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Erschienen in: European Journal of Pediatrics 1/2021

21.06.2020 | Original Article

Real-world data for pediatric medulloblastoma: can we improve outcomes?

verfasst von: Paula Sedano, Carmen González-San Segundo, Lourdes De Ingunza, Pedro Cuesta-Álvaro, Marta Pérez-Somarriba, Francisco Diaz-Gutiérrez, Carmen Garrido Colino, Alvaro Lassaletta

Erschienen in: European Journal of Pediatrics | Ausgabe 1/2021

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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.
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Metadaten
Titel
Real-world data for pediatric medulloblastoma: can we improve outcomes?
verfasst von
Paula Sedano
Carmen González-San Segundo
Lourdes De Ingunza
Pedro Cuesta-Álvaro
Marta Pérez-Somarriba
Francisco Diaz-Gutiérrez
Carmen Garrido Colino
Alvaro Lassaletta
Publikationsdatum
21.06.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Pediatrics / Ausgabe 1/2021
Print ISSN: 0340-6199
Elektronische ISSN: 1432-1076
DOI
https://doi.org/10.1007/s00431-020-03722-4

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