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Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
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Re-irradiation in Children With Recurrent Medulloblastoma.

Ayça İribaş Çelik1, Kübra Özkaya Toraman2, Rejin Kebudi3

  • 1Faculty of Medicine, Department of Radiation Oncology, Istanbul University, Istanbul, Turkey.

Pediatric Blood & Cancer
|August 12, 2025
PubMed
Summary

Re-irradiation may prolong survival in pediatric patients with recurrent medulloblastoma. This study found that re-irradiation, combined with chemotherapy, improved outcomes for some patients with relapsed medulloblastoma.

Keywords:
childrencraniospinalmedulloblastomarecurrencere‐irradiation

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Area of Science:

  • Pediatric Oncology
  • Radiation Oncology
  • Neuro-Oncology

Background:

  • Medulloblastoma recurrence presents a significant challenge for improving patient survival rates.
  • Salvage treatment options for recurrent medulloblastoma are limited, with tumor control remaining difficult.
  • Re-irradiation is a potential strategy for recurrent brain tumors, but its efficacy in medulloblastoma requires further investigation.

Purpose of the Study:

  • To evaluate the effectiveness of re-irradiation in pediatric and adolescent patients with recurrent medulloblastoma.
  • To assess survival outcomes, including progression-free survival (PFS) and overall survival (OS), following re-irradiation.
  • To analyze factors influencing survival and evaluate treatment-related toxicities.

Main Methods:

  • Retrospective analysis of pediatric and adolescent patients (≤18 years) diagnosed with medulloblastoma between 1990 and 2020 who received re-irradiation for recurrence.
  • Evaluation of patient and tumor characteristics, treatment details (including surgery, chemotherapy, and radiation techniques), PFS, OS, and acute/late treatment effects.
  • Univariable analysis to identify prognostic factors for survival after recurrence.

Main Results:

  • Twenty-seven patients with recurrent medulloblastoma received re-irradiation.
  • The 2- and 5-year PFS rates were 33% and 19%, respectively; 2- and 5-year OS rates were 44% and 24%, respectively.
  • Improved survival was associated with male gender, late relapse (>24 months), and post-re-irradiation chemotherapy. No significant survival difference was observed between focal irradiation and craniospinal irradiation (CSI).

Conclusions:

  • Re-irradiation can be a viable treatment option for recurrent medulloblastoma.
  • The findings suggest that re-irradiation may offer a survival benefit for selected patients.
  • Further research is warranted to optimize re-irradiation strategies and supportive care for recurrent medulloblastoma.