Prognostic Clinical and Biologic Features for Overall Survival after Relapse in Childhood Medulloblastoma

儿童髓母细胞瘤复发后总体生存率的预后临床和生物学特征

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作者:Sophie Huybrechts, Gwénaël Le Teuff, Arnault Tauziède-Espariat, Caroline Rossoni, Anaïs Chivet, Émilie Indersie, Pascale Varlet, Stéphanie Puget, Rachid Abbas, Olivier Ayrault, Léa Guerrini-Rousseau, Jacques Grill, Dominique Valteau-Couanet, Christelle Dufour

Abstract

Given the very poor prognosis for children with recurrent medulloblastoma, we aimed to identify prognostic factors for survival post-relapse in children with childhood medulloblastoma. We retrospectively collected clinico-biological data at diagnosis and main clinical characteristics at relapse of children newly diagnosed with a medulloblastoma between 2007 and 2017 at Gustave Roussy and Necker Hospital. At a median follow-up of 6.6 years (range, 0.4-12.3 years), relapse occurred in 48 out 155 patients (31%). The median time from diagnosis to relapse was 14.3 months (range, 1.2-87.2 months). Relapse was local in 9, metastatic in 22 and combined (local and metastatic) in 17 patients. Second-line treatment consisted of chemotherapy in 31 cases, radiotherapy in 9, SHH-inhibitor in four and no treatment in the remaining four. The 1-year overall survival rate post-relapse was 44.8% (CI 95%, 31.5% to 59.0%). While molecular subgrouping at diagnosis was significantly associated with survival post-relapse, the use of radiotherapy at relapse and time to first relapse (>12 months) might also have a potential impact on post-relapse survival.

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