Salvage Therapy for Childhood Medulloblastoma: A Single Center Experience.

Autor:	Kameda-Smith MM; Department of Surgery, McMaster University, Hamilton, Ontario, Canada.; Stem Cell and Cancer Research Institute, McMaster University, Hamilton, Ontario, Canada.; McMaster University, Hamilton, Ontario, Canada., Wang A; McMaster University, Hamilton, Ontario, Canada., Abdulhadi N; Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada., Voth R; McMaster University, Hamilton, Ontario, Canada., Sergeant A; McMaster University, Hamilton, Ontario, Canada., Maharaj A; McMaster University, Hamilton, Ontario, Canada., Bakhshinyan D; Stem Cell and Cancer Research Institute, McMaster University, Hamilton, Ontario, Canada., Adile AA; Stem Cell and Cancer Research Institute, McMaster University, Hamilton, Ontario, Canada., Pai AM; McMaster University, Hamilton, Ontario, Canada., Ajani O; Department of Surgery, McMaster University, Hamilton, Ontario, Canada.; Pediatrics, McMaster University, Hamilton, Ontario, Canada.; McMaster University, Hamilton, Ontario, Canada., Yarascavitch B; Department of Surgery, McMaster University, Hamilton, Ontario, Canada.; Pediatrics, McMaster University, Hamilton, Ontario, Canada.; McMaster University, Hamilton, Ontario, Canada., Alyman MC; McMaster University, Hamilton, Ontario, Canada., Duckworth J; McMaster University, Hamilton, Ontario, Canada., Samaan MC; McMaster University, Hamilton, Ontario, Canada., Farrokhyar F; Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.; McMaster University, Hamilton, Ontario, Canada., Singh SK; Department of Surgery, McMaster University, Hamilton, Ontario, Canada.; Pediatrics, McMaster University, Hamilton, Ontario, Canada.; Stem Cell and Cancer Research Institute, McMaster University, Hamilton, Ontario, Canada.; McMaster University, Hamilton, Ontario, Canada., Fleming A; Pediatrics, McMaster University, Hamilton, Ontario, Canada.; McMaster University, Hamilton, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques [Can J Neurol Sci] 2019 Jul; Vol. 46 (4), pp. 403-414.
DOI:	10.1017/cjn.2019.39
Abstrakt:	Introduction: Children diagnosed with medulloblastoma (MB) who are refractory to upfront therapy or experience recurrence have very poor prognoses. Although phase I and phase II trials exist, these treatments bear significant treatment-related morbidity and mortality. Methods: A retrospective review of children diagnosed with a recurrence of MB from 2002 to 2015 at McMaster University was undertaken. Results: Recurrent disease in 10 patients involved leptomeningeal dissemination, with 3 experiencing local recurrence. In three recurrent patients the disease significantly progressed, and the children were palliated. The remaining 10 children underwent some form of salvage therapy, including surgical re-resection, radiation, and chemotherapy, either in isolation or in varying combinations. Of the 13 children experiencing treatment-refractory or recurrent disease, 4 are currently alive with a median follow-up of 38.5 months (75.5 months). Of the eight patients with molecular subgrouping data, none of the Wnt MB experienced recurrence. Conclusion: Recurrent MB carried a poor prognosis with a 5-year overall survival (OS) of 18.2% despite the administration of salvage therapy. The upfront therapy received, available treatment, and tolerability of the proposed salvage therapy resulted in significant heterogeneity in the treatment of our recurrent cohort.
Databáze:	MEDLINE
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