The utility of routine surveillance screening with magnetic resonance imaging (MRI) to detect tumour recurrence in children with low-grade central nervous system (CNS) tumours: a systematic review.
Autor: | Stevens SP; Cancer Research UK Clinical Trials Unit (CRCTU), Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK., Main C; Cancer Research UK Clinical Trials Unit (CRCTU), Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK., Bailey S; Sir James Spence Institute of Child Health, Royal Victoria Infirmary, Newcastle upon Tyne, UK., Pizer B; Alder Hey Children's NHS Foundation Trust, Liverpool, UK., English M; Birmingham Women and Children's Hospital NHS Foundation Trust, Birmingham, UK., Phillips R; Centre for Reviews and Dissemination (CRD), University of York, York, UK., Peet A; Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK., Avula S; Alder Hey Children's NHS Foundation Trust, Liverpool, UK., Wilne S; Queen's Medical Centre, Nottingham University Hospitals' NHS Trust, Nottingham, UK., Wheatley K; Cancer Research UK Clinical Trials Unit (CRCTU), Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK., Kearns PR; Cancer Research UK Clinical Trials Unit (CRCTU), Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK.; Birmingham Women and Children's Hospital NHS Foundation Trust, Birmingham, UK., Wilson JS; Cancer Research UK Clinical Trials Unit (CRCTU), Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK. j.s.wilson.1@bham.ac.uk. |
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Jazyk: | angličtina |
Zdroj: | Journal of neuro-oncology [J Neurooncol] 2018 Sep; Vol. 139 (3), pp. 507-522. Date of Electronic Publication: 2018 Jun 09. |
DOI: | 10.1007/s11060-018-2901-x |
Abstrakt: | Background: Magnetic resonance imaging (MRI) is routinely used as a surveillance tool to detect early asymptomatic tumour recurrence with a view to improving patient outcomes. This systematic review aimed to assess its utility in children with low-grade CNS tumours. Methods: Using standard systematic review methods, twelve databases were searched up to January 2017. Results: Seven retrospective case series studies (n = 370 patients) were included, with average follow-up ranging from 5.6 to 7 years. No randomised controlled trials (RCTs) were identified. Due to study heterogeneity only a descriptive synthesis could be undertaken. Imaging was most frequent in the first year post-surgery (with 2-4 scans) reducing to around half this frequency in year two and annually thereafter for the duration of follow-up. Diagnostic yield ranged from 0.25 to 2%. Recurrence rates ranged from 5 to 41%, with most recurrences asymptomatic (range 65-100%). Collectively, 56% of recurrences had occurred within the first year post-treatment (46% in the first 6-months), 68% by year two and 90% by year five. Following recurrence, 90% of patients underwent treatment changes, mainly repeat surgery (72%). Five-year OS ranged from 96 to 100%, while five-year recurrence-free survival ranged from 67 to 100%. None of the studies reported quality of life measures. Conclusion: This systematic review highlights the paucity of evidence currently available to assess the utility of MRI surveillance despite it being routine clinical practice and costly to patients, their families and healthcare systems. This needs to be evaluated within the context of an RCT. |
Databáze: | MEDLINE |
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