Influence of a child's sex on medulloblastoma outcome.
BACKGROUND
Aggressive treatment of medulloblastoma, the most common pediatric brain tumor, has not improved survival. Identifying better prognostic indicators may warrant less morbid therapy.


OBJECTIVE
To investigate the role of sex on outcome of medulloblastoma.


METHODS
Retrospective study of significant factors for survival with a median follow-up of 82 months.


METHODS
University medical center.


METHODS
A total of 109 consecutive, pediatric patients treated for primary medulloblastoma from 1970 to 1995 with surgery and postoperative radiotherapy and, after 1979, chemotherapy.


METHODS
Factors independently associated with survival.


RESULTS
The final multivariate model predicting improved survival included sex (hazard ratio, 0.52; 95% confidence interval [CI], 0.29-0.92; P=.03; favoring female), metastases at presentation (hazard ratio, 2.01; 95% CI, 1.14-3.52; P=.02), and extent of surgical resection (hazard ratio, 0.60; 95% CI, 0.34-1.04; P=.07; favoring greater resection). The overall, 5-year freedom from progression was 40% and survival was 49%. Radiotherapy dose (P=.72), and chemotherapy (P=.90) did not significantly affect a disease outcome.


CONCLUSIONS
The sex of the child was an important predictor for survival of medulloblastoma; girls had a much better outcome. The difference in survival between sexes should be evaluated in prospective, clinical trials.
Weil
M D
MD
Department of Radiation Oncology, University of California, San Francisco, USA. mweil@brown.uhcolorado.edu
Lamborn
K
K
Edwards
M S
MS
Wara
W M
WM
D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008527:Medulloblastoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012737:Sex Factors; D016019:Survival Analysis