title: Long-term outcome and clinical prognostic factors in children with medulloblastoma treated in the prospective randomised multicentre trial HIT'91.
abstract: OBJECTIVE
  To analyse long-term outcome and clinical prognostic factors in medulloblastoma.
  
  
  METHODS
  We analysed 280 patients with medulloblastoma (3-18 years) included from 1991 to 1997 in the randomised multicentre trial HIT'91 comparing pre-('sandwich') and postradiation ('maintenance') chemotherapy (median follow-up of survivors for 10 years).
  
  
  RESULTS
  In 187 patients with complete staging, overall survival (OS) was higher after maintenance compared to sandwich treatment for M0 (10-year OS 91% and 62%, p=0.001) and M1 patients (10-year OS 70% and 34%, p=0.020). In M2/3 disease, 10-year OS was 42% and 45%. Incomplete staging, metastases, younger age and sandwich chemotherapy were independent adverse risk factors. Twelve percent of all relapses (13 of 107) occurred after more than five years, and 12 patients had secondary neoplasms.
  
  
  CONCLUSIONS
  After maintenance therapy, long-term survival was excellent in fully assessable patients with localised medulloblastoma, and favourable for M1 patients. Patients should be followed longer for late relapses and secondary tumours.
authors.affiliation: Department of Pediatrics, University of Wuerzburg, Germany.
authors.forename: Katja von
authors.initials: KV
authors.lastname: Hoff
authors.affiliation: Department of Pediatrics, University of Wuerzburg, Germany.
authors.forename: Bernward
authors.initials: B
authors.lastname: Hinkes
authors.affiliation: Department of Pediatrics, University of Wuerzburg, Germany.
authors.forename: Nicolas U
authors.initials: NU
authors.lastname: Gerber
authors.affiliation: Department of Pediatrics, University of Wuerzburg, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Deinlein
authors.affiliation: University Children's Hospital of Magdeburg, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Mittler
authors.affiliation: Division of Paediatric Haematology and Oncology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Urban
authors.affiliation: Division of Paediatric Haematology and Oncology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Benesch
authors.affiliation: Department of Neuroradiology, University of Wuerzburg, Germany.
authors.forename: Monika
authors.initials: M
authors.lastname: Warmuth-Metz
authors.affiliation: Department of Neurosurgery, ev. Hospital Oldenburg, Germany.
authors.forename: Niels
authors.initials: N
authors.lastname: Soerensen
authors.affiliation: Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University of Mainz, Germany.
authors.forename: Isabella
authors.initials: I
authors.lastname: Zwiener
authors.affiliation: Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University of Mainz, Germany.
authors.forename: Heiko
authors.initials: H
authors.lastname: Goette
authors.affiliation: Department of Pediatrics, University of Wuerzburg, Germany.
authors.forename: Paul G
authors.initials: PG
authors.lastname: Schlegel
authors.affiliation: Department of Neuropathology, University of Bonn, Germany.
authors.forename: Torsten
authors.initials: T
authors.lastname: Pietsch
authors.affiliation: Department of Radiation Oncology, University of Leipzig, Germany.
authors.forename: Rolf D
authors.initials: RD
authors.lastname: Kortmann
authors.affiliation: Department of Pediatrics, University of Wuerzburg, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Kuehl
authors.affiliation: Department of Pediatrics, University of Wuerzburg, Germany; University Medical Center Hamburg-Eppendorf, Department of Pediatric Hematology and Oncology, Hamburg, Germany. Electronic address: rutkowski@uke.de.
authors.forename: Stefan
authors.initials: S
authors.lastname: Rutkowski
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002528:Cerebellar Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008527:Medulloblastoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D016609:Neoplasms, Second Primary; D016016:Proportional Hazards Models; D015996:Survival Rate; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D014750:Vincristine