No abstract

The geriatric oncology consultation led to a modification of the cancer treatment plan in more than one third of cases. Further studies are needed to determine whether these modifications improve the outcome of these older patients.

New guidelines to evaluate the response to treatment in solid tumors using imaging techniques have major limitations and important implications for radiological workload. This consensus statement from the International Cancer Imaging Society (ICIS) reviews the RECIST criteria and addresses several challenges regarding tumour measurement. Recommendations are made regarding tumour measurement and other issues are raised. The growing need to introduce a multimodality approach to monitoring response is recognized. ICIS welcomes a dialogue with the authors of RECIST to address issues raised in this review.

We conclude that all therapeutic trial results should be reviewed by peer analysis of all presumed responders by an EC. International guidelines for response evaluation should be updated by including more reliable methods of measurements and definition of minimal imaging procedures.

This review focuses on imaging of osteosarcoma and Ewing's sarcoma of the long bones in children during preoperative neoadjuvant chemotherapy. Morphological criteria on plain films and conventional static MRI are insufficiently correlated with histological response. We review the contribution of dynamic MRI, diffusion-weighted MR and nuclear medicine (18FDG-PET) to monitor tumoural necrosis. MRI is currently the best method to evaluate local extension prior to tumour resection, especially to assess the feasibility of conservative surgery. Quantitative models in dynamic MRI and 18FDG-PET are currently being developed in order to find new early prognostic criteria, but for the time being, treatment protocols are still based on the gold standard of histological response.