Résultats du traitement du médulloblastome à Casablanca de 2000 à 2012

Elbachiri, Meriem; Dao, A.; Jabir, H.; Sahraoui, S.; Taleb, Amina; Bouchbika, Zineb; Benchakroun, N.; Jouhadi, H.; Tawfiq, N.; Benider, A.

doi:10.1016/j.canrad.2015.05.026

Cited by 2 publications

(3 citation statements)

References 13 publications

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“…Similar large proportions of high-risk MB cases have been described in other LMICs, including a retrospective synopsis in Morocco, where 70% of cases were high risk. 13 Age-adjusted analysis of our data indicated that 59% of patients under the age group 3-15 years were of high risk, which is in line with other LMIC reports documenting high-risk frequencies of 50% -60%. 17,23,24 Overall, standard-risk MB was significantly less prevalent than the high-risk counterparts and constituted only 28.6% of our cohort with a OS5 rate of 78.7%, comparable with international outcomes of 80% -85%.…”

Section: Discussionsupporting

confidence: 91%

“…The OS rates of classic, desmoplastic nodular or MBEN and LCA variants were 66.1%, 58.9% and 39.5%, respectively, which are all lower than the previously reported rates. 13,17,22 Historically, maximal safe resection with GTR, or at least NTR, is considered to be optimal neurosurgical standard of care. Maintaining an appropriate balance between the extent of resection and respect for surrounding organs at risk is critical.…”

Section: Discussionmentioning

confidence: 99%

“…Data from low-and-middleincome countries (LMICs) exhibit a substantial variation in incidence rates ranging from 6% to 50%. 10,11,12,13,14 The exact epidemiological, clinicopathological characteristics and survival outcomes of MB within South Africa's markedly heterogeneous population are unknown. The risk stratification of children with MB using the modified Chang system allows for identification of standard-and high-risk groups.…”

Section: Introductionmentioning

confidence: 99%

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Sequential improvement in paediatric medulloblastoma outcomes in a low-and-middle-income country setting over three decades

Riedemann

Figaji

Davidson

et al. 2021

South African Journal of Oncology

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Background: Medulloblastoma (MB) is the commonest malignant brain tumour of childhood. Accurate clinical data on paediatric MB in the low-and-middle-income countries (LMIC) setting are lacking. Sequential improvements in outcomes seen in high-income countries are yet to be reflected in LMICs.Aim: The aim of this study was quantification of paediatric MB outcomes in the LMIC setting over three decades of advances in multidisciplinary intervention.Setting: Cape Town, South Africa.Methods: This was a retrospective study of 136 children with MB diagnosed between 1985 and 2015. The modified Chang criteria were used for risk stratification. The primary objective of this study was overall survival (OS), quantified by analysis of epidemiological, clinical and pathological data.Results: OS improved significantly during the most recent decade (2005–2015) when compared with the preceding two decades (1985–1995 and 1995–2005). Despite reduced-dose craniospinal irradiation (CSI) for standard risk cases, OS was significantly greater than during the preceding two decades. High-risk disease was identified in 71.4% of cases and was associated with significantly inferior OS compared with standard-risk cases. Improved OS was positively correlated with the therapeutic era, three-dimensional (3D) conformal radiotherapy technique, older age at diagnosis, classic and desmoplastic histology, extent of resection and absence of leptomeningeal spread on imaging.Conclusion: Advances in multidisciplinary management of MB in our combined service are associated with improved survival. Access to improved imaging modalities, advances in surgical techniques, increased number of patients receiving risk-adapted combination chemotherapy or radiotherapy, as well as CSI using a linear accelerator with 3D planning, are considered as contributing factors.

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