Frontiers in Oncology (May 2024)

Impact of treatment and clinical characteristics on the survival of children with medulloblastoma in Mexico

  • Violeta Salceda-Rivera,
  • Isidoro Tejocote-Romero,
  • Isidoro Tejocote-Romero,
  • Diana S. Osorio,
  • Rosalba Bellido-Magaña,
  • Araceli López-Facundo,
  • Susana E. Anaya-Aguirre,
  • Daniel Ortiz-Morales,
  • Daniel Ortiz-Morales,
  • Roberto Rivera-Luna,
  • Evelyne Reyes-Gutiérrez,
  • Rebeca Rivera-Gómez,
  • Liliana Velasco-Hidalgo,
  • Deyanira Cortés-Alva,
  • Sandra Lagarda-Arrechea,
  • Farina E. Arreguín-González,
  • Alma E. Benito-Reséndiz,
  • Silvia Chávez-Gallegos,
  • Eloy Pérez-Rivera,
  • Guillermo J. Gaytán-Fernández,
  • Guillermo J. Gaytán-Fernández,
  • José A. León-Espitia,
  • Jociela Domínguez-Sánchez,
  • Carlos Leal-Cavazos,
  • Citlalli Simón-González,
  • Tania C. Larios-Farak,
  • Nubia A. Macías-García,
  • Ana C. García-Espinosa,
  • Francisco Guerrero-Maymes,
  • Paola Casillas-Toral,
  • Oscar González-Ramella

DOI
https://doi.org/10.3389/fonc.2024.1376574
Journal volume & issue
Vol. 14

Abstract

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IntroductionData on medulloblastoma outcomes and experiences in low- and middle-income countries, especially in Latin America, is limited. This study examines challenges in Mexico’s healthcare system, focusing on assessing outcomes for children with medulloblastoma in a tertiary care setting.MethodsA retrospective analysis was conducted, involving 284 patients treated at 21 pediatric oncology centers in Mexico.ResultsHigh-risk patients exhibited markedly lower event-free survival than standard-risk patients (43.5% vs. 78.3%, p<0.001). Influential factors on survival included anaplastic subtype (HR 2.4, p=0.003), metastatic disease (HR 1.9, p=0.001); residual tumor >1.5cm², and lower radiotherapy doses significantly impacted event-free survival (EFS) and overall survival (OS). Platinum-based chemotherapy showed better results compared to the ICE protocol in terms of OS and EFS, which was associated with higher toxicity. Patients under 3 years old displayed notably lower OS and EFS compared to older children (36.1% vs. 55.9%, p=0.01).

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