The Role of Chemotherapy in the Treatment of Adult Medulloblastoma

World Neurosurg. 2022 Jul:163:e435-e449. doi: 10.1016/j.wneu.2022.04.004. Epub 2022 Apr 6.

Abstract

Background: The role of chemotherapy (CT) in the treatment of adult patients with medulloblastoma (MB) is unclear. The aim of this study is to compare the survival difference between adult patients with MB treated with and without chemotherapy.

Methods: Data were derived from the SEER (Surveillance Epidemiology and End Results) database from 2010 to 2018. The Kaplan-Meier method with log-rank tests, univariate and multivariate Cox proportional hazard analyses, and propensity score matching (PSM) were used to investigate the association between chemotherapy and survival. We further conducted an exploratory subgroup analysis. The outcomes of interest were cancer-specific survival (CSS) and overall survival (OS).

Results: We included 333 patients in this study, with 227 patients in the CT cohort and 106 in the nonchemotherapy cohort. The median follow-up time and the median age of the study population were 61 months and 30 years, respectively. The 5-year CSS of the CT cohort was superior to the nonchemotherapy cohort, whereas the 5-year OS was not. Kaplan-Meier curves after PSM supported the survival benefit of CT on CSS but not on OS. In the multivariate analysis after PSM, CT was the only prognostic factor for CSS, whereas there were no independent prognostic factors for OS. The survival of patients receiving CT who were diagnosed between 2010 and 2018 was better than that of previous patients. The subgroup analysis showed that there were interaction effects between CT and sex.

Conclusions: CT improved CSS for adult patients with MB. With therapeutic advances, adult patients with MB might benefit from the use of CT.

Keywords: Adult medulloblastoma; Cancer-specific survival; Chemotherapy; Overall survival; Propensity score matching; SEER database.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cerebellar Neoplasms* / drug therapy
  • Humans
  • Medulloblastoma* / drug therapy
  • Prognosis
  • Propensity Score
  • SEER Program