Long‐term results of a prospective study on the treatment of medulloblastoma in adults

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Abstract
BACKGROUND.: Because medulloblastoma (MB) is rare in adults, the few studies on this condition have been retrospective, and the follow‐up has tended to be short. Furthermore, the different therapeutic strategies used in these patients has made it difficult to assess survival rates and prognostic factors.METHODS.: In 1989, a prospective Phase II trial was initiated to evaluate the efficacy of treatment for adults with MB. Patients were staged completely with a neuroradiologic examination of the brain and neuroaxis and by cerebrospinal fluid cytology, according to Chang's staging system. Low‐risk patients received radiotherapy alone, whereas high‐risk patients received 2 cycles of upfront chemotherapy followed by radiotherapy and adjuvant chemotherapy. The current article reports on the long‐term results from that trial.RESULTS.: After a median follow up of 7.6 years, among a total of 36 adults with MB, the overall progression‐free survival (PFS) and overall survival (OS) rates at 5 years were 72% and 75%, respectively. In low‐risk patients, the 5‐year PFS rate was 80%, and the 5‐year OS rate was 80%; in high‐risk patients, the 5‐year PFS rate was 69%, and the 5‐year OS rate was 73%.CONCLUSIONS.: In adult patients with MB, long‐term follow‐up was essential for evaluating the real impact of treatments. Low‐risk and high‐risk patients did not differ significantly in terms of PFS or OS. Cancer 2007. © 2007 American Cancer Society.