TY - JOUR
T1 - Reduced-dose craniospinal irradiation is feasible for standard-risk adult medulloblastoma patients.
AU - Massimino, Maura
AU - Sunyach, Marie Pierre
AU - Barretta, Francesco
AU - Gandola, Lorenza
AU - Garegnani, Anna
AU - Pecori, Emilia
AU - Spreafico, Filippo
AU - Bonneville-Levard, Alice
AU - Meyronet, David
AU - Mottolese, Carmine
AU - Boschetti, Luna
AU - Biassoni, Veronica
AU - Schiavello, Elisabetta
AU - Giussani, Carlo
AU - Carrabba, Giorgio
AU - Diletto, Barbara
AU - Pallotti, Federica
AU - Stefini, Roberto
AU - Ferrari, Andrea
AU - Terenziani, Monica
AU - Casanova, Michela
AU - Luksch, Roberto
AU - Meazza, Cristina
AU - Podda, Marta
AU - Chiaravalli, Stefano
AU - Puma, Nadia
AU - Bergamaschi, Luca
AU - Morosi, Carlo
AU - Calareso, Giuseppina
AU - Giangaspero, Felice
AU - Antonelli, Manila
AU - Buttarelli, Francesca Romana
AU - Frappaz, Didier
N1 - Place: United States
PY - 2020/7/1
Y1 - 2020/7/1
N2 - INTRODUCTION: Medulloblastoma is the most common malignant brain tumor in children, but accounts for only 1risk pediatric medulloblastoma, current therapy includes craniospinal irradiation (CSI) at reduced doses (23.4 Gy) associated with chemotherapy. Whereas most same-stage adult patients are still given CSI at 36 Gy, with or without chemotherapy, we report here on our use of reduced-dose CSI associated with chemotherapy for older patients. METHODS: We gathered non-metastatic patients over 18 years old (median age 28 years, range 18-48) with minimal or no residual disease after surgery, no negative histological subtypes, treated between 1996-2018 at the Centre Léon Bérard (Lyon) and the INT (Milano). A series of 54 children with similar tumors treated in Milano was used for comparison. RESULTS: Forty-four adults were considered (median follow-up 101 months): 36 had 23.4 Gy of CSI, and 8 had 30.6 Gy, plus a boost to the posterior fossa/tumor bed; 43 had chemotherapy as all 54 children, who had a median 83-month follow-up. The PFS and OS were 82.2 ± 6.19 ± 5.2 years, and 78.5 ± 6.95.2 ± 7.8 not significantly different from those of the children. CSI doses higher than 23.4 Gy did not influence PFS. Female adult patients tended to have a better outcome than males. CONCLUSION: The results obtained in our combined series are comparable with, or even better than those obtained after high CSI doses, underscoring the need to reconsider this treatment in adults.
AB - INTRODUCTION: Medulloblastoma is the most common malignant brain tumor in children, but accounts for only 1risk pediatric medulloblastoma, current therapy includes craniospinal irradiation (CSI) at reduced doses (23.4 Gy) associated with chemotherapy. Whereas most same-stage adult patients are still given CSI at 36 Gy, with or without chemotherapy, we report here on our use of reduced-dose CSI associated with chemotherapy for older patients. METHODS: We gathered non-metastatic patients over 18 years old (median age 28 years, range 18-48) with minimal or no residual disease after surgery, no negative histological subtypes, treated between 1996-2018 at the Centre Léon Bérard (Lyon) and the INT (Milano). A series of 54 children with similar tumors treated in Milano was used for comparison. RESULTS: Forty-four adults were considered (median follow-up 101 months): 36 had 23.4 Gy of CSI, and 8 had 30.6 Gy, plus a boost to the posterior fossa/tumor bed; 43 had chemotherapy as all 54 children, who had a median 83-month follow-up. The PFS and OS were 82.2 ± 6.19 ± 5.2 years, and 78.5 ± 6.95.2 ± 7.8 not significantly different from those of the children. CSI doses higher than 23.4 Gy did not influence PFS. Female adult patients tended to have a better outcome than males. CONCLUSION: The results obtained in our combined series are comparable with, or even better than those obtained after high CSI doses, underscoring the need to reconsider this treatment in adults.
M3 - Article
JO - Journal of Neuro-Oncology
JF - Journal of Neuro-Oncology
SN - 0167-594X
IS - 3
ER -