Treatment outcome and prognostic factors for adult patients with medulloblastoma: The Rare Cancer Network (RCN) experience. Issue 1 (April 2018)

• Record Type: Journal Article
• Authors: Atalar, Banu; Ozsahin, Mahmut; Call, Jason; Napieralska, Aleksandra; Kamer, Serra; Villa, Salvador; Erpolat, Petek; Negretti, Laura; Lassen-Ramshad, Yasmin; Onal, Cem; Akyurek, Serap; Ugurluer, Gamze; Baumert, Brigitta G.; Servagi-Vernat, Stephanie; Miller, Robert C.; Ozyar, Enis; Sio, Terence T.
• Is Part Of: Radiotherapy and oncology. Volume 127:Issue 1(2018)
• Page Start: 96
• Page End: 102
• Publication Date: 2018-04
• Subjects: CSI craniospinal irradiation -- CT chemotherapy -- KPS Karnofsky Performance Status -- MB medulloblastoma -- RCN Rare Cancer Network -- RT radiotherapy -- SHH sonic hedgehog -- SRS stereotactic radiosurgery -- WNT wingless; Adult medulloblastoma -- Chemotherapy -- Craniospinal -- Multimodality -- Radiotherapy -- Rare Cancer Network (RCN); Oncology -- Periodicals; Radiotherapy -- Periodicals; Tumors -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiothérapie -- Périodiques; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9940642
• DOI: 10.1016/j.radonc.2017.12.028
• Languages: English
• ISSNs: 0167-8140

Abstract

Abstract: 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.