DSpace Collection: Coleção voltada para a inserção de resumos desenvolvidos pela área de pediatria, seus servidores e/ou colaboradores.

PATH-30. Exosomes as a source of plasma CTDNA to identify point mutations in pediatric glioma patients

2024-04-18T14:58:07Z

Title: PATH-30. Exosomes as a source of plasma CTDNA to identify point mutations in pediatric glioma patients Authors: Nobre, Liana Figueiredo; Carreiro, Isabel Albuquerque Porto; Camacho, Aline Helen da Silva; Reis, Rafaela; Chimelli, Leila Maria Cardão; Ferman, Sima Esther; Monte-Mór, Bárbara da Costa Reis; Renault, Ilana Zalcberg Abstract: PURPOSE: By reducing dose to normal brain tissue, proton radio therapy (PRT) may lessen neurocognitive risk traditionally associated with photon radiotherapy (XRT). We examined change in neurocognitive scores over time in pediatric medulloblastoma patients treated with PRT versus XRT. METHODS: Neurocognitive scores from 79 patients (37 PRT, 42 XRT) were examined. Patients were treated between 2007–2018 on the same treatment protocols that differed only by craniospinal modality (PRT versus XRT). Change in scores over time since diagnosis were compared between groups. RESULTS: Groups were similar on most demographic/ clinical variables: sex (67.1% male), age at diagnosis (mean 8.6 years), CSI dose (median 23.4 Gy), length of follow-up (mean 4.3 years), and parental education (mean 14.3 years). Boost dose (p<0.001) and margin (p=0.001) differed between groups. Adjusting for covariates, the PRT group exhibited superior outcomes in global IQ, perceptual reasoning, and working memory versus the XRT group (all p<0.05). The XRT group exhibited significant de cline in global IQ, working memory, and processing speed (all p<0.05). The PRT group exhibited stable scores in all domains except processing speed (p=0.003). Posterior fossa syndrome imparted risk independent of mo dality. CONCLUSION: This is the first study comparing neurocognitive tra jectories between pediatric patients treated for medulloblastoma with PRT versus XRT on comparable, contemporary protocols. PRT was associated with more favorable neurocognitive outcomes in most domains compared to XRT, although processing speed emerged as vulnerable in both groups. This is the strongest evidence to date of an intellectual sparing advantage with PRT in the treatment of pediatric medulloblastoma. Description: p. 430–431.

LINC-28. Epidemiological characteristics and survival outcomes of children with medulloblastoma treated at the national cancer institute (INCA) in Rio de Janeiro, Brazil

2024-10-24T12:58:07Z

Title: LINC-28. Epidemiological characteristics and survival outcomes of children with medulloblastoma treated at the national cancer institute (INCA) in Rio de Janeiro, Brazil Authors: Oigman, Gabriela; Osorio, Diana; Stanek, Joseph; Finlay, Jonathan Lester; Vianna, Denizar; Ferman, Sima Esther Abstract: Background: Medulloblastoma (MB), the most malignant brain tumor of childhood has survival outcomes exceeding 80% for standard risk and 60% for high risk patients in high-income countries (HIC). These results have not been replicated in low-to-middle income countries (LMIC), where 80% of children with cancer live. Brazil is an upper-middle income country according to World Bank, with features of LMIC and HIC. Methods: We conducted a retrospective review of 126 children (0–18 years) diagnosed with MB from 1997 to 2016 at INCA. Data on patients, disease characteristics and treatment information were retrieved from the charts and summarized descriptively; overall survival (OS) and event-free survival (EFS) were calculated using the Kaplan-Meier Method. Results: The male/female ratio was 1.42 and the median age at diagnosis was 7.9 years. Headache (79%) and nausea/vomiting (75%) were the most common presenting symptoms. The median time from onset of symptoms to surgery was 50 days. The OS for standard-risk patients was 69% and 53% for high-risk patients. Patients initiating radiation therapy within 42 days after surgery (70.6% versus 59.6% p=0.016) experienced better OS. Forty-five patients (35%) had metastatic disease at admission. Lower maternal education correlated with lower OS (71.3% versus 49% p=0.025). Patients who lived >40km from INCA fared better (OS= 68.2% versus 51.1% p=0.032). Almost 20% of families lived below the Brazilian minimum wage. Conclusions: These findings suggest that socioeconomic factors, education, early diagnosis and continuous data collection, besides oncological treatment must be adressed to improve the survival of children with MB Description: p. 384.