Treatment outcome and prognostic factors for adult patients with medulloblastoma: The Rare Cancer Network (RCN) experience

Publication date: Available online 17 January 2018
Source:Radiotherapy and Oncology
Author(s): Banu Atalar, Mahmut Ozsahin, Jason Call, Aleksandra Napieralska, Serra Kamer, Salvador Villa, Petek Erpolat, Laura Negretti, Yasmin Lassen-Ramshad, Cem Onal, Serap Akyurek, Gamze Ugurluer, Brigitta G. Baumert, Stephanie Servagi-Vernat, Robert C. Miller, Enis Ozyar, Terence T. Sio
Background and purposeThe optimal treatment for adults with newly diagnosed medulloblastoma (MB) has not been defined. We report a large series of cases from the Rare Cancer Network.Material and methodsThirteen institutions enrolled 206 MB patients who underwent postoperative radiotherapy (RT) between 1976 and 2014. Log-rank univariate and Cox-modeled multivariate analyses were used to analyze data collected.ResultsMedian patient age was 29 years; follow-up was 31 months. All patients had the tumor resected; surgery was complete in 140 (68%) patients. Postoperative RT was given in 202 (98%) patients, and 94% received craniospinal irradiation (CSI) and, usually, a posterior fossa boost. Ninety-eight (48%) patients had chemotherapy, mostly cisplatin and vincristine-based. The 10-year local control, overall survival, and disease-free survival rates were 46%, 51%, and 38%, respectively. In multivariate analyses, Karnofsky Performance Status (KPS) ≥80 and CSI were significant for disease-free and overall survival (P ≤ .04 for all); receiving chemotherapy and KPS ≥80 correlated with better local-control rates.ConclusionsPatients with high KPS who received CSI had better rates of disease-free and overall survival. Chemotherapy was associated with better local control. These results may serve as a benchmark for future studies designed to improve outcomes for adults with medulloblastoma.



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