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: Dittes, Christine (Author) , Adolph, Jonas E. (Author) , Tippelt, Stephan (Author) , Mikasch, Ruth (Author) , Obrecht, Denise (Author) , Mynarek, Martin (Author) , Rutkowski, Stefan (Author) , Pfister, Stefan (Author) , Milde, Till (Author) , Witt, Olaf (Author) , Bison, Brigitte (Author) , Warmuth-Metz, Monika (Author) , Kortmann, Rolf-Dieter (Author) , Dietzsch, Stefan (Author) , Pietsch, Torsten (Author) , Timmermann, Beate (Author) , Sträter, Ronald (Author) , Bode, Udo (Author) , Faldum, Andreas (Author) , Kwiecien, Robert (Author) , Fleischhack, Gudrun (Author)
Format: Article (Journal)
Language:English
Published: 18 January 2022
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
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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
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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.
Item Description:Gesehen am 22.03.2022
Physical Description:Online Resource
ISSN:2072-6694
DOI:10.3390/cancers14030471