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

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

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Background and purpose: The 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 methods: Thirteen 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. Results: Median 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. Conclusions: Patients 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.

Original languageEnglish (US)
JournalRadiotherapy and Oncology
DOIs
StateAccepted/In press - Jan 1 2018

Keywords

  • Adult medulloblastoma
  • Chemotherapy
  • Craniospinal
  • Multimodality
  • Radiotherapy
  • Rare Cancer Network (RCN)

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Radiology Nuclear Medicine and imaging

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    Atalar, B., Ozsahin, M., Call, J., Napieralska, A., Kamer, S., Villa, S., Erpolat, P., Negretti, L., Lassen-Ramshad, Y., Onal, C., Akyurek, S., Ugurluer, G., Baumert, B. G., Servagi-Vernat, S., Miller, R. C., Ozyar, E., & Sio, T. T. (Accepted/In press). Treatment outcome and prognostic factors for adult patients with medulloblastoma: The Rare Cancer Network (RCN) experience. Radiotherapy and Oncology. https://doi.org/10.1016/j.radonc.2017.12.028