Effect Of Postoperative Combined Radiation Therapy And Adjuvant Chemotherapy Versus Radiation Therapy Alone On The Five-year Survival In Pediatric Medulloblastomas: A Systematic Review

Objective: To determine the effect of postoperative radiation therapy followed by adjuvant chemotherapy versus radiation therapy alone on the 5-year event-free survival probability, 5-year survival probability, toxicity and infection in pediatric medulloblastomas. Methods: We searched MEDLINE, Ovid, Cochrane Library and CBMdisc for RCTs. Data was extracted by two reviewers using the designed extraction form. RevMan were used for data management and analysis. Results: Three RCTs were found. The combined results showed that postoperative radiation therapy followed by adjuvant chemotherapy for pediatric medulloblastoma can not increase the 5-year event-free survival probability and the 5-year survival probability, with increased the hematological toxicity and infection rate. Conclusion: To compare with postoperative radiation therapy alone for treatment of pediatric medulloblastomas, postoperative radiation therapy followed by adjuvant chemotherapy can not increase the 5-year event-free survival probability and the 5-year survival probability, with increased hematological toxicity and infection rate. However, the effect of postoperative radiation therapy followed by adjuvant chemotherapy in high-risk children, on the quality of life with long-term survived children and the regimen of chemotherapy...