Prolongation of radiotherapy duration is associated with inferior overall survival in patients with pediatric medulloblastoma and central nervous system primitive neuroectodermal tumors

Sujith Baliga, Benjamin V.M. Bajaj, Rafi Kabarriti, Clemens Grassberger, Brooke Patteson, Beow Yeap, Jana L. Fox, Madhur K. Garg, Torunn I. Yock

Research output: Contribution to journalArticle

Abstract

Background: The importance of radiotherapy (RT) duration in medulloblastoma in the modern era of chemotherapy has not been well elucidated. The aim of this study was to determine the impact of RT treatment duration on overall survival (OS) in pediatric medulloblastoma and cenral nervous system neuroectodermal tumors (PNETs). Methods: The National Cancer Database (NCDB) was queried to identify patients with newly diagnosed medulloblastoma and CNS PNETs diagnosed between 2004 and 2014. Patients were excluded if they had extraneural metastasis, did not receive standard craniospinal irradiation dose, had a nonstandard total dose outside of 54 or 55.8 Gy, did not receive adjuvant chemotherapy, or if the RT duration was outside of the expected range of 37 to 80 days. The Kaplan-Meier estimator was used to estimate the association between RT duration (≤45 days or >45 days) and OS. Multivariate Cox regression was used to assess other confounders of OS. Results: Six-hundred twenty-five patients met inclusion criteria, of which 181 were assigned to the “RT long" (>45 days) cohort (29.0%) and 444 (71.0%) to the “RT short” group (≤45 days). The five-year OS for the “RT short” compared with “RT long” cohort was 82.2% versus 70.9%, respectively (log-rank, P < 0.0037). For average risk patients, the five-year OS was 84.6% versus 86.4% for “RT short” and “RT long,” respectively (log-rank, P = 0.40). However, for high-risk patients, five-year OS was 77.7% versus 51.0% (log-rank, P < 0.0001) in the “RT short” and “RT long” cohorts. Conclusion: For patients with high-risk medulloblastoma and CNS PNETs, RT duration >45 days was associated with inferior OS.

Original languageEnglish (US)
Article numbere28558
JournalPediatric Blood and Cancer
Volume67
Issue number10
DOIs
StateAccepted/In press - 2020

Keywords

  • PNET
  • RT duration
  • medulloblastoma

ASJC Scopus subject areas

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

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