Correspondence

More on Surveillance of Children with Medulloblastoma

N Engl J Med 1995; 332:191January 19, 1995

Article

To the Editor:

The reporting by Torres et al. on surveillance scanning of children with medulloblastoma (March 31 issue)1 represents the opinion of a minority of clinical investigators caring for children with this type of tumor. As the leaders of the Brain Tumor Committee of the Pediatric Oncology Group, sponsored by the National Cancer Institute, we can state with confidence that the Pediatric Oncology Group strongly supports surveillance scanning of all children with brain tumors, including those with medulloblastoma. Similarly, the Children's Cancer Group has recently published guidelines that clearly state the need for surveillance scanning of children with a spectrum of brain tumors, including medulloblastoma. Kramer et al.2 present guidelines for surveillance scanning of children with medulloblastoma for at least 10 years. In fact, one of the authors of this report, the senior neuroradiologist Dr. Zimmerman, is a coauthor of the report by Torres et al. The guidelines presented by Kramer et al. may represent a change in the philosophy and recommendations expressed in the Journal article.

Opportunities for salvage therapy in patients with medulloblastoma do exist, justifying surveillance procedures to detect recurrent disease.3 We believe it is critical that physicians providing care for children with medulloblastoma and, equally important, the health maintenance organizations and insurance companies that pay for services for these children realize that surveillance scanning is indeed indicated and should be considered the standard of care for children with medulloblastoma and other brain tumors.

Henry S. Friedman, M.D.
Duke University Medical Center, Durham, NC 27710

Larry E. Kun, M.D.
St. Jude Children's Research Hospital, Memphis, TN 38101-0318

3 References

1. 1

   Torres CF, Rebsamen S, Silber JH, et al. Surveillance scanning of children with medulloblastoma. N Engl J Med 1994;330:892-895
   Full Text | Web of Science | Medline

2. 2

   Kramer ED, Vezina LG, Packer RJ, Fitz CR, Zimmerman RA, Cohen MD. Staging and surveillance of children with central nervous system neoplasms: recommendations of the Neurology and Tumor Imaging Committees of the Children's Cancer Group. Pediatr Neurosurg 1994;20:254-262
   CrossRef | Web of Science | Medline

3. 3

   Mahoney D, Strother D, Bowen T, et al. High dose melphalan (MELP) and cyclophosphamide (CTX) with autologous bone marrow rescue (ABMR) for recurrent/progressive malignant brain tumors (BT) in children: a phase I-II Pediatric Oncology Group study. Prog Proc Am Soc Clin Oncol 1994;13:174-174 abstract.
   

Citing Articles (7)

Citing Articles

1. 1

   Ryan DeMarchi, Michael Ellis, Cynthia Hawkins, James T. Rutka. 2012. Medulloblastoma and primitive neuroectodermal tumors. , 503-517.
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2. 2

   Daniel C. Bowers, Soumya Adhikari, Yasmin M. El-Khashab, Lynn Gargan, Kevin C. Oeffinger. (2009) Survey of long-term follow-up programs in the United States for survivors of childhood brain tumors. Pediatric Blood & Cancer 53:7, 1295-1301
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3. 3

   Daniel C. Bowers, Lynn Gargan, Bradley E. Weprin, Arlynn F. Mulne, Roy D. Elterman, Louis Munoz, Cole A. Giller, Naomi J. Winick. (2007) Impact of site of tumor recurrence upon survival for children with recurrent or progressive medulloblastoma. Journal of Neurosurgery: Pediatrics 107:1, 5-10
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4. 4

   Ute Bartels, Manohar Shroff, Lillian Sung, Ugo Dag-Ellams, Normand Laperriere, James Rutka, Eric Bouffet. (2006) Role of spinal MRI in the follow-up of children treated for medulloblastoma. Cancer 107:6, 1340-1347
   CrossRef

5. 5

   Bilgehan Yal?n, Mnevver Bykpamuku, Nejat Akalan, Ay?enur Cila, M. Tezer Kutluk, Canan Akyz. (2002) Value of surveillance imaging in the management of medulloblastoma. Medical and Pediatric Oncology 38:2, 91-97
   CrossRef

6. 6

   Evanthia Galanis, Jan C. Buckner, Paul Novotny, Roscoe F. Morton, William L. McGinnis, Robert Dinapoli, Paula Schomberg, Judith R. O'Fallon. (2000) Efficacy of neuroradiological imaging, neurological examination, and symptom status in follow-up assessment of patients with high-grade gliomas. Journal of Neurosurgery 93:2, 201-207
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7. 7

   E. Bouffet, G. Perilongo, A. Canete, M. Massimino. (1998) Intracranial ependymomas in children: A critical review of prognostic factors and a plea for cooperation. Medical and Pediatric Oncology 30:6, 319-329
   CrossRef