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

Abstract

<b>Purpose:</b> The present study summarized cases of children (<i>n</i> = 32) with medulloblastoma (MB) who were treated using stratified therapy based on risk grading and also discussed the factors affecting prognosis. <b>Methods:</b> 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. <b>Results:</b> 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 (<i>p</i> < 0.01). The degree of tumor resection, pathological type, and the presence of preoperative implantation were secondary factors affecting the prognosis (<i>p</i> < 0.05). Age was correlated with the PFS rate. There was no correlation between age/tumor location/tumor size and prognosis (<i>p</i> > 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. <b>Conclusions:</b> Personalized treatment strategies based on the risk stratification of MB and postoperative stratified comprehensive treatment could help improve the prognosis for MB.