Abstract
We retrospectively studied 26 consecutive adults treated for medulloblastoma using paediatric protocols. Between 1987 and 2003, patients ≥18 years old were given adjuvant chemotherapy consisting of one of two 'paediatric' regimens (depending on the time of presentation) and craniospinal local-boost radiotherapy: regimen A (n = 12), vincristine (VCR), intrathecal and/or intravenous methotrexate and conventional radiotherapy; or regimen B (n = 11) sequencing intensive doses of multiple agents followed by hyperfractionated accelerated radiotherapy (HART). A VCR-lomustine-based maintenance followed both regimens. Three additional patients received a tailored treatment due to their impaired neurological status after surgery. The median age at diagnosis was 26 years (range 18-41 years). With a median follow-up of 46 months, 5-year disease-free and overall survival rates were 65 ± 11% and 73 ± 10%, respectively, for the series as a whole. All patients who received regimen B (5 of whom had metastatic Chang M2-M3 disease) are alive with no evidence of disease at 39 months. Although the number of patients is limited, our data suggest that the sandwich sequential, moderately intensive chemotherapy in combination with HART is an effective treatment for medulloblastoma in adults, and this approach seems to overcome previously-recognised risk factors.
| Original language | English |
|---|---|
| Pages (from-to) | 1304-1310 |
| Number of pages | 7 |
| Journal | European Journal of Cancer |
| Volume | 41 |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - Jun 2005 |
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Keywords
- Adults
- Brain tumours
- High-dose chemotherapy
- Hyperfractionated accelerated radiotherapy
- Medulloblastoma
- Young adult cancer
ASJC Scopus subject areas
- Cancer Research
- Hematology
- Oncology
Cite this
Survival of adults treated for medulloblastoma using paediatric protocols. / Spreafico, Filippo; Massimino, Maura; Gandola, Lorenza; Cefalo, Graziella; Mazza, Elena; Landonio, Giuseppe; Pignoli, Emanuele; Poggi, Geraldina; Terenziani, Monica; Pedrazzoli, Paolo; Siena, Salvatore; Fossati-Bellani, Franca.
In: European Journal of Cancer, Vol. 41, No. 9, 06.2005, p. 1304-1310.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Survival of adults treated for medulloblastoma using paediatric protocols
AU - Spreafico, Filippo
AU - Massimino, Maura
AU - Gandola, Lorenza
AU - Cefalo, Graziella
AU - Mazza, Elena
AU - Landonio, Giuseppe
AU - Pignoli, Emanuele
AU - Poggi, Geraldina
AU - Terenziani, Monica
AU - Pedrazzoli, Paolo
AU - Siena, Salvatore
AU - Fossati-Bellani, Franca
PY - 2005/6
Y1 - 2005/6
N2 - We retrospectively studied 26 consecutive adults treated for medulloblastoma using paediatric protocols. Between 1987 and 2003, patients ≥18 years old were given adjuvant chemotherapy consisting of one of two 'paediatric' regimens (depending on the time of presentation) and craniospinal local-boost radiotherapy: regimen A (n = 12), vincristine (VCR), intrathecal and/or intravenous methotrexate and conventional radiotherapy; or regimen B (n = 11) sequencing intensive doses of multiple agents followed by hyperfractionated accelerated radiotherapy (HART). A VCR-lomustine-based maintenance followed both regimens. Three additional patients received a tailored treatment due to their impaired neurological status after surgery. The median age at diagnosis was 26 years (range 18-41 years). With a median follow-up of 46 months, 5-year disease-free and overall survival rates were 65 ± 11% and 73 ± 10%, respectively, for the series as a whole. All patients who received regimen B (5 of whom had metastatic Chang M2-M3 disease) are alive with no evidence of disease at 39 months. Although the number of patients is limited, our data suggest that the sandwich sequential, moderately intensive chemotherapy in combination with HART is an effective treatment for medulloblastoma in adults, and this approach seems to overcome previously-recognised risk factors.
AB - We retrospectively studied 26 consecutive adults treated for medulloblastoma using paediatric protocols. Between 1987 and 2003, patients ≥18 years old were given adjuvant chemotherapy consisting of one of two 'paediatric' regimens (depending on the time of presentation) and craniospinal local-boost radiotherapy: regimen A (n = 12), vincristine (VCR), intrathecal and/or intravenous methotrexate and conventional radiotherapy; or regimen B (n = 11) sequencing intensive doses of multiple agents followed by hyperfractionated accelerated radiotherapy (HART). A VCR-lomustine-based maintenance followed both regimens. Three additional patients received a tailored treatment due to their impaired neurological status after surgery. The median age at diagnosis was 26 years (range 18-41 years). With a median follow-up of 46 months, 5-year disease-free and overall survival rates were 65 ± 11% and 73 ± 10%, respectively, for the series as a whole. All patients who received regimen B (5 of whom had metastatic Chang M2-M3 disease) are alive with no evidence of disease at 39 months. Although the number of patients is limited, our data suggest that the sandwich sequential, moderately intensive chemotherapy in combination with HART is an effective treatment for medulloblastoma in adults, and this approach seems to overcome previously-recognised risk factors.
KW - Adults
KW - Brain tumours
KW - High-dose chemotherapy
KW - Hyperfractionated accelerated radiotherapy
KW - Medulloblastoma
KW - Young adult cancer
UR - http://www.scopus.com/inward/record.url?scp=20444501389&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=20444501389&partnerID=8YFLogxK
U2 - 10.1016/j.ejca.2005.02.022
DO - 10.1016/j.ejca.2005.02.022
M3 - Article
VL - 41
SP - 1304
EP - 1310
JO - European Journal of Cancer
JF - European Journal of Cancer
SN - 0959-8049
IS - 9
ER -