Mb-52response Assessment in Pediatric Neuro-oncology (rapno) Committee Guidelines for Response Assessment in Medulloblastoma and Other Leptomeningeal Seeding Tumors
Year: 2016
Type: article
Abstract: Currently, there are no standard response criteria for clinical trials involving children or adults with medulloblastoma. An international panel of adult and pediatric neuro-oncologists, radiologists, radiation oncologists, and neurosurgeons was established to develop a consensus on recommendations for response assessment that can be prospectively evaluated. Major confounding issues in medulloblastoma were identified based upon review of the literature and current practices, and response recommendations developed. These recommendations apply to all patients with medulloblastoma and other CSF disseminating tumors. The working group proposes that the following criteria should be used to assess response: MR imaging (brain and spine), CSF cytology, and neurologic examination. A uniform radiologic examination of brain and spine performed in < 1 hour using common, readily available, sequences is proposed. Baseline brain MRI for clinical trials should be performed within 72 hours of surgery, and repeated 2-3 weeks later if extensive parenchymal postsurgical changes obscure residual tumor. Central review should be performed prior to inclusion in clinical trials to ensure appropriate risk stratification and cohort assignment. Pre-operative spine MRI can be used as the baseline spine evaluation in clinical trials when feasible; if not feasible or of poor quality, it should be repeated within 72 hours post-operatively. Leptomeningeal disease assessment at baseline should include neurologic examination, pre-contrast and post-contrast MRI, and CSF cytology/flow cytometry. Timing of response assessment should be determined based on scientific rationale of each study. Specific recommendations and response definitions to be prospectively tested in clinical trials will be presented.
Source: Neuro-Oncology
Authors: Kathy Warren, Julie Harreld, Marc Chamberlain, Gilbert Vezina, Monika Warmuth-Metz, Katja von Hoff, Roger Packer, Alba Brandes, Moshe Reiss, Stewart Goldman, Michael Fisher, Tina Poussaint, Ian Pollack, Michael Prados, Patrick Wen, Susan Chang, Christelle Dufour, David Zurakowski, Rolf-Dieter Kortmann, Mark Kieran
Institutions: National Institutes of Health, National Cancer Institute, St. Jude Children's Research Hospital, Seattle Cancer Care Alliance, Children's National, University of Würzburg, University Medical Center Hamburg-Eppendorf, Istituto delle Scienze Neurologiche di Bologna, Maria Fareri Children's Hospital, Lurie Children's Hospital, Children's Hospital of Philadelphia, Boston Children's Hospital, Children's Hospital of Pittsburgh, University of California, San Francisco, Dana-Farber Cancer Institute, Institut Gustave Roussy, Leipzig University
Language: English
Subfield: Genetics
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2423127007