Detection of recurrence in childhood solid tumors

Howell, Lisa; Mensah, Adjoa; Brennan, Bernadette; Makin, Guy

doi:10.1002/cncr.20896

Cited by 25 publications

(30 citation statements)

References 82 publications

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“…4 Although there have been some improvements in the outcome for children with brain tumors, 5 the prognosis for children with high grade or diffuse intrinsic pontine gliomas, relapsed medulloblastoma, and ependymoma is extremely poor. 6,7 In order to achieve the necessary delicate balance between improved treatment and avoidance of damage to the developing brain, we need a better understanding of the underlying biology of these tumors.…”

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confidence: 99%

Pediatric brain tumor cancer stem cells: cell cycle dynamics, DNA repair, and etoposide extrusion

et al. 2010

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Reliable model systems are needed to elucidate the role cancer stem cells (CSCs) play in pediatric brain tumor drug resistance. The majority of studies to date have focused on clinically distinct adult tumors and restricted tumor types. Here, the CSC component of 7 newly established primary pediatric cell lines (2 ependymomas, 2 medulloblastomas, 2 gliomas, and a CNS primitive neuroectodermal tumor) was thoroughly characterized. Comparison of DNA copy number with the original corresponding tumor demonstrated that genomic changes present in the original tumor, typical of that particular tumor type, were retained in culture. In each case, the CSC component was approximately 3–4-fold enriched in neurosphere culture compared with monolayer culture, and a higher capacity for multilineage differentiation was observed for neurosphere-derived cells. DNA content profiles of neurosphere-derived cells expressing the CSC marker nestin demonstrated the presence of cells in all phases of the cell cycle, indicating that not all CSCs are quiescent. Furthermore, neurosphere-derived cells demonstrated an increased resistance to etoposide compared with monolayer-derived cells, having lower initial DNA damage, potentially due to a combination of increased drug extrusion by ATP-binding cassette multidrug transporters and enhanced rates of DNA repair. Finally, orthotopic xenograft models reflecting the tumor of origin were established from these cell lines. In summary, these cell lines and the approach taken provide a robust model system that can be used to develop our understanding of the biology of CSCs in pediatric brain tumors and other cancer types and to preclinically test therapeutic agents.

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confidence: 99%

Pediatric brain tumor cancer stem cells: cell cycle dynamics, DNA repair, and etoposide extrusion

et al. 2010

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“…The usefulness of ongoing surveillance imaging remains controversial [9, 12, 13, 17] Chong et al [18] recently reported on the radiation exposure burden placed on survivors of various cancers. Five-year cumulative estimates of individual radiation exposures were calculated to range from 10 mSv to 642 mSv (median, 61 mSv) resulting from 690 imaging procedures.…”

Section: Roles Of Surveillance Imagingmentioning

confidence: 99%

“…They further pointed out that routine scheduled surveillance appointments failed to detect half of the relapse cases they report [12]. Similarly, Howell et al [17] reported 37 recurrences of solid tumors in a cohort of 186 pediatric patients followed for a median of almost 6 years. More than half of the recurrences were symptomatic.…”

Section: Need For Outcomes Analysis Of Surveillance Imaging Studiesmentioning

confidence: 99%

“…More than half of the recurrences were symptomatic. They further estimated that for every recurrence, 42 routine MR examinations, 129 CT examinations and 257 chest radiographs were performed [17]. …”

Section: Need For Outcomes Analysis Of Surveillance Imaging Studiesmentioning

confidence: 99%

“…Not only must the potential impact of repeated exposures to ionizing radiation be considered [31–37] but also the potential impact of repeated contrast administration, anesthesia risks [8, 38], costs of time, resources and funds [8, 9, 11, 17] and the impact of false-positive and false-negative findings.…”

Section: Need For Outcomes Analysis Of Surveillance Imaging Studiesmentioning

confidence: 99%

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Oncological imaging: tumor surveillance in children

Kaste

2011

Pediatr Radiol

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As the need for accurate diagnostic imaging often continues throughout a cancer survivor’s life, imaging methods with the least toxicity must be used so as to provide needed information without contributing to long-term sequelae that might compound toxicities inherent with the primary disease and its treatment. In this regard, the costs, benefits and potential risks of post-therapy monitoring for disease recurrence warrant periodic review. Unfortunately, few analyses are available regarding the impact of surveillance imaging on the detection of disease recurrence, salvage rates of relapse disease and long-term survival outcomes for pediatric cancer survivors. This review will examine the role and limitations of surveillance imaging in pediatric oncology.

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A systematic review of evidence for and against routine surveillance imaging after completing treatment for childhood extracranial solid tumors

et al. 2020

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Background Regular off‐treatment imaging is often used to assess for recurrence of disease after childhood cancer treatment. It is unclear if this increases survival, or what burden surveillance places on patients, families, or health‐care services. This systematic review examines the impact of routine surveillance imaging after treatment of pediatric extracranial solid tumors. Methods Collaborative patient and public involvement informed the design and interpretation of this work. Thirteen electronic databases, conference proceedings, and trial registries were searched alongside reference list checking and forward citation searching from 1990 onwards. Studies were screened and data were extracted by two researchers. Risk of bias was assessed using a modified ROBINS‐I tool. Relevant outcomes were overall survival, psychological distress indicators, number of imaging tests, cost‐effectiveness, and qualitative data regarding experiences of surveillance programs. PROSPERO (CRD42018103764). Results Of 17 727 records identified, 55 studies of 10 207 patients were included. All studies used observational methods. Risk of bias for all except one study was moderate, serious, or critical. Data were too few to conduct meta‐analysis; however, narrative synthesis was performed. Surveillance strategies varied, and poorly reported, involving many scans and substantial radiation exposure (eg, neuroblastoma, median 133.5 mSv). For most diseases, surveillance imaging was not associated with increased overall survival, with the probable exception of Wilms tumor. No qualitative or psychological distress data were identified. Conclusions At present, there is insufficient evidence to evaluate the effects of routine surveillance imaging on survival in most pediatric extracranial solid tumors. More high‐quality data are required, preferably through randomized controlled trials with well‐conducted qualitative elements.

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Detection of recurrence in childhood solid tumors

Cited by 25 publications

References 82 publications

Pediatric brain tumor cancer stem cells: cell cycle dynamics, DNA repair, and etoposide extrusion

Pediatric brain tumor cancer stem cells: cell cycle dynamics, DNA repair, and etoposide extrusion

Oncological imaging: tumor surveillance in children

A systematic review of evidence for and against routine surveillance imaging after completing treatment for childhood extracranial solid tumors

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