Survival for children with medulloblastoma following tumor recurrence or progression

Abstract

1556 Background: Despite improvement in therapies, a substantial number of children with medulloblastoma experience tumor progression. The objectives of this single institution report are to report the 5 year post-progression survival and to identify prognostic factors for survival among children with progressive or recurrent medulloblastoma. Methods: The relationship between post-progression survival and demographic, tumor, and treatment factors were examined among 46 patients (22 females; mean age at diagnosis = 6.5 years; mean age at progression = 8.4 years) with recurrent medulloblastoma. Differences were calculated by Kaplan-Meier log rank analysis. Results: The probability of 5 year post-progression survival among patients in this study with progressive medulloblastoma was 26.3%. Twenty-two (48%) patients had local recurrence only, 5 (11%) had local + distant recurrence, and 19 (41%) had distant recurrence only. Patients with local recurrence only had a significantly prolonged post-progression survival compared to those with local + distant and distant recurrence (p = 0.039). The 17 patients treated with radiation therapy (RT) following progression had prolonged PPS (p = 0.003). Other categorical variables, including patient sex, age < 3 years at diagnosis, age < 6 years at diagnosis, age at progression, interval from diagnosis to progression, initial tumor stage, initial adjuvant therapy, and treatment with chemotherapy or autologous stem cell transplant following progression, were not associated with prolonged post-progression survival. Conclusions: Although the post-progression survival is poor for children with recurrent medulloblastoma, certain patients groups differ appreciably in their likelihood of post-progression survival. Patients with who have a local recurrence only and those who receive RT following progression have prolonged post-progression survival. No significant financial relationships to disclose.