| Item type: | Article | ||||||||||||||||||||||||||||||||||||||||||||||
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| Journal or Publication Title: | European journal of cancer | ||||||||||||||||||||||||||||||||||||||||||||||
| Publisher: | ELSEVIER SCI LTD | ||||||||||||||||||||||||||||||||||||||||||||||
| Place of Publication: | OXFORD | ||||||||||||||||||||||||||||||||||||||||||||||
| Volume: | 49 | ||||||||||||||||||||||||||||||||||||||||||||||
| Number of Issue or Book Chapter: | 4 | ||||||||||||||||||||||||||||||||||||||||||||||
| Page Range: | pp. 893-903 | ||||||||||||||||||||||||||||||||||||||||||||||
| Date: | 2013 | ||||||||||||||||||||||||||||||||||||||||||||||
| Institutions: | Medicine > Lehrstuhl für Neurologie | ||||||||||||||||||||||||||||||||||||||||||||||
| Identification Number: |
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| Classification: |
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| Keywords: | PROSPECTIVE RANDOMIZED-TRIAL; PROGNOSTIC-FACTORS; CHILDRENS CANCER; ADJUVANT CHEMOTHERAPY; RADIOTHERAPY; TUMOR; CHILDHOOD; PATTERNS; SURVIVAL; THERAPY; Brain tumour; Medulloblastoma; Adults; Treatment; Radiotherapy; Chemotherapy | ||||||||||||||||||||||||||||||||||||||||||||||
| Dewey Decimal Classification: | 600 Technology > 610 Medical sciences Medicine | ||||||||||||||||||||||||||||||||||||||||||||||
| Status: | Published | ||||||||||||||||||||||||||||||||||||||||||||||
| Refereed: | Yes, this version has been refereed | ||||||||||||||||||||||||||||||||||||||||||||||
| Created at the University of Regensburg: | Unknown | ||||||||||||||||||||||||||||||||||||||||||||||
| Item ID: | 29131 |
Web of ScienceAbstract
Background: Medulloblastoma in adulthood is rare. Knowledge is limited, and the efficacy and toxicity of chemotherapy - especially in nonmetastatic disease - is still elusive. Methods: Seventy adults aged >= 21 years (median age: 28.5 years) with nonmetastatic medulloblastoma were followed as observational patients within the prospective paediatric multicentre trial HIT 2000. Treatment consisted ...
Abstract
Background: Medulloblastoma in adulthood is rare. Knowledge is limited, and the efficacy and toxicity of chemotherapy - especially in nonmetastatic disease - is still elusive. Methods: Seventy adults aged >= 21 years (median age: 28.5 years) with nonmetastatic medulloblastoma were followed as observational patients within the prospective paediatric multicentre trial HIT 2000. Treatment consisted of radiotherapy (35.2 Gy to the craniospinal axis and a boost to 55.2 Gy to the posterior fossa) followed in most patients by maintenance chemotherapy (lomustine (CCNU), vincristine and cisplatin, n = 49). Results: The implementation of maintenance chemotherapy was feasible. Peripheral neuropathy (74%) and haematotoxicity (55%) during maintenance chemotherapy appear to be more common in adults than in children. At a median follow-up of 3.7 years, the 4-year event-free survival (EFS) and overall survival (OS) rates +/- standard error (SE) were 68% +/- 7% and 89% +/- 5%. Patients with desmoplastic medulloblastoma and lateral tumour location (n = 19) had a lower EFS compared to patients with centrally located desmoplastic tumours (n = 10) (p = 0.011). Absence of residual postoperative tumour (n = 40) was associated to a lower rate of progression/relapse compared to present (n = 11) or unknown (n = 12) residual tumour status (p = 0.006). Lateral tumour location and unknown residual tumour status were independent negative prognostic factors. Conclusions: Maintenance chemotherapy is applicable in adults with nonmetastatic medulloblastoma. Histological subtype and tumour location were newly identified risk factors in this age-group, and should be further analysed in prospective trials. (C) 2012 Elsevier Ltd. All rights reserved.
Metadata last modified: 29 Sep 2021 07:39
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