Distinctive clinical course and pattern of relapse in adolescents with medulloblastoma
- Pediatric Brain Tumor Program, The Hospital for Sick Children, Toronto, Ontario (Canada)
- Department of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario (Canada)
- Department of Neurology-Oncology, British Columbia's Children's Hospital, Vancouver, British Columbia (Canada)
- Department of Radiation Oncology, Princess Margaret Hospital, Toronto, Ontario (Canada)
- Department of Hematology/Oncology, IWK Health Centre, Halifax, Nova Scotia (Canada)
- Department of Hematology/Oncology, Montreal Children's Hospital, Montreal, Quebec (Canada)
- Department of Hematology/Oncology, Kingston General Hospital, Kingston, Ontario (Canada)
- Department of Hematology/Oncology, McMaster University, Hamilton, Ontario (Canada)
- Department of Hematology/Oncology, Saskatoon Cancer Center, Saskatoon, Saskatchewan (Canada)
- Departments of Oncology and Pediatrics, University of Calgary, Calgary, Alberta (Canada)
- Department of Hematology/Oncology, Stollery Children's Hospital, Edmonton, Alberta (Canada)
- 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, Vol. 64, Issue 2; Other Information: DOI: 10.1016/j.ijrobp.2005.07.962; PII: S0360-3016(05)02211-X; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
Similar Records
No Salvage Using High-Dose Chemotherapy Plus/Minus Reirradiation for Relapsing Previously Irradiated Medulloblastoma
Common Strategy for Adult and Pediatric Medulloblastoma: A Multicenter Series of 253 Adults