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Radiotherapy for recurrent medulloblastoma in children and adolescents: survival after re-irradiation and first-time irradiation

Background: Radiotherapy (RT) involving craniospinal irradiation (CSI) is important in the initial treatment of medulloblastoma. At recurrence, the re-irradiation options are limited and associated with severe side-effects. Methods: For pre-irradiated patients, patients with re-irradiation (RT2) wer...

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Main Authors: Adolph, Jonas E. (Author) , Fleischhack, Gudrun (Author) , Tschirner, Sebastian (Author) , Rink, Lydia (Author) , Dittes, Christine (Author) , Mikasch, Ruth (Author) , Dammann, Philipp (Author) , Mynarek, Martin (Author) , Obrecht-Sturm, Denise (Author) , Rutkowski, Stefan (Author) , Bison, Brigitte (Author) , Warmuth-Metz, Monika (Author) , Pietsch, Torsten (Author) , Pfister, Stefan (Author) , Pajtler, Kristian Wilfried (Author) , Milde, Till (Author) , Kortmann, Rolf-Dieter (Author) , Dietzsch, Stefan (Author) , Timmermann, Beate (Author) , Tippelt, Stephan (Author)
Format: Article (Journal)
Language:English
Published: 22 May 2024
In: Cancers
Year: 2024, Volume: 16, Issue: 11, Pages: 1-13
ISSN:2072-6694
DOI:10.3390/cancers16111955
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.3390/cancers16111955
Verlag, kostenfrei, Volltext: https://www.mdpi.com/2072-6694/16/11/1955
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Author Notes:Jonas E. Adolph, Gudrun Fleischhack, Sebastian Tschirner, Lydia Rink, Christine Dittes, Ruth Mikasch, Philipp Dammann, Martin Mynarek, Denise Obrecht-Sturm, Stefan Rutkowski, Brigitte Bison, Monika Warmuth-Metz, Torsten Pietsch, Stefan M. Pfister, Kristian W. Pajtler, Till Milde, Rolf-Dieter Kortmann, Stefan Dietzsch, Beate Timmermann and Stephan Tippelt on behalf of the German GPOH HIT-Network
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Summary:Background: Radiotherapy (RT) involving craniospinal irradiation (CSI) is important in the initial treatment of medulloblastoma. At recurrence, the re-irradiation options are limited and associated with severe side-effects. Methods: For pre-irradiated patients, patients with re-irradiation (RT2) were matched by sex, histology, time to recurrence, disease status and treatment at recurrence to patients without RT2. Results: A total of 42 pre-irradiated patients with RT2 were matched to 42 pre-irradiated controls without RT2. RT2 improved the median PFS [21.0 (CI: 15.7-28.7) vs. 12.0 (CI: 8.1-21.0) months] and OS [31.5 (CI: 27.6-64.8) vs. 20.0 (CI: 14.0-36.7) months]. Concerning long-term survival after ten years, RT2 only lead to small improvements in OS [8% (CI: 1.4-45.3) vs. 0%]. RT2 improved survival most without (re)-resection [PFS: 17.5 (CI: 9.7-41.5) vs. 8.0 (CI: 6.6-12.2)/OS: 31.5 (CI: 27.6-NA) vs. 13.3 (CI: 8.1-20.1) months]. In the RT-naïve patients, CSI at recurrence improved their median PFS [25.0 (CI: 16.8-60.6) vs. 6.6 (CI: 1.5-NA) months] and OS [40.2 (CI: 18.7-NA) vs. 12.4 (CI: 4.4-NA) months]. Conclusions: RT2 could improve the median survival in a matched cohort but offered little benefit regarding long-term survival. In RT-naïve patients, CSI greatly improved their median and long-term survival.
Item Description:Gesehen am 02.12.2024
Physical Description:Online Resource
ISSN:2072-6694
DOI:10.3390/cancers16111955

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