title: Metastatic medulloblastoma in 10-year-old girl treated successfully with chemotherapy without radiotherapy.
abstract: We report a case of high risk medulloblastoma with leptomeningeal intracranial and spinal metastasis in a 10-year-old girl treated successfully with conventional prolonged chemotherapy without radiotherapy. This is a particular case of medulloblastoma that at onset did not receive standard therapy for medulloblastoma i.e. neither surgery nor craniospinal irradiation. This 10-year-old Chinese girl affected with localized medulloblastoma was previously treated at a medical department in China only with radiotherapy on the posterior fossa. When the child arrived in Italy with progressed metastatic medulloblastoma, she was treated with carboplatin/etoposide association i.v. followed by oral etoposide and partial surgery of the primitive mass. The schedule of chemotherapy was etoposide 300 mg/sqm followed by carboplatin 1000 mg/sqm in one day every 21-28 days for the first six courses, then etoposide 200 mg/sqm and carboplatin 600 mg/sqm in one day every 28-35 days for further 11 courses and oral etoposide 50 mg/sqm/day for ten consecutive days and one week interval between two cycles for one year. At present the girl is alive and disease-free, and has been off-therapy for 31 months. Interestingly, in this case a long-lasting complete remission was obtained without radiotherapy and without myeloablative chemotherapy. Oral etoposide played an important role in achieving a complete remission.
authors.affiliation: Department of Pediatrics, University La Sapienza, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Schiavetti
authors.forename: G
authors.initials: G
authors.lastname: Varrasso
authors.forename: P
authors.initials: P
authors.lastname: Maurizi
authors.forename: G
authors.initials: G
authors.lastname: Trasimeni
authors.forename: C
authors.initials: C
authors.lastname: Carapella
authors.forename: M A
authors.initials: MA
authors.lastname: Castello
mesh_terms: D000284:Administration, Oral; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D002528:Cerebellar Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000556:secondary* / Q000601:surgery; D002648:Child; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008279:Magnetic Resonance Imaging; D008527:Medulloblastoma / Q000175:diagnosis / Q000188:drug therapy* / Q000556:secondary* / Q000601:surgery
chemical_list: D000970:Antineoplastic Agents; D000972:Antineoplastic Agents, Phytogenic; D005047:Etoposide; D016190:Carboplatin