Shi Xuejiao, Sun Xiaoyang, Fan Wenqi, Dai Xuan, Jiang Mawei
Department of Oncology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, P. R. China.
Radiat Oncol. 2025 Apr 11;20(1):52. doi: 10.1186/s13014-025-02632-9.
This study aimed to determine the clinical impact of radiation response on survival in patients with medulloblastoma (MB) and to explore the predictive factor of radiation response.
Data from 170 pediatric patients with MB and residual disease or metastasis before radiotherapy (RT) were analyzed.
The median follow-up period was 5.2 years. A total of 74 (43.5%) patients achieved CR, 85 (50.0%) patients achieved PR, 8 (4.7%) patients had SD, and 3 (1.8%) patients developed PD after RT. The five-year post-RT progression-free (prtPFS) and overall survival (prtOS) were superior in patients who achieved CR compared to those who did not (prtPFS: 67% ± 6% vs. 42% ± 6%, P < 0.001; prtOS: 82% ± 5% vs. 44% ± 6%, P < 0.001). Multivariable logistic regression analysis showed that residual disease site was the predictive factor for radiation response, patients who had residual disease in both the brain and spinal cord before RT had higher non-CR rate (OR: 7.312, 95%CI 3.375-15.845, P < 0.001). Multivariate Cox analysis revealed that radiation response and large cell/anaplastic subtype were independent prognostic factors for survival (P < 0.05).
Radiation response was an independent prognostic factor for survival in patients with MB. Patients who did not achieve CR after RT should receive intensified adjuvant chemotherapy to improve survival.
本研究旨在确定放疗反应对髓母细胞瘤（MB）患者生存的临床影响，并探索放疗反应的预测因素。
分析了170例放疗（RT）前有MB且伴有残留疾病或转移的儿科患者的数据。
中位随访期为5.2年。放疗后，共有74例（43.5%）患者达到完全缓解（CR），85例（50.0%）患者达到部分缓解（PR），8例（4.7%）患者病情稳定（SD），3例（1.8%）患者疾病进展（PD）。达到CR的患者放疗后五年无进展生存期（prtPFS）和总生存期（prtOS）优于未达到CR的患者（prtPFS：67%±6%对42%±6%，P<0.001；prtOS：82%±5%对44%±6%，P<0.001）。多变量逻辑回归分析显示，残留疾病部位是放疗反应的预测因素，放疗前脑和脊髓均有残留疾病的患者非CR率较高（比值比：7.312，95%置信区间3.375-15.845，P<0.001）。多变量Cox分析显示，放疗反应和大细胞/间变性亚型是生存的独立预后因素（P<0.05）。
放疗反应是MB患者生存的独立预后因素。放疗后未达到CR的患者应接受强化辅助化疗以提高生存率。
