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Follow-Up After Treatment
Source: Childhood Medulloblastoma and Other Central Nervous System Embryonal Tumors Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: April 11, 2025 · Captured 2026-09-09.
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Relapse in children with embryonal tumors is most likely to occur within the first 18 months of diagnosis.[43,64] Surveillance imaging of the brain and spine is usually undertaken at routine intervals during and after treatment (see Table 2). The frequency of such imaging, designed to detect recurrent disease at an early, asymptomatic state, has been arbitrarily determined and has not been shown to clearly influence survival.[65-68] Growth hormone replacement therapy has not been shown to increase the likelihood of disease relapse and should not impact the frequency of surveillance testing.[37]
| Surveillance Period | Frequency of Visits During Surveillance Period | Testing |
|---|---|---|
| MRI = magnetic resonance imaging. | ||
| aFor pineoblastoma, continue spinal evaluations every 6 months until 5 years from diagnosis. Although these suggestions are based on a small sample size, there is evidence for continuing surveillance testing of the spine until 5 years after diagnosis.[69] | ||
| First 3 years after diagnosis | Every 3 months | Physical examination |
| Imaging of the brain every 3 months for the first 3 years, then every 6 months for the ensuing 2 years, and then as per preference of the treating physician or per protocol; MRI of the spine every 3 months for the first 2 years, then every 6 months for 1 year, and then as per preference of the treating physician or per protocola | ||
| Endocrinology evaluation once a year | ||
| Neuropsychological testing every 1–2 years | ||
| 3–5 years after diagnosis | Every 6 months | Physical examination |
| Imaging of the brain and spine once a year | ||
| Endocrinology evaluation once a year | ||
| Neuropsychological testing every 1–2 years | ||
| More than 5 years after diagnosis | Once a year | Physical examination |
| Imaging of the brain once a year | ||
| Endocrinology evaluation once a year | ||
| Neuropsychological testing every 1–2 years (optional) | ||
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The development of surveillance strategies other than imaging for patients with medulloblastoma is the subject of ongoing research. In one study of 134 children with newly diagnosed medulloblastoma, copy number variants were detected at baseline in 123 patients (92%) by primary tumor testing and in 65 patients (49%) by CSF testing. Copy number variants were detected more frequently in the CSF of patients with disseminated disease and in those with subsequent progression. Prospective studies will be necessary to evaluate the potential for CSF copy number analysis to become a component of surveillance testing, as a measure of medulloblastoma minimal residual disease and early relapse.[51]
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Childhood and adolescent cancer survivors require close monitoring because cancer therapy side effects may persist or develop months or years after treatment. For specific information about the incidence, type, and monitoring of late effects in childhood and adolescent cancer survivors, see Late Effects of Treatment for Childhood Cancer.
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