3868 - Meta of classical chemotherapy compared with high-dose chemotherapy combined with autologous stem cell transplantation in newly diagnosed medulloblastoma patients after radiotherapy

Background

High-dose chemotherapy combined with autologous stem cell rescue (HDCT+ASCR) has been used to treat newly diagnosed medulloblastoma (MB), but there was no high-level evidence to support its efficacy.

Methods

Databases were retrieved, and patients were divided into two groups: group A was radiotherapy combined with HCDT+ASCR, and group B was classical radiotherapy and chemotherapy. The clinical benefit rate, progression-free survival (PFS), total survival (OS) and toxicities data were extracted.

Results

22 clinical trials met the inclusion criteria, 416 in group A and 2331 in group B. There was no difference in CBR between two groups (80.0% vs. 71.5%, P = 0.262). The 3-year PFS (3-y PFS) of group A was significantly better than group B (79.0% vs. 69.5%, P = 0.004). The analysis found that there was no difference between the two groups of the standard risk group or the high-risk group. In the standard risk group, the 5-y PFS of group A was significantly better than group B (83.6% vs.75.6%, P = 0.004). Comparison of 3-y OS and 5-y OS between two groups of all MB patients showed no difference (P = 0.086; P = 0.507), stratified analysis was the same result. The gastrointestinal toxicity in group A was significantly higher than that in group B (P = 0.016), and the level 3/4 ototoxicity in high-risk group A was higher than that in group B (P < 0.001).

Conclusions

HDCT+ASCR was not recommended for newly diagnosed high-risk MB patients. The clinical significance of HDCT+ASCR at the time of initiation in the standard risk group remains to be further explored.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The Second Hospital of Hebei Medical University.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.