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Long-term Outcomes of Protocol-Based Treatment for Newly Diagnosed Medulloblastoma

 Won Kee Ahn  ;  Seung Min Hahn  ;  Hong In Yoon  ;  Jeongshim Lee  ;  Eun Kyung Park  ;  Kyu Won Shim  ;  Dong Seok Kim  ;  Chang-Ok Suh  ;  Se Hoon Kim  ;  Chuhl Joo Lyu  ;  Jung Woo Han 
 CANCER RESEARCH AND TREATMENT, Vol.56(2) : 652-664, 2024-04 
Journal Title
Issue Date
Alkylating Agents / therapeutic use ; Antineoplastic Combined Chemotherapy Protocols / adverse effects ; Cerebellar Neoplasms* / diagnosis ; Cerebellar Neoplasms* / drug therapy ; Child ; Combined Modality Therapy ; Hematopoietic Stem Cell Transplantation* ; Humans ; Medulloblastoma* / drug therapy ; Medulloblastoma* / therapy
Autologous stem cell rescue ; Children ; High-dose chemotherapy ; Medulloblastoma
Purpose The Korean Society of Pediatric Neuro-Oncology (KSPNO) conducted treatment strategies for children with medulloblastoma (MB) by using alkylating agents for maintenance chemotherapy or tandem high-dose chemotherapy (HDC) with autologous stem cell rescue (ASCR) according to the risk stratification. The purpose of the study was to assess treatment outcomes and complications based on risk-adapted treatment and HDC.Materials and Methods Fifty-nine patients diagnosed with MB were enrolled in this study. Patients in the standard-risk (SR) group received radiotherapy (RT) after surgery and chemotherapy using the KSPNO M051 regimen. Patients in the high-risk (HR) group received two and four chemotherapy cycles according to the KSPNO S081 protocol before and after reduced RT for age following surgery and two cycles of tandem HDC with ASCR consolidation treatment.Results In the SR group, 24 patients showed 5-year event-free survival (EFS) and overall survival (OS) estimates of 86.7% (95% confidence interval [CI], 73.6 to 100) and 95.8% (95% CI, 88.2 to 100), respectively. In the HR group, more infectious complications and mortality occurred during the second HDC than during the first. In the HR group, the 5-year EFS and OS estimates were 65.5% (95% CI, 51.4 to 83.4) and 72.3% (95% CI, 58.4 to 89.6), respectively.Conclusion High intensity of alkylating agents for SR resulted in similar outcomes but with a high incidence of hematologic toxicity. Tandem HDC with ASCR for HR induced favorable EFS and OS estimates compared to those reported previously. However, infectious complications and treatment-related mortalities suggest that a reduced chemotherapy dose is necessary, especially for the second HDC.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Seok(김동석)
Kim, Se Hoon(김세훈) ORCID logo https://orcid.org/0000-0001-7516-7372
Park, Eun Kyung(박은경)
Shim, Kyu Won(심규원) ORCID logo https://orcid.org/0000-0002-9441-7354
Ahn, Won Kee(안원기) ORCID logo https://orcid.org/0000-0003-3668-7396
Lyu, Chuhl Joo(유철주) ORCID logo https://orcid.org/0000-0001-7124-7818
Yoon, Hong In(윤홍인) ORCID logo https://orcid.org/0000-0002-2106-6856
Hahn, Seung Min(한승민) ORCID logo https://orcid.org/0000-0001-9832-6380
Han, Jung Woo(한정우) ORCID logo https://orcid.org/0000-0001-8936-1205
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