Results of treating children with medulloblastoma in Azerbaijan of 2020.

Abstract

e14519 Background: Medulloblastoma (a primitive neuroectodermal tumor of the posterior cranial fossa) is the most common CNS tumor in children; it takes 20-30% of all brain tumors. In about 40% of cases of primary detected tumors, there are already metastatic lesions of the brain and spinal cord. Treatment of medulloblastoma is a difficult problem. It requires a multidisciplinary approach and modern technical support of the medical institution. Only after the opening of the children's oncology department of the National Oncology Center in 2012, it became possible for children with a medulloblastoma to use modern treatment by HIT-2000 and HIT 2015 protocols. Methods: For the period 2012-2020, a total amount of 45 children were treated with a diagnosis of medulloblastoma (34 boys, girls-11). The average age of children was 12 years. Complete removal of the tumor was reached in 27, subtotal removal of 18 patients. Taking into account the age, the histological variant and the size of the residual tumor after surgery, the patients were divided into high and medium risk groups. Treatment according to the average risk group was carried out in 27 patients and high risk group - in 18. Craniospinal radiation therapy was carried out in 45 patients in the prescribed manner (SOD 25-30 Gy for the entire CNS and additionally for the posterior cranial fossa 25-30 Gy). In parallel with radiation therapy, vincristine is used, in dose of 1.5 mg / m2 weekly, only 8 times, followed by 8 courses of maintenance chemotherapy (cisplatin 70 mg / m2, lomustine 75 mg / m2 and vincristine 1.5 mg / m2). Results: Children in general satisfactorily tolerated both chemo- and radiotherapy. No serious complications of treatment were noted. During the observation period ( 8 years), relapses were observed in 5 children out of 45 treated, in 3 there was a progression during treatment, 8 children died. Thus, out of 45 children, 37 are alive with no signs of illness. 8-year survival rate was 82% ± 7%. Conclusions: The introduction and subsequent modification of modern foreign protocols into the practice of our center made it possible for the first time to achieve quite good results for this difficult category of patients.