We molecularly analyzed three cases of metastatic medulloblastoma treated with 24.0 Gy of CSI by DNA methylation analysis using the Illumina EPIC array.
All three patients had spinal metastases at the time of diagnosis. Postoperative treatment included multiple courses of chemotherapy, 24 Gy of CSI with focal boost to primary and metastatic sites, and high-dose chemotherapy. There was no disease progression observed during the 9.0, 7.7, and 5.7 years post-diagnosis follow-up. The molecular diagnosis was Group 3/4 in all three cases. Cases 1 and 2 belonged to Subtypes 7 and 4, both of which were reported to be good prognostic subtypes among the group. Case 3 belonged to Subtype 5 with MYC amplification.
The present cases suggest that the novel subtype classification in Group 3/4 medulloblastoma may be useful for risk stratification of patients with metastatic medulloblastoma who received lower dose of CSI than standard treatment.
方法:我们使用IlluminaEPIC阵列通过DNA甲基化分析,对3例接受24.0GyCSI治疗的转移性髓母细胞瘤进行分子分析。
结果:所有3例患者在诊断时都有脊柱转移。术后治疗包括多个疗程的化疗,24Gy的CSI,局部增强至原发和转移部位,和大剂量化疗。在诊断后的9.0、7.7和5.7年随访期间未观察到疾病进展。在所有三例病例中,分子诊断均为第3/4组。病例1和2属于亚型7和4,据报道这两种亚型在该组中是良好的预后亚型。病例3属于具有MYC扩增的亚型5。
结论:目前的病例表明,3/4组髓母细胞瘤的新亚型分类可能有助于转移性髓母细胞瘤患者的风险分层,这些患者接受的CSI剂量低于标准治疗。