The Neurologic Assessment in Neuro-Oncology (NANO) scale: a tool to assess neurologic function for integration into the Response Assessment in Neuro-Oncology (RANO) criteria.
- Nayak L Center for Neuro-Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA.
- DeAngelis LM Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, USA.
- Brandes AA Department of Medical Oncology, Azienda USL-IRCCS Institute of Neurological Science, Bologna, Italy.
- Peereboom DM Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, Ohio, USA.
- Galanis E Department of Oncology, Mayo Clinic, Rochester, Minnesota, USA.
- Lin NU Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA.
- Soffietti R Department of Neurology and Neuro-Oncology, University of Turin, Turin, Italy.
- Macdonald DR Department of Oncology, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada.
- Chamberlain M Department of Neurology, Fred Hutchinson Cancer Research Center and Seattle Cancer Care Alliance, University of Washington School of Medicine, Seattle, Washington, USA.
- Perry J Division of Neurology, Sunnybrook Health Science Center, University of Toronto, Toronto, Ontario, Canada.
- Jaeckle K Department of Neurology and Hematology/Oncology, Mayo Clinic, Jacksonville, Florida, USA.
- Mehta M Department of Radiation Oncology, Miami Cancer Institute, Miami, Florida, USA.
- Stupp R Department of Oncology, University of Zurich, Zurich, Switzerland.
- Muzikansky A Biostatistics Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
- Pentsova E Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, USA.
- Cloughesy T Neuro-Oncology Program, Ronald Reagan UCLA Medical Center, University of CaliforniaLos Angeles, Los Angeles, California, USA.
- Iwamoto FM Division of Neuro-Oncology, Neurological Institute of New York College of Physicians and Surgeons, Columbia University, New York, USA.
- Tonn JC Department of Neurosurgery, LMU University of Munich, Munich, Germany.
- Vogelbaum MA Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, Ohio, USA.
- Wen PY Center for Neuro-Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA.
- van den Bent MJ Neuro-Oncology Unit, Erasmus MC Cancer Center, Erasmus MC, Rotterdam, The Netherlands.
- Reardon DA Center for Neuro-Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA.
- 2017-04-29
Published in:
- Neuro-oncology. - 2017
brain tumor
neurologic function
outcome
response criteria
Brain Neoplasms
Humans
Neuroimaging
Treatment Outcome
English
Background
The Macdonald criteria and the Response Assessment in Neuro-Oncology (RANO) criteria define radiologic parameters to classify therapeutic outcome among patients with malignant glioma and specify that clinical status must be incorporated and prioritized for overall assessment. But neither provides specific parameters to do so. We hypothesized that a standardized metric to measure neurologic function will permit more effective overall response assessment in neuro-oncology.
Methods
An international group of physicians including neurologists, medical oncologists, radiation oncologists, and neurosurgeons with expertise in neuro-oncology drafted the Neurologic Assessment in Neuro-Oncology (NANO) scale as an objective and quantifiable metric of neurologic function evaluable during a routine office examination. The scale was subsequently tested in a multicenter study to determine its overall reliability, inter-observer variability, and feasibility.
Results
The NANO scale is a quantifiable evaluation of 9 relevant neurologic domains based on direct observation and testing conducted during routine office visits. The score defines overall response criteria. A prospective, multinational study noted a >90% inter-observer agreement rate with kappa statistic ranging from 0.35 to 0.83 (fair to almost perfect agreement), and a median assessment time of 4 minutes (interquartile range, 3-5).
Conclusion
The NANO scale provides an objective clinician-reported outcome of neurologic function with high inter-observer agreement. It is designed to combine with radiographic assessment to provide an overall assessment of outcome for neuro-oncology patients in clinical trials and in daily practice. Furthermore, it complements existing patient-reported outcomes and cognition testing to combine for a global clinical outcome assessment of well-being among brain tumor patients.
The Macdonald criteria and the Response Assessment in Neuro-Oncology (RANO) criteria define radiologic parameters to classify therapeutic outcome among patients with malignant glioma and specify that clinical status must be incorporated and prioritized for overall assessment. But neither provides specific parameters to do so. We hypothesized that a standardized metric to measure neurologic function will permit more effective overall response assessment in neuro-oncology.
Methods
An international group of physicians including neurologists, medical oncologists, radiation oncologists, and neurosurgeons with expertise in neuro-oncology drafted the Neurologic Assessment in Neuro-Oncology (NANO) scale as an objective and quantifiable metric of neurologic function evaluable during a routine office examination. The scale was subsequently tested in a multicenter study to determine its overall reliability, inter-observer variability, and feasibility.
Results
The NANO scale is a quantifiable evaluation of 9 relevant neurologic domains based on direct observation and testing conducted during routine office visits. The score defines overall response criteria. A prospective, multinational study noted a >90% inter-observer agreement rate with kappa statistic ranging from 0.35 to 0.83 (fair to almost perfect agreement), and a median assessment time of 4 minutes (interquartile range, 3-5).
Conclusion
The NANO scale provides an objective clinician-reported outcome of neurologic function with high inter-observer agreement. It is designed to combine with radiographic assessment to provide an overall assessment of outcome for neuro-oncology patients in clinical trials and in daily practice. Furthermore, it complements existing patient-reported outcomes and cognition testing to combine for a global clinical outcome assessment of well-being among brain tumor patients.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1093/neuonc/nox029
- PMID 28453751
- Persistent URL
- https://folia.unifr.ch/global/documents/47551
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