Molecular characterization of long-term survivors of metastatic medulloblastoma treated with reduced-dose craniospinal irradiation.

Autor: Irikura T; Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan., Fukuoka K; Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan. kohfukuoka@gmail.com., Nakazawa A; Department of Clinical Research, Saitama Children's Medical Center, Saitama, Japan., Ichimura K; Department of Brain Disease Translational Research, Faculty of Medicine, Juntendo University, Tokyo, Japan., Kurihara J; Department of Neurosurgery, Saitama Children's Medical Center, Saitama, Japan., Koh K; Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan.
Jazyk: angličtina
Zdroj: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery [Childs Nerv Syst] 2023 Sep; Vol. 39 (9), pp. 2505-2507. Date of Electronic Publication: 2023 Apr 25.
DOI: 10.1007/s00381-023-05971-8
Abstrakt: Background and Aims: Current standard treatment for metastatic medulloblastoma consists of 36 Gray (Gy) of craniospinal irradiation (CSI) supplemented with local irradiation and adjuvant chemotherapy after surgery. Although contemporary protocols have been designed to limit a radiation dose using risk-adapted CSI dosing to reduce neurocognitive morbidity, high-dose CSI remains the standard of care. Recently, the molecular classification of medulloblastoma has been emerging but its clinical significance has not been established particularly in patients with metastatic medulloblastoma treated with lower dose of CSI.
Methods: We molecularly analyzed three cases of metastatic medulloblastoma treated with 24.0 Gy of CSI by DNA methylation analysis using the Illumina EPIC array.
Results: All three patients had spinal metastases at the time of diagnosis. Postoperative treatment included multiple courses of chemotherapy, 24 Gy of CSI with focal boost to primary and metastatic sites, and high-dose chemotherapy. There was no disease progression observed during the 9.0, 7.7, and 5.7　years post-diagnosis follow-up. The molecular diagnosis was Group 3/4 in all three cases. Cases 1 and 2 belonged to Subtypes 7 and 4, both of which were reported to be good prognostic subtypes among the group. Case 3 belonged to Subtype 5 with MYC amplification.
Conclusions: The present cases suggest that the novel subtype classification in Group 3/4 medulloblastoma may be useful for risk stratification of patients with metastatic medulloblastoma who received lower dose of CSI than standard treatment.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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