Evidence map›Paper›PMID 31468270›Full record

Trial reportJournal of neuro-oncology2019

Re-irradiation for children with recurrent medulloblastoma in Toronto, Canada: a 20-year experience.

Derek S Tsang, Nasim Sarhan, Vijay Ramaswamy, Liana Nobre, Ryan Yee, Michael D Taylor, Cynthia Hawkins, Ute Bartels, Annie Huang, Uri Tabori and 3 more

Abstract readClinical Trial
PubMed Publisher
In one paragraph

Trial report in Journal of neuro-oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed
1.4field-weighted citation impact, top 17% of its field
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

14 citing papers in PubMed, 26 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Review
  6. Article
  7. Role of Radiotherapy in Patients With Relapsed Medulloblastoma.Brain tumor research and treatment · 2023
    Review
  8. Article
  9. Article
  10. Review
  11. Article
  12. Review
  13. Review
  14. Article
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

13 authors at 2 institutions in 1 country.

Derek S TsangRadiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON, M5G 2M9, Canada. derek.tsang@rmp.uhn.ca.ORCID http://orcid.org/0000-0002-9762-6901
Nasim SarhanRadiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON, M5G 2M9, Canada.
Vijay RamaswamyDivision of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada.ORCID http://orcid.org/0000-0002-6557-895X
Liana NobreDivision of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada.
Ryan YeeRadiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON, M5G 2M9, Canada.
Michael D TaylorDivision of Neurosurgery, Hospital for Sick Children, Toronto, ON, Canada.
Cynthia HawkinsPaediatric Laboratory Medicine, Hospital for Sick Children, Toronto, ON, Canada.
Ute BartelsDivision of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada.
Annie HuangDivision of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada.
Uri TaboriDivision of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada.
David C HodgsonRadiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON, M5G 2M9, Canada.
Eric BouffetDivision of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada.
Normand LaperriereRadiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON, M5G 2M9, Canada.
Hospital for Sick Children · CAUniversity Health Network · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeChildren with recurrent medulloblastoma have a poor prognosis. Re-irradiation is an option for some patients, but has not been well-studied in the era of molecular characterization for pediatric medulloblastoma.

methodsThis was a retrospective cohort study of 14 children age 18 years and younger at initial diagnosis with recurrent medulloblastoma, who received two or more courses of radiation therapy (RT). Molecular subgrouping was performed using nanoString and was available for nine patients. The primary study endpoint was overall survival.

resultsRe-irradiation (RT2) was directed at the supratentorial brain in six patients, infratentorial brain in one patient, and spine in seven patients. In addition, six patients received stem cell transplant as part of salvage therapy. Median OS for all patients was 12.4 months. One patient with recurrent Wnt-activated medulloblastoma remains alive with 154 months' survival; median survival was not reached for four patients with Group 4 disease, while three with Shh-activated disease had median survival of 2.2 months. A single patient with Group 3 disease died 4.3 months after RT2. Patients treated with RT2 to the spine for diffuse disease had poorer OS (p = 0.02), as compared to focal RT2 for intracranial recurrence. Distant failure, outside RT2 volumes, was the predominant pattern of recurrence after RT2.

conclusionsRe-irradiation for recurrent pediatric medulloblastoma can offer some patients disease control, particularly those with focally recurrent disease in the brain. Prospective studies are needed to confirm subgroups of patients who may benefit most from RT2.

Indexed as

Salvage TherapyAdolescentAdultCerebellar NeoplasmsChildChild, PreschoolFemaleFollow-Up StudiesHumansMaleMedulloblastomaPrognosisRe-IrradiationRetrospective StudiesSurvival RateYoung Adult

Identifiers

PMID31468270
OpenAlexW2970975449

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.