Evidence map›Paper›PMID 25605817›Full record

Trial reportNeuro-oncology2016

Medulloblastoma subgroup-specific outcomes in irradiated children: who are the true high-risk patients?

Vijay Ramaswamy, Marc Remke, Jennifer Adamski, Ute Bartels, Uri Tabori, Xin Wang, Annie Huang, Cynthia Hawkins, Donald Mabbott, Normand Laperriere and 2 more

Abstract readClinical Trial
In one paragraph

Trial report in Neuro-oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 72 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
72citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

72 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
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  6. Trial
  7. From developmental origins to relapse: molecular and therapeutic insights in medulloblastoma.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026
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  8. Observational
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12 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Vijay RamaswamyDivision of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., J.A., U.B., U.T., A.H., D.M., N.L., E.B.); Program in Developmental and Stem Cell Biology, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., M.R., X.W., M.D.T.); Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada (V.R., M.R., X.W., A.H., C.H., M.D.T); Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., M.R., X.W., M.D.T.); Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada (C.H.); Department of Radiation Oncology, Princess Margaret Cancer Center, Toronto, Ontario, Canada (N.L.).
Marc RemkeDivision of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., J.A., U.B., U.T., A.H., D.M., N.L., E.B.); Program in Developmental and Stem Cell Biology, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., M.R., X.W., M.D.T.); Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada (V.R., M.R., X.W., A.H., C.H., M.D.T); Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., M.R., X.W., M.D.T.); Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada (C.H.); Department of Radiation Oncology, Princess Margaret Cancer Center, Toronto, Ontario, Canada (N.L.).
Jennifer AdamskiDivision of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., J.A., U.B., U.T., A.H., D.M., N.L., E.B.); Program in Developmental and Stem Cell Biology, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., M.R., X.W., M.D.T.); Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada (V.R., M.R., X.W., A.H., C.H., M.D.T); Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., M.R., X.W., M.D.T.); Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada (C.H.); Department of Radiation Oncology, Princess Margaret Cancer Center, Toronto, Ontario, Canada (N.L.).
Ute BartelsDivision of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., J.A., U.B., U.T., A.H., D.M., N.L., E.B.); Program in Developmental and Stem Cell Biology, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., M.R., X.W., M.D.T.); Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada (V.R., M.R., X.W., A.H., C.H., M.D.T); Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., M.R., X.W., M.D.T.); Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada (C.H.); Department of Radiation Oncology, Princess Margaret Cancer Center, Toronto, Ontario, Canada (N.L.).
Uri TaboriDivision of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., J.A., U.B., U.T., A.H., D.M., N.L., E.B.); Program in Developmental and Stem Cell Biology, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., M.R., X.W., M.D.T.); Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada (V.R., M.R., X.W., A.H., C.H., M.D.T); Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., M.R., X.W., M.D.T.); Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada (C.H.); Department of Radiation Oncology, Princess Margaret Cancer Center, Toronto, Ontario, Canada (N.L.).
Xin WangDivision of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., J.A., U.B., U.T., A.H., D.M., N.L., E.B.); Program in Developmental and Stem Cell Biology, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., M.R., X.W., M.D.T.); Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada (V.R., M.R., X.W., A.H., C.H., M.D.T); Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., M.R., X.W., M.D.T.); Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada (C.H.); Department of Radiation Oncology, Princess Margaret Cancer Center, Toronto, Ontario, Canada (N.L.).
Annie HuangDivision of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., J.A., U.B., U.T., A.H., D.M., N.L., E.B.); Program in Developmental and Stem Cell Biology, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., M.R., X.W., M.D.T.); Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada (V.R., M.R., X.W., A.H., C.H., M.D.T); Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., M.R., X.W., M.D.T.); Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada (C.H.); Department of Radiation Oncology, Princess Margaret Cancer Center, Toronto, Ontario, Canada (N.L.).
Cynthia HawkinsDivision of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., J.A., U.B., U.T., A.H., D.M., N.L., E.B.); Program in Developmental and Stem Cell Biology, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., M.R., X.W., M.D.T.); Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada (V.R., M.R., X.W., A.H., C.H., M.D.T); Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., M.R., X.W., M.D.T.); Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada (C.H.); Department of Radiation Oncology, Princess Margaret Cancer Center, Toronto, Ontario, Canada (N.L.).
Donald MabbottDivision of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., J.A., U.B., U.T., A.H., D.M., N.L., E.B.); Program in Developmental and Stem Cell Biology, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., M.R., X.W., M.D.T.); Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada (V.R., M.R., X.W., A.H., C.H., M.D.T); Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., M.R., X.W., M.D.T.); Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada (C.H.); Department of Radiation Oncology, Princess Margaret Cancer Center, Toronto, Ontario, Canada (N.L.).
Normand LaperriereDivision of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., J.A., U.B., U.T., A.H., D.M., N.L., E.B.); Program in Developmental and Stem Cell Biology, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., M.R., X.W., M.D.T.); Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada (V.R., M.R., X.W., A.H., C.H., M.D.T); Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., M.R., X.W., M.D.T.); Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada (C.H.); Department of Radiation Oncology, Princess Margaret Cancer Center, Toronto, Ontario, Canada (N.L.).
Michael D TaylorDivision of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., J.A., U.B., U.T., A.H., D.M., N.L., E.B.); Program in Developmental and Stem Cell Biology, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., M.R., X.W., M.D.T.); Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada (V.R., M.R., X.W., A.H., C.H., M.D.T); Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., M.R., X.W., M.D.T.); Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada (C.H.); Department of Radiation Oncology, Princess Margaret Cancer Center, Toronto, Ontario, Canada (N.L.).
Eric BouffetDivision of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., J.A., U.B., U.T., A.H., D.M., N.L., E.B.); Program in Developmental and Stem Cell Biology, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., M.R., X.W., M.D.T.); Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada (V.R., M.R., X.W., A.H., C.H., M.D.T); Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada (V.R., M.R., X.W., M.D.T.); Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada (C.H.); Department of Radiation Oncology, Princess Margaret Cancer Center, Toronto, Ontario, Canada (N.L.).

Funding

Mouse models to discover new drivers of medulloblastomaR01CA159859 · NCI · SANFORD BURNHAM PREBYS MEDICAL DISCOVERY INSTITUTE · PI Michael D. Taylor, WILLIAM A WEISS · 2011 to 2026
$10.4M
Medulloblastoma and MetastasesR01CA148699 · NCI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI TAYLOR, MICHAEL D., WEISS, WILLIAM A · 2010 to 2014
$2.4M
Canadian Institutes of Health ResearchNCI NIH HHS R01CA148699NCI NIH HHS R01CA159859
6 · The paper itself

Abstract

backgroundThe advent of integrated genomics has fundamentally changed our understanding of medulloblastoma. Although survival differences exist among the 4 principal subgroups, this has yet to be elucidated in a North American cohort of irradiated patients.

methodsNinety-two consecutive patients between the ages of 3 and 17 treated with surgery, craniospinal irradiation, and chemotherapy were identified at the Hospital for Sick Children. Molecular subgrouping was performed using nanoString.

resultsTwo treatment periods were identified: prior to 2006 as per the protocols of the Children's Oncology Group, and after 2006 per the St Jude Medulloblastoma 03 protocol. Five-year progression-free survival (PFS) over the entire cohort was 0.801 (95% CI: 0.692-0.875) with no significant difference between treatment protocols. Strikingly, we found that Group 4 patients had excellent 5-year PFS of 0.959 (95% CI: 0.744-0.994) for average risk and 0.887 (95% CI: 0.727-0.956) across all Group 4 patients. Group 3 patients had 5-year PFS of 0.733 (95% CI: 0.436-0.891). Sonic hedgehog patients did poorly across both treatment protocols, with 5-year PFS of 0.613 (95% CI: 0.333-0.804), likely owing to a high proportion of TP53 mutated patients in this age group.

conclusionsIn a cohort of irradiated patients over 3 years of age, PFS for Group 4 patients was significantly improved compared with initial reports. The impact of subgroup affiliation in these children needs to be assessed in large prospectively treated cooperative protocols to determine if more than just WNT patients can be safely selected for de-escalation of therapy.

Indexed as

Cranial IrradiationAdolescentCerebellar NeoplasmsChildChild, PreschoolFemaleFollow-Up StudiesHumansMaleMedulloblastomaNeoplasm GradingPrognosisRisk FactorsSurvival Ratechemotherapymedulloblastomaradiationsubgroups

Identifiers

PMID25605817
PMCPMC4724171

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.