Prognostic factors affecting infantile medulloblastoma outcomes in the molecular era: a 12-year single-center experience from Egypt

Author:

El-Hemaly Ahmed1ORCID,El-Ayadi Moatasem1,Ahmed Soha2,Taha Hala34,Magdy Marwa4,Refaat Amal5,Ammar Hany6,Maher Eslam7,Badawy Eman8,Rady Mohamed9,El-Beltagy Mohamed9,Zaghloul Mohamed S10,El-Haddad Alaa1

Affiliation:

1. Department of Pediatric Oncology, National Cancer Institute (NCI)–Cairo University & Children's Cancer Hospital of Egypt (CCHE), Cairo, Egypt

2. Department of Clinical Oncology & Nuclear Medicine, Suez University

3. Department of Pathology, NCI–Cairo University, Cairo, Egypt

4. Department of Pathology, CCHE, Cairo, Egypt

5. Department of Radiodiagnosis, NCI–Cairo University & CCHE, Cairo, Egypt

6. Department of Clinical Oncology, Aswan University & Radiation Oncology Department, CCHE, Cairo, Egypt

7. Department of Clinical Research, CCHE, Cairo, Egypt

8. Department of Medical Affairs, Pierre Fabre, Cairo, Egypt

9. Department of Neurosurgery, CCHE, Cairo, Egypt

10. Department of Radiation Oncology, NCI–Cairo University, & CCHE, Cairo, Egypt

Abstract

Aims: To assess the clinical, pathological and molecular characteristics (Sonic hedgehog and group 3/4 molecular subtypes expression) and treatment modalities for infantile medulloblastoma in correlation with outcomes. Materials & methods: A retrospective study of 86 medulloblastoma patients (≤3 years) was conducted. M0 patients <2.5 years received four cycles of chemotherapy followed by focal radiotherapy (FRT) and chemotherapy. Between 2007 and 2015, Metastatic patients <2.5 years received craniospinal irradiation (CSI) after the end of chemotherapy. After 2015, metastatic patients <2.5 years received CSI postinduction. Results: The hazard ratio for death was significantly higher in the FRT (HR = 2.8) group compared with the CSI group (hazard ratio = 1). Metastatic disease significantly affected the overall survival of the Sonic hedgehog group and the overall survival and event-free survival of group 3/4. Conclusion: Metastatic disease had a significant impact on outcomes. FRT is not effective in treating infantile medulloblastoma.

Publisher

Future Medicine Ltd

Subject

Cancer Research,Oncology,General Medicine

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