Outcomes of relapsed medulloblastoma in young children after initial craniospinal irradiation-sparing approaches: multinational cohort study

Infant and young childhood medulloblastoma (iMB) is usually treated without craniospinal irradiation (CSI) to avoid neurocognitive late effects. Many of these children relapse. A large multinational cohort study of patients with relapsed iMB, age younger than 6 years, and initially treated without CSI, found a 3-year postrelapse survival rate of 52.4% among patients who received therapy with curative intent (salvage CSI in 73% of patients). Variables associated with improved postrelapse survival for CSI-naïve children with relapsed iMB were localized relapse, sonic hedgehog molecular subgroup, CSI use after relapse, and age ≥ 36 months at initial diagnosis.