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2 "Won Kee Ahn"
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Pediatric cancer
Long-term Outcomes of Protocol-Based Treatment for Newly Diagnosed Medulloblastoma
Won Kee Ahn, Seung Min Hahn, Hong In Yoon, Jeongshim Lee, Eun Kyung Park, Kyu Won Shim, Dong Seok Kim, Chang-Ok Suh, Se Hoon Kim, Chuhl Joo Lyu, Jung Woo Han
Cancer Res Treat. 2024;56(2):652-664.   Published online November 30, 2023
DOI: https://doi.org/10.4143/crt.2023.865
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The Korean Society of Pediatric Neuro-Oncology (KSPNO) conducted treatment strategies for children with medulloblastoma (MB) by using alkylating agents for maintenance chemotherapy or tandem high-dose chemotherapy (HDC) with autologous stem cell rescue (ASCR) according to the risk stratification. The purpose of the study was to assess treatment outcomes and complications based on risk-adapted treatment and HDC.
Materials and Methods
Fifty-nine patients diagnosed with MB were enrolled in this study. Patients in the standard-risk (SR) group received radiotherapy (RT) after surgery and chemotherapy using the KSPNO M051 regimen. Patients in the high-risk (HR) group received two and four chemotherapy cycles according to the KSPNO S081 protocol before and after reduced RT for age following surgery and two cycles of tandem HDC with ASCR consolidation treatment.
Results
In the SR group, 24 patients showed 5-year event-free survival (EFS) and overall survival (OS) estimates of 86.7% (95% confidence interval [CI], 73.6 to 100) and 95.8% (95% CI, 88.2 to 100), respectively. In the HR group, more infectious complications and mortality occurred during the second HDC than during the first. In the HR group, the 5-year EFS and OS estimates were 65.5% (95% CI, 51.4 to 83.4) and 72.3% (95% CI, 58.4 to 89.6), respectively.
Conclusion
High intensity of alkylating agents for SR resulted in similar outcomes but with a high incidence of hematologic toxicity. Tandem HDC with ASCR for HR induced favorable EFS and OS estimates compared to those reported previously. However, infectious complications and treatment-related mortalities suggest that a reduced chemotherapy dose is necessary, especially for the second HDC.

Citations

Citations to this article as recorded by  
  • Ferroptosis Transcriptional Regulation and Prognostic Impact in Medulloblastoma Subtypes Revealed by RNA-Seq
    Christophe Desterke, Yuanji Fu, Jenny Bonifacio-Mundaca, Claudia Monge, Pascal Pineau, Jorge Mata-Garrido, Raquel Francés
    Antioxidants.2025; 14(1): 96.     CrossRef
  • 3,146 View
  • 154 Download
  • 1 Web of Science
  • 1 Crossref
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The Efficacy of Alternate Systemic Intravenous Chemotherapy and Intra-arterial Chemotherapy Approach for Eye Globe Salvage in Retinoblastoma
Jung Woo Han, Christopher Seungkyu Lee, Seung Min Hahn, Won Kee Ahn, Hyo Sun Kim, Hyeseon Yun, Sung Chul Lee, Byung Moon Kim, Dong Joon Kim, Chuhl Joo Lyu
Cancer Res Treat. 2023;55(1):270-278.   Published online May 24, 2022
DOI: https://doi.org/10.4143/crt.2021.1537
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The advances in the treatment of retinoblastoma have enabled salvaging the globe in advanced stages with intra-arterial chemotherapy (IAC). We developed a strategy of alternate application of systemic intravenous chemotherapy (IVC) and IAC (referred to as alternate systemic IVC and IAC; ASIAC) to reduce central nervous metastases during IAC and examined its efficacy and safety in eye globe salvage in this study.
Materials and Methods
Between January 2010 and February 2021, 43 eyes of 40 patients received ASIAC treatment for retinoblastoma at the Yonsei Cancer Center, Yonsei University Health System. Their medical records were reviewed retrospectively to evaluate the eye salvage rate (ESR), defined from diagnosis to enucleation. High-risk retinoblastoma was defined as group D or E by the International Classification of Retinoblastoma.
Results
The study enrolled 38 and five cases of high-risk and low-risk retinoblastoma, respectively. In total, 178 IAC and 410 IVC courses were administered, with a median of 4 (interquartile range [IQR], 3.0 to 5.0) IAC and 9 (IQR, 6.0 to 11) IVC courses per eye, respectively. The 5-year ESR was 60.4%±8.7% for the whole cohort, 100% for low-risk retinoblastoma, and 53.6%±9.8% for high-risk retinoblastoma. Among those diagnosed since 2015, the 5-year ESR for high-risk retinoblastoma was 63.5%±14.0%. Fifteen eyes underwent enucleation; no viable tumor was found in three enucleated eyes. There were no deaths in this cohort.
Conclusion
Primary IAC-IVC (i.e., ASIAC) for patients with retinoblastoma was tolerable and effective in salvaging the eye and maintaining survival.

Citations

Citations to this article as recorded by  
  • Selective ophthalmic arterial injection using a balloon catheter for retinoblastoma: a seven-year clinical evaluation
    Sota Oguro, Yi Ning Chen, Takashi Yamane, Makoto Mohri, Shigenobu Suzuki
    Japanese Journal of Ophthalmology.2024; 68(4): 346.     CrossRef
  • Hematological Second Primary Malignancy in Pediatric Retinoblastoma: A Case Report and Systematic Review
    Seung Hyun Park, Hyun Young Park, Heejin Kim, Jung Woo Han, Jin Sook Yoon
    Ophthalmic Plastic & Reconstructive Surgery.2024; 40(5): 487.     CrossRef
  • 5,367 View
  • 132 Download
  • 2 Web of Science
  • 2 Crossref
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