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Intracranial Orthotopic Allografting of Medulloblastoma Cells in Immunocompromised Mice
Published on: October 3, 2010
Medulloblastoma in adults : A retrospective single institution analysis
Indrawati Hadi1, Olarn Roengvoraphoj1, Maximilian Niyazi1
1Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
Purpose:
Adult medulloblastoma is a rare disease treated according to the current pediatric treatment guidelines. This retrospective analysis investigated the clinical outcomes and prognostic factors of adult medulloblastoma patients, who received multimodal therapy at our institution.
Methods:
Treatment charts of all patients over the age of 15 years of age with de novo medulloblastoma, who had been treated at our institution between 2001 and 2014, were retrospectively analyzed. Patients' demographic parameters, initial symptoms, treatment modalities, toxicities, and survival outcomes were investigated.
Results:
In all, 21 patients with a median age of 30.2 years were identified. The most frequent histologies were desmoplastic and classic, and the most common molecular subtype was sonic hedgehog (SHH). After tumor resection, all patients received craniospinal irradiation (median dose 35.2 Gy) and a boost to the posterior fossa (median dose 19.8 Gy). Simultaneous chemotherapy with vincristine was given to 20 patients and sequential chemotherapy to 15 patients. The most common side effects were hematological toxicities. Median overall survival (OS) has not been reached after a median follow-up of 92 months. Estimated 5‑ and 10-year OS was 89 and 80%, respectively. Estimated 5‑ and 10-year progression-free survival (PFS) was 89 and 81%, respectively. In univariate analysis, a shorter interval between tumor resection and end of irradiation was significantly associated with improved OS and PFS, anaplastic histology with worse OS and PFS.
Conclusions:
The combined modality treatment showed a good outcome in adults with medulloblastoma. Treatment time was revealed to be prognostic and should be kept as short as possible.
Insights
Multimodal therapy shows good outcomes for adult medulloblastoma patients. Shorter treatment intervals improve survival, highlighting the importance of timely intervention for this rare cancer.
Area of Science:
- Neuro-oncology
- Radiation oncology
- Medical oncology
Background:
- Adult medulloblastoma is rare and typically treated using pediatric guidelines.
- Investigating outcomes in adults is crucial due to differences in treatment response and toxicity.
Purpose of the Study:
- To retrospectively analyze clinical outcomes and prognostic factors in adult medulloblastoma patients.
- To evaluate the effectiveness of multimodal therapy in this population.
Main Methods:
- Retrospective analysis of 21 adult patients (age > 15) treated between 2001-2014.
- Data collected included demographics, symptoms, treatment modalities (surgery, craniospinal irradiation, chemotherapy), toxicities, and survival.
- Molecular subtype (sonic hedgehog - SHH) and histology were analyzed.
Main Results:
- Median age was 30.2 years; common subtypes included desmoplastic and classic, with SHH being most frequent.
- Multimodal therapy (surgery, irradiation, chemotherapy) resulted in high survival rates: 5-year OS 89%, 10-year OS 80%.
- Shorter interval between resection and irradiation correlated with improved overall survival (OS) and progression-free survival (PFS); anaplastic histology predicted worse outcomes.
Conclusions:
- Combined modality treatment demonstrates favorable outcomes for adult medulloblastoma.
- Treatment duration is a significant prognostic factor; minimizing the time between surgery and radiation is recommended.
