RADT-38. 1ST REPORT: CLINICAL ANALYSIS OF MEDULLOBLASTOMA PATIENTS TREATED WITH RADIOTHERAPY IN KUWAIT

Abstract BACKGROUND AND AIMS Reports from Middle east indicate lower survival in medulloblastoma (MB), though these studies are mainly from single institutions. This nation wide, retrospective study aimed to be the 1st report to analyze the outcomes for MB treated by Radiotherapy in Kuwait. METHODS Patients adults and Peadiatrics with newly diagnosed MB, treated from 1/2015 to 12/2024 in Kuwait Cancer Control Centered. RESULTS It included 24 patients (20 child and 4 adults) with a median age of 10 years, 3 patients (12.5%) were <3 years old and 16 (66.74%) were male. The most common presenting symptoms were Headache, Vomiting and Ataxia. GTR in 12 (50%) patients, 5(20.8%) had VP shunt/EVD, 4 patients (16.7%) had metastatic disease at diagnosis, 11 (45.8%) were high risk. The histologic subtype were: Desmoplastic/Nodular: 8 (33.3%), Classic: 9(37.5%), Anaplastic/Large Cell: 7(29.1%).Molecular Groups (where available) were, Non-WNT/non-SHH: 2, SHH: 3(12.5%), WNT: 1(4.2%), and 2 MYC-amplified. Median Radiotherapy dose: 54 Gy (range: 7.2–55.8 Gy), 22(91.6%) received Craniospinal Irradiation (CSI), 14(58.3%)Started radiotherapy ≤42 days post-op, 8 (33.3%) had RT interruptions (1–23 days) due to toxicity. Chemotherapy, Concurrent VCR with RT: 8 (33.3%) and Adjuvant CTx (post-RT): 16 (66.7%). Median cycles: 6 (range: 3–8). Median Follow-up: 4.2 years,5-year OS: 65% (Standard Risk (SR): 80%, High Risk (HR): 50%. Relapse Rate: 42% (10/24), Median Time to Relapse: 18 months. Site of Relapse,5 Local, 4 Spinal/metastatic and 1 Combined. Residual Disease Post-Op:14 (58.3%) had Higher relapse rate (64% vs, 25% in no-residual cases) 75% disease-free for patient who started RT before 42 days compared to 50% in those delayed. CONCLUSIONS This national cohort of MB in describes less favorable prognosis compared to reported outcomes. This warrants further assessment of the attributes which may include: surgical, and radiation treatment factors, patient factors, and timing of interventions. Can cause Something like this