Craniospinal radiotherapy in adult medulloblastoma.
OBJECTIVE
To evaluate the outcome and prognostic factors of adult patients with medulloblastoma.


METHODS
26 adult medulloblastoma patients with a median age of 27 were subjected to craniospinal radiotherapy. A dose of 30.6 Gy with 1.8 Gy/fraction/day was prescribed to M0 patients, while 36 Gy were to be applied in patients with positive cerebrospinal liquor findings. The posterior fossa was boosted to 54 Gy. While 20 patients underwent external-beam radiotheray alone, only six received sequential adjuvant chemotherapy.


RESULTS
Male/female ratio was 1.2. Preradiotherapy Karnofsky performance status was recorded as median 100%. 50% were classified as poor risk (n = 10, subtotal resection; n = 3, M+). The median follow-up time was 46.5 months. The 5-year actuarial survival rates for recurrence-free, distant metastasis-free, disease-free, and overall survival were 82.5%, 90.8%, 73.5%, and 89.7%, respectively. Patient characteristics, treatment factors and tumor characteristics failed to show any significance in univariate analysis. Grade 3 or 4 late morbidities were not observed.


CONCLUSIONS
Yet, the current standard of care seems to remain craniospinal irradiation after maximal surgical resection of the primary neoplasm without clear indications for adjuvant chemotherapy.
Selek
Ugur
U
Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey. ugurselek@yahoo.com
Zorlu
Faruk
F
Hurmuz
Pervin
P
Cengiz
Mustafa
M
Turker
Alev
A
Soylemezoglu
Figen
F
Gurkaynak
Murat
M
D000293:Adolescent; D000328:Adult; D002528:Cerebellar Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D015331:Cohort Studies; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008527:Medulloblastoma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D011379:Prognosis; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D013131:Spine / Q000528:radiation effects*; D015996:Survival Rate; D016896:Treatment Outcome