Distinctive clinical course and pattern of relapse in adolescents with medulloblastoma

Journal Article · Wed Feb 01 04:00:00 EST 2006 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2005.0· OSTI ID:20793297

Tabori, Uri ^[1]; Sung, Lillian ^[2]; Hukin, Juliette ^[3]; Laperriere, Normand ^[4]; Crooks, Bruce ^[5]; Carret, Anne-Sophie ^[6]; Silva, Mariana ^[7]; Odame, Isaac ^[8]; Mpofu, Chris ^[9]; Strother, Douglas ^[10]; Wilson, Beverly ^[11]; Samson, Yvan ^[12]; Bouffet, Eric ^[1]

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1. Pediatric Brain Tumor Program, The Hospital for Sick Children, Toronto, Ontario (Canada)
2. Department of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario (Canada)
3. Department of Neurology-Oncology, British Columbia's Children's Hospital, Vancouver, British Columbia (Canada)
4. Department of Radiation Oncology, Princess Margaret Hospital, Toronto, Ontario (Canada)
5. Department of Hematology/Oncology, IWK Health Centre, Halifax, Nova Scotia (Canada)
6. Department of Hematology/Oncology, Montreal Children's Hospital, Montreal, Quebec (Canada)
7. Department of Hematology/Oncology, Kingston General Hospital, Kingston, Ontario (Canada)
8. Department of Hematology/Oncology, McMaster University, Hamilton, Ontario (Canada)
9. Department of Hematology/Oncology, Saskatoon Cancer Center, Saskatoon, Saskatchewan (Canada)
10. Departments of Oncology and Pediatrics, University of Calgary, Calgary, Alberta (Canada)
11. Department of Hematology/Oncology, Stollery Children's Hospital, Edmonton, Alberta (Canada)
12. Department of Hematology/Oncology, Centre Hospitalier Universitaire de Quebec, Quebec, Quebec (Canada)

Purpose: To report the clinical course of adolescents with medulloblastoma, with specific emphasis on prognosis and pattern of relapse. Methods and Materials: We retrospectively studied the clinical course and outcomes of children aged 10-20 years with medulloblastoma, treated at centers throughout Canada between 1986 and 2003. To better assess time to relapse, a cohort of patients aged 3-20 years at diagnosis was generated. Results: A total of 72 adolescents were analyzed. Five-year overall survival and event-free survival rates were 78.3% {+-} 5.4% and 68.0% {+-} 6.2%, respectively. Late relapses occurred at a median of 3.0 years (range, 0.3-6.8 years). In univariate analysis, conventional risk stratification and the addition of chemotherapy to craniospinal radiation did not have prognostic significance. Female patients had improved overall survival (p = 0.007). Time to relapse increased with age in a linear fashion. After relapse, patients faired poorly regardless of treatment modality. Patients who did not receive chemotherapy initially had improved progression-free survival at relapse (p 0.05). Conclusions: Our study suggests that adolescents with medulloblastoma might have a unique prognosis and pattern of relapse, dissimilar to those in younger children. They might benefit from different risk stratifications and prolonged follow-up. These issues should be addressed in future prospective trials.

• OSTI ID: 20793297
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 2 Vol. 64; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ADOLESCENTS
CANADA
CHEMOTHERAPY
CHILDREN
DIAGNOSIS
HAZARDS
PATIENTS
STRATIFICATION