Document Detail

Improved survival with the use of adjuvant chemotherapy in the treatment of medulloblastoma.
MedLine Citation:
PMID:  1847194     Owner:  NLM     Status:  MEDLINE    
Between 1975 and 1989, 108 children with newly diagnosed medulloblastoma/primitive neuroectodermal tumor (MB/PNET) of the posterior fossa were treated at the authors' institution. The patients were managed uniformly, and treatment included aggressive surgical resections, postoperative staging evaluations for extent of disease, and craniospinal radiation therapy with a local boost. Beginning in 1983, children with MB/PNET were prospectively assigned to risk groups; those with "standard-risk" MB/PNET were treated with radiation therapy alone, while those in the "poor-risk" group received similar radiation therapy plus adjuvant chemotherapy with 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU), vincristine, and cisplatin. The 5-year actuarial disease-free survival rate for all patients treated between 1975 and 1982 was 68%, and 73% when patients who died within 2 weeks after operation were excluded. This survival rate was statistically better for patients treated after 1982 (82%) compared to those treated between 1975 and 1982 (49%) (p less than 0.004). There was no difference in disease-free survival rates over time for children with standard-risk factors; however, there was a significant difference in the 5-year survival rate for poor-risk patients treated prior to 1982 (35%) compared to those treated later (87%) (p less than 0.001). For the group as a whole, a younger age at diagnosis correlated with a poorer survival rate; however, this relationship between age and outcome was significant only for children treated before 1983 (p less than 0.001). These results demonstrated an encouraging survival rate for children with MB/PNET, especially those treated with aggressive surgical resection followed by both radiation therapy and chemotherapy. The results strongly suggest that chemotherapy has a role for some, and possibly all, children with MB/PNET.
R J Packer; L N Sutton; J W Goldwein; G Perilongo; G Bunin; J Ryan; B H Cohen; G D'Angio; E D Kramer; R A Zimmerman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  74     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  1991 Mar 
Date Detail:
Created Date:  1991-03-19     Completed Date:  1991-03-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  433-40     Citation Subset:  AIM; IM    
Neuro-Oncology Program, Children's Hospital of Philadelphia, University of Pennsylvania Medical School.
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MeSH Terms
Brain Neoplasms / drug therapy*,  mortality,  radiotherapy
Child, Preschool
Cisplatin / therapeutic use
Infant, Newborn
Medulloblastoma / drug therapy*,  mortality,  radiotherapy
Neoplasms, Germ Cell and Embryonal / drug therapy,  radiotherapy
Prospective Studies
Reg. No./Substance:

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