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Titolo:
Efficacy of neuroradiological imaging, neurological examination, and symptom status in follow-up assessment of patients with high-grade gliomas
Autore:
Galanis, E; Buckner, JC; Novotny, P; Morton, RF; McGinnis, WL; Dinapoli, R; Schomberg, P; OFallon, JR;
Indirizzi:
Mayo Clin & Mayo Fdn, Dept Oncol, Rochester, MN 55905 USA Mayo Clin & MayoFdn Rochester MN USA 55905 ncol, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn, Dept Neurol, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn Rochester MN USA 55905 urol, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn, Dept Hlth Sci Res, Rochester, MN 55905 USA Mayo Clin& Mayo Fdn Rochester MN USA 55905 Res, Rochester, MN 55905 USA N Cent Canc Treatment Grp, Rochester, MN USA N Cent Canc Treatment Grp Rochester MN USA atment Grp, Rochester, MN USA
Titolo Testata:
JOURNAL OF NEUROSURGERY
fascicolo: 2, volume: 93, anno: 2000,
pagine: 201 - 207
SICI:
0022-3085(200008)93:2<201:EONINE>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
PHASE-I EVALUATION; MEDULLOBLASTOMA; SURVEILLANCE; CHILDREN;
Keywords:
glioma; magnetic resonance imaging; computerized tomography; tumor recurrence; clinical deterioration;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
17
Recensione:
Indirizzi per estratti:
Indirizzo: Galanis, E Mayo Clin & Mayo Fdn, Dept Oncol, 200 1st St SW, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn 200 1st St SW Rochester MN USA 55905 5 USA
Citazione:
E. Galanis et al., "Efficacy of neuroradiological imaging, neurological examination, and symptom status in follow-up assessment of patients with high-grade gliomas", J NEUROSURG, 93(2), 2000, pp. 201-207

Abstract

Object It is standard practice for the oncological follow-up of patients with brain tumors (especially in the setting of clinical trials) to include neurological examination and neuroradiological studies such as computerizedtomography (CT) or magnetic resonance (MR) imaging in addition to evaluation of the patients' symptomatology and performance score. The validity of this practice and its impact on the welfare of patients with high-grade gliomas has not been adequately assessed. The purpose of this study is to provide such an assessment. Methods. The authors studied 231 similarly treated patients who were participating in three prospective North Central Cancer Treatment Group or Mayo Clinic trials who developed progressive disease during follow up. Accordingto the protocol, the symptom status, performance score, results of neurological examination, and CT or MR status were recorded prospectively in each patient at each evaluation (every 6-8 weeks). At progression, 177 (77%) of 231 patients experienced worsening of their baseline symptoms or they developed new ones. In the remaining 54 asymptomatic patients (23%), neuroradiological imaging revealed the progression. Asymptomatic progression was more likely to be detected on MR imaging compared with CT studies (p < 0.01). In no asymptomatic patient was progression detected on neurological examination alone. The median survival time after tumor recurrence was 13.3 weeks in symptomatic patients compared with 41.7 weeks in the asymptomatic group (p < 0.0001). Asymptomatic patients were more aggressively treated, with surgery (p < 0.0001) and second-line chemotherapy(p < 0.0002). Multivariate analysis of survival time following first progression by using both classification and regression trees and Cox models showed that treatment at recurrence was the most important prognostic variable. Conclusions. Symptoms are the most frequent indicators of progression in patients with high-grade gliomas (77%). All asymptomatic progressions were detected on neuroradiological studies; MR imaging was more likely than CT scanning to reveal asymptomatic recurrences. Survival after disease progression was significantly longer in asymptomatic patients and could be related both to treatment following progression and to other favorable prognostic factors such as performance score.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/12/20 alle ore 05:37:59