Survivors of pediatric medulloblastoma have an increased risk of morbidity and mortality, compared with the general population, according to a study presented at the 20th International Symposium on Pediatric Neuro-Oncology (ISPNO).
The study revealed increased risks of stroke, severe hearing loss, and other adverse outcomes among long-term medulloblastoma survivors.
For this study, researchers analyzed data on 5-year medulloblastoma survivors diagnosed in Ontario, Canada, between 1987 and 2015. The survivors were followed from the index date (5 years from diagnosis or the latest relapse/subsequent cancer before 18 years of age) until December 31, 2020, death, or relapse/new cancer after 18 years of age.
The researchers matched 230 medulloblastoma survivors to 1150 cancer-free control individuals based on age, sex, and location. In both cohorts, 65.7% of individuals were female. The median age attained was 24 years in the survivor cohort and 25 years in the control cohort.
Most (81.3%) medulloblastoma survivors had received craniospinal irradiation, 23.5% had carboplatin exposure, and 70.4% had a cyclophosphamide equivalent dose of at least 8000 mg/m2.
The median follow-up from the index date was 11 years in the medulloblastoma cohort and 13 years in the control cohort.
Compared with healthy control individuals, survivors of medulloblastoma had a greater risk of death (hazard ratio [HR], 21.5; 95% CI, 9.8-54.0), hospitalization (HR, 4.6; 95% CI, 3.5-5.9), stroke (HR, 45.6; 95% CI, 12.8-289.8), subsequent malignant neoplasms (HR, 20.7; 95% CI, 8.2-63.2), and severe hearing loss (HR, 96.3; 95% CI, 39.7-317.3).
Medulloblastoma survivors also had an increased need for outpatient mental health care (HR, 1.9; 95% CI, 1.6-2.3), home care services (HR, 7.9; 95% CI, 5.8-10.9), and disability support (HR, 10.0; 95% CI, 7.3-13.6).
“Survivors of pediatric medulloblastoma experience a high burden of severe late sequelae compared to population controls,” the researchers wrote in their poster presentation. “Future work should address the role of mitigation strategies or early interventions for preventing strokes and hearing loss.”
Coltin H, Pequeno P, Liu N, et al. Long-term medical and functional outcomes of medulloblastoma survivors: A population-based, matched cohort study. Presented at ISPNO 2022; June 12-15, 2022. Abstract MEDB-07.