ABSTRACT
Medulloblastoma (MB) is a malignant embryonal tumor that develops especially in childhood, with overall survival (OS) at 5 years of up to 70%. The objective of this study is to analyze treatment delivery variables in a retrospective cohort and evaluate the impact of these treatment quality parameters on survival. From 2000 to 2018, 40 pediatric patients with medulloblastoma, treated according to current international protocols, were retrospectively analyzed. Treatment delivery quality indicators were analyzed including the extent of surgery, radiotherapy (RT) parameters, and chemotherapy variables, related with time and dose-intensity deviations. With a median follow-up of 74 months (range, 6-195), OS at 5 years was 74 ± 7%, 81 ± 8% for standard-risk, and 55 ± 16% for high-risk patients (p = 0.090). Disease-free survival at 5 years was not significantly affected by extent of surgery (p = 0.428) and RT-related variables such as surgery-RT interval (p = 0.776) neither RT duration (p = 0.172) or maintenance chemotherapy compliance (p = 0.634). Multivariate analysis identified risk groups predictive of worse DFS (p = 0.032) and leptomeningeal dissemination associated with inferior OS (p = 0.029).Conclusion: Treatment delivery optimization has improved survival rates of patients with MB. Despite this, in our study, we have not established a clear influence of the considered radiotherapy and chemotherapy treatment quality parameters on outcomes. What is Known: ⢠Improvement in treatment modalities during the last decades has reached a 5-year OS of up to 70% in these patients. ⢠Extent of resection and radiotherapy parameters such as interval between surgery-radiotherapy and radiotherapy duration has been described as probable survival prognostic factors. What is New: ⢠Differences in medulloblastoma survival rates between prospective studies and retrospective series. ⢠The impact on survival of the three main treatment variables, surgery, radiotherapy and chemotherapy, susceptible to improvement.
Subject(s)
Cerebellar Neoplasms , Medulloblastoma , Antineoplastic Combined Chemotherapy Protocols , Cerebellar Neoplasms/drug therapy , Child , Humans , Medulloblastoma/drug therapy , Prognosis , Prospective Studies , Retrospective Studies , Survival Rate , Treatment OutcomeSubject(s)
Chondroma/surgery , Gastrointestinal Neoplasms/surgery , Gastrointestinal Stromal Tumors/surgery , Leiomyosarcoma/surgery , Lung Neoplasms/surgery , Paraganglioma, Extra-Adrenal/surgery , Stomach Neoplasms/surgery , Chondroma/diagnosis , Chondroma/pathology , Female , Gastrectomy , Gastrointestinal Neoplasms/diagnosis , Gastrointestinal Neoplasms/pathology , Gastrointestinal Stromal Tumors/diagnosis , Gastrointestinal Stromal Tumors/pathology , Humans , Leiomyosarcoma/diagnosis , Leiomyosarcoma/pathology , Lung Neoplasms/diagnosis , Lung Neoplasms/pathology , Paraganglioma, Extra-Adrenal/diagnosis , Paraganglioma, Extra-Adrenal/pathology , Stomach Neoplasms/diagnosis , Stomach Neoplasms/pathology , Tomography, X-Ray Computed , Young AdultSubject(s)
Gastrointestinal Hemorrhage/etiology , Rectum , Vena Cava, Inferior/abnormalities , Abdominal Pain/etiology , Arteriovenous Malformations/diagnostic imaging , Arteriovenous Malformations/etiology , Colon/blood supply , Colonoscopy , Female , Gastrointestinal Hemorrhage/diagnostic imaging , Humans , Liver/blood supply , Tomography, X-Ray Computed , Vena Cava, Inferior/diagnostic imaging , Young AdultABSTRACT
No disponible
Subject(s)
Humans , Child , Neoplasm Metastasis/drug therapy , Neoplasm Metastasis/radiotherapy , Lung , Radiation , Prospective StudiesABSTRACT
No disponible
Subject(s)
Female , Humans , Young Adult , Gastrointestinal Hemorrhage/etiology , Venae Cavae/abnormalities , Tomography, X-Ray ComputedABSTRACT
No disponible