Abstract
Abstract Craniospinal irradiation (CSI) has been a major component of the standard of care treatment backbone of childhood medulloblastoma. However, chemotherapy regimens have varied based on protocol, patient age, and molecular subtyping. In one of the largest studies to date, we analyze treatment outcomes in children with newly-diagnosed medulloblastoma treated with pre-irradiation chemotherapy followed by risk-adapted radiotherapy and maintenance chemotherapy. A total of 153 patients from the Polish Pediatric Neuro-oncology Group were included in the analysis. Median age at diagnosis was 8.0 years. Sixty-seven patients were classified as standard risk and 86 as high risk. Overall survival (OS) and event-free survival (EFS) for standard-risk patients at 5 years (± standard error) were 87 ± 4.3% and 84 ± 4.6% respectively, while 5-year OS and EFS for high-risk patients were 81 ± 4.3% and 79 ± 4.5% respectively. This study demonstrates promising survival outcomes in patients treated with pre-irradiation chemotherapy followed by risk-adapted CSI and adjuvant chemotherapy. Such an approach may be useful in cases where initiation of radiotherapy may need to be delayed, a common occurrence in many institutions globally.
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