Survival of children under 3 years old with medulloblastoma: a study from the Mexican Cooperative Group for Childhood Malignancies (AMOHP).
BACKGROUND
The prognosis of medulloblastoma in children under 3 years of age is poor.


METHODS
A retrospective analysis was performed to evaluate children under 3 years of age with medulloblastoma. Overall survival (OS) and progression-free survival (PFS) were assessed in children with and without metastasis.


RESULTS
A total of 534 children were diagnosed with medulloblastoma during the study period, 49 (9.1%) of whom were under 3 years of age and were evaluated. Their ages ranged from 5 to 35 months with a mean of 18.5 months. In 39 (79.6%) of these patients the tumors were staged as T3M0 or under, while 10 (20.4%) had metastasis at diagnosis. The OS was 38% and PFS 37% in the whole series, while PFS was 32% in those with metastasis and 40% in those without ( P=0.78). For those who received radiotherapy the PFS was 62%, and in those not treated with radiotherapy PFS was nil ( P=0.0001). When the children were divided into those who received surgical treatment plus chemotherapy and those who received surgery plus radiotherapy plus chemotherapy, the PFS was nil and 66%, respectively ( P=0.00001).


CONCLUSIONS
Because of the high morbidity of radiotherapy in children under 3 years old, surgery continues to be the basis of improved prognosis, followed by chemotherapy.
Rivera-Luna
Roberto
R
Department of Oncology, Instituto Nacional de Pediatria, Insurgentes Sur 3700-C, Mexico, D.F. Mexico 04530. riveraluna@infosel.net.mx
López
Enrique
E
Rivera-Marquez
Hugo
H
Rivera-Ortegón
Francisco
F
Altamirano-Alvarez
Eduardo
E
Mercado
Gabriela
G
Covarrubias
Gilberto
G
Rueda-Franco
Fernando
F
Marhx-Bracho
Alfonso
A
Gutiérrez
Pedro
P
D000970:Antineoplastic Agents / Q000627:therapeutic use; D002528:Cerebellar Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery*; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003388:Cranial Fossa, Posterior; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008527:Medulloblastoma / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery*; D019635:Neurosurgical Procedures; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
D000970:Antineoplastic Agents