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

J Neurooncol. 2012 Feb;106(3):595-600. doi: 10.1007/s11060-011-0696-0. Epub 2011 Aug 27.

Abstract

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.

Publication types

  • Clinical Trial, Phase II

MeSH terms

  • Adult
  • Antineoplastic Agents / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Cerebellar Neoplasms / drug therapy*
  • Cerebellar Neoplasms / mortality
  • Cerebellar Neoplasms / radiotherapy
  • Cisplatin / administration & dosage*
  • Etoposide / administration & dosage*
  • Female
  • Humans
  • Longitudinal Studies
  • Magnetic Resonance Imaging
  • Male
  • Medulloblastoma / drug therapy*
  • Medulloblastoma / mortality
  • Medulloblastoma / radiotherapy
  • Middle Aged
  • Survival Analysis

Substances

  • Antineoplastic Agents
  • Etoposide
  • Cisplatin