Subtyping of Group 3/4 medulloblastoma as a potential prognostic biomarker among patients treated with reduced dose of craniospinal irradiation

2023 Fiscal Year Final Research Report

• Project/Area Number: 22K15953
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 52050:Embryonic medicine and pediatrics-related
• Research Institution: Saitama Children's Medical Center
• Principal Investigator: Fukuoka KoheiKohei 埼玉県立小児医療センター (臨床研究部), 血液腫瘍科, 医長 (60746717)
• Project Period (FY): 2022-04-01 – 2024-03-31
• Keywords: 髄芽腫 / メチル化解析 / 分子分類

Outline of Final Research Achievements

One of the most significant challenges in patients with medulloblastoma is reducing the dose of craniospinal irradiation (CSI) to minimize neurological sequelae in survivors. Molecular characterization of patients receiving lower than standard dose of CSI therapy is important to facilitate further reduction of treatment burden. We conducted moelcular genetic analysis to investigate molecular prognostic markers in 38 patients with medulloblastoma treated with reduced-dose CSI. There were 38 medulloblastoma patients who received CSI dosed under 24.0Gy. Patients with poor prognostic subtype showed worse prognosis than that of others (5-year progression survival rate 90.4% vs. 22.2%; p<0.0001).
Although these findings require validation in a larger cohort, the present findings suggest that novel subtyping of Group 3/4 medulloblastoma may be a promising prognostic biomarker even among patients treated with lower-dose CSI than standard treatment.

Free Research Field

小児科学

Academic Significance and Societal Importance of the Research Achievements

本研究の目的は、減量放射線治療を受けた髄芽腫症例に対する分子遺伝学的解析を行う事で予後分子マーカーを見出し、真に本治療でも治癒しうる髄芽腫症例を抽出する事にあった。世界的にも、本腫瘍においては、低リスク症例には減量放射線治療を採用していく流れであり、我が国の現在進行中の臨床試験も同様であるが、それらには未だ明確な根拠に乏しく、今回回の研究成果は、減量放射線治療の髄芽腫に対する適応を考える上で、極めて重要なデータとなり得る。実際に減量放射線治療を受けた髄芽腫症例の分子遺伝学的解析の研究は国内初の研究となった。