OTHR-12 INCIDENCE, CLINICAL PRESENTATION, MANAGEMENT AND ONE- AND TWO-YEAR SURVIVAL OF PATIENTS WITH MEDULLOBLASTOMA AT INKOSI ALBERT LUTHULI CENTRAL HOSPITAL, KWAZULU NATAL PROVINCE: A TEN YEAR REVIEW

Epidemiology, clinical presentation, stage and multidisciplinary treatment modalities for Medulloblastoma (Mb) at Inkosi Albert Luthuli Central Hospital (IALCH) for the 10 year period from 2003 to 2012. It also evaluated the 1 and 2 year survival rate. Methodology: Single center- retrospective study of Mb patients below the age of 18 years in a low and middle income country (LMIC) setting.

The 30 patients included in the study, median age was 9 years. Male to female ratio of 1.3:1. 70% were black race. Average incidence was 14 per 1000 children years. Headache was most common symptom in 70% of the patients. Majority presented with advanced non metastatic disease (T3b). All patients had shunt insertion prior to debulking surgery and 60% had gross total resection. More than half of the cases had reduced dose irradiation (30.6Gy) to the cranial and spinal compared to 36% who had 36Gy. 96% received concurrent vincristine with radiotherapy. 89.7% received adjuvant chemotherapy and 82.8% completed 6 cycles. There was not enough data to determine any trends in the different modalities of treatment offered over the period of 10 years. One year survival rate was 83.33% [95% CI 64.55; 93.70%] and probability of surviving two years was 80.00% [95% CI 60.87%; 91.60%].

Children present with advanced stages requiring multi-level surgeries. Dedicated multi-disciplinary approach to treatment conferred decent survival outcomes despite the advanced stages at presentation. Similar successes were reflected in the only other study on the subject in Cape Town in a 3 decade retrospective study between the years 1985-2005. These studies highlight the importance of implementing multidisciplinary team management in parallel with modern radiotherapy techniques to improve survival for children with medulloblastoma. Current training programs like Access to Care Capetown could further improve the outcome in countries establishing or transitioning to new radiotherapy techniques.