Korean J Pediatr Hematol Oncol.
2000 Oct;7(2):249-255.
Survival Rates and Prognostic Factors in Childhood Medulloblastoma and Supratentorial Primitive Neuroectodermal Tumor
- Affiliations
-
- 1Department of Pediatrics, Seoul National University, College of Medicine, Seoul, Korea. hyshin@plaza.snu.ac.kr
- 2Department of Clinical Pathology, Seoul National University, College of Medicine, Seoul, Korea.
- 3Department of Pathology, Seoul National University, College of Medicine, Seoul, Korea.
- 4Department of Neurosurgery, Seoul National University, College of Medicine, Seoul, Korea.
- 5Department of Therapeutic Radiology, Seoul National University, College of Medicine, Seoul, Korea.
- 6Department of Pediatrics, Radiology, Seoul National University, College of Medicine, Seoul, Korea.
Abstract
- PURPOSE: Children under 3 years old with medulloblastoma (MB) or supratentorial primitive neuroectodermal tumor (SPNET) have a poor prognosis. They are more susceptible to the deleterious effects of craniospinal radiation (CSR). This study was undertaken to determine the survival rates and prognostic factors of currently used treatment.
METHPDS: Retrospective review of 19 children (MB 16, SPNET 3) who were newly diagnosed as MB or SPNET at Seoul National University Children's Hospital from April 1996 to August 2000 was done. Eligible Patients were treated with postoperative induction chemotherapy using Children's Cancer Group (CCG) 9921A or 9931. Patients over 3 year of age received CSR as well.
RESULTS
Three Patients with SPNET are all alive without disease. However, 6 patients under 3 years old at diagnosis with MB were all dead whereas only one patient had an event among 10 patients over 3 years old at diagnosis. Among patients with MB, age under 3 years at diagnosis or residual tumors after induction chemotherapy correlated with poor outcome. Metastasis at diagnosis, postoperative residual disease or extent of excision did not have a significant effect on survival statistically. Three-year event-free survival (EFS) of patients with MB was 53%. Three-year EFS of patients over 3 years old at diagnosis with MB was 85.7% and 1-year EFS of under 3 years old at diagnosis with MB was 16.7%.
CONCLUSION
The combined use of chemotherapy and CSR in the treatment of MB and SPNET improved survival in children over 3 years old, whereas any treatment failed to improve survival in children under 3 years old. So, there's a need for a new treatment modality to improve survival of children under 3 year of age.
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