), but this trend did not retain significance when analyzed by pathology subgroups. Conclusion: Surveillance neuroimaging detects a proportion of asymptomatic relapses, particularly late relapses, and may provide lead time for other therapies on investigational trials. During the first year after diagnosis, radiographic detection of asymptomatic relapse was infrequent. A prospective study is needed to formulate a rational surveillance schedule based on the biologic behavior of these tumors.

Original languageEnglish (US)
Pages (from-to)4135-4140
Number of pages6
JournalJournal of Clinical Oncology
Volume19
Issue number21
StatePublished - Nov 1 2001
Externally publishedYes

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Neuroimaging
Brain Neoplasms
Pediatrics
Recurrence
Ependymoma
Medulloblastoma
Glioma
Survival
Investigational Therapies
Clinical Pathology
Appointments and Schedules
Cohort Studies
Prospective Studies
Pathology

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Surveillance neuroimaging to detect relapse in childhood brain tumors : A Pediatric Oncology Group study. / Minn, A. Y.; Pollock, Bradley H; Garzarella, L.; Dahl, G. V.; Kun, L. E.; Ducore, Jonathan M; Shibata, A.; Kepner, J.; Fisher, P. G.

In: Journal of Clinical Oncology, Vol. 19, No. 21, 01.11.2001, p. 4135-4140.

Research output: Contribution to journalArticle

Minn, AY, Pollock, BH, Garzarella, L, Dahl, GV, Kun, LE, Ducore, JM, Shibata, A, Kepner, J & Fisher, PG 2001, 'Surveillance neuroimaging to detect relapse in childhood brain tumors: A Pediatric Oncology Group study', Journal of Clinical Oncology, vol. 19, no. 21, pp. 4135-4140.
Minn, A. Y. ; Pollock, Bradley H ; Garzarella, L. ; Dahl, G. V. ; Kun, L. E. ; Ducore, Jonathan M ; Shibata, A. ; Kepner, J. ; Fisher, P. G. / Surveillance neuroimaging to detect relapse in childhood brain tumors : A Pediatric Oncology Group study. In: Journal of Clinical Oncology. 2001 ; Vol. 19, No. 21. pp. 4135-4140.
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abstract = "Purpose: To investigate the prognostic significance of surveillance neuroimaging for detection of relapse among children with malignant brain tumors. Patients and Methods: A historical cohort study examined all children who experienced relapse from 1985 to 1999 on one of 10 Pediatric Oncology Group trials for malignant glioma, medulloblastoma, or ependymoma. Results: For all 291 patients (median age at diagnosis, 8.2 years), median time to first relapse was 8.8 months (range, 0.6 to 115.6 months). Ninety-nine relapses were radiographic, and 192, clinical; median time to relapse was 15.7 versus 6.6 months, respectively (P = .0001). When stratified by pathology, radiographic and clinical groups showed differences in median time to relapse for malignant glioma (7.8 v 4.3 months, respectively; P = .041) and medulloblastoma (23.6 v 8.9 months, respectively; P = .0006) but not ependymoma (19.5 v 13.3 months, respectively; P = .19). When stratified by early (< 8.8 months) or late (≥ 8.8 months) time to relapse, 115 early relapses were clinical, and 32, radiographic; for late relapses, 77 were clinical, and 67, radiographic (P = .001). Overall survival (OS) from relapse was significantly longer for radiographic compared with clinical detection (median, 10.8 months; 1-year OS, 46{\%} v median, 5.5 months; 1-year OS, 33{\%}; P = .002), but this trend did not retain significance when analyzed by pathology subgroups. Conclusion: Surveillance neuroimaging detects a proportion of asymptomatic relapses, particularly late relapses, and may provide lead time for other therapies on investigational trials. During the first year after diagnosis, radiographic detection of asymptomatic relapse was infrequent. A prospective study is needed to formulate a rational surveillance schedule based on the biologic behavior of these tumors.",
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T2 - A Pediatric Oncology Group study

AU - Minn, A. Y.

AU - Pollock, Bradley H

AU - Garzarella, L.

AU - Dahl, G. V.

AU - Kun, L. E.

AU - Ducore, Jonathan M

AU - Shibata, A.

AU - Kepner, J.

AU - Fisher, P. G.

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N2 - Purpose: To investigate the prognostic significance of surveillance neuroimaging for detection of relapse among children with malignant brain tumors. Patients and Methods: A historical cohort study examined all children who experienced relapse from 1985 to 1999 on one of 10 Pediatric Oncology Group trials for malignant glioma, medulloblastoma, or ependymoma. Results: For all 291 patients (median age at diagnosis, 8.2 years), median time to first relapse was 8.8 months (range, 0.6 to 115.6 months). Ninety-nine relapses were radiographic, and 192, clinical; median time to relapse was 15.7 versus 6.6 months, respectively (P = .0001). When stratified by pathology, radiographic and clinical groups showed differences in median time to relapse for malignant glioma (7.8 v 4.3 months, respectively; P = .041) and medulloblastoma (23.6 v 8.9 months, respectively; P = .0006) but not ependymoma (19.5 v 13.3 months, respectively; P = .19). When stratified by early (< 8.8 months) or late (≥ 8.8 months) time to relapse, 115 early relapses were clinical, and 32, radiographic; for late relapses, 77 were clinical, and 67, radiographic (P = .001). Overall survival (OS) from relapse was significantly longer for radiographic compared with clinical detection (median, 10.8 months; 1-year OS, 46% v median, 5.5 months; 1-year OS, 33%; P = .002), but this trend did not retain significance when analyzed by pathology subgroups. Conclusion: Surveillance neuroimaging detects a proportion of asymptomatic relapses, particularly late relapses, and may provide lead time for other therapies on investigational trials. During the first year after diagnosis, radiographic detection of asymptomatic relapse was infrequent. A prospective study is needed to formulate a rational surveillance schedule based on the biologic behavior of these tumors.

AB - Purpose: To investigate the prognostic significance of surveillance neuroimaging for detection of relapse among children with malignant brain tumors. Patients and Methods: A historical cohort study examined all children who experienced relapse from 1985 to 1999 on one of 10 Pediatric Oncology Group trials for malignant glioma, medulloblastoma, or ependymoma. Results: For all 291 patients (median age at diagnosis, 8.2 years), median time to first relapse was 8.8 months (range, 0.6 to 115.6 months). Ninety-nine relapses were radiographic, and 192, clinical; median time to relapse was 15.7 versus 6.6 months, respectively (P = .0001). When stratified by pathology, radiographic and clinical groups showed differences in median time to relapse for malignant glioma (7.8 v 4.3 months, respectively; P = .041) and medulloblastoma (23.6 v 8.9 months, respectively; P = .0006) but not ependymoma (19.5 v 13.3 months, respectively; P = .19). When stratified by early (< 8.8 months) or late (≥ 8.8 months) time to relapse, 115 early relapses were clinical, and 32, radiographic; for late relapses, 77 were clinical, and 67, radiographic (P = .001). Overall survival (OS) from relapse was significantly longer for radiographic compared with clinical detection (median, 10.8 months; 1-year OS, 46% v median, 5.5 months; 1-year OS, 33%; P = .002), but this trend did not retain significance when analyzed by pathology subgroups. Conclusion: Surveillance neuroimaging detects a proportion of asymptomatic relapses, particularly late relapses, and may provide lead time for other therapies on investigational trials. During the first year after diagnosis, radiographic detection of asymptomatic relapse was infrequent. A prospective study is needed to formulate a rational surveillance schedule based on the biologic behavior of these tumors.

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