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, 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>
Patients treated for oligoastrocytoma should follow-up for secondary prevention. Secondary prevention strategies following oligoastrocytoma include a clinical assessment of neurological function and [[corticosteroid]] use (Macdonald criteria), routine imaging (MRI and Positron Emission Tomography) at scheduled intervals after treatment.  
Secondary prevention measures of nasopharyneal cancer include routine physical examination and imaging at scheduled intervals after treatment. Dental screening and screening for thyroid cancers are recommended among patients who had received radiation therapy to the oral cavity and cervical region, respectively.


==Secondary Prevention==
==Secondary Prevention==
===Follow up after treatment===
===Follow up after treatment===
Patients treated for nasopharyngeal carcinoma should follow-up for secondary prevention. Follow-up measures are shown in the table below:<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>
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]]
{| style="border: 0px; font-size: 90%; margin: 3px; width: 600px" align=center
*Tapering [[steroid]] usage as early as possible
|valign=top|
*Checking for signs of [[venous thromboembolism]]
|+
*Laboratory tests
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Follow up}}
**Generally not indicated, unless patient is on [[chemotherapy]] ([[complete blood count]]), [[steroids]] ([[glucose]] level), and [[anticonvulsants]] (complete blood count and [[liver function tests]])
! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Description}}
*[[MRI]] every 3-4 months
|-
**Evaluation of tumor extension on T2 fluid-attenuated inversion recovery (FLAIR)-weighted [[MRI]]
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
*[[PET|Positron emission tomography]]
:Physical exam
**To differentiate [[tumor]] recurrence from radiation-induced tumor [[necrosis]]
| style="padding: 5px 5px; background: #F5F5F5;" |
*Every 1-3 months during the 1st year after treatment
*Every 2-6 months during the 2nd year after treatment
*Every 4-8 months between the 3rd and 5th years after treatment
*Annually thereafter
|-
| 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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