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World Journal of Pediatrics

, Volume 13, Issue 4, pp 367–373 | Cite as

Treatment of pediatric average-risk medulloblastoma using craniospinal irradiation less than 2500 cGy and chemotherapy: single center experience in Korea

  • Jong Hyung Yoon
  • Kyung Duk Park
  • Hyoung Jin Kang
  • Hyery Kim
  • Ji Won Lee
  • Seung-Ki Kim
  • Kyu-Chang Wang
  • Sung-Hye Park
  • Il Han Kim
  • Hee Young ShinEmail author
Original Article

Abstract

Background

Although craniospinal irradiation (CSI) of 2340 cGy plus tumor booster with chemotherapy have been established as a standard treatment of childhood average-risk (AvR) medulloblastoma (MBL) in Western counties, there are a few recent reports in outcomes of AvR MBL using this strategy in Korean and other Asian children. We investigated the outcome of the Korean children with AvR MBL who were treated with CSI <2500 cGy and chemotherapy.

Methods

Between January 2001 and December 2010, clinical characteristics and outcomes of 42 patients who were diagnosed with AvR MBL postoperatively and treated with radiation including CSI <2500 cGy and chemotherapy in Seoul National University Children’s Hospital were analyzed.

Results

Their median age was 9 years (range: 3–18.8), and 29 were male. Histological subtypes were classic type in 28 patients, nodular/desmoplastic in 7, and large cell/anaplastic (LCA) in 7. All the patients received adjuvant radiotherapy (CSI with median 2340 cGy and booster) and multiagent chemotherapy as the first-line treatment. With a median follow-up of 54 months, 12 patients experienced relapse or progression of the tumor. The 3- and 5-year disease-free survival (DFS) rates were 78.0%±6.5% and 75.0%±6.9%, respectively, and overall survival (OS) rates were 85.3%±5.6% and 76.8%±6.9%, respectively. The LCA subtype was associated with poorer DFS (P=0.023) and OS (P=0.008), compared with non-LCA subtypes.

Conclusions

The outcomes of children and adolescents with AvR MBL treated with radiation including CSI <2500 cGy and chemotherapy, are compatible to those in Western countries; however, the LCA subtype has a poor outcome with this strategy.

Key words

average-risk craniospinal irradiation medulloblastoma 

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Copyright information

© Children's Hospital, Zhejiang University School of Medicine and Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Jong Hyung Yoon
    • 1
    • 5
  • Kyung Duk Park
    • 1
  • Hyoung Jin Kang
    • 1
  • Hyery Kim
    • 1
  • Ji Won Lee
    • 1
  • Seung-Ki Kim
    • 2
  • Kyu-Chang Wang
    • 2
  • Sung-Hye Park
    • 3
  • Il Han Kim
    • 4
  • Hee Young Shin
    • 1
    • 6
    Email author
  1. 1.Department of PediatricsCancer Research InstituteNew YorkUSA
  2. 2.Department of NeurosurgerySeoul National University College of MedicineSeoulKorea
  3. 3.Department of PathologySeoul National University College of MedicineSeoulKorea
  4. 4.Department of Radiation OncologySeoul National University College of MedicineSeoulKorea
  5. 5.Department of Pediatrics, Hallym University College of medicineChuncheon Sacred Heart HospitalChuncheonKorea
  6. 6.Division of Hematology/Oncology, Department of Pediatrics, Seoul National University College of MedicineSeoul National University Children’s HospitalSeoulKorea

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