SURVEY OF CANADIAN NEURO-ONCOLOGY CLINICIANS ABOUT THE TREATMENT OF ADULT MEDULLOBLASTOMA

Abstract Given the rarity of adult medulloblastoma, optimal chemotherapy strategy is unknown and its management thought to vary from institution institution. Guidelines often omit suggestions for specific regimens, reflecting lack high-quality evidence in this population. We sought understand Canadian medulloblastoma practice patterns, hoping inform future quality metrics guidelines. METHODS: In March 2022, a 30-question survey was sent out 71 neuro-oncology clinicians on Adolescent Young Adult national rounds mailing list. Snowball sampling permitted. RESULTS: The response rate 35%. Radiation oncologists (11), neuro-oncologists (8), medical (4), neurosurgeons (2) responded 6/10 provinces. They each treated average 1.6 patients per year. Most (61%) said that molecular subgrouping always done at their centre. Half indicated cerebrospinal fluid testing diagnosis. most common (64%) radiation regimen 36 Gy (in 20 fractions) craniospinal irradiation + 18 10 boost. Concomitant rarely given while adjuvant frequently administered. Cisplatin/Lomustine/Vincristine (57%), but other regimens included Cisplatin/ Lomustine/ Vincristine alternating with Cyclophosphamide/ (21%), (14%), carboplatin-based (14%). Respondents noted challenges prescribing population: drug toxicities, limited resources, clinical uncertainty. There support standard-of-care guidelines 92%. CONCLUSIONS: significant variation among centres treating medulloblastoma. This can serve as an opportunity improvement research.