Response assessment in paediatric low-grade glioma: recommendations from the Response Assessment in Pediatric Neuro-Oncology (RAPNO) working group

Jason Fangusaro, Olaf Witt, Pablo Hernáiz Driever, Asim K. Bag, Peter de Blank, Nadja Kadom, Lindsay Kilburn, Robert M. Lober, Nathan J. Robison, Michael J. Fisher, Roger J. Packer, Tina Young Poussaint, Ludmila Papusha, Shivaram Avula, Alba A. Brandes, Eric Bouffet, Daniel Bowers, Anton Artemov, Murali Chintagumpala, David ZurakowskiMartin van den Bent, Brigitte Bison, Kristen W. Yeom, Walter Taal, Katherine E. Warren

Research output: Contribution to journalReview articlepeer-review

107 Scopus citations


Paediatric low-grade gliomas (also known as pLGG) are the most common type of CNS tumours in children. In general, paediatric low-grade gliomas show clinical and biological features that are distinct from adult low-grade gliomas, and the developing paediatric brain is more susceptible to toxic late effects of the tumour and its treatment. Therefore, response assessment in children requires additional considerations compared with the adult Response Assessment in Neuro-Oncology criteria. There are no standardised response criteria in paediatric clinical trials, which makes it more difficult to compare responses across studies. The Response Assessment in Pediatric Neuro-Oncology working group, consisting of an international panel of paediatric and adult neuro-oncologists, clinicians, radiologists, radiation oncologists, and neurosurgeons, was established to address issues and unique challenges in assessing response in children with CNS tumours. We established a subcommittee to develop consensus recommendations for response assessment in paediatric low-grade gliomas. Final recommendations were based on literature review, current practice, and expert opinion of working group members. Consensus recommendations include imaging response assessments, with additional guidelines for visual functional outcomes in patients with optic pathway tumours. As with previous consensus recommendations, these recommendations will need to be validated in prospective clinical trials.

Original languageEnglish (US)
Pages (from-to)e305-e316
JournalThe Lancet Oncology
Issue number6
StatePublished - Jun 2020


  • Age of Onset
  • Central Nervous System Neoplasms/diagnostic imaging
  • Child
  • Consensus
  • Endpoint Determination/standards
  • Female
  • Glioma/diagnostic imaging
  • Humans
  • Magnetic Resonance Imaging/standards
  • Male
  • Neoplasm Grading
  • Neuroimaging/standards
  • Perfusion Imaging/standards
  • Positron-Emission Tomography/standards
  • Predictive Value of Tests
  • Time Factors
  • Treatment Outcome
  • Tumor Burden

ASJC Scopus subject areas

  • Oncology


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