Peer-reviewed article
LINC-28. EPIDEMIOLOGICAL CHARACTERISTICS AND SURVIVAL OUTCOMES OF CHILDREN WITH MEDULLOBLASTOMA TREATED AT THE NATIONAL CANCER INSTITUTE (INCA) IN RIO DE JANEIRO, BRAZIL
Oigman G, Osorio D, Stanek J, Finlay J, Vianna D et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined 126 children with medulloblastoma treated in Brazil between 1997 and 2016 to understand their survival outcomes and the factors affecting them. Overall survival was 69% for standard-risk patients and 53% for high-risk patients, lower than rates reported in high-income countries. The study found that socioeconomic factors, maternal education, and time to treatment initiation all significantly affected survival. The researchers conclude that addressing socioeconomic inequality alongside medical treatment is essential to improve outcomes for children with this cancer.
Key points
- Overall survival was 69% for standard-risk medulloblastoma patients and 53% for high-risk patients
- Patients who started radiation therapy within 42 days of surgery had better survival (70.6% versus 59.6%)
- Lower maternal education was associated with lower overall survival (49% versus 71.3%)
- 35% of patients presented with metastatic disease at admission
- 20% of families lived below the Brazilian minimum wage
Limitations
This is a retrospective chart review from a single institution over 20 years, which may not be representative of all children with medulloblastoma in Brazil or other LMICs. The study does not control for potential confounding variables in the statistical analyses of socioeconomic factors.
Abstract
Abstract BACKGROUND Medulloblastoma (MB), the most malignant brain tumor of childhood has survival outcomes exceeding 80% for standard risk and 60% for high risk patients in high-income countries (HIC). These results have not been replicated in low-to-middle income countries (LMIC), where 80% of children with cancer live. Brazil is an upper-middle income country according to World Bank, with features of LMIC and HIC. METHODS We conducted a retrospective review of 126 children (0–18 years) diagnosed with MB from 1997 to 2016 at INCA. Data on patients, disease characteristics and treatment information were retrieved from the charts and summarized descriptively; overall survival (OS) and event-free survival (EFS) were calculated using the Kaplan-Meier Method. RESULTS The male/female ratio was 1.42 and the median age at diagnosis was 7.9 years. Headache (79%) and nausea/vomiting (75%) were the most common presenting symptoms. The median time from onset of symptoms to surgery was 50 days. The OS for standard-risk patients was 69% and 53% for high-risk patients. Patients initiating radiation therapy within 42 days after surgery (70.6% versus 59.6% p=0.016) experienced better OS. Forty-five patients (35%) had metastatic disease at admission. Lower maternal education correlated with lower OS (71.3% versus 49% p=0.025). Patients who lived >40km from INCA fared better (OS= 68.2% versus 51.1% p=0.032). Almost 20% of families lived below the Brazilian minimum wage. CONCLUSIONS These findings suggest that socioeconomic factors, education, early diagnosis and continuous data collection, besides oncological treatment must be adressed to improve the survival of children with MB.