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Management and outcomes of treating pediatric medulloblastoma: an eight years’ experience in an Iranian pediatric center

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Abstract

Purpose

The clinical management of pediatric medulloblastoma requires a multidisciplinary approach, which can be challenging, especially in low- and middle-income countries. The aim of this study was to identify current challenges and describe the treatment and outcomes of Iranian pediatric patients with medulloblastoma who were referred to our center in Tehran, Iran.

Methods

Our retrospective review included 126 patient records from April 2007 to May 2015. The records were analyzed for epidemiologic features, treatment modalities, overall survival, and progression-free survival. Data were analyzed using SPSS 22.0 software.

Results

Median age at diagnosis was 6 years (male:female ratio, 2.3:1). At the time of diagnosis, 7 patients were 2 years or younger, and 76 (60.3%) were categorized as having high-risk disease. Overall, 100 patients had gross or near-total surgical resection. Cerebral spinal fluid involvement was detected in 22.2% of the patients tested, and spinal involvement was detected in 25% of the patients who underwent spinal MRI. Metastasis stages at the time of diagnosis were as follows: M0: 48.4% patients, M1: 16.7%, M2: 5.5%, and M3: 21.4%. Median times of follow-up and progression-free survival were 16 and 12 months, respectively. Probability of 7-year overall survival and progression-free survival were 59 and 53.8%, respectively.

Conclusions

Results of the current retrospective study emphasize the need for implementing measures to improve outcome for our patients with medulloblastoma. Such measures include a multidisciplinary approach, unified national treatment guidelines, better disease and metastasis staging, twinning initiatives, and seeking a second opinion when needed.

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Author information

Authors and Affiliations

  1. MAHAK Pediatric Cancer Treatment and Research Center, Tehran, Iran

    Azim Mehrvar, Maryam Tashvighi, Amir Abbas Hedayati Asl, Naghmeh Niktoreh-Mofrad, Negar Afsar, Ali Naderi, Mardawig Allebouyeh & Mohammad Faranoush

  2. AJA University of Medical Sciences, Tehran, Iran

    Azim Mehrvar

  3. Islamic Azad University of Medical Sciences, Qom, Iran

    Maryam Tashvighi

  4. Department of Pediatric Hematology and Oncology, University Children’s Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany

    Naghmeh Niktoreh-Mofrad

  5. Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Narjes Mehrvar

  6. Department of Global Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Ibrahim Qaddoumi

  7. Pediatric Growth and Development Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran

    Mohammad Faranoush

Authors
  1. Azim Mehrvar
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Contributions

Concept and design: A. Mehrvar, N. Niktoreh-Mofrad.

Assembly of data and statistical analysis: N. Niktoreh-Mofrad.

Manuscript writing: N. Niktoreh-Mofrad, A. Mehrvar.

Manuscript revision: N. Niktoreh-Mofrad, I. Qaddoumi, N. Mehrvar.

Provision and follow-up of patients: A. Mehrvar, M. Tashvighi, A.A. HedayatiAsl, M. Faranoush, M. Alebouyeh, N. Afsar, A. Naderi, N. Niktoreh-Mofrad.

Corresponding author

Correspondence to Naghmeh Niktoreh-Mofrad.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Mehrvar, A., Tashvighi, M., Hedayati Asl, A.A. et al. Management and outcomes of treating pediatric medulloblastoma: an eight years’ experience in an Iranian pediatric center. Childs Nerv Syst 34, 639–647 (2018). https://doi.org/10.1007/s00381-017-3672-y

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