Meta of classical chemotherapy compared with high-dose chemotherapy and autologous stem cell rescue in newly diagnosed medulloblastoma after radiotherapy. Issue 30 (29th July 2022)

• Record Type: Journal Article
• Authors: Zhang, Mengting; Liu, Chunmei; Zhou, Huandi; Wang, Wenyan; Wang, Lixin; Shi, Baojun; Xue, Xiaoying
• Is Part Of: Medicine. Volume 101:Issue 30(2022)
• Page Start: e29372
• Publication Date: 2022-07-29
• Subjects: autologous stem cell rescue -- high-dose chemotherapy -- medulloblastoma -- OS -- PFS; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000029372
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Background: High-dose chemotherapy combined with autologous stem cell rescue (HDCT + ASCR) has been used to treat newly diagnosed medulloblastoma, but there was no high-level evidence to support its efficacy. Methods: Databases were retrieved, and patients were divided into 2 groups: group A was radiotherapy combined with HCDT + ASCR, and group B was classical radiotherapy and chemotherapy. The clinical benefit rate, progression-free survival (PFS), overall survival (OS) and toxicities data were extracted. Results: 22 clinical trials met the inclusion criteria, 416 in group A and 2331 in group B. There was no difference in CBR between 2 groups (80.0% vs 71.5%, P .262). The 3-year PFS (3-y PFS) of group A was significantly better than group B (79.0% vs 69.5%, P = .004). The analysis found that there was no difference between the 2 groups of the standard risk group or the high-risk group. In the standard risk group, the 5-y PFS of group A was significantly better than group B (83.6% vs75.6%, P = .004). Comparison of 3-y OS and 5-y OS between 2 groups of all MB patients showed no difference ( P = .086; P = .507), stratified analysis was the same result. The gastrointestinal toxicity in group A was significantly higher than that in group B ( P = .016), and the level 3/4 ototoxicity in high-risk group A was higher than that in group B ( P = .001). Conclusions: HDCT + ASCR can prolong 3-year PFS significantly, and prolong 5-y PFS significantly in the standard risk group, but increase gastrointestinal toxicity significantly for newly diagnosed medulloblastoma.