Long-term outcomes by clinical and molecular risk stratification in patients with medulloblastoma receiving risk-adapted therapy - PubMed
5 hours ago
- #risk stratification
- #medulloblastoma
- #radiotherapy
- Risk stratification for medulloblastoma increasingly uses molecular classification, but real-world evidence is limited.
- A global database (Chinese cohort: 729; international: 494) was analyzed for survival outcomes using clinical and molecular data.
- Clinical risk stratification was effective, but metastatic stage alone failed to stratify survival across molecular subgroups.
- Average-risk group had better 5-year OS (84.4%) and PFS (77.5%) compared to high-risk group (77.2% and 68.2%).
- Key genetic events (e.g., TP53 mutation, MYC amplification) were strongly linked to survival, and combining them with clinical features improved prognostic discrimination.
- Radiotherapy dose effects were context-dependent; no significant OS/PFS difference was seen between 30.6 and 36.0 Gy CSI in high-risk SHH, group_3, and group_4 patients receiving chemotherapy.
- 36.0 Gy CSI was warranted for aggressive MYC-amplified group_3 medulloblastoma, even without dissemination.