M1 Medulloblastoma: high risk at any age
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- Sanders, R.P., Onar, A., Boyett, J.M. et al. J Neurooncol (2008) 90: 351. doi:10.1007/s11060-008-9671-9
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Background: The prognosis for children with M1 medulloblastoma (positive CSF cytology) has not been well-defined. Methods: We retrospectively reviewed the records of 285 newly diagnosed medulloblastoma patients treated between 1984 and 2006. Older children received post-operative craniospinal and tumor bed irradiation; radiotherapy for younger children depended on treatment era and physician/family preference. Results: 55 patients were <3 years old and 230 patients were ≥ 3 years old at diagnosis. We detected significant (P < 0.0001) associations between M1 disease and EFS for the entire cohort and for both younger and older patients. Among younger children, M1 patients had lower EFS than M0 (P = 0.0044). Conclusions: Children <3 years old with M1 medulloblastoma fared poorly in our small series. Survival for older children with M1 disease treated with higher-dose CSI was better than that of M2/M3 patients, but still less than optimal; our findings do not support reduction in therapy for either cohort.