Assessment of Waldeyer's ring in pediatric and adolescent Hodgkin lymphoma patients-Importance of multimodality imaging: Results from the EuroNet-PHL-C1 trial.
18F-FDG-PET
CT
ENT investigation
MRI
Waldeyer's ring
multimodality imaging
pediatric Hodgkin lymphoma
staging
Journal
Pediatric blood & cancer
ISSN: 1545-5017
Titre abrégé: Pediatr Blood Cancer
Pays: United States
ID NLM: 101186624
Informations de publication
Date de publication:
04 2021
04 2021
Historique:
received:
24
11
2020
revised:
29
12
2020
accepted:
30
12
2020
pubmed:
5
2
2021
medline:
10
8
2021
entrez:
4
2
2021
Statut:
ppublish
Résumé
In the EuroNet Pediatric Hodgkin Lymphoma (EuroNet-PHL) trials, decision on Waldeyer's ring (WR) involvement is usually based on clinical assessment, that is, physical examination and/or nasopharyngoscopy. However, clinical assessment only evaluates mucosal surface and is prone to interobserver variability. Modern cross-sectional imaging technology may provide valuable information beyond mucosal surface, which may lead to a more accurate WR staging. The EuroNet-PHL-C1 trial recruited 2102 patients, of which 1752 underwent central review including reference reading of their cross-sectional imaging data. In 14 of 1752 patients, WR was considered involved according to clinical assessment. In these 14 patients, the WR was re-assessed by applying an imaging-based algorithm considering information from The imaging-based algorithm confirmed WR involvement only in four of the 14 patients. Of the remaining 10 patients, four had retropharyngeal lymph node involvement and six an inconspicuous WR. Applying the imaging-based algorithm to 100 consecutive patients with physiological appearance of their WR on clinical assessment, absence of WR involvement could be confirmed in 99. However, suspicion of WR involvement was raised in one patient. The imaging-based algorithm was feasible and easily applicable at initial staging of young patients with Hodgkin lymphoma. It increased the accuracy of WR staging, which may contribute to a more individualized treatment in the future.
Sections du résumé
BACKGROUND
In the EuroNet Pediatric Hodgkin Lymphoma (EuroNet-PHL) trials, decision on Waldeyer's ring (WR) involvement is usually based on clinical assessment, that is, physical examination and/or nasopharyngoscopy. However, clinical assessment only evaluates mucosal surface and is prone to interobserver variability. Modern cross-sectional imaging technology may provide valuable information beyond mucosal surface, which may lead to a more accurate WR staging.
PATIENTS, MATERIALS, AND METHODS
The EuroNet-PHL-C1 trial recruited 2102 patients, of which 1752 underwent central review including reference reading of their cross-sectional imaging data. In 14 of 1752 patients, WR was considered involved according to clinical assessment. In these 14 patients, the WR was re-assessed by applying an imaging-based algorithm considering information from
RESULTS
The imaging-based algorithm confirmed WR involvement only in four of the 14 patients. Of the remaining 10 patients, four had retropharyngeal lymph node involvement and six an inconspicuous WR. Applying the imaging-based algorithm to 100 consecutive patients with physiological appearance of their WR on clinical assessment, absence of WR involvement could be confirmed in 99. However, suspicion of WR involvement was raised in one patient.
CONCLUSIONS
The imaging-based algorithm was feasible and easily applicable at initial staging of young patients with Hodgkin lymphoma. It increased the accuracy of WR staging, which may contribute to a more individualized treatment in the future.
Substances chimiques
Fluorodeoxyglucose F18
0Z5B2CJX4D
Types de publication
Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e28903Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021 The Authors. Pediatric Blood & Cancer published by Wiley Periodicals LLC.
Références
Bhatia S, Yasui Y, Robison LL, et al. High risk of subsequent neoplasms continues with extended follow-up of childhood Hodgkin's disease: report from the Late Effects Study Group. J Clin Oncol. 2003;21:4386-4394.
Schellong G, Riepenhausen M, Bruch C, et al. Late valvular and other cardiac diseases after different doses of mediastinal radiotherapy for Hodgkin disease in children and adolescents: report from the longitudinal GPOH follow-up project of the German-Austrian DAL-HD studies. Pediatr Blood Cancer. 2010;55:1145-1152.
Mauz-Körholz C, Metzger ML, Kelly KM, et al. Pediatric Hodgkin lymphoma. JCO. 2015;33:2975-2985.
Kluge R, Kurch L, Georgi T, Metzger M. Current role of FDG-PET in pediatric Hodgkin's lymphoma. Semin Nucl Med. 2017;47:242-257.
Flerlage JE, Kelly KM, Beishuizen A, et al. Staging Evaluation and Response Criteria Harmonization (SEARCH) for Childhood, Adolescent and Young Adult Hodgkin Lymphoma (CAYAHL): methodology statement. Pediatr Blood Cancer. 2017;64:e26421.
Kaplan HS, Rosenberg SA. The treatment of Hodgkin's disease. Med Clin North Am. 1966;50:1591-1610.
Karnofsky DA. The staging of Hodgkin's disease. Cancer Res. 1966;26:1090-1094.
Guimaraes AC, de Carvalho GM, Bento LR, Correa C, Gusmoa RJ. Clinical manifestations in children with tonsillar lymphoma: a systematic review. Crit Rev Oncol Hematol. 2014;90:146-151.
Seelisch J, de Alarcon P, Flerlage J, et al. Expert consensus statements for Waldeyer's ring involvement in pediatric Hodgkin lymphoma: the Staging, Evaluation, and Response Criteria Harmonization (SEARCH) for Childhood, Adolescent and Young Adult Hodgkin lymphoma (CAYAHL) Group. Pediatr Blood Cancer. 2020;16:e28361.
Brodsky L. Modern assessment of tonsils and adenoids. Pediatr Clin North Am. 1989;36:1551-1569.
Li Y-X, Fang H, Lui Q-F, et al. Clinical features and treatment outcome of nasal-type NK-T-cell lymphoma of Waldeyer ring. Clin Trials Obs. 2008;112:3057-3064.
Qin Y, Lijuan Lu, Lu Y, Yang K. Hodgkin lymphoma involving the tonsil misdiagnosed as tonsillar carcinoma: a case report and review of the literature. Medicine. 2018;97:e976.
Kurch L, Mauz-Körholz C, Bertling S, et al. The EuroNet paediatric Hodgkin network-modern imaging data management for real time central review in multicentre trials. Klin Padiatr. 2013;225:357-361.
Juweid ME, Stroobants S, Hoekstra OS, et al. Use of positron emission tomography for response assessment of lymphoma: consensus of the Imaging Subcommittee of International Harmonization Project in Lymphoma. JCO. 2007;25(5):571-578.
Akcay A, Kara CO, Dagdeviren E, Zencir M. Variation in tonsil size in 4- to 17-year-old schoolchildren. J Otolaryngol. 2006;35:270-274.
Costa NS, Salisbury SR, Donnelly LF. Retropharyngeal lymph nodes in children: a common imaging finding and potential source of misinterpretation. AJR Am J Roentgenol. 2011;196:433-437.
Guimaraes AC, de Carvalho GM, Correa CRS, Gusmao RJ. Association between unilateral tonsillar enlargement and lymphoma in children: a systematic review and meta-analysis. Crit Rev Oncol Hematol. 2015;93:304-311.
Nemec SF, Krestan CR, Noebauer-Huhmann IM, et al. Radiological normal anatomy of the larynx and pharynx and imaging techniques. Radiologe. 2009;49:8-16.
Shammas A, Lim R, Charron M. Pediatric FDG PET/CT: physiologic uptake, normal variants, and benign conditions. Radiographics. 2009;29:1467-1486.
Som PM, Curtin HD, Mancuso AA. Imaging-based nodal classification for evaluation of neck metastatic adenopathy. AJR. 2000;174:837-844.
Hassan A, Siddique M, Bashir H, et al. (18)F-FDG-PET-CT imaging versus bone marrow biopsy in pediatric Hodgkin's lymphoma: a quantitative assessment of marrow uptake and novel insights into clinical implication of bone marrow involvement. Eur J Nucl Med Mol Imaging. 2017;44:1198-1206.
Purz S, Mauz-Körholz C, Körholz D, et al. 18F-Fluorodeoxyglucose positron emission tomography for detection of bone marrow involvement in children and adolescents with Hodgkin's lymphoma. J Clin Oncol. 2011;29:3523-3528.
Bi X-W, Li Y-X, Fang H, et al. High-dose and extented-field intensity modulated radiation therapy for early stage NK/T-cell lymphoma of Waldeyer's ring: dosimetric analysis and clinical outcome. Int J Radiat Oncol Biol Phys. 2013;87:1086-1093.
Yahalom J, Illidge T, Specht L, et al. Modern radiation therapy for extranodal lymphomas: field and dose guidelines from the International Lymphoma Radiation Oncology Group. Int J Radiat Oncol Biol Phys. 2015;92:11-31.
Lautenschläger S, Iancu G, Flatten V, et al. Advantage of proton-radiotherapy for pediatric patients and adolescents with Hodgkin's disease. Radiat Oncol. 2019;14:157.