Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, Aflac Cancer Center, Emory University and the Children's Healthcare of Atlanta, Atlanta, GA, USA.
Department CCU Pediatric Oncology, Hopp Children's Cancer Center (KiTZ), University Hospital and German Cancer Research Center (DKFZ), Heidelberg, Germany.
Lancet Oncol. 2020 Jun;21(6):e305-e316. doi: 10.1016/S1470-2045(20)30064-4.
Paediatric low-grade gliomas (also known as pLGG) are the most common type of CNS tumours in children. In general, paediatric low-grade gliomas show clinical and biological features that are distinct from adult low-grade gliomas, and the developing paediatric brain is more susceptible to toxic late effects of the tumour and its treatment. Therefore, response assessment in children requires additional considerations compared with the adult Response Assessment in Neuro-Oncology criteria. There are no standardised response criteria in paediatric clinical trials, which makes it more difficult to compare responses across studies. The Response Assessment in Pediatric Neuro-Oncology working group, consisting of an international panel of paediatric and adult neuro-oncologists, clinicians, radiologists, radiation oncologists, and neurosurgeons, was established to address issues and unique challenges in assessing response in children with CNS tumours. We established a subcommittee to develop consensus recommendations for response assessment in paediatric low-grade gliomas. Final recommendations were based on literature review, current practice, and expert opinion of working group members. Consensus recommendations include imaging response assessments, with additional guidelines for visual functional outcomes in patients with optic pathway tumours. As with previous consensus recommendations, these recommendations will need to be validated in prospective clinical trials.
儿科低级别胶质瘤（也称为 pLGG）是儿童中枢神经系统肿瘤中最常见的类型。一般来说，儿科低级别胶质瘤在临床表现和生物学特征上与成人低级别胶质瘤不同，并且发育中的儿童大脑更容易受到肿瘤及其治疗的毒性晚期效应的影响。因此，与成人神经肿瘤学反应评估标准相比，儿童的反应评估需要额外的考虑因素。儿科临床试验中没有标准化的反应标准，这使得更难以跨研究比较反应。由国际儿科和成人神经肿瘤学家、临床医生、放射科医生、放射肿瘤学家和神经外科医生组成的儿科神经肿瘤学反应评估工作组旨在解决评估中枢神经系统肿瘤儿童反应时的问题和独特挑战。我们成立了一个小组委员会，为儿科低级别胶质瘤的反应评估制定共识建议。最终建议基于文献回顾、当前实践和工作组成员的专家意见。共识建议包括影像学反应评估，并为视神经通路肿瘤患者的视觉功能结果提供了额外的指导。与之前的共识建议一样，这些建议需要在前瞻性临床试验中进行验证。
