Survival of adults treated for medulloblastoma using paediatric protocols

Filippo Spreafico, Maura Massimino, Lorenza Gandola, Graziella Cefalo, Elena Mazza, Giuseppe Landonio, Emanuele Pignoli, Geraldina Poggi, Monica Terenziani, Paolo Pedrazzoli, Salvatore Siena, Franca Fossati-Bellani

Research output: Contribution to journalArticlepeer-review

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 languageEnglish
Pages (from-to)1304-1310
Number of pages7
JournalEuropean Journal of Cancer
Volume41
Issue number9
DOIs
Publication statusPublished - Jun 2005

Keywords

  • Adults
  • Brain tumours
  • High-dose chemotherapy
  • Hyperfractionated accelerated radiotherapy
  • Medulloblastoma
  • Young adult cancer

ASJC Scopus subject areas

  • Cancer Research
  • Hematology
  • Oncology

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