Treatment of high risk medulloblastomas in children above the age of 3 years: a SFOP study.
OBJECTIVE
Improvement of EFS of children older than 3 years with high risk medulloblastoma.


METHODS
Between 1993 and 1999, 115 patients (3-18 years, mean 8 years) with high risk medulloblastoma were included. After surgery treatment consisted of chemotherapy ('8in1' and etoposide/carboplatin) before and after craniospinal radiotherapy.


RESULTS
Patients were staged using Chang-criteria (PF residue only, M1 and M2/M3) by local investigator as well as by central review panel (82.4% concordance). Chemotherapy was well tolerated without major delays in radiotherapy. With a mean follow up of 81 months (9-119), 5-year EFS was 49.8% and OS 60.1%. In detail according to subgroups EFS was 68.8% for PF residue only, 58.8% for M1 disease and 43.1% for M2/M3.


CONCLUSIONS
M1 patients are legitimate high risk patients. Survival rates are still very low for high risk medulloblastoma patients and future trials should therefore focus on more intensive (chemotherapy/radiotherapy) treatment.
Verlooy
J
J
Department of Paediatric Oncology, Institut Curie, Service d'Oncologie Pediatrique, 26 rue d'Ulm, 75231 Paris Cedex 05, France.
Mosseri
V
V
Bracard
S
S
Tubiana
A Lellouch
AL
Kalifa
C
C
Pichon
F
F
Frappaz
D
D
Chastagner
P
P
Pagnier
A
A
Bertozzi
A-I
AI
Gentet
J C
JC
Sariban
E
E
Rialland
X
X
Edan
C
C
Bours
D
D
Zerah
M
M
Le Gales
C
C
Alapetite
C
C
Doz
F
F
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D002528:Cerebellar Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy / Q000379:methods; D018572:Disease-Free Survival; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D008527:Medulloblastoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D011182:Postoperative Care; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
D005047:Etoposide; D016190:Carboplatin