Treatment outcome and prognostic factors for adult patients with medulloblastoma: The Rare Cancer Network (RCN) experience

Affiliation auteurs!!!! Error affiliation !!!!
TitreTreatment outcome and prognostic factors for adult patients with medulloblastoma: The Rare Cancer Network (RCN) experience
Type de publicationJournal Article
Year of Publication2018
AuteursAtalar B, Ozsahin M, Call J, Napieralska A, Kamer S, Villa S, Erpolat P, Negretti L, Lassen-Ramshad Y, Onal C, Akyurek S, Ugurluer G, Baumert BG, Servagi-Vernat S, Miller RC, Ozyar E, Sio TT
JournalRADIOTHERAPY AND ONCOLOGY
Volume127
Pagination96-102
Date PublishedAPR
Type of ArticleArticle
ISSN0167-8140
Mots-clésAdult medulloblastoma, Chemotherapy, Craniospinal, multimodality, radiotherapy, Rare Cancer Network (RCN)
Résumé

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

DOI10.1016/j.radonc.2017.12.028