Abstract
BackgroundMedulloblastomas are a rare disease in adult population. Currently the main treatment consists in surgical resection. There is a lack of prospective evidence and the adequate regimen of chemotherapy and radiotherapy is yet to be defined. MethodsWe conducted a retrospective study including adult patients with medulloblastoma treated at a tertiary referral center. The aim of this study was to estimate Overall survival (OS) and disease-free survival (DFS). ResultsWe identified a total of 58 patients. Median age was 28 years (range 16 – 62). A total of 26 patients, (44%) received at least one chemotherapy regimen. The most frequent combination was Vincristine/Cisplatin/Cyclophosphamide (VPC) (29%). 43% were treated with a concomitant chemoradiotherapy. DFS was 35.5 months, (range 4-100 months). Patients who underwent partial tumor removal presented 62-month OS. Patients with total resection surgery did not reach median OS (HR 1.98, CI 0.67 – 5.8). Those treated with chemotherapy did not reach OS. Patients without chemotherapy regimen have 62-month OS (HR 0.6 CI 0.19 – 1.8) Patients treated with VPC did not meet median overall survival, meanwhile other regimen implementations demonstrated 43-month OS (HR 2.00 CI 0.71 – 5.62) (p = 0.18). Patients who wereńt treated with chemoradiotherapy did not reach OS vs patients treated with sequential radiotherapy and chemotherapy (HR 0.65, CI 0.21 – 1.99) (P 0.45). Performance status was an important predictor of OS, patients with ECOG 3 demonstrated 12 months of OS meanwhile patients with ECOG 0 – 2 did not reach a median OS (HR 2.7, CI 1.63 – 4.55). Related to adverse events, 16% of patients treated with chemotherapy presented grade 3 and 4 toxicity. 10% of these patients manifested grade 3 or 4 neutropenia. A total of 51 pts (88%) received radiotherapy. 22 patients developed radioepithelitis (38%) and 13 pts developed radiotherapy-associated CNS toxicity. ConclusionsIn this study of 58 adult patients diagnosed with Medulloblastoma the results showed a performance status as an important OS prognostic factor. Sequential chemotherapy or concomitant therapy did not show an OS significance probably related to the size of our population. Legal entity responsible for the studyThe authors. FundingHas not received any funding. DisclosureAll authors have declared no conflicts of interest.
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