Evidence map›Paper›PMID 40495013›Full record

ArticleJournal of neuro-oncology2025

Impact of partial substitution of cisplatin with cyclophosphamide on acute toxicities in standard-risk medulloblastoma.

Sarah Magdy Metwally, Moatasem El-Ayadi, Eslam Maher, Mohamed Sherif El-Minawi, Mohamed S Zaghloul, Hala Taha, Sherif Aboulnaga, Iman Sidhom

Abstract read
In one paragraph

Article in Journal of neuro-oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Sarah Magdy Metwally *Department of Pediatric Oncology, National Cancer Institute, Cairo University, Cairo, Egypt. sarah.magdy@57357.org.ORCID https://orcid.org/0000-0002-9803-7957
Moatasem El-Ayadi *Department of Pediatric Oncology, National Cancer Institute, Cairo University, Cairo, Egypt.ORCID https://orcid.org/0000-0001-9791-0104
Eslam MaherDepartment of Clinical Research, Children's Cancer Hospital Egypt (CCHE-57357), Cairo, Egypt.ORCID https://orcid.org/0000-0001-5428-1555
Mohamed Sherif El-MinawiDepartment of Otolaryngology, Kasr El-Ainy School of Medicine, Cairo University, Cairo, Egypt.
Mohamed S ZaghloulDepartment of Radiation Oncology, Children's Cancer Hospital Egypt (CCHE-57357), Cairo, Egypt.ORCID https://orcid.org/0000-0002-1999-6528
Hala TahaDepartment of Pathology, Children's Cancer Hospital Egypt (CCHE-57357), Cairo, Egypt.
Sherif AboulnagaDepartment of Pediatric Oncology, National Cancer Institute, Cairo University, Cairo, Egypt.
Iman SidhomDepartment of Pediatric Oncology, National Cancer Institute, Cairo University, Cairo, Egypt. ImanSidhom@cu.edu.eg.ORCID https://orcid.org/0000-0002-5105-3140

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMedulloblastoma (MB) treatment includes surgery, irradiation, and chemotherapy (CT). Cisplatin-based regimens for standard-risk (SR) MB are effective but associated with significant toxicities, particularly ototoxicity. This study compares the toxicity profiles of two CT regimens, focusing on grade ≥ 3 ototoxicity, hematologic, hepatic, renal, and neurologic toxicities.

methodsThis study included SR-MB patients aged 3-18 years. Cohort A (2016-2019) received adjuvant CT adopted from the Children's Oncology Group (COG) A9961 Regimen A protocol, with data collected retrospectively. Cohort B (2020-July 2022) received CT adopted from the ACNS0331 protocol, with data collected prospectively. Toxicities were assessed and graded using the Common Terminology Criteria for Adverse Events (CTCAE) v5.0.

resultsA total of 168 patients aged 3 to 18 years were enrolled, 112 (67%) in cohort A and 56 (33%) in cohort B. Grade ≥ 3 ototoxicity was significantly higher in cohort A (24% vs. 3.6%, p < 0.001). Neurotoxicity occurred in 26% vs. 12.5% (p = 0.046). Anemia and thrombocytopenia in 71% vs. 52% (p = 0.04). Febrile neutropenia was more common in cohort B (66% vs. 38%, p < 0.001). No significant differences were found in grade ≥ 3 leukopenia, nephrotoxicity or hepatotoxicity. The 2-year overall survival was 96.4% (95% CI: 93.1-99.9) in cohort A vs. 86.6% (95% CI: 77.8-96.4) in cohort B (p = 0.11). Event-free survival was 92.9% (95% CI: 88.2-97.8) vs. 86.8% (95% CI: 78-96.4) (p = 0.29).

conclusionPartial substitution of cisplatin with cyclophosphamide showed a better toxicity profile, particularly for ototoxicity and neurotoxicity, with no significant difference in survival.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsCerebellar NeoplasmsCisplatinCyclophosphamideMedulloblastomaAdolescentChildChild, PreschoolFemaleFollow-Up StudiesHumansMaleOtotoxicityRetrospective StudiesCisplatinCyclophosphamideChemotherapyCisplatinCyclophosphamideMedulloblastomaOtotoxicityToxicity

Identifiers

PMID40495013
PMCPMC12263714

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.