title: The role of radiotherapy in adult medulloblastoma: long-term single-institution experience and a review of the literature.
abstract: Medulloblastoma (MB) occurs infrequently in adult patients and standard treatment is still controversial. We report our long-term, single-institution experience of adult MB and a review of the literature. We analysed adult patients with histologically proved MB treated by postoperative radiotherapy. Primary endpoints were local control (LC), disease-free survival (DFS), and overall survival (OS). Acute toxicity was reported according to CTC-NCI score vers. 3.0 and specific neuropsychological assessment analysis was performed to define late brain toxicity. From 1990-2008, 13 patients were treated by craniospinal (CSI, 12/13) or cranial irradiation (1/13, because of bad clinical conditions). Median follow up was 101 months (64-218). Complete radiological response was observed in 12/13 patients and a partial response in 1/13. Ten-year LC, OS, and DFS were 91, 76, and 84%, respectively. Two patients died because of local and spinal progression after 13 and 62 months. Acute G3 haematological toxicity (RTOG score) was observed for one patient only. The neuropsychological analysis did not reveal late toxicity related to brain radiotherapy. This experience confirms the efficacy and safety of radiotherapy in adult MB patients, resulting in very interesting 10-year LC and OS.
authors.affiliation: Bio-Images and Radiological Sciences Department, Radiotherapy Institute, Catholic University of Rome, 00168 Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Balducci
authors.forename: S
authors.initials: S
authors.lastname: Chiesa
authors.forename: D
authors.initials: D
authors.lastname: Chieffo
authors.forename: S
authors.initials: S
authors.lastname: Manfrida
authors.forename: N
authors.initials: N
authors.lastname: Dinapoli
authors.forename: A
authors.initials: A
authors.lastname: Fiorentino
authors.forename: F
authors.initials: F
authors.lastname: Miccichè
authors.forename: V
authors.initials: V
authors.lastname: Frascino
authors.forename: C
authors.initials: C
authors.lastname: Anile
authors.forename: V
authors.initials: V
authors.lastname: Valentini
authors.forename: B
authors.initials: B
authors.lastname: De Bari
mesh_terms: D000293:Adolescent; D000328:Adult; D002528:Cerebellar Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D059248:Chemoradiotherapy / Q000009:adverse effects* / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008527:Medulloblastoma / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D008875:Middle Aged; D009483:Neuropsychological Tests; D055815:Young Adult