A retrospective analysis of surgery combined with radiotherapy or surgery combined with radiotherapy plus chemotherapy for medulloblastoma patients / 中华神经医学杂志

ABSTRACT

Objective To compare the survival benefit of surgery combined with radiotherapy or surgery combined with radiotherapy plus chemotherapy for medulloblastoma patients,to analyze the related prognostic factors.Methods The clinical data of 79 patients with medulloblastoma,admitted to our hospital from June 2002 to January 2014,were retrospectively analyzed; the 5-year overall survival and event-free survival of patients accepted surgery combined with radiotherapy or surgery combined with radiotherapy plus chemotherapy were compared; Cox regression model was used to analyze the related prognostic factors.Results Totally,74 patients accepted total removal and 5 subtotal removal;after the surgery,radiotherapy only was performed in 41 patients and radiotherapy plus chemotherapy in 38.The overall survival (73.2％ vs.81.6％) and event-free survival (65.9％ vs.76.3％) showed no significant differences between patients receiving radiotherapy and patients receiving radiotherapy plus chemotherapy after surgery (P＞0.05).The 5-year overall survival in patients with residual tumor or recurrence and patients classified as high risk population was significantly lower than that in patients without residual tumor or recurrence and patients not classified as high risk population (P＜0.05); The Cox regression analysis showed that the high risk population (RR=22.461,P=0.038) and recurrence/metastasis (RR=65.547,P=0.000) are independent risk factors influencing the prognosis of medulloblastoma.Conclusions Surgical resection plus postsurgical radiotherapy acts as the first choice for treatment of medulloblastoma.Patients classified as high risk population and patients with recurrence/metastasis have poor prognosis.