Medulloblastoma. The identification of prognostic subgroups and implications for multimodality management
For 43 medulloblatoma patients who had five-and ten-year actuarial survival rates of 56%, prognostic factors of statistical significance included: T-stage, M-stage and histopathologic tumor score. Posterior fossa local control rates were also function of T-stage and TS. Combining TS with T-stage, patients fell into three prognostic and local control groups, which may have different future management implications: Small (T1,2) tumors of favorable (TS less than or equal to 5) histology had a 92% ten-year actuarial survival rate with 100% (8/8) local control; no change from current management is suggested. For the intermediate prognosis group, increasing the irradiation dose alone may improve survival because these tumors exhibited an irradiation dose-response relationship. However, it is the poor prognosis group which might be suitable for future adjuvant chemotherapy or radiosensitizer trials since there is no evidence that higher irradiation doses improve local control. This article identifies prognostic subgroups based on histologic type and TM staging in medulloblastoma patients which potentially may be utilized to improve therapeutic results, and confirms the value of staging patients with central nervous system malignancies.
- Research Organization:
- Department of Radiation Medicine, Massachusetts General Hospital, Boston
- OSTI ID:
- 5995267
- Journal Information:
- Cancer (Philadelphia); (United States), Vol. 51:2
- Country of Publication:
- United States
- Language:
- English
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BRAIN
BIOLOGICAL RADIATION EFFECTS
NEOPLASMS
RADIOTHERAPY
PATIENTS
SURVIVAL CURVES
CHEMOTHERAPY
CLASSIFICATION
COMPARATIVE EVALUATIONS
DOSE-RESPONSE RELATIONSHIPS
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SPINAL CORD
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MATHEMATICS
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NUCLEAR MEDICINE
ORGANS
RADIATION EFFECTS
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