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000271966 041__ $$aEnglish
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000271966 1001_ $$00000-0002-3216-8452$$aObrecht-Sturm, Denise$$b0
000271966 245__ $$aTreatment response as surrogate to predict risk for disease progression in pediatric medulloblastoma with persistent magnetic resonance imaging lesions after first-line treatment.
000271966 260__ $$aOxford$$bOxford Univ. Press$$c2024
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000271966 520__ $$aThis study aims at clarifying the impact of persistent residual lesions following first-line treatment for pediatric medulloblastoma.Data on 84 pediatric patients with medulloblastoma and persistent residual lesions on centrally reviewed magnetic resonance imaging (MRI) at the end of first-line therapy were analyzed.Twenty patients (23.8%) had residual lesions in the tumor bed (R+/M0), 51 (60.7%) had distant lesions (R0/M+) and 13 (15.5%) had both (R+/M+). Overall response to first-line therapy was minor or partial (≥ 25% reduction, minor response [MR]/PR) for 64 (76.2%) and stable disease (SD) for 20 patients (23.8%). Five-year post-primary-treatment progression-free (pptPFS) and overall survival (pptOS) were superior after MR/PR (pptPFS: 62.5 ± 7.0%[MR/PR] vs. 35.9 ± 12.8%[SD], P = .03; pptOS: 79.7 ± 5.9[MR/PR] vs. 55.5 ± 13.9[SD], P = .04). Furthermore, R+/M + was associated with a higher risk for progression (5-year pptPFS: 22.9 ± 17.9%[R+, M+] vs. 72.4 ± 12.0%[R+, M0]; P = .03). Watch-and-wait was pursued in 58 patients, while n = 26 received additional treatments (chemotherapy only, n = 19; surgery only, n = 2; combined, n = 3; valproic acid, n = 2), and their outcomes were not superior to watch-and-wait (5-year pptPFS: 58.5 ± 7.7% vs. 51.6 ± 10.7% P = .71; 5-year pptOS: 76.3 ± 6.9% vs. 69.8 ± 9.7%, P = .74). For the whole cohort, 5-year pptPFS by molecular subgroup (58 cases) were WNT: 100%, SHH: 50.0 ± 35.4%, group-4, 52.5 ± 10.5, group-3 54.2 ± 13.8%; (P = .08).Overall response and extent of lesions can function as surrogate parameters to predict outcomes in pediatric MB patients with persistent lesions after first-line therapy. Especially in the case of solitary persistent medulloblastoma MRI lesions, additional therapy was not beneficial. Therefore, treatment response, extent/kind of residual lesions and further diagnostic information need consideration for indication of additional treatments for persisting lesions.
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000271966 650_7 $$2Other$$aMRI
000271966 650_7 $$2Other$$achildren
000271966 650_7 $$2Other$$amedulloblastoma
000271966 650_7 $$2Other$$apersistent residual disease
000271966 650_2 $$2MeSH$$aHumans
000271966 650_2 $$2MeSH$$aMedulloblastoma: diagnostic imaging
000271966 650_2 $$2MeSH$$aMedulloblastoma: pathology
000271966 650_2 $$2MeSH$$aMale
000271966 650_2 $$2MeSH$$aChild
000271966 650_2 $$2MeSH$$aFemale
000271966 650_2 $$2MeSH$$aMagnetic Resonance Imaging: methods
000271966 650_2 $$2MeSH$$aCerebellar Neoplasms: diagnostic imaging
000271966 650_2 $$2MeSH$$aCerebellar Neoplasms: pathology
000271966 650_2 $$2MeSH$$aDisease Progression
000271966 650_2 $$2MeSH$$aChild, Preschool
000271966 650_2 $$2MeSH$$aAdolescent
000271966 650_2 $$2MeSH$$aFollow-Up Studies
000271966 650_2 $$2MeSH$$aPrognosis
000271966 650_2 $$2MeSH$$aRetrospective Studies
000271966 650_2 $$2MeSH$$aSurvival Rate
000271966 650_2 $$2MeSH$$aInfant
000271966 650_2 $$2MeSH$$aNeoplasm, Residual: diagnostic imaging
000271966 650_2 $$2MeSH$$aNeoplasm, Residual: pathology
000271966 7001_ $$aSchömig, Lena$$b1
000271966 7001_ $$00000-0003-3302-2719$$aMynarek, Martin$$b2
000271966 7001_ $$aBison, Brigitte$$b3
000271966 7001_ $$aSchwarz, Rudolf$$b4
000271966 7001_ $$0P:(DE-2719)2812617$$aPietsch, Torsten$$b5$$udzne
000271966 7001_ $$00000-0002-5447-5322$$aPfister, Stefan M$$b6
000271966 7001_ $$aSill, Martin$$b7
000271966 7001_ $$aSturm, Dominik$$b8
000271966 7001_ $$00000-0001-5441-1962$$aSahm, Felix$$b9
000271966 7001_ $$aKortmann, Rolf-Dieter$$b10
000271966 7001_ $$aGerber, Nicolas U$$b11
000271966 7001_ $$avon Bueren, André O$$b12
000271966 7001_ $$aFleischhack, Gudrun$$b13
000271966 7001_ $$0P:(DE-2719)9000979$$aSchüller, Ulrich$$b14
000271966 7001_ $$aNussbaumer, Gunther$$b15
000271966 7001_ $$aBenesch, Martin$$b16
000271966 7001_ $$aRutkowski, Stefan$$b17
000271966 773__ $$0PERI:(DE-600)2094060-9$$a10.1093/neuonc/noae071$$gVol. 26, no. 9, p. 1712 - 1722$$n9$$p1712 - 1722$$tNeuro-Oncology$$v26$$x1522-8517$$y2024
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