Treatment outcome in medulloblastoma with the POG 9031 protocol : a single institution review

Background

The aim of the present study was to identify the various clinicopathological features and treatment outcome of cases of medulloblastoma who had received concurrent Chemoradiotherapy post operatively and treated as per the POG 9031 protocol at a tertiary care centre.

Methods

Medical records were reviewed to identify patients of Medulloblastoma who were treated between January 2005 and January 2015 at our centre. Data was gathered on demographics, clinical presentation, tumor characteristics, chemotherapy & radiotherapy protocols, adverse events and survival. The Chang-Harisiadis system was used for staging. Patients were classified as either poor risk (T3b-4, M1 or > 1.5 cm²residual tumor) or standard risk disease (T1-3a, M0 and

Results

A total of 31 patients were included in the study. Seventy one percent of our patients (22/31) were in the Standard risk group. The median age of the study population was 9 years The treatment protocol followed was Surgery followed by Craniospinal Irradiation followed by Chemotherapy as per the POG9031 protocol. Of the 31 patients who underwent Surgery, 27 had a Gross total resection. In the cohort, only 2 patients had severe toxicities necessitating withdrawal of treatment. Fifteen patients (48%) were found to have some cognitive decline on follow up. The median follow-up period was 48 months (12 –108 months) . The 5 year survival calculated from the Kaplan Meier curve was 74 %. Parameters like Age, sex, size of the lesion, Ki67 and Histopathological variant had no significant impact on the survival outcome, however a significant correlation was seen with the risk status (Median PFS 30 months vs 12 months in the standard risk and poor risk respectively).

Conclusions

Based on our data, we found that our schedule of medulloblastoma treatment was well tolerated. The 5 year survival of 70% seen with our treatment schedule is at par with that seen in existing literature. The neurocognitive decline seen in 48% of our patients is in keeping with existing dat.a

Clinical trial identification

Legal entity responsible for the study

Amrita Institute of Medical sciences

Funding

Amrita Institute of Medical Sciences

Disclosure

All authors have declared no conflicts of interest.