Long-term results of a prospective study on the treatment of medulloblastoma in adults.
BACKGROUND
Because medulloblastoma (MB) is rare in adults, the few studies on this condition have been retrospective, and the follow-up has tended to be short. Furthermore, the different therapeutic strategies used in these patients has made it difficult to assess survival rates and prognostic factors.


METHODS
In 1989, a prospective Phase II trial was initiated to evaluate the efficacy of treatment for adults with MB. Patients were staged completely with a neuroradiologic examination of the brain and neuroaxis and by cerebrospinal fluid cytology, according to Chang's staging system. Low-risk patients received radiotherapy alone, whereas high-risk patients received 2 cycles of upfront chemotherapy followed by radiotherapy and adjuvant chemotherapy. The current article reports on the long-term results from that trial.


RESULTS
After a median follow up of 7.6 years, among a total of 36 adults with MB, the overall progression-free survival (PFS) and overall survival (OS) rates at 5 years were 72% and 75%, respectively. In low-risk patients, the 5-year PFS rate was 80%, and the 5-year OS rate was 80%; in high-risk patients, the 5-year PFS rate was 69%, and the 5-year OS rate was 73%.


CONCLUSIONS
In adult patients with MB, long-term follow-up was essential for evaluating the real impact of treatments. Low-risk and high-risk patients did not differ significantly in terms of PFS or OS.
Brandes
Alba A
AA
Department of Medical Oncology, Azienda Unità Sanitaria Locale (USL) Bellaria-Maggiore Hospital, Bologna, Italy. aa.brandes@yahoo.it
Franceschi
Enrico
E
Tosoni
Alicia
A
Blatt
Valeria
V
Ermani
Mario
M
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002528:Cerebellar Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008297:Male; D008527:Medulloblastoma / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D009367:Neoplasm Staging; D011446:Prospective Studies; D011878:Radiotherapy; D015996:Survival Rate; D013995:Time; D016896:Treatment Outcome