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Distinctive clinical course and pattern of relapse in adolescents with medulloblastoma.
- Source :
-
International journal of radiation oncology, biology, physics [Int J Radiat Oncol Biol Phys] 2006 Feb 01; Vol. 64 (2), pp. 402-7. Date of Electronic Publication: 2005 Sep 28. - Publication Year :
- 2006
-
Abstract
- Purpose: To report the clinical course of adolescents with medulloblastoma, with specific emphasis on prognosis and pattern of relapse.<br />Methods and Materials: We retrospectively studied the clinical course and outcomes of children aged 10-20 years with medulloblastoma, treated at centers throughout Canada between 1986 and 2003. To better assess time to relapse, a cohort of patients aged 3-20 years at diagnosis was generated.<br />Results: A total of 72 adolescents were analyzed. Five-year overall survival and event-free survival rates were 78.3%+/-5.4% and 68.0%+/-6.2%, respectively. Late relapses occurred at a median of 3.0 years (range, 0.3-6.8 years). In univariate analysis, conventional risk stratification and the addition of chemotherapy to craniospinal radiation did not have prognostic significance. Female patients had improved overall survival (p=0.007). Time to relapse increased with age in a linear fashion. After relapse, patients faired poorly regardless of treatment modality. Patients who did not receive chemotherapy initially had improved progression-free survival at relapse (p=0.05).<br />Conclusions: Our study suggests that adolescents with medulloblastoma might have a unique prognosis and pattern of relapse, dissimilar to those in younger children. They might benefit from different risk stratifications and prolonged follow-up. These issues should be addressed in future prospective trials.
- Subjects :
- Adolescent
Adult
Age Factors
Analysis of Variance
Cerebellar Neoplasms drug therapy
Cerebellar Neoplasms radiotherapy
Child
Disease-Free Survival
Female
Humans
Male
Medulloblastoma drug therapy
Medulloblastoma radiotherapy
Medulloblastoma secondary
Prognosis
Recurrence
Retrospective Studies
Sex Factors
Cerebellar Neoplasms mortality
Medulloblastoma mortality
Neoplasm Recurrence, Local mortality
Subjects
Details
- Language :
- English
- ISSN :
- 0360-3016
- Volume :
- 64
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- International journal of radiation oncology, biology, physics
- Publication Type :
- Academic Journal
- Accession number :
- 16198067
- Full Text :
- https://doi.org/10.1016/j.ijrobp.2005.07.962