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Adult medulloblastoma: multiagent chemotherapy with cisplatinum and etoposide: a single institutional experience.

Author(s): Silvani A, Gaviani P, Lamperti E, Botturi A, Dimeco F, Franzini A, Ferroli P, Fariselli L, Milanesi I, Erbetta A, Pollo B, Salmaggi A

Affiliation(s): Department of Neuro-oncology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy, silvani@istituto-besta.it.

Publication date & source: 2011-08-27, J Neurooncol., [Epub ahead of print]

In 1991, a prospective phase II trial was initiated to evaluate the efficacy of treatment for adults with medulloblastoma (MB). After surgery, patients were staged with a neuroradiologic examination of the brain and neuroaxis and by cerebrospinal fluid cytology. All patients received three cycles of upfront cisplatinum (cisplatinum) and etoposide (VP16) chemotherapy followed by cranio-spinal radiation therapy. The current article reports on the long-term results from that trial. After a median follow-up of 14.9 years, among a total of 28 adults with MB, the overall progression-free survival and overall survival (OS) rates at 5 years were 57.6 and 80%, respectively. The median OS for the whole group of patients was 11.3 years. The observed toxicity was mainly hematological, with leukopenia and thrombocytopenia (16% of grades 3 and 4). In summary, in our small series of patients, the role of combination administration of CDDP + VP16 started before the initiation of radiotherapy in reducing recurrences, particularly distant recurrences, remains unclear. To know whether adding chemotherapy to craniospinal radiation in adult therapy increases relapse-free and overall survival, we must await the results of a larger randomized controlled clinical trial.

Page last updated: 2011-12-09

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