Frequency of Office Visits
Children who have undergone treatment of supratentorial PNETs require ongoing follow-up. Concerns relate to the aggressive nature of supratentorial PNETs, with a high risk of local recurrence and the potential for CSF dissemination of disease. Routine follow-up clinical assessments along with surveillance craniospinal imaging are used to identify disease recurrence, dissemination, or progression.
- Every 3 months for first 3 years: In the authors’ center, the child is typically reassessed by the oncologist and neurosurgeon with MRI scans of the spine and brain every 3 months for the first 3 years. The frequency of assessments is decreased if there is no tumor recurrence or progression or is increased if the tumor recurs or progresses.
Frequency of Imaging
- Every 3 months: The appropriate frequency of surveillance imaging has yet to be determined for supratentorial PNETs. Considering the probability of early recurrence, imaging every 3 months in the first 3 years and less frequent imaging thereafter seems appropriate. When there is question of disease progression on imaging, CSF cytology may be a useful adjunct. Although CSF is generally taken from the lumbar CSF cistern, there may be discordance between lumbar and cranial CSF examinations, and the precise survival impact of CSF cytology is not fully characterized (22).
Other Investigations Required
- Neuropsychological assessment: Neuropsychological assessments may be required after treatment has been completed.