TY - JOUR
T1 - Treatment outcome and prognostic factors for adult patients with medulloblastoma
T2 - The Rare Cancer Network (RCN) experience
AU - Atalar, Banu
AU - Ozsahin, Mahmut
AU - Call, Jason
AU - Napieralska, Aleksandra
AU - Kamer, Serra
AU - Villa, Salvador
AU - Erpolat, Petek
AU - Negretti, Laura
AU - Lassen-Ramshad, Yasmin
AU - Onal, Cem
AU - Akyurek, Serap
AU - Ugurluer, Gamze
AU - Baumert, Brigitta G.
AU - Servagi-Vernat, Stephanie
AU - Miller, Robert C.
AU - Ozyar, Enis
AU - Sio, Terence T.
PY - 2018/4/1
Y1 - 2018/4/1
N2 - Background and purpose: The optimal treatment for adults with newly diagnosed medulloblastoma (MB) has not been defined. We report a large series of cases from the Rare Cancer Network. Material and methods: Thirteen institutions enrolled 206 MB patients who underwent postoperative radiotherapy (RT) between 1976 and 2014. Log-rank univariate and Cox-modeled multivariate analyses were used to analyze data collected. Results: Median patient age was 29 years; follow-up was 31 months. All patients had the tumor resected; surgery was complete in 140 (68%) patients. Postoperative RT was given in 202 (98%) patients, and 94% received craniospinal irradiation (CSI) and, usually, a posterior fossa boost. Ninety-eight (48%) patients had chemotherapy, mostly cisplatin and vincristine-based. The 10-year local control, overall survival, and disease-free survival rates were 46%, 51%, and 38%, respectively. In multivariate analyses, Karnofsky Performance Status (KPS) >= 80 and CSI were significant for disease-free and overall survival (P <= .04 for all); receiving chemotherapy and KPS >= 80 correlated with better local-control rates. Conclusions: Patients with high KPS who received CSI had better rates of disease-free and overall survival. Chemotherapy was associated with better local control. These results may serve as a benchmark for future studies designed to improve outcomes for adults with medulloblastoma. (C) 2018 Elsevier B. V. All rights reserved. Radiotherapy and Oncology 127 (2018) 96-102
AB - Background and purpose: The optimal treatment for adults with newly diagnosed medulloblastoma (MB) has not been defined. We report a large series of cases from the Rare Cancer Network. Material and methods: Thirteen institutions enrolled 206 MB patients who underwent postoperative radiotherapy (RT) between 1976 and 2014. Log-rank univariate and Cox-modeled multivariate analyses were used to analyze data collected. Results: Median patient age was 29 years; follow-up was 31 months. All patients had the tumor resected; surgery was complete in 140 (68%) patients. Postoperative RT was given in 202 (98%) patients, and 94% received craniospinal irradiation (CSI) and, usually, a posterior fossa boost. Ninety-eight (48%) patients had chemotherapy, mostly cisplatin and vincristine-based. The 10-year local control, overall survival, and disease-free survival rates were 46%, 51%, and 38%, respectively. In multivariate analyses, Karnofsky Performance Status (KPS) >= 80 and CSI were significant for disease-free and overall survival (P <= .04 for all); receiving chemotherapy and KPS >= 80 correlated with better local-control rates. Conclusions: Patients with high KPS who received CSI had better rates of disease-free and overall survival. Chemotherapy was associated with better local control. These results may serve as a benchmark for future studies designed to improve outcomes for adults with medulloblastoma. (C) 2018 Elsevier B. V. All rights reserved. Radiotherapy and Oncology 127 (2018) 96-102
KW - Adult medulloblastoma
KW - Chemotherapy
KW - Craniospinal
KW - Multimodality
KW - Radiotherapy
KW - Rare Cancer Network (RCN)
KW - NONMETASTATIC MEDULLOBLASTOMA
KW - ADJUVANT CHEMOTHERAPY
KW - RISK MEDULLOBLASTOMA
KW - SURVIVAL
KW - MULTICENTER
KW - RECURRENCE
KW - STRATEGY
U2 - 10.1016/j.radonc.2017.12.028
DO - 10.1016/j.radonc.2017.12.028
M3 - Article
C2 - 29373196
SN - 0167-8140
VL - 127
SP - 96
EP - 102
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
IS - 1
ER -