A retrospective review of the long-term outcomes of postoperative radiation therapy in adolescent and young adult patients with medulloblastoma
Keywords:
Adolescent and young adult, medulloblastoma, radiation therapy, middle-income countryAbstract
Backgrounds: Medulloblastoma (MB) is a rare tumor in adolescent and young adult patients (AYA). Before 2017, there was no standard treatment for AYA with MB due to conflicting data.
Objective: The aim of this study was to evaluate the local control (LC) and overall survival (OS) of MB in AYA at our institute.
Materials and Methods: Patients 15-39 years old with MB who were sent for postoperative radiation therapy (RT) from 2007-2019 at our institute were included. Kaplan–Meier statistics were used to estimate the LC and OS.
Results: Seven patients were included. The median age at RT was 18.3 years (16.7-28.6 years). Males were more common than females, 5 males vs. 2 females. Near total resection or gross total resection was achieved in 71.4% (5 in 7 patients). Only one patient had metastatic disease (M1). The majority (71.4%) of patients were at standard risk. Six patients received RT alone. One patient received combined chemotherapy and RT. The median craniospinal irradiation (CSI) dose and total RT dose were 36 Gy (23.4-46 Gy) and 54 Gy (54-56 Gy), respectively. Local recurrence (LR) was found in one patient 4.3 years after finishing RT. Her initial treatment was subtotal resection (STR) followed by RT alone; CSI 36 Gy and posterior fossa boost to 55.8 Gy. The median clinical follow-up time and the median MRI follow-up time were 5.8 years (1.3-11.4 years) and 5.8 years (0.6-11.3 years), respectively. The median local control was 4.3 years (0.6-11.3 years) and the median overall survival was 7.7 years (1.3-11.7 years).
Conclusions: Treatment outcomes of AYA with MB from a single tertiary hospital in a middle-income country had a good LC and OS with acceptable treatment-related toxicities.
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