Publication

Abstract : Background/Objectives: Treatment outcomes for medulloblastoma with optimal therapy (surgery, radiation and chemotherapy) have led to 5‐year overall survival (OS) rates in developed countries of 80% and 60% for standard and high risk disease, respectively. In resource limited settings, similar outcomes are possible and new challenges include follow‐up of treatment related side effects. This study assessed the outcomes of medulloblastoma in a tertiary care setting and follow‐up of these patients. Design/Methods: A total of 36 cases of medulloblastoma below 18 years were treated on POG9031 or CCG9921 between January 2005 and January 2015. Patients were classified as standard risk or high risk disease based on modified Chang criteria. The prognostic value of age, sex, risk category, histopathological variants was assessed by univariate analysis using the log‐rank test. Nonparametric OS curves were computed using the Kaplan‐Meier estimates, and the log‐rank test was used to compare survival according to histologic subtype. Results: A total of 27 cases were eligible for analysis. The median age of diagnosis was 8 years and median follow‐up was 24 months. The 5‐year OS and 95% confidence interval was 90% (95% CI: 47‐99%) and 60% (95% CI:13‐88%) for standard risk and high‐risk disease, respectively. 17 (63%) cases had regular follow‐up with a medical provider post completion of therapy, 8 (33%) cases were documented to have mild cognitive decline, though no formal testing had been done.10 cases (40%) were regularly followed for endocrine sequelae, of which 2 cases (7%) had a diagnosed growth hormone deficiency. Conclusions: Based on our institutional data, we found that our medulloblastoma outcomes were similar to what has been reported in developed countries. However new challenges exist in the follow‐up and management of treatment related side effects in these patients. This underlies the current need for multi‐disciplinary follow‐up and care of this ever‐growing population of cancer survivors.