Medulloblastoma: Experience of a single institution

Wolff, Johannes; Huettermann, U.; Ritter, J; Sträeter, Ronald; Palm, D.; Ruebe, Christian; Kraehling, K. H.; Jürgens, H.

doi:10.1055/s-2008-1043884

Cited by 3 publications

(1 citation statement)

References 11 publications

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“…This retrospective study re ects the clinical experience with treatment of adult medulloblastoma at one institution over a 20-year time period. Patient characteristics are comparable to those reported by several authors for small cohorts of adult patients (Giordana et al, 1999;Noel and Merrer, 1997;Wolff et al, 1998). The ndings of previous retrospective studies are supported and expanded by the addition of these patients to the body of data published to date.…”

Section: Discussionsupporting

confidence: 86%

Survival and recurrence factors in adult medulloblastoma: The M.D. Anderson Cancer Center experience from 1978 to 1998

Kunschner¹,

Kuttesch²,

Hess³

et al. 2001

Neuro-Oncol

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Medulloblastoma is a rare adult primary brain tumor for which limited retrospective studies are available to elucidate natural history or to guide therapy. A retrospective chart and imaging review of adult patients (aged >18 years) with medulloblastoma was performed to identify survival and prognostic factors. Fifty-seven patients were evaluated at the University of Texas M.D. Anderson Cancer Center from 1978-1998. Statistical analysis of prognostic factors and overall survival was performed for a subgroup of 28 patients who were followed exclusively at our institution from the time of diagnosis until death or last follow-up. These 28 patients had an overall survival of 91% at 3 years and 84% at 5 years, whereas median survival was not reached after a median follow-up of 168 weeks (range, 9-602 weeks). Progression-free survival for all patients was 68% at 3 years and 62% at 5 years, and was not statistically different between poor- and standard-risk patients. Univariate analysis of clinical features, such as age, sex, extent of local disease, extent of resection, and use of adjuvant chemotherapy, did not identify any prognostic variables for survival among the 28 patients. Patterns of recurrence revealed that the posterior fossa was the most common site (56%), followed by bone marrow (25%). Adult medulloblastoma appears to have a favorable prognosis after treatment with maximally surgically feasible resection followed by craniospinal irradiation. Optimal treatment remains to be clarified, as both standard-risk and poor-risk patients have prolonged disease-free survival. The marked difference between survival and progression-free survival suggests that salvage therapy, usually with combination chemotherapy in this cohort of patients, is of benefit. More formal analysis of the survival benefit was not possible, however, because of the small number of patients treated at recurrence with any one therapeutic regimen.

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Section: Discussionsupporting

confidence: 86%

Survival and recurrence factors in adult medulloblastoma: The M.D. Anderson Cancer Center experience from 1978 to 1998

Kunschner¹,

Kuttesch²,

Hess³

et al. 2001

Neuro-Oncol

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Sun

Yeh

Wang

et al. 2002

Journal of Neuro-Oncology

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Medulloblastoma in China: Clinicopathologic Analyses of SHH, WNT, and Non-SHH/WNT Molecular Subgroups Reveal Different Therapeutic Responses to Adjuvant Chemotherapy

Zhang

Ren

et al. 2014

PLoS ONE

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Medulloblastoma (MB) is one of the most common primary central nervous system tumors in children. Data is lacking of a large cohort of medulloblastoma patients in China. Also, our knowledge on the sensitivity of different molecular subgroups of MB to adjuvant radiation therapy (RT) or chemotherapy (CHT) is still limited. The authors performed a retrospective study of 173 medulloblastoma patients treated at two institutions from 2002 to 2011. Formalin-fixed paraffin embedded (FFPE) tissues were available in all the cases and sections were stained to classify histological and molecular subgroups. Univariate and multivariate analyses were used to investigate prognostic factors. Of 173 patients, there were 118 children and 55 adults, 112 males and 61 females. Estimated 5-year overall survival (OS) rates for all patients, children and adults were 52%, 48% and 63%, respectively. After multivariate analysis, postoperative primary radiation therapy (RT) and chemotherapy (CHT) were revealed as favorable prognostic factors influencing OS and EFS. Postoperative primary chemotherapy (CHT) was found significantly improving the survival of children (p<0.001) while it was not a significant prognostic factor for adult patients. Moreover, patients in WNT subtype had better OS (p = 0.028) than others (SHH and Non-SHH/WNT subtypes) given postoperative adjuvant therapies. Postoperative primary RT was found to be a strong prognostic factor influencing the survival in all histological and molecular subgroups (p<0.001). Postoperative primary CHT was found significantly to influence the survival of classic medulloblastoma (CMB) (OS p<0.001, EFS p<0.001), SHH subgroup (OS p = 0.020, EFS p = 0.049) and WNT subgroup (OS p = 0.003, EFS p = 0.016) but not in desmoplastic/nodular medulloblastoma (DMB) (OS p = 0.361, EFS p = 0.834) and Non-SHH/WNT subgroup (OS p = 0.127, EFS p = 0.055). Our study showed postoperative primary CHT significantly influence the survival of CMB, SHH subgroup and WNT subgroup but not in DMB and Non-SHH/WNT subgroup of MB.

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Medulloblastoma: Experience of a single institution

Abstract: The prognosis of medulloblastoma has clearly improved with the reduction of the perioperative mortality, standardized radiotherapy, and the introduction of intense chemotherapy.

Cited by 3 publications

References 11 publications

Survival and recurrence factors in adult medulloblastoma: The M.D. Anderson Cancer Center experience from 1978 to 1998

Survival and recurrence factors in adult medulloblastoma: The M.D. Anderson Cancer Center experience from 1978 to 1998

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Medulloblastoma in China: Clinicopathologic Analyses of SHH, WNT, and Non-SHH/WNT Molecular Subgroups Reveal Different Therapeutic Responses to Adjuvant Chemotherapy

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