Treatment of patients with progression of cerebral medulloblastoma in adults

Abstract

The aim of this work was to evaluate the results of treatment of patients with progression of primary cerebral medulloblastomas in adults. The study included 10 patients with progression of brain medulloblastomas, who had been treated since 2016 to 2021 treatment was carried out on the basis of the Chelyabinsk Regional Centre for Oncology and Nuclear Medicine. The mean age of patients with relapse of brain medulloblastoma was 27.14 ± 4.30 years (from 23 to 35 years). Males predominated (n = 9) and in one case a relapse was recorded in a woman. The median time to relapse was 56 months (12 to 144 months). According to the method of recurrence treatment, in 3 cases, for recurrence, repeated stereotaxic radiation therapy was performed using the CyberKnife device with ROD = 7 Gy in three fractions up to SOD = 24 Gy, the remaining 7 patients underwent chemotherapy according to the PCV scheme. The median overall survival was 130 months (CI: 59.6–200.3), 1-year overall survival rates were 100 %; 5-year-old – 76.7 %; 7-year-old – 53.7 %. When analyzing the relationship between the size of the residual tumor and survival rates, we found that with a residual tumor size of more than 1.5 cm, the 5-year overall survival rate was significantly lower compared to a small residual tumor – 54 % and 77 % respectively (p = 0.005). The best indicators of method-specific survival were observed during polychemotherapy: 27 months compared to 21 months when performing stereotactic radiation therapy (p = 0.782).