TY - JOUR
T1 - Adult medulloblastoma
T2 - Multiagent chemotherapy with cisplatinum and etoposide: A single institutional experience
AU - Silvani, A.
AU - Gaviani, P.
AU - Lamperti, E.
AU - Botturi, A.
AU - DiMeco, F.
AU - Franzini, A.
AU - Ferroli, P.
AU - Fariselli, L.
AU - Milanesi, I.
AU - Erbetta, A.
AU - Pollo, B.
AU - Salmaggi, A.
PY - 2012/2
Y1 - 2012/2
N2 - In 1991, a prospective phase II trial was initiated to evaluate the efficacy of treatment for adults with medulloblastoma (MB). After surgery, patients were staged with a neuroradiologic examination of the brain and neuroaxis and by cerebrospinal fluid cytology. All patients received three cycles of upfront cisplatinum (cisplatinum) and etoposide (VP16) chemotherapy followed by craniospinal radiation therapy. The current article reports on the long-term results from that trial. After a median follow-up of 14.9 years, among a total of 28 adults with MB, the overall progression-free survival and overall survival (OS) rates at 5 years were 57.6 and 80%, respectively. The median OS for the whole group of patients was 11.3 years. The observed toxicity was mainly hematological, with leukopenia and thrombocytopenia (16% of grades 3 and 4). In summary, in our small series of patients, the role of combination administration of CDDP ? VP16 started before the initiation of radiotherapy in reducing recurrences, particularly distant recurrences, remains unclear. To know whether adding chemotherapy to craniospinal radiation in adult therapy increases relapse-free and overall survival, we must await the results of a larger randomized controlled clinical trial.
AB - In 1991, a prospective phase II trial was initiated to evaluate the efficacy of treatment for adults with medulloblastoma (MB). After surgery, patients were staged with a neuroradiologic examination of the brain and neuroaxis and by cerebrospinal fluid cytology. All patients received three cycles of upfront cisplatinum (cisplatinum) and etoposide (VP16) chemotherapy followed by craniospinal radiation therapy. The current article reports on the long-term results from that trial. After a median follow-up of 14.9 years, among a total of 28 adults with MB, the overall progression-free survival and overall survival (OS) rates at 5 years were 57.6 and 80%, respectively. The median OS for the whole group of patients was 11.3 years. The observed toxicity was mainly hematological, with leukopenia and thrombocytopenia (16% of grades 3 and 4). In summary, in our small series of patients, the role of combination administration of CDDP ? VP16 started before the initiation of radiotherapy in reducing recurrences, particularly distant recurrences, remains unclear. To know whether adding chemotherapy to craniospinal radiation in adult therapy increases relapse-free and overall survival, we must await the results of a larger randomized controlled clinical trial.
KW - Adult patients
KW - Chemotherapy
KW - Cisplatinum
KW - Etoposide
KW - Medulloblastoma
UR - http://www.scopus.com/inward/record.url?scp=84857049683&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84857049683&partnerID=8YFLogxK
U2 - 10.1007/s11060-011-0696-0
DO - 10.1007/s11060-011-0696-0
M3 - Article
C2 - 21874383
AN - SCOPUS:84857049683
SN - 0167-594X
VL - 106
SP - 595
EP - 600
JO - Journal of Neuro-Oncology
JF - Journal of Neuro-Oncology
IS - 3
ER -