title: Survival After Relapse of Medulloblastoma.
abstract: Survival after recurrence of medulloblastoma has not been reported in an unselected cohort of patients in the contemporary era. We reviewed 55 patients diagnosed with medulloblastoma between 2000 and 2010, and treated at Seattle Children's Hospital to evaluate patterns of relapse treatment and survival. Fourteen of 47 patients (30%) over the age of 3 experienced recurrent or progressive medulloblastoma after standard therapy. The median time from diagnosis to recurrence was 18.0 months (range, 3.6 to 62.6 mo), and site of recurrence was metastatic in 86%. The median survival after relapse was 10.3 months (range, 1.3 to 80.5 mo); 3-year survival after relapse was 18%. There were trend associations between longer survival and having received additional chemotherapy (median survival 12.8 vs. 1.3 mo, P=0.16) and radiation therapy (15.4 vs. 5.9 mo, P=0.20). Isolated local relapse was significantly associated with shorter survival (1.3 vs. 12.8 mo, P=0.009). Recurrence of medulloblastoma is more likely to be metastatic than reported in previous eras. Within the limits of our small sample, our data suggest a potential survival benefit from retreatment with cytotoxic chemotherapy and radiation even in heavily pretreated patients. This report serves as a baseline against which to evaluate novel therapy combinations.
authors.affiliation: *Department of Pediatrics, Division of Pediatric Hematology-Oncology, University of Michigan School of Medicine, Ann Arbor, MI †Division of Pediatric Hematology-Oncology, Seattle Children's Hospital ‡Fred Hutchinson Cancer Research Center ∥Division of Pediatric Hematology-Oncology, Department of Pediatrics, University of Washington, Seattle, WA §Department of Oncology, Division of Neuro-Oncology, St Jude Children's Research Hospital, Memphis, TN.
authors.forename: Carl
authors.initials: C
authors.lastname: Koschmann
authors.forename: Karina
authors.initials: K
authors.lastname: Bloom
authors.forename: Santhosh
authors.initials: S
authors.lastname: Upadhyaya
authors.forename: J Russell
authors.initials: JR
authors.lastname: Geyer
authors.forename: Sarah E S
authors.initials: SE
authors.lastname: Leary
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008527:Medulloblastoma / Q000401:mortality* / Q000473:pathology / Q000556:secondary / Q000628:therapy; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000532:radiotherapy; D012008:Recurrence; D019233:Retreatment / Q000379:methods; D012189:Retrospective Studies; D015996:Survival Rate