Peer-reviewed article
LINC-31. TREATMENT OUTCOME IN CHILDREN WITH MEDULLOBLASTOMA IN MEDIUM-INCOME COUNTRY: AN EXPERIENCE FROM A SINGLE TERTIARY CENTRE IN KUALA LUMPUR, MALAYSIA
Loh C, Alias H, Lau D ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study reviewed treatment outcomes for 31 children with medulloblastoma (the most common malignant brain tumour in children) treated at a hospital in Kuala Lumpur, Malaysia between 2000 and 2017. Children received chemotherapy and cranio-spinal radiation according to international protocols. Three-year survival was 69.6%, but 35.5% of patients abandoned treatment before completion, and survivors faced serious complications including learning difficulties and secondary cancers.
Key points
- Medulloblastoma comprised 30% of all brain tumour cases in the cohort (31 out of 103 cases)
- Mean age at presentation was 7.6 years, with male to female ratio of 2:1
- High treatment abandonment rate of 35.5% (11 out of 31 patients) occurred during treatment
- Three-year overall survival was 69.6% and event-free survival was 74.8%
- Among survivors, severe complications included learning difficulties and secondary malignancies (meningioma and thyroid carcinoma) at average 15.5 years post-diagnosis
Limitations
This is a retrospective study from a single centre without molecular subtyping of tumours, which limits generalisability and prevents comparison of outcomes by tumour biology. The high treatment abandonment rate means the reported survival figures may not reflect the full impact of available treatments for the eligible population.
Abstract
Abstract INTRODUCTION Medulloblastoma is the most common malignant brain tumour in children. The overall outcome has improved however, this was not translated to developing nations. METHOD This was a retrospective review of patients from January 2000 to December 2017. Treatment was given using modified SIOP PNET 4 protocol: cranio spinal irradiation (CSI), a total of 54G with vincristine followed by 8 cycles of adjuvant chemotherapy. Prior to year 2007, patients had CSI with or without adjuvant chemotherapy. Those <3 years old received modified UKCCSG/SIOP CNS protocol with 2 weekly chemotherapy for a duration of 392 days followed by CSI when required. All patients had MRI brain and spine, and tissue histopathological examination but without molecular subtype. RESULTS Medulloblastoma comprised of 30% (n=31) out of total 103 brain tumour cases. Mean age at presentation was 7.6 years old (SD 4.4) with male to female ratio of 2:1. Average time of symptoms was 4.8 weeks. Majority, 77.4% was high risk and 19.4% was standard risk. There was high treatment abandonment rate (35.5%, n=11). Three patients returned and completed treatment after multiple surgeries in an average of 9 months. Three years OS and EF were 69.6% and 74.8%, respectively. Six patients aged < 3years; half had advance disease on palliative care post surgery. Other survivors had severe learning difficulty and two had second malignancy (meningioma and thyroid carcinoma) at average 15.5 years after diagnosis. CONCLUSION Strategy to reduce treatment abandonment is crucial. Moreover, multidisciplinary management and molecular stratification are important in improving the outcome.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Modified SIOP PNET 4 protocol comprising cranio-spinal irradiation (54Gy) with vincristine followed by 8 cycles of adjuvant chemotherapy; children under 3 years received modified UKCCSG/SIOP CNS protocol with 2 weekly chemotherapy for 392 days followed by CSI when required
- Population
- 31 children (mean age 7.6 years, range implied under 18) with medulloblastoma treated at a tertiary centre in Kuala Lumpur, Malaysia between 2000-2017
Key finding
Three-year overall survival was 69.6% (no denominator given for calculation)