对尤文肉瘤和骨肉瘤患儿进行监测成像的意义。

IF 1.2 4区 医学 Q4 HEMATOLOGY
Pediatric Hematology and Oncology Pub Date : 2024-05-01 Epub Date: 2024-02-12 DOI:10.1080/08880018.2024.2311407
Scott Greve Brekke, Arne Lucke, Henrik Hasle, Thomas Baad-Hansen
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引用次数: 0

摘要

儿童和青少年的原发性骨肿瘤虽然罕见,但却给诊断和治疗带来了巨大挑战。接受尤文肉瘤和骨肉瘤治疗的儿童在治疗结束后需要进行为期 5 年的随访,包括对肿瘤原发部位和肺部进行放射学监测。关于对儿童进行放射成像随访的频率和方式,目前尚未达成共识。这项回顾性描述性研究对 69 名患者(34 名尤文肉瘤患者和 35 名骨肉瘤患者)的 1279 张随访图像中的异常结果进行了调查。共发现 9 例复发,尤文组 4 例(3 例局部复发,1 例肺部复发),骨肉瘤组 5 例(1 例局部复发,4 例肺部复发)。其中,只有两名患者出现无症状复发,其余患者均通过影像学检查发现复发。尤文肉瘤组复发检测的阳性预测值为 0.44,骨肉瘤组为 0.5。在尤文肉瘤患者影像随访计划中,异常检测概率为 12%(95% CI,10-15)。骨肉瘤患者的概率为 6%(95% CI,4-8)。我们的数据表明,随访图像中的异常发现很少代表肿瘤复发。由于两组患者的监测方案不同,尤文肉瘤患者主要通过核磁共振成像进行监测,而骨肉瘤患者主要通过 X 光片进行跟踪,因此第一组患者中偶然发现的情况有所增加。不过,在解释成像数据时必须结合临床信息,避免在做出治疗决定时孤立地依赖成像结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The significance of surveillance imaging in children with Ewing sarcoma and osteosarcoma.

Primary bone tumors in children and adolescents, while rare, pose significant challenges in diagnosis and management. Children treated for Ewing sarcoma and osteosarcoma are offered a 5-year follow-up program after end of treatment, including radiological surveillance of primary location of tumor and the lungs. There is no consensus regarding how often and how the children should be followed with radiological imaging. This retrospective descriptive study of 69 patients (34 with Ewing sarcoma and 35 with osteosarcoma) investigated the consequences of abnormal findings in 1279 follow-up images. Nine relapses were detected, 4 in the Ewing group (3 local and 1 pulmonary) and 5 in the osteosarcoma group (1 local and 4 pulmonary). Of these, only two patients exhibited symptomatic relapses, with the remainder identified through imaging. The positive predictive value for relapse detection was 0.44 in the Ewing group, and 0.5 in the osteosarcoma group. In the Ewing sarcoma patient image follow-up program, the probability of anomaly detection was 12% (95% CI, 10-15). For osteosarcoma patients, the likelihood was 6% (95% CI, 4-8). Our data indicates that abnormal findings on follow-up images rarely represents relapse of tumor. As the surveillance protocol differs between the patient groups, wherein Ewing sarcoma patients primarily are monitored through MRI while osteosarcoma patients are predominantly tracked via X-rays, there is an increased occurrence of incidental findings in the first group. However, it is imperative to interpret imaging data in conjunction with clinical information, avoiding isolated reliance on imaging results when making treatment decisions.

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来源期刊
CiteScore
2.60
自引率
5.90%
发文量
71
审稿时长
6-12 weeks
期刊介绍: PHO: Pediatric Hematology and Oncology covers all aspects of research and patient management within the area of blood disorders and malignant diseases of childhood. Our goal is to make PHO: Pediatric Hematology and Oncology the premier journal for the international community of clinicians and scientists who together aim to define optimal therapeutic strategies for children and young adults with cancer and blood disorders. The journal supports articles that address research in diverse clinical settings, exceptional case studies/series that add novel insights into pathogenesis and/or clinical care, and reviews highlighting discoveries and challenges emerging from consortia and conferences. Clinical studies as well as basic and translational research reports regarding cancer pathogenesis, genetics, molecular diagnostics, pharmacology, stem cells, molecular targeting, cellular and immune therapies and transplantation are of interest. Papers with a focus on supportive care, late effects and on related ethical, legal, psychological, social, cultural, or historical aspects of these fields are also appreciated. Reviews on important developments in the field are welcome. Articles from scientists and clinicians across the international community of Pediatric Hematology and Oncology are considered for publication. The journal is not dependent on or connected with any organization or society. All submissions undergo rigorous peer review prior to publication. Our Editorial Board includes experts in Pediatric Hematology and Oncology representing a wide range of academic and geographic diversity.
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