Medulloblastoma in adults: evaluation of the Dutch society for neuro-oncology treatment protocol

被引：4

作者：

Bleeker, L. ^{[1
]}

Kouwenhoven, M. C. M. ^{[1
]}

de Heer, I. ^{[2
]}

Lissenberg-Witte, B. I. ^{[3
]}

Gijsbers, A. H. ^{[4
]}

Dubbink, H. J. ^{[5
]}

Kros, J. M. ^{[5
]}

Gijtenbeek, J. M. M. ^{[6
]}

Kurt, E. ^{[7
]}

van der Rijt, C. C. D. ^{[8
]}

Swaak-Kragten, A. T. ^{[9
]}

de Vos, F. Y. ^{[10
]}

van der Weide, H. L. ^{[11
]}

French, P. J. ^{[2
]}

van den Bent, M. J. ^{[2
]}

Wesseling, P. ^{[12
,13
]}

Bromberg, J. E. C. ^{[2
]}

机构：

[1] Amsterdam UMC, Brain Tumor Ctr Amsterdam, Dept Neurol, Amsterdam, Netherlands

[2] Erasmus MC Canc Inst, Brain Tumor Ctr, Dept Neurol, Rotterdam, Netherlands

[3] Amsterdam UMC, Dept Epidemiol & Data Sci, Amsterdam, Netherlands

[4] Nationwide Network Registry Histopathol & Cytopath, Houten, Netherlands

[5] Erasmus MC Canc Inst, Brain Tumor Ctr, Dept Pathol, Rotterdam, Netherlands

[6] Radboud Univ Nijmegen, Med Ctr, Dept Neurol, Nijmegen, Netherlands

[7] Radboud Univ Nijmegen, Med Ctr, Dept Neurosurg, Nijmegen, Netherlands

[8] Erasmus MC Canc Inst, Dept Med Oncol, Rotterdam, Netherlands

[9] Erasmus MC Canc Inst, Dept Radiat Oncol, Rotterdam, Netherlands

[10] Univ Med Ctr Utrecht, Canc Ctr, Dept Med Oncol, Utrecht, Netherlands

[11] Univ Groningen, Univ Med Ctr Groningen, Dept Radiat Oncol, Groningen, Netherlands

[12] Univ Amsterdam, Med Ctr VUmc, Dept Pathol, Amsterdam, Netherlands

[13] Princess Maxima Ctr Pediat Oncol, Lab Childhood Canc Pathol, Utrecht, Netherlands

来源：

JOURNAL OF NEURO-ONCOLOGY | 2023年 / 162卷 / 01期

关键词：

Medulloblastoma; Adults; Treatment; Methylation array; Toxicity; CENTRAL-NERVOUS-SYSTEM; CHILDHOOD MEDULLOBLASTOMA; CLASSIFICATION; TUMORS;

D O I：

10.1007/s11060-023-04285-8

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

PurposeMedulloblastoma is a rare tumor in adults. The objective of this nationwide, multicenter study was to evaluate the toxicity and efficacy of the Dutch treatment protocol for adult medulloblastoma patients.MethodsAdult medulloblastoma patients diagnosed between 2010 and 2018 were identified in the Dutch rare tumors registry or nationwide pathology database. Patients with intention to treat according to the national treatment protocol were included. Risk stratification was performed based on residual disease, histological subtype and extent of disease. All patients received postoperative radiotherapy [craniospinal axis 36 Gy/fossa posterior boost 19.8 Gy (14.4 Gy in case of metastases)]. High-risk patients received additional neoadjuvant (carboplatin-etoposide), concomitant (vincristine) and adjuvant chemotherapy (carboplatin-vincristine-cyclophosphamide) as far as feasible by toxicity. Methylation profiling, and additional next-generation sequencing in case of SHH-activated medulloblastomas, were performed.ResultsForty-seven medulloblastoma patients were identified, of whom 32 were treated according to the protocol. Clinical information and tumor material was available for 28 and 20 patients, respectively. The histological variants were mainly classic (43%) and desmoplastic medulloblastoma (36%). Sixteen patients (57%) were considered standard-risk and 60% were SHH-activated medulloblastomas. Considerable treatment reductions and delays in treatment occurred due to especially hematological and neurotoxicity. Only one high-risk patient could complete all chemotherapy courses. 5-years progression-free survival (PFS) and overall survival (OS) for standard-risk patients appeared worse than for high-risk patients (PFS 69% vs. 90%, OS 81% vs. 90% respectively), although this wasn't statistically significant.ConclusionCombined chemo-radiotherapy is a toxic regimen for adult medulloblastoma patients that may result in improved survival.

引用

页码：225 / 235

页数：11

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