BACKGROUND: Most reported data of chemoradiotherapy protocols for the treatment of medulloblastoma describe children who were treated in the first decade of life. To consider the feasibility of this approach in adolescents, the authors studied their clinical course with specific emphasis on toxicity, tolerability, and prognosis. METHODS: In this retrospective study, the authors examined the toxicity profiles and outcomes of children age 10-20 years with medulloblastoma who were treated at centers throughout Canada between 1986 and 2003. Detailed toxicity data from 2 chemotherapy protocols were collected for teenagers and were compared with data from a group of control patients age 5-10 years. RESULTS: In total, 72 teenagers were analyzed. Grade >/= 2 ototoxicity and neurotoxicity occurred in 45% and 71% of chemotherapy-treated patients, respectively. Grade 3-4 hematotoxicty occurred in 95% of patients. Toxicity resulted in delay of treatment for 73% of patients and dose modification in 75% of patients, including protocol discontinuation in 25% of patients. Weight loss > 10% was encountered in 73% of patients and required intervention in 45% of patients. Teenagers had significantly more hematotoxicity and neurotoxicity compared with controls on both chemotherapeutic protocols. Ototoxicity was similar in both age groups. Toxicity resulted in significantly more treatment delays and dose modifications in teenager patients compared with controls. The 5-year overall and event-free survival rates (+/- standard deviation) were 78% +/- 6% and 70% +/- 6%, respectively. The mean time (+/- standard deviation) to disease recurrence was 3.2 +/- 2.2 years. CONCLUSIONS: The increased toxicity rate and high incidence of treatment modifications in this study suggested that current pediatric protocols may require modifications for teenagers with medulloblastoma. The results highlighted several issues that should be addressed in future prospective trials. (c) 2005 American Cancer Society.
BACKGROUND: Most reported data of chemoradiotherapy protocols for the treatment of medulloblastoma describe children who were treated in the first decade of life. To consider the feasibility of this approach in adolescents, the authors studied their clinical course with specific emphasis on toxicity, tolerability, and prognosis. METHODS: In this retrospective study, the authors examined the toxicity profiles and outcomes of children age 10-20 years with medulloblastoma who were treated at centers throughout Canada between 1986 and 2003. Detailed toxicity data from 2 chemotherapy protocols were collected for teenagers and were compared with data from a group of control patients age 5-10 years. RESULTS: In total, 72 teenagers were analyzed. Grade >/= 2 ototoxicity and neurotoxicity occurred in 45% and 71% of chemotherapy-treated patients, respectively. Grade 3-4 hematotoxicty occurred in 95% of patients. Toxicity resulted in delay of treatment for 73% of patients and dose modification in 75% of patients, including protocol discontinuation in 25% of patients. Weight loss > 10% was encountered in 73% of patients and required intervention in 45% of patients. Teenagers had significantly more hematotoxicity and neurotoxicity compared with controls on both chemotherapeutic protocols. Ototoxicity was similar in both age groups. Toxicity resulted in significantly more treatment delays and dose modifications in teenager patients compared with controls. The 5-year overall and event-free survival rates (+/- standard deviation) were 78% +/- 6% and 70% +/- 6%, respectively. The mean time (+/- standard deviation) to disease recurrence was 3.2 +/- 2.2 years. CONCLUSIONS: The increased toxicity rate and high incidence of treatment modifications in this study suggested that current pediatric protocols may require modifications for teenagers with medulloblastoma. The results highlighted several issues that should be addressed in future prospective trials. (c) 2005 American Cancer Society.
Authors: Kari L Bjornard; Laura S Gilchrist; Hiroto Inaba; Barthelemy Diouf; Marilyn J Hockenberry; Nina S Kadan-Lottick; Daniel C Bowers; M Eileen Dolan; Nicole J Ullrich; William E Evans; Kirsten K Ness Journal: Lancet Child Adolesc Health Date: 2018-09-01
Authors: Dagmar Beier; Martin Proescholdt; Christiane Reinert; Torsten Pietsch; David T W Jones; Stefan M Pfister; Elke Hattingen; Clemens Seidel; Linda Dirven; Ralf Luerding; Jaap Reijneveld; Monika Warmuth-Metz; Matteo Bonsanto; Michael Bremer; Stephanie E Combs; Stefan Rieken; Ulrich Herrlinger; Holger Kuntze; Regine Mayer-Steinacker; Dag Moskopp; Thomas Schneider; Andreas Beringer; Uwe Schlegel; Walter Stummer; Helmut Welker; Astrid Weyerbrock; Frank Paulsen; Stefan Rutkowski; Michael Weller; Wolfgang Wick; Rolf-Dieter Kortmann; Ulrich Bogdahn; Peter Hau Journal: Neuro Oncol Date: 2018-02-19 Impact factor: 12.300