อัตราการรอดชีวิตของผู้ป่วยเมดุลโลบลาสโตมา ในโรงพยาบาลรามาธิบดี

Abstract

Abstract :

Medulloblastoma is the most common malignant brain tumor in children. After tumor removal, 36 Gy for craniospinal irradiation (CSI) plus 60 Gy for local irradiation is the standard treatment for the children > 3 years. With this approach, 5 year relapse free survival rate is 40 percent. However, these patients have morbidities related to the dose of CSI. The objective of this study is to evaluate the survival rate of medulloblastoma treated with reduced dose of CSI in average risk (M0) group and full dose of CSI in high risk (M+) group and both groups received adjuvant chemotherapy. After tumor removal, M0 patients received 24 Gy CSI and M+ patients received 36 Gy CSI plus 54 to 60 Gy at posterior fossa. After radiation, patients received the adjuvant chemotherapy consisted of vincristine, cyclophosphamide, cisplatinum, and etoposide. Twenty two patients were studied, 17 males and 5 females. The mean age was 6.6+3.2 years. Thirteen patients were classified as M0 and 9 as M+. The 5 year progression free and survival rate in average group were 54.4 percent and 56.3 percent respectively. The 5 year progression free and survival rate in high risk group were 50.8 percent and 42.3 percent respectively. The relapse rate was 36 percent. The median follow up time was 36.1 months (7.3 to 92.0 months). Seven patients died of relapse and 1 died of toxicity. In conclusion, both average and high risk medulloblastoma patients can achieve the favorable results with reduced dose of CSI and adjuvant chemotherapy.