| Item type: | Article | ||||||||||||||||||||||||||||||||||||||||||||||||
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| Journal or Publication Title: | Journal of neurology | ||||||||||||||||||||||||||||||||||||||||||||||||
| Publisher: | DR DIETRICH STEINKOPFF VERLAG | ||||||||||||||||||||||||||||||||||||||||||||||||
| Place of Publication: | DARMSTADT | ||||||||||||||||||||||||||||||||||||||||||||||||
| Volume: | 252 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Number of Issue or Book Chapter: | 3 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Page Range: | pp. 291-299 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Date: | 2005 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Institutions: | Medicine > Lehrstuhl für Neurologie | ||||||||||||||||||||||||||||||||||||||||||||||||
| Identification Number: |
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| Classification: |
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| Keywords: | CHILDRENS CANCER GROUP; PRIMITIVE NEUROECTODERMAL TUMORS; PROSPECTIVE RANDOMIZED-TRIAL; RECURRENT MEDULLOBLASTOMA; ADJUVANT CHEMOTHERAPY; INTERNATIONAL SOCIETY; RADIATION-THERAPY; RADIOTHERAPY; VINCRISTINE; CHILDHOOD; adult; medulloblastoma; radiotherapy; chemotherapy; primitive neuroectodermal tumor; secondline therapy | ||||||||||||||||||||||||||||||||||||||||||||||||
| 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: | 29336 |
Web of ScienceAbstract
Adult medulloblastoma is a rare tumor with few retrospective studies published so far. The role of adjuvant chemotherapy or chemotherapy at relapse is unclear. This study reports therapy and outcome in all adult (>= 16 years old) medulloblastoma ( n = 34) and supratentorial primitive neuroectodermal tumor ( PNET) patients (n = 2) treated in 2 neuro-oncological centers between 1976 and 2002. The ...
Abstract
Adult medulloblastoma is a rare tumor with few retrospective studies published so far. The role of adjuvant chemotherapy or chemotherapy at relapse is unclear. This study reports therapy and outcome in all adult (>= 16 years old) medulloblastoma ( n = 34) and supratentorial primitive neuroectodermal tumor ( PNET) patients (n = 2) treated in 2 neuro-oncological centers between 1976 and 2002. The median age was 24.5 years ( range 16 - 76). After resection, 16 patients were treated with craniospinal radiotherapy alone, 20 patients also received adjuvant chemotherapy ( 8 vincristine, CCNU, cisplatin; 7 methotrexate alone or methotrexate/ vincristine-based polychemotherapy; 5 other protocols). Median survival in the whole cohort was 126 months (2+ - 200+ months). Five-year and 10-year survival rates were 79% and 56%. Adjuvant chemotherapy was associated with a non-significant trend to prolonged survival ( relative risk (RR) 1.89; p = 0.068). The median progression-free survival (PFS) after primary therapy was 83 months. At relapse, 10 of 12 evaluable patients achieved a complete response upon second-line therapy. The median survival times from first (n=17) and second relapse (n=9) were 21 months ( 0 - 67+ months; 5/17 without second relapse) and 20 months ( 1 - 29 months). Cox regression analysis revealed the infiltration of the floor of the 4th ventricle at diagnosis as the only therapy-independent prognostic factor ( RR 0.48; p=0.03). In conclusion, adjuvant chemotherapy may prolong survival in adult medulloblastoma patients. Moreover, second-line therapy may be beneficial for these patients. As in pediatric medulloblastoma patients, primary infiltration of the floor of the 4th ventricle indicates a poor prognosis.
Metadata last modified: 29 Sep 2021 07:39
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