Prognostic factors and secondary malignancies in childhood medulloblastoma

T. Stavrou, C. M. Bromley, H. S. Nicholson, J. Byrne, R. J. Packer, A. M. Goldstein, G. H. Reaman

Research output: Contribution to journalArticle

80 Scopus citations

Abstract

Purpose: Little is known of the outcome of long-term survivors of childhood medulloblastoma, one of the most common pediatric malignancies. To determine the potential for secondary malignancies, a retrospective outcome evaluation in 88 consecutive cases of childhood medulloblastoma was performed. Patients and Methods: The records of all patients with childhood medulloblastoma diagnosed at Children's National Medical Center in Washington, DC from 1969 through 1997 were reviewed. Results: The median follow-up time was 92 months (range 6-257 months). Overall survival was 59% at 5 years and 52% at 10 years. Univariate analysis showed that age at diagnosis, extent of surgical resection, presence of metastatic disease (M stage), ventriculoperitoneal shunt placement within 30 days from diagnosis, posterior fossa radiation therapy dose, and adjuvant chemotherapy significantly affected survival. Although based on small numbers, the risk of second neoplasms was significantly increased in this cohort. Multiple basal cell carcinomas developed in the areas of radiation therapy in two patients; these patients also had nevoid basal cell carcinoma syndrome (NBCCS) diagnosed. One other patient died of glioblastoma multiforme 8 years after treatment of medulloblastoma. A meningioma developed in another patient 10 years after radiation therapy. Conclusion: As survival of medulloblastoma patients improves, increased surveillance regarding secondary malignancies is required, especially because radiation-induced tumors may occur many years after treatment. These two cases of NBCCS also illustrate the importance of considering the concomitant diagnosis of NBCCS in young patients with medulloblastoma. In those patients, alternative therapy should be considered to minimize radiation therapy-related sequelae.

Original languageEnglish (US)
Pages (from-to)431-436
Number of pages6
JournalJournal of Pediatric Hematology/Oncology
Volume23
Issue number7
DOIs
StatePublished - 2001
Externally publishedYes

Keywords

  • Medulloblastoma
  • Nevoid basal cell carcinoma syndrome
  • Prognostic factors
  • Secondary malignancies

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Oncology
  • Hematology

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    Stavrou, T., Bromley, C. M., Nicholson, H. S., Byrne, J., Packer, R. J., Goldstein, A. M., & Reaman, G. H. (2001). Prognostic factors and secondary malignancies in childhood medulloblastoma. Journal of Pediatric Hematology/Oncology, 23(7), 431-436. https://doi.org/10.1097/00043426-200110000-00008