Patterns of relapse are similar between patients with standard-risk medulloblastoma and those with high-risk medulloblastoma, according to research presented in a poster at the Society for Neuro-Oncology 27th Annual Meeting.
Data from a literature review revealed a local relapse rate of 18.8% among standard-risk patients and 20.0% among high-risk patients. Rates of distant relapse were 48.5% and 54.6%, respectively.
Researchers conducted this review of the literature and clinical trial protocols to evaluate current practice in post-treatment monitoring and patterns of relapse in patients with medulloblastoma aged 3-21 years. The studies were published from 1990 to the present.
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The researchers identified 8 multicenter clinical trials in which post-therapy surveillance (with MRI or lumbar puncture) was performed every 3-6 months for 2 years. Surveillance varied after 2 years. An additional 5 trials did not include information on post-therapy surveillance.
The researchers also analyzed relapse patterns in 8 multicenter trials including standard-risk patients and 6 multicenter trials including high-risk patients.
The standard-risk trials included a total of 1796 patients, and the overall relapse rate was 22.5%. The rate of local relapse was 18.8%, the rate of distant relapse was 48.5%, and the rate of distant and local relapse was 32.2%.
The high-risk trials included a total of 651 patients, and the overall relapse rate was 28.4%. The rate of local relapse was 20.0%, the rate of distant relapse was 54.6%, and the rate of distant and local relapse was 24.9%.
The researchers also looked at patterns of relapse in 16 single-center studies, which encompassed a total of 1025 patients. The overall relapse rate was 29.4%, the rate of local relapse was 22.6%, the rate of distant relapse was 53.8%, and the rate of distant and local relapse was 23.6%.
“Patterns of relapse are consistent across risk stratification, with a high rate of distant relapse,” the researchers wrote. “Surveillance of the entire neuraxis is important for relapse detection and should be incorporated for both high- and standard-risk patients. Radiographic surveillance every 3 months for the first 2 years is important to detect majority of relapses.”
Disclosures: The study authors did not provide disclosures.
Reference
Park C, Packer R, Rood B, et al. Spinal post-treatment surveillance in medulloblastoma: A systematic review of the literature and clinical trials. Presented at SNO 2022; November 16-20, 2022. Abstract INNV-16.
