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[Medulloblastoma in childhood. Survival rates and functional results (author's transl)]
Insights
This study on pediatric medulloblastoma found that while radiotherapy improves survival rates, it significantly contributes to long-term neurodevelopmental deficits in children. Survivors often experience cognitive and behavioral impairments due to treatment.
Area of Science:
- Pediatric Oncology
- Neuro-oncology
- Radiation Oncology
Context:
- Medulloblastoma is a common malignant brain tumor in children.
- Treatment historically involved surgery and whole central nervous system radiotherapy.
- Long-term sequelae of treatment require careful evaluation.
Purpose:
- To assess the survival rates and long-term neurodevelopmental outcomes in children treated for medulloblastoma.
- To investigate the impact of whole central nervous system radiotherapy on cognitive and behavioral functions.
- To compare outcomes with a non-irradiated control group to determine radiotherapy's contribution to sequelae.
Summary:
- A series of 57 pediatric medulloblastoma cases treated between 1964-1976 were analyzed.
- Post-operative mortality was 10.5%, with 5-year survival at 46.6% overall, increasing to 50% with radiotherapy.
- Survivors frequently exhibited significant mental and behavioral disturbances, with 91% showing behavioral issues and 87% experiencing cognitive deficits.
Impact:
- Radiotherapy, while improving survival, is identified as a significant factor in the development of neurodevelopmental deficits in medulloblastoma survivors.
- Findings highlight the need for strategies to mitigate treatment-related neurotoxicity in pediatric brain tumor patients.
- The study underscores the critical balance between oncological outcomes and quality of life for long-term survivors.
Abstract:
The authors report on a series of 57 medulloblastomas operated upon in children from 1964 ot 1976. Among these children, 44 completed the treatment with radiotherapy of the whole central nervous system. The post-operative mortality rate in 10,5%. Postoperative death occurred mainly in infants or when the tumor involved the brain stem. The five years survival rate is 46,6% in the whole series. It raises up to 50% in the series of the patients who completed the treatment with radiotherapy. The study shows that the life of survivals is frequently impaired by mental or behavioural disturbances. I.Q. varies from 70 to 90 in 66% of the children; it is below 70 in 20%. Behavioural disturbances are found in 91% of cases, wrong space orientation, speech or writing disabilities in 87%. In order to evaluate the responsibility of ray therapy in the development of these sequelae, the results have been compared to those of a series of cerebellar astrocytomas surgically removed, but not irradiated. The comparison shows that radiotherapy is at least partially responsible for the mental and behavioural disturbances.