AI Chat Paper
Note: Please note that the following content is generated by AMiner AI. SciOpen does not take any responsibility related to this content.
{{lang === 'zh_CN' ? '文章概述' : 'Summary'}}
{{lang === 'en_US' ? '中' : 'Eng'}}
Chat more with AI
PDF (1.6 MB)
Collect
Submit Manuscript AI Chat Paper
Show Outline
Outline
Show full outline
Hide outline
Outline
Show full outline
Hide outline
Research Article | Open Access

Clinical outcomes of adult medulloblastoma: A retrospective analysis at a single institute

Tao Jiang1Jin Zhu2,3Jing Dong2Junmei Wang1,4Jiang Du1,4Chunde Li1( )Yuqi Zhang2( )
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
Department of Neurosurgery, Tsinghua University Yuquan Hospital, Beijing 100040, China
Medical Center, Tsinghua University, Beijing 100084, China
Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China
Show Author Information

Abstract

Objectives:

Adult medulloblastoma is a rare tumor, and few retrospective studies on medulloblastoma have been published to date. A standard treatment regimen has not yet been established. Accordingly, this study was designed to determine the treatment outcomes and prognostic factors for patients with adult medulloblastoma.

Methods:

We retrospectively reviewed all cases of adult medulloblastoma at the Beijing Tiantan Hospital between 2004 and 2007. There were 33 patients in total. Tumor removal followed by radiotherapy was performed in all patients. Five patients received maintenance chemotherapy after radiotherapy. Statistical analysis was performed using the log-rank test, Kaplan-Meier method, and Cox regression analysis.

Results:

The median follow-up period was 73 months. The 5-year progression-free survival (PFS) and overall survival (OS) rates were 45.5% ± 8.7% and 51.5% ± 8.7%, respectively. Recurrence or progression was observed in 21 patients, and 14 patients were still alive. Tumor location at the midline with infiltration to the floor of the fourth ventricle was associated with the worst PFS and OS (P = 0.032). Hemispheric desmoplastic/nodular medulloblastomas (DNMBs) were associated with a better outcome than midline DNMB. The average-risk group tended to have a better 5-year PFS rate than the high-risk group (P = 0.065).

Conclusions:

Tumor location is an important prognostic marker for adulthood MB. We propose a molecular and clinical staging system should be established for adulthood MB. Further prospective clinical trials should be performed to draw a conclusion.

References

[1]
Northcott PA, Shih DJH, Remke M, Cho YJ, Kool M, Hawkins C, Eberhart CG, Dubuc A, Guettouche T, Cardentey Y, Bouffet E, Pomeroy SL, Marra M, Malkin D, Rutka JT, Korshunov A, Pfister S, Taylor MD. Rapid, reliable, and reproducible molecular sub-grouping of clinical medulloblastoma samples. Acta Neuropathol 2012, 123(4): 615-626.
[2]
Taylor MD, Northcott PA, Korshunov A, Remke M, Cho YJ, Clifford SC, Eberhart CG, Parsons DW, Rutkowski S, Gajjar A, Ellison DW, Lichter P, Gilbertson RJ, Pomeroy SL, Kool M, Pfister SM. Molecular subgroups of medulloblastoma: The current consensus. Acta Neuropathol 2012, 123(4): 465-472.
[3]
Wefers AK, Warmuth-Metz M, Pöschl J, von Bueren AO, Monoranu C-M, Seelos K, Peraud A, Tonn J-C, Koch A, Pietsch T. Subgroup-specific localization of human medulloblastoma based on pre-operative MRI. Acta Neuropathol 2014, 127(6): 931-933.
[4]
Teo WY, Shen JH, Su JMF, Yu A, Wang J, Chow WY, Li XN, Jones J, Dauser R, Whitehead W. Implications of tumor location on subtypes of medulloblastoma. Pediatric Blood Cancer 2013, 60(9): 1408-1410.
[5]
Rieken S, Gaiser T, Mohr A, Welzel T, Witt O, Kulozik AE, Wick W, Debus J, Combs SE. Outcome and prognostic factors of desmoplastic medulloblastoma treated within a multidisciplinary treatment concept. BMC Cancer 2010, 10: 450.
[6]
Remke M, Hielscher T, Northcott PA, Witt H, Ryzhova M, Wittmann A, Benner A, von Deimling A, Scheurlen W, Perry A, Croul S, Kulozik AE, Lichter P, Taylor MD, Pfister SM, Korshunov A. Adult medulloblastoma comprises three major molecular variants. J Clin Oncol: Offic J Am Soc Clin Oncol 2011, 29(19): 2717-2723.
[7]
Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, Scheithauer BW, Kleihues P. The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol 2007, 114(2): 97-109.
[8]
Silvani A, Gaviani P, Lamperti E, Botturi A, DiMeco F, Franzini A, Ferroli P, Fariselli L, Milanesi I, Erbetta A, Pollo B, Salmaggi A. Adult medulloblastoma: multiagent chemotherapy with cisplatinum and etoposide: A single institutional experience. J Neuro-Oncol 2012, 106(3): 595-600.
[9]
Brandes AA, Franceschi E, Tosoni A, Blatt V, Ermani M. Long-term results of a prospective study on the treatment of medulloblastoma in adults. Cancer 2007, 110(9): 2035-2041.
[10]
Call JA, Naik M, Rodriguez FJ, Giannini C, Wu WT, Buckner JC, Parney IF, Laack NN. Long-term outcomes and role of chemotherapy in adults with newly diagnosed medulloblastoma. Am J Clin Oncol 2014, 37(1): 1-7.
[11]
Brandes AA, Franceschi E. Shedding light on adult medulloblastoma: current management and opportunities for advances. Am Soc Clin Oncol Educat Book/ASCO Am Soc Clin Oncol Meet 2014, 34: e82-e87
[12]
Smoll NR. Relative survival of childhood and adult medulloblastomas and primitive neuroectodermal tumors (PNETs). Cancer 2012, 118(5): 1313-1322.
[13]
Menon G, Krishnakumar K, Nair S. Adult medulloblastoma: Clinical profile and treatment results of 18 patients. J Clin Neurosci 2008, 15(2): 122-126.
[14]
Herrlinger U, Steinbrecher A, Rieger J, Hau P, Kortmann RD, Meyermann R, Schabet M, Bamberg M, Dichgans J, Bogdahn U, Weller M. Adult medulloblastoma: prognostic factors and response to therapy at diagnosis and at relapse. J Neurol 2005, 252: 291-299.
[15]
Friedrich C, von Bueren AO, von Hoff K, Kwiecien R, Pietsch T, Warmuth-Metz M, Hau P, Deinlein F, Kuehl J, Kortmann RD. Treatment of adult nonmetastatic medulloblastoma patients according to the paediatric HIT 2000 protocol: A prospective observational multicentre study. Eur J Cancer 2013, 49(4): 893-903.
[16]
Padovani L, Sunyach MP, Perol D, Mercier C, Alapetite C, Haie-Meder C, Hoffstetter S, Muracciole X, Kerr C, Wagner JP, Lagrange JL, Maire JP, Cowen D, Frappaz D, Carrie C. Common strategy for adult and pediatric medulloblastoma: A multicenter series of 253 adults. Int J Radiat Oncol Biol Phys 2007, 68(2): 433-440.
[17]
Chan AW, Tarbell NJ, Black PM, Louis DN, Frosch MP, Ancukiewicz M, Chapman P, Loeffler JS. Adult medulloblastoma: Prognostic factors and patterns of relapse. Neurosurgery 2000, 47(3): 623-631.
[18]
Gibson P, Tong YA, Robinson G, Thompson MC, Currle DS, Eden C, Kranenburg TA, Hogg T, Poppleton H, Martin J, Finkelstein D, Pounds S, Weiss A, Patay Z, Scoggins M, Ogg R, Pei Y, Yang ZJ, Brun S, Lee Y, Zindy F, Lindsey JC, Taketo MM, Boop FA, Sanford RA, Gajjar A, Clifford SC, Roussel MF, McKinnon PJ, Gutmann DH, Ellison DW, Wechsler-Reya R, Gilbertson RJ. Subtypes of medulloblastoma have distinct developmental origins. Nature 2010, 468(7327): 1095-1099.
[19]
Kunschner LJ, Kuttesch J, Hess K, Yung WK. Survival and recurrence factors in adult medulloblastoma: The M.D. Anderson Cancer Center experience from 1978 to 1998. Neuro-Oncol 2001, 3(3): 167-173.
[20]
Prados MD, Warnick RE, Wara WM, Larson DA, Lamborn K, Wilson CB. Medulloblastoma in adults. Int J Radiat Oncol Biol Phys 1995, 32(4): 1145-1152.
[21]
Massimino M, Antonelli M, Gandola L, Miceli R, Pollo B, Biassoni V, Schiavello E, Buttarelli FR, Spreafico F, Collini P, Giangaspero F. Histological variants of medulloblastoma are the most powerful clinical prognostic indicators. Pediatric Blood Cancer 2013, 60(2): 210-216.
[22]
Rutkowski S, Gerber NU, von Hoff K, Gnekow A, Bode U, Graf N, Berthold F, Henze G, Wolff JEA, Warmuth-Metz M, Soerensen N, Emser A, Ottensmeier H, Deinlein F, Schlegel PG, Kortmann RD, Pietsch T, Kuehl J, German Pediatric Brain Tumor Study G. Treatment of early childhood medulloblastoma by postoperative chemotherapy and deferred radiotherapy. Neuro-Oncol 2009, 11(2): 201-210.
[23]
Northcott PA, Hielscher T, Dubuc A, Mack S, Shih D, Remke M, Al-Halabi H, Albrecht S, Jabado N, Eberhart CG, Grajkowska W, Weiss WA, Clifford SC, Bouffet E, Rutka JT, Korshunov A, Pfister S, Taylor MD. Pediatric and adult sonic hedgehog medulloblastomas are clinically and molecularly distinct. Acta Neuropathol 2011, 122(2): 231-240.
Brain Science Advances
Pages 17-24
Cite this article:
Jiang T, Zhu J, Dong J, et al. Clinical outcomes of adult medulloblastoma: A retrospective analysis at a single institute. Brain Science Advances, 2015, 1(1): 17-24. https://doi.org/10.18679/CN11-6030_R.2015.004

521

Views

10

Downloads

0

Crossref

Altmetrics

Received: 06 March 2015
Revised: 05 May 2015
Accepted: 12 May 2015
Published: 01 September 2015
© The authors 2015.

This article is published with open access at www.TNCjournal.com

Return