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A systematic review and meta-analysis with focus on radiotherapy of pediatric standard-risk medulloblastoma : New strategies are needed to improve survival and reduce side-effects

Edvardsson, Anneli LU ; Lannering, Birgitta ; Gorgisyan, Jenny LU orcid ; Munck af Rosenschöld, Per LU orcid and Björk-Eriksson, Thomas (2025) In Radiotherapy and Oncology 211. p.1-9
Abstract

We explored the impact of different radiotherapy (RT) treatment modalities and prescriptions on outcomes for standard risk pediatric medulloblastoma patients (MB-SR). A systematic review and meta-analysis were performed. Primary MB-SR patients, aged 3–21 years treated with cranio-spinal axis and tumor boost RT during 1995–2024 were included. Data on progression-free and overall survival outcomes (PFS and OS) and side-effects were extracted. Trial efforts for MB-SR have focused on mitigation of side-effects through de-escalation of RT, with practically unchanged PFS and OS during the past 30 years. The three major changes firstly reduced radiation dose to the cranio-spinal axis, secondly reduced boost volume from the entire posterior... (More)

We explored the impact of different radiotherapy (RT) treatment modalities and prescriptions on outcomes for standard risk pediatric medulloblastoma patients (MB-SR). A systematic review and meta-analysis were performed. Primary MB-SR patients, aged 3–21 years treated with cranio-spinal axis and tumor boost RT during 1995–2024 were included. Data on progression-free and overall survival outcomes (PFS and OS) and side-effects were extracted. Trial efforts for MB-SR have focused on mitigation of side-effects through de-escalation of RT, with practically unchanged PFS and OS during the past 30 years. The three major changes firstly reduced radiation dose to the cranio-spinal axis, secondly reduced boost volume from the entire posterior fossa to only the tumor volume with margin and finally the importance of increased conformity. Sixteen different studies and 2002 patients were included in pooled random-effects models, revealing a 5-year PFS and OS of 76.9 % and 83.8 %, respectively. However, new strategies are needed to further improvement of survival and reduced side-effects.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Meta-analysis, Pediatric medulloblastoma, Proton therapy, Radiotherapy, Systematic review
in
Radiotherapy and Oncology
volume
211
article number
111045
pages
1 - 9
publisher
Elsevier
external identifiers
  • scopus:105011856564
  • pmid:40652966
ISSN
0167-8140
DOI
10.1016/j.radonc.2025.111045
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025
id
84d1fc7e-0de1-4b36-a41a-94719b2a9f1e
date added to LUP
2025-09-01 22:13:21
date last changed
2025-10-14 10:59:51
@article{84d1fc7e-0de1-4b36-a41a-94719b2a9f1e,
  abstract     = {{<p>We explored the impact of different radiotherapy (RT) treatment modalities and prescriptions on outcomes for standard risk pediatric medulloblastoma patients (MB-SR). A systematic review and meta-analysis were performed. Primary MB-SR patients, aged 3–21 years treated with cranio-spinal axis and tumor boost RT during 1995–2024 were included. Data on progression-free and overall survival outcomes (PFS and OS) and side-effects were extracted. Trial efforts for MB-SR have focused on mitigation of side-effects through de-escalation of RT, with practically unchanged PFS and OS during the past 30 years. The three major changes firstly reduced radiation dose to the cranio-spinal axis, secondly reduced boost volume from the entire posterior fossa to only the tumor volume with margin and finally the importance of increased conformity. Sixteen different studies and 2002 patients were included in pooled random-effects models, revealing a 5-year PFS and OS of 76.9 % and 83.8 %, respectively. However, new strategies are needed to further improvement of survival and reduced side-effects.</p>}},
  author       = {{Edvardsson, Anneli and Lannering, Birgitta and Gorgisyan, Jenny and Munck af Rosenschöld, Per and Björk-Eriksson, Thomas}},
  issn         = {{0167-8140}},
  keywords     = {{Meta-analysis; Pediatric medulloblastoma; Proton therapy; Radiotherapy; Systematic review}},
  language     = {{eng}},
  pages        = {{1--9}},
  publisher    = {{Elsevier}},
  series       = {{Radiotherapy and Oncology}},
  title        = {{A systematic review and meta-analysis with focus on radiotherapy of pediatric standard-risk medulloblastoma : New strategies are needed to improve survival and reduce side-effects}},
  url          = {{http://dx.doi.org/10.1016/j.radonc.2025.111045}},
  doi          = {{10.1016/j.radonc.2025.111045}},
  volume       = {{211}},
  year         = {{2025}},
}