PT  - JOURNAL ARTICLE
AU  - Yanik, Gregory A.
AU  - Parisi, Marguerite T.
AU  - Naranjo, Arlene
AU  - Nadel, Helen
AU  - Gelfand, Michael J.
AU  - Park, Julie R.
AU  - Ladenstein, Ruth L.
AU  - Poetschger, Ulrike
AU  - Boubaker, Ariane
AU  - Valteau-Couanet, Dominique
AU  - Lambert, Bieke
AU  - Castellani, Maria-Rita
AU  - Bar-Sever, Zvi
AU  - Oudoux, Aurore
AU  - Kaminska, Anna
AU  - Kreissman, Susan G.
AU  - Shulkin, Barry L.
AU  - Matthay, Katherine K.
TI  - Validation of Postinduction Curie Scores in High-Risk Neuroblastoma: A Children’s Oncology Group and SIOPEN Group Report on SIOPEN/HR-NBL1
AID  - 10.2967/jnumed.117.195883
DP  - 2018 Mar 01
TA  - Journal of Nuclear Medicine
PG  - 502--508
VI  - 59
IP  - 3
4099  - http://jnm.snmjournals.org/content/59/3/502.short
4100  - http://jnm.snmjournals.org/content/59/3/502.full
SO  - J Nucl Med2018 Mar 01; 59
AB  - A semiquantitative 123I-metaiodobenzylguanidine (123I-MIBG) scoring method (the Curie score, or CS) was previously examined in the Children’s Oncology Group (COG) high-risk neuroblastoma trial, COG A3973, with a postinduction CS of more than 2 being associated with poor event-free survival (EFS). The validation of the CS in an independent dataset, International Society of Paediatric Oncology European Neuroblastoma/High-Risk Neuroblastoma 1 (SIOPEN/HR-NBL1), is now reported. Methods: A retrospective analysis of 123I-MIBG scans obtained from patients who had been prospectively enrolled in SIOPEN/HR-NBL1 was performed. All patients exhibited 123I-MIBG–avid, International Neuroblastoma Staging System stage 4 neuroblastoma. 123I-MIBG scans were evaluated at 2 time points, diagnosis (n = 345) and postinduction (n = 330), before consolidation myeloablative therapy. Scans of 10 anatomic regions were evaluated, with each region being scored 0–3 on the basis of disease extent and a cumulative CS generated. Cut points for outcome analysis were identified by Youden methodology. CSs from patients enrolled in COG A3973 were used for comparison. Results: The optimal cut point for CS at diagnosis was 12 in SIOPEN/HR-NBL1, with a significant outcome difference by CS noted (5-y EFS, 43.0% ± 5.7% [CS ≤ 12] vs. 21.4% ± 3.6% [CS > 12], P < 0.0001). The optimal CS cut point after induction was 2 in SIOPEN/HR-NBL1, with a postinduction CS of more than 2 being associated with an inferior outcome (5-y EFS, 39.2% ± 4.7% [CS ≤ 2] vs. 16.4% ± 4.2% [CS > 2], P < 0.0001). The postinduction CS maintained independent statistical significance in Cox models when adjusted for the covariates of age and MYCN gene copy number. Conclusion: The prognostic significance of postinduction CSs has now been validated in an independent cohort of patients (SIOPEN/HR-NBL1), with a postinduction CS of more than 2 being associated with an inferior outcome in 2 independent large, cooperative group trials.