First name
Michael
Middle name
J
Last name
Fisher

Title

Guideline for Children With Cancer Receiving General Anesthesia for Procedures and Imaging.

Year of Publication

2022

Date Published

2022 Mar 01

ISSN Number

1536-3678

Abstract

<p>Children with cancer and those undergoing hematopoietic stem cell transplantation frequently require anesthesia for imaging as well as diagnostic and therapeutic procedures from diagnosis through follow-up. Due to their underlying disease and side effects of chemotherapy and radiation, they are at risk for complications during this time, yet no published guideline exists for preanesthesia preparation. A comprehensive literature review served as the basis for discussions among our multidisciplinary panel of oncologists, anesthesiologists, nurse practitioners, clinical pharmacists, pediatric psychologists, surgeons and child life specialists at the Children's Hospital of Philadelphia. Due to limited literature available, this panel created an expert consensus guideline addressing anesthesia preparation for this population.</p>

DOI

10.1097/MPH.0000000000002430

Alternate Title

J Pediatr Hematol Oncol

PMID

35235547

Title

Risk Factors for Treatment Refractory and Relapsed Optic Pathway Glioma in Children with Neurofibromatosis Type 1.

Year of Publication

2022

Date Published

2022 Jan 09

ISSN Number

1523-5866

Abstract

<p><strong>BACKGROUND: </strong>Nearly one-third of patients with neurofibromatosis type 1-associated optic pathway glioma (NF1-OPG) fail frontline chemotherapy; however, little is known about risk factors for treatment failure.</p>

<p><strong>METHODS: </strong>We performed a retrospective multi-institutional cohort study to identify baseline risk factors for treatment-refractory/relapsed disease and poor visual outcome in children with NF1-OPG. Refractory/relapsed NF1-OPG was defined as requirement of two or more treatment regimens due to progression or relapse.</p>

<p><strong>RESULTS: </strong>Of 111 subjects eligible for inclusion, adequate clinical and visual data were available for 103 subjects from 7 institutions. Median follow-up from initiation of first chemotherapy regimen was 95 months (range 13-185). Eighty-four (82%) subjects received carboplatin-based frontline chemotherapy. Forty-five subjects (44%) experienced refractory/relapsed disease, with median time of 21.5 months (range 2-149) from initiation of first treatment to start of second treatment. The proportion of patients without refractory/relapsed disease at 2 and 5 years was 78% and 60%. In multivariable analyses, age less than 24 months at initial treatment, posterior tumor location, and familial inheritance were associated with refractory/relapsed NF1-OPG by 2 years. Both age less than 24 months and posterior tumor location were associated with refractory/relapsed NF1-OPG by 5 years. Subjects with moderate to severe vision loss at last follow-up were more likely to have posterior tumor location, optic disc abnormalities, or abnormal visual acuity at initial treatment.</p>

<p><strong>CONCLUSION: </strong>Young age, posterior tumor location, and optic disc abnormalities may identify patients with the greatest likelihood of refractory/relapsed NF1-OPG and poor visual outcomes, and who may benefit from newer treatment strategies.</p>

DOI

10.1093/neuonc/noac013

Alternate Title

Neuro Oncol

PMID

35018469

Title

FDG-PET in two cases of neurofibromatosis type 1 and atypical malignancies.

Year of Publication

2014

Number of Pages

e345-8

Date Published

2014 Apr

ISSN Number

1198-0052

Abstract

<p>Patients with neurofibromatosis type 1 (nf1) are at increased risk for both benign and malignant tumours, and distinguishing the malignant potential of an individual tumour is a common clinical problem in these patients. Here, we review two cases of uncommon malignancies (Hodgkin lymphoma and mediastinal germ-cell tumour) in patients with nf1. Although (18)F-fluorodeoxyglucose positron-emission tomography (fdg-pet) has been used to differentiate benign neurofibromas from malignant peripheral nerve sheath tumours, fdg-pet characteristics for more rare tumours have been poorly described in children with nf1. Here, we report the role of pet imaging in clinical decision-making in each case. In nf1, fdg-pet might be useful in the clinical management of unusual tumour presentations and might help to provide information about the malignant potential of uncommon tumours.</p>

DOI

10.3747/co.21.1803

Alternate Title

Curr Oncol

PMID

24764718

WATCH THIS PAGE

Subscription is not available for this page.