Medulloblastoma/primitive neuroectodermal tumor in adults: prognostic factors and treatment results: a single-center experience from Turkey

Ertas, Gulcin; Üçer, Ali Riza; Altundag, Muzaffer B.; Durmus, Sema; Calikoglu, Tamer; Ozbagi, Kenan; Abanuz, Hayati; Altundağ, Kadri̇; Demirkasimoglu, Atila

doi:10.1007/s12032-007-0044-6

Cited by 8 publications

(2 citation statements)

References 14 publications

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“…Medulloblastomas occur rarely in adolescents and adults, however about 1% of all non-pediatric brain tumors are identified as primitive neuroectodermal tumors (PNET), among which medulloblastoma is the major subgroup [3,4]. In this population, a clear distinction must be made between infratentorial and supratentorial medulloblastomas, in the latter location also referred to as PNET, which despite histological resemblance are associated with poorer outcome due to their rapidly invasive growth [5]. Early locoregional infiltration has been shown to compromise local control rates and predispose for systemic spread of disease via the neuraxis in case of supratentorial location [6].…”

Section: Introductionmentioning

confidence: 99%

Outcome and prognostic factors of desmoplastic medulloblastoma treated within a multidisciplinary treatment concept

et al. 2010

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BackgroundDesmoplasia in medulloblastoma is often diagnosed in adult patients and was repeatedly associated with improved results. Today, all medulloblastoma patients receive intensive multimodal treatment including surgery, radiotherapy and chemotherapy. This study was set up to investigate treatment outcome and prognostic factors after radiation therapy in patients with desmoplastic medulloblastomas.MethodsTwenty patients treated for desmoplastic medulloblastoma in the Department of Radiation Oncology at the University of Heidelberg between 1984 and 2007 were included. Data were collected retrospectively. Tumor resection was performed in all patients. All patients underwent postsurgical radiotherapy (RT). Two patients underwent whole brain radiotherapy (WBRT), and 18 patients received craniospinal irradiation (CSI). In all patients, an additional boost was delivered to the posterior fossa. The median dose to the whole brain and the craniospinal axis was 35.2 Gray (Gy), and 54.4 Gy to the posterior fossa. Fourteen patients received chemotherapy, including seven who were treated with combined radiochemotherapy and twelve who received adjuvant chemotherapy. Statistical analysis was performed using the log-rank test and the Kaplan-Meier method.ResultsMedian follow-up was 59 months. Overall (OS), local (LPFS) and distant progression-free survival (DPFS) was 80%, 71.2%, and 83.3% at 60 months. Patients who suffered from local or distant relapses had significantly worse outcome. Five patients died from recurrent medulloblastoma. Treatment-associated toxicity was acceptable.ConclusionsMultimodal approaches with surgical resection followed by chemoirradiation achieved high response rates with long OS in desmoplastic medulloblastoma patients. Staging parameters expected to predict for poor prognosis did not significantly influence outcome. However, success of any first line regimen had strong impact on disease control, and remission was achieved in no patient with relapsing disease. Multimodal concepts must be evaluated in further clinical trials.

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Section: Introductionmentioning

confidence: 99%

Outcome and prognostic factors of desmoplastic medulloblastoma treated within a multidisciplinary treatment concept

et al. 2010

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“…Postoperatif kalıntı miktarı en önemli prognostik faktörlerdendir (12)(13)(14). Hidrosefali ve kafa içi basınç artışının eşlik ettiği hastalarda cerrahi öncesi yüksek doz deksametazon tedavisi başlanmalı, gerekirse ventrikuloperitoneal şant takılmalıdır (15 (18)(19)(20)(21)(22).…”

Section: Cerrahi Tedaviunclassified

Current Treatment of Medulloblastoma

Or¹,

Güney²,

Dizman³

et al. 2013

Acta Oncol Tur.

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ÖZETMedulloblastom çocukluk çağının ikinci en sık görülen ve en malign beyin tümörüdür. Yetişkinlerde ise oldukça nadir rastlanır. Medulloblastom tanılı hastalar tedavi öncesi standart risk ve yüksek riskli olmak üzere iki gruba ayrılır. Cerrahi rezeksiyonu takiben kraniospinal radyoterapi tedavinin temelini oluşturur. Günümüzde tedaviye kemoterapinin eklenmesi sağkalımın artmasına katkıda bulunmuştur. Ayrıca kemoterapinin eklenmesi ile total radyoterapi dozu da düşürülmüştür. Tedavide yeni kemoterapik ajanların geliştirilmesi ve yeni radyoterapi teknikleri hastaların uyumunu arttırmıştır. Anahtar Kelimeler: Medulloblastom; Kraniospinal ışınlama; Radyoterapi ABSTRACT Medulloblastoma is the second most common and most malignant brain tumor in children. But in adults medulloblastomas occur rarely. The patients with medulloblastoma are stratified two groups before treatment: avarage risk and high risk. Surgical resection followed by craniospinal irradiation has been the mainstay of medulloblastoma therapy. In recent years, chemotherapy has been introduced to reduce the total dose of radiation and increase the survival rate. The new radiotherapy techniques and chemotherapy agents increase compliance to treatment.

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The role of radiotherapy in adult medulloblastoma: long-term single-institution experience and a review of the literature

Boccadoro¹,

Chiesa²,

Chieffo

et al. 2011

J Neurooncol

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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.

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Medulloblastoma/primitive neuroectodermal tumor in adults: prognostic factors and treatment results: a single-center experience from Turkey

Cited by 8 publications

References 14 publications

Outcome and prognostic factors of desmoplastic medulloblastoma treated within a multidisciplinary treatment concept

Outcome and prognostic factors of desmoplastic medulloblastoma treated within a multidisciplinary treatment concept

Current Treatment of Medulloblastoma

The role of radiotherapy in adult medulloblastoma: long-term single-institution experience and a review of the literature

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