항암치료를 받은 수모세포종환아에서 예후인자들이 생존률에 미치는 영향

Abstract

Purpose: Brain tumors are the second most common tumor in childhood, and medulloblastomas comprise 15-25% of brain tumors. The well known prognostic factors factors are age at diagnosis, stage of disease, and extent of surgical excision. In this study, we analysed the prognostic factors in patients who received chemotheraphy after excision. Methods: We reviewed the medical records of 61 patients who received chemotherapy among the 94 patients who were diagnosed and treated between Jan 1985 and Sep 2001 in the Department of Pediatrics and Neurosurgery at Severance Hospital. Results: Among the total survival rate of patients who underwent chemotherapy, the 3-yr progression-free survival rate was 66.5±6.3% and the 15-yr progression-free survival rate was 60.3±6.7%. The progression-free survival rate for patients with age at diagnosis over 3 yrs old and under 3 yrs old, was 64.5±7.7% and 48.2±12.9% respectively and there was no statistically significant difference. The survival rate of the high vs low risk group by staging was 72.7±10.5% and 54.6±8.3% respectively, and there was no significant difference. The survival rate of patients with total removal vs subtotal removal was 65.8±11.8% and 56.8±8.2% respectively, showing no statistical difference. Conclusion: The reason there is no difference in survival rate according to the traditional prognostic factors is that chemotherapy has improved not only the total survival rate but also the survival rate in patients with poor traditional prognostic factors. So, sufficient removal of tumor followed by proper chemotherapy and radiotherapy is an important factor which influences the survival rate of medulloblastoma patients.