Oligoastrocytoma secondary prevention: Difference between revisions

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==Overview==
==Overview==
Patients treated for oligoastrocytoma should follow-up for secondary prevention. Secondary prevention strategies following oligoastrocytoma include a clinical assessment of neurological function and [[corticosteroid]] usage (Macdonald criteria), checking for signs of [[venous thromboembolism]], regular laboratory tests, and routine imaging (MRI and Positron Emission Tomography) at scheduled intervals after treatment.<ref name="pmid20555079">{{cite journal| author=Stupp R, Tonn JC, Brada M, Pentheroudakis G, ESMO Guidelines Working Group| title=High-grade malignant glioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. | journal=Ann Oncol | year= 2010 | volume= 21 Suppl 5 | issue=  | pages= v190-3 | pmid=20555079 | doi=10.1093/annonc/mdq187 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20555079  }} </ref>
Patients treated for oligoastrocytoma should follow-up for secondary prevention. Secondary prevention strategies following oligoastrocytoma include a clinical assessment of neurological function and [[corticosteroid]] usage, checking for signs of [[venous thromboembolism]], regular laboratory tests, and routine imaging (MRI and [[PET|Positron Emission Tomography]]) at scheduled intervals after treatment.<ref name="pmid20555079">{{cite journal| author=Stupp R, Tonn JC, Brada M, Pentheroudakis G, ESMO Guidelines Working Group| title=High-grade malignant glioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. | journal=Ann Oncol | year= 2010 | volume= 21 Suppl 5 | issue=  | pages= v190-3 | pmid=20555079 | doi=10.1093/annonc/mdq187 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20555079  }} </ref>


==Secondary Prevention==
==Secondary Prevention==
===Follow up after treatment===
===Follow up after treatment===
Patients treated for oligoastrocytoma should follow-up for secondary prevention. Follow-up measures are shown in the table below:<ref name="pmid20555079">{{cite journal| author=Stupp R, Tonn JC, Brada M, Pentheroudakis G, ESMO Guidelines Working Group| title=High-grade malignant glioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. | journal=Ann Oncol | year= 2010 | volume= 21 Suppl 5 | issue=  | pages= v190-3 | pmid=20555079 | doi=10.1093/annonc/mdq187 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20555079  }} </ref>
Patients treated for oligoastrocytoma should follow-up for secondary prevention. Follow-up measures for oligoastrocytoma include:<ref name="pmid20555079">{{cite journal| author=Stupp R, Tonn JC, Brada M, Pentheroudakis G, ESMO Guidelines Working Group| title=High-grade malignant glioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. | journal=Ann Oncol | year= 2010 | volume= 21 Suppl 5 | issue=  | pages= v190-3 | pmid=20555079 | doi=10.1093/annonc/mdq187 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20555079  }} </ref>
*Clinical assessment of [[neurology|neurological function]]
*Clinical assessment of [[neurology|neurological function]]
*Tapering [[steroid]] usage as early as possible
*Tapering [[steroid]] usage as early as possible
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*Laboratory tests
*Laboratory tests
**Generally not indicated, unless patient is on [[chemotherapy]] ([[complete blood count]]), [[steroids]] ([[glucose]] level), and [[anticonvulsants]] (complete blood count and [[liver function tests]])
**Generally not indicated, unless patient is on [[chemotherapy]] ([[complete blood count]]), [[steroids]] ([[glucose]] level), and [[anticonvulsants]] (complete blood count and [[liver function tests]])
*MRI every 3-4 months
*[[MRI]] every 3-4 months
**Evaluation of tumor extension on T2 fluid-attenuated inversion recovery (FLAIR)-weighted [[MRI]]
*[[PET|Positron emission tomography]]
*[[PET|Positron emission tomography]]
**To differentiate [[tumor]] recurrence from radiation-induced tumor [[necrosis]]  
**To differentiate [[tumor]] recurrence from radiation-induced tumor [[necrosis]]
{| style="border: 0px; font-size: 90%; margin: 3px; width: 600px" align=center
|valign=top|
|+
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Follow up}}
! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Description}}
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
:Clinical assessment of neurological function
| style="padding: 5px 5px; background: #F5F5F5;" |
 
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
:Nasendoscopy
| style="padding: 5px 5px; background: #F5F5F5;" |
*Immediately following radiation therapy
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
:Scanning
:*CT Scan
:*MRI
| style="padding: 5px 5px; background: #F5F5F5;" |
Scans are performed at routine intervals as follows:
*Baseline scanning is performed at 3-6 months after treatment, further scans are scheduled based on finding of physical exam and symptoms experienced by the patient
*Scanning for asymptomatic patients is not recommended
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
:Thyroid hormone testing
| style="padding: 5px 5px; background: #F5F5F5;" |
*Thyroid stimulating hormone testing every 12 months if the neck was exposed to radiation
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
:Dental screening
| style="padding: 5px 5px; background: #F5F5F5;" |
*Only recommended if oral cavity was exposed to radiation
|-
|}
<sup>Table adapted from Pfister DG, et al. Head and neck cancers, version 2.2013. Featured updates to the NCCN guidelines. J Natl Compr Canc Netw. 2013;11(8):917-23.<ref name="pmid23946171">{{cite journal| author=Pfister DG, Ang KK, Brizel DM, Burtness BA, Busse PM, Caudell JJ et al.| title=Head and neck cancers, version 2.2013. Featured updates to the NCCN guidelines. | journal=J Natl Compr Canc Netw | year= 2013 | volume= 11 | issue= 8 | pages= 917-23 | pmid=23946171 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23946171  }} </ref></sup>


==References==
==References==
{{Reflist|2}}
{{Reflist|1}}


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Latest revision as of 14:43, 27 November 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

Overview

Patients treated for oligoastrocytoma should follow-up for secondary prevention. Secondary prevention strategies following oligoastrocytoma include a clinical assessment of neurological function and corticosteroid usage, checking for signs of venous thromboembolism, regular laboratory tests, and routine imaging (MRI and Positron Emission Tomography) at scheduled intervals after treatment.[1]

Secondary Prevention

Follow up after treatment

Patients treated for oligoastrocytoma should follow-up for secondary prevention. Follow-up measures for oligoastrocytoma include:[1]

References

  1. 1.0 1.1 Stupp R, Tonn JC, Brada M, Pentheroudakis G, ESMO Guidelines Working Group (2010). "High-grade malignant glioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up". Ann Oncol. 21 Suppl 5: v190–3. doi:10.1093/annonc/mdq187. PMID 20555079.


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