MBCL-02. ROLE OF PREOPERATIVE CHEMOTHERAPY IN METASTATIC MEDULLOBLASTOMA: A COMPARATIVE STUDY IN 92 CHILDREN. (4th December 2020)

• Record Type: Journal Article
• Authors: Guerrini-Rousseau, Léa; Abbas, Rachid; Huybrechts, Sophie; Kieffer-Renaux, Virginie; Puget, Stéphanie; Andreiuolo, Felipe; Beccaria, Kevin; Blauwblomme, Thomas; Bolle, Stéphanie; Dhermain, Frédéric; Longaud, Audrey; Roujeau, Thomas; Rose, Christian Sainte; Tauziede-Esperiat, Arnaud; Varlet, Pascale; Zerah, Michel; Valteau-Couanet, Dominique; Dufour, Christelle; Jacques, Grill
• Is Part Of: Neuro-oncology. Volume 22(2020)Supplement 3
• Page Start: iii387
• Page End: iii387
• Publication Date: 2020-12-04
• Subjects: Brain Neoplasms -- Periodicals; Brain -- Tumors -- Periodicals; Brain -- Cancer -- Periodicals; Nervous system -- Cancer -- Periodicals; 616.99481
• DOI: 10.1093/neuonc/noaa222.478
• Languages: English
• ISSNs: 1522-8517

Abstract

Abstract: BACKGROUND: Previous pilot studies have shown the feasibility of preoperative chemotherapy in patients with medulloblastoma, but benefits and risks compared with initial surgery have not been assessed. METHODS: Two therapeutic strategies were retrospectively compared in 92 patients with metastatic medulloblastoma treated at Gustave Roussy, France, between 2002 and 2015: surgery at diagnosis (n=54; group A) and surgery delayed after carboplatin and etoposide-based preoperative therapy (n=38; group B). Treatment strategies were similar in both groups. RESULTS: The rate of complete tumor excision was significantly higher in group B than in group A (93.3% versus 57.4%, p=0.0013). Post-operative complications, chemotherapy-associated side effects and local progressions were not increased in group B. Preoperative chemotherapy led to a decrease in the primary tumor size in all patients, 4/38 patients experiencing meanwhile a distant progression. The histological review of 19 matched tumor pairs (before and after chemotherapy) showed that proliferation was reduced and histological diagnosis feasible and accurate even after preoperative chemotherapy. The 5-year progression-free and overall survival rates were comparable between groups. Comparison of the longitudinal neuropsychological data showed that intellectual outcome tended to be better in group B (the mean predicted intellectual quotient value was 6 points higher throughout the follow-up). CONCLUSION: Preoperative chemotherapy is a safe and efficient strategy for metastatic medulloblastoma. It increases the rate of complete tumor excision and may improve the neuropsychological outcome without jeopardizing survival.