Analysis of the personalized treatment and the relevant prognostic factors in children with medulloblastoma  

作　　者：LIHUA CHEN HONGTIAN ZHANG YONG XIA KAI SUN WENJIN CHEN RUXIANG XU 

机构地区：[1]Department of Neurosurgery,Sichuan Provincial People’s Hospital,University of Electronic Science and Technology of China,Chengdu,610072,China [2]Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital,Chengdu,610072,China

出　　处：《BIOCELL》2023年第5期1065-1073,共9页生物细胞（英文）

基　　金：funded by the Key Research and Development Project of the Science and Technology Department of Sichuan Province(No.2021YFS0010).

摘　　要：Purpose:The present study summarized cases of children(n=32)with medulloblastoma(MB)who were treated using stratified therapy based on risk grading and also discussed the factors affecting prognosis.Methods:According to the risk stratification criteria,the cases were divided into the following four risk groups:low,standard,high,and very high.The 5-year overall survival(OS)and progression-free survival(PFS)rates were summarized.Further,the effects on the prognosis of tumor size,tumor stage,degree of resection,treatment mode,metastatic recurrence,molecular typing,and risk stratification were analyzed.Results:In the present study,following surgery,3 cases abandoned radiotherapy(RT)and chemotherapy(CHT),7 cases(<3 years of age)received only CHT,and 22 cases received combined RT and CHT.Total and near-total tumor resections were performed in 29 cases(90.6%).Subtotal resections were performed in 3 cases,and there were no surgery-related deaths.The average follow-up duration was 47 months.The average 5-year PFS and OS rates were 57.3%±7.2%and 68.7%±8.6%,respectively.The OS and PFS rates were significantly correlated with tumor-risk stratification,molecular staging,tumor stage,treatment mode,and recurrence after surgery(p<0.01).The degree of tumor resection,pathological type,and the presence of preoperative implantation were secondary factors affecting the prognosis(p<0.05).Age was correlated with the PFS rate.There was no correlation between age/tumor location/tumor size and prognosis(p>0.05).Favorable prognostic factors in the low-and standard-risk groups were stage M0,wingless-type MB,postoperative RT combined with CHT,no postoperative recurrence,age≥3 years,and total tumor resection.Conclusions:Personalized treatment strategies based on the risk stratification of MB and postoperative stratified comprehensive treatment could help improve the prognosis for MB.

关 键 词：Medulloblastoma in children Risk stratification Individualized therapy Prognostic influencing factor 

分 类 号：R73[医药卫生—肿瘤]