Local and systemic therapy of recurrent medulloblastomas in children and adolescents: results of the P-HIT-REZ 2005 study
Recurrent medulloblastomas are associated with survival rates <10%. Adequate multimodal therapy is being discussed as having a major impact on survival. In this study, 93 patients with recurrent medulloblastoma treated in the German P-HIT-REZ 2005 Study were analyzed for survival (PFS, OS) depend...
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
18 January 2022
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| In: |
Cancers
Year: 2022, Volume: 14, Issue: 3, Pages: 1-24 |
| ISSN: | 2072-6694 |
| DOI: | 10.3390/cancers14030471 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3390/cancers14030471 Verlag, lizenzpflichtig, Volltext: https://www.mdpi.com/2072-6694/14/3/471 |
| Author Notes: | Christine Gaab, Jonas E. Adolph, Stephan Tippelt, Ruth Mikasch, Denise Obrecht, Martin Mynarek, Stefan Rutkowski, Stefan M. Pfister, Till Milde, Olaf Witt, Brigitte Bison, Monika Warmuth-Metz, Rolf-Dieter Kortmann, Stefan Dietzsch, Torsten Pietsch, Beate Timmermann, Ronald Sträter, Udo Bode, Andreas Faldum, Robert Kwiecien and Gudrun Fleischhack |
| Summary: | Recurrent medulloblastomas are associated with survival rates <10%. Adequate multimodal therapy is being discussed as having a major impact on survival. In this study, 93 patients with recurrent medulloblastoma treated in the German P-HIT-REZ 2005 Study were analyzed for survival (PFS, OS) dependent on patient, disease, and treatment characteristics. The median age at the first recurrence was 10.1 years (IQR: 6.9-16.1). Median PFS and OS, at first recurrence, were 7.9 months (CI: 5.7-10.0) and 18.5 months (CI: 13.6-23.5), respectively. Early relapses/progressions (<18 months, n = 30/93) found mainly in molecular subgroup 3 were associated with markedly worse median PFS (HR: 2.34) and OS (HR: 3.26) in regression analyses. A significant survival advantage was found for the use of volume-reducing surgery as well as radiotherapy. Intravenous chemotherapy with carboplatin and etoposide (ivCHT, n = 28/93) showed improved PFS and OS data and the best objective response rate (ORR) was 66.7% compared to oral temozolomide (oCHT, n = 47/93) which was 34.8%. Intraventricular (n = 43) as well as high-dose chemotherapy (n = 17) at first relapse was not related to a significant survival benefit. Although the results are limited due to a non-randomized study design, they may serve as a basis for future treatment decisions in order to improve the patients’ survival. |
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| Item Description: | Gesehen am 22.03.2022 |
| Physical Description: | Online Resource |
| ISSN: | 2072-6694 |
| DOI: | 10.3390/cancers14030471 |