Radiotherapy for recurrent medulloblastoma in children and adolescents

• Verfasst von: Adolph, Jonas E. [VerfasserIn]
• Verfasst von: Fleischhack, Gudrun [VerfasserIn]
• Verfasst von: Tschirner, Sebastian [VerfasserIn]
• Verfasst von: Rink, Lydia [VerfasserIn]
• Verfasst von: Dittes, Christine [VerfasserIn]
• Verfasst von: Mikasch, Ruth [VerfasserIn]
• Verfasst von: Dammann, Philipp [VerfasserIn]
• Verfasst von: Mynarek, Martin [VerfasserIn]
• Verfasst von: Obrecht-Sturm, Denise [VerfasserIn]
• Verfasst von: Rutkowski, Stefan [VerfasserIn]
• Verfasst von: Bison, Brigitte [VerfasserIn]
• Verfasst von: Warmuth-Metz, Monika [VerfasserIn]
• Verfasst von: Pietsch, Torsten [VerfasserIn]
• Verfasst von: Pfister, Stefan [VerfasserIn]
• Verfasst von: Pajtler, Kristian Wilfried [VerfasserIn]
• Verfasst von: Milde, Till [VerfasserIn]
• Verfasst von: Kortmann, Rolf-Dieter [VerfasserIn]
• Verfasst von: Dietzsch, Stefan [VerfasserIn]
• Verfasst von: Timmermann, Beate [VerfasserIn]
• Verfasst von: Tippelt, Stephan [VerfasserIn]
• Titel: Radiotherapy for recurrent medulloblastoma in children and adolescents
• Titelzusatz: survival after re-irradiation and first-time irradiation
• Verf.angabe: Jonas E. Adolph, Gudrun Fleischhack, Sebastian Tschirner, Lydia Rink, Christine Dittes, Ruth Mikasch, Philipp Dammann, Martin Mynarek, Denise Obrecht-Sturm, Stefan Rutkowski, Brigitte Bison, Monika Warmuth-Metz, Torsten Pietsch, Stefan M. Pfister, Kristian W. Pajtler, Till Milde, Rolf-Dieter Kortmann, Stefan Dietzsch, Beate Timmermann and Stephan Tippelt on behalf of the German GPOH HIT-Network
• E-Jahr: 2024
• Jahr: 22 May 2024
• Umfang: 13 S.
• Illustrationen: Illustrationen
• Fussnoten: Gesehen am 02.12.2024
• Titel Quelle: Enthalten in: Cancers
• Ort Quelle: Basel : MDPI, 2009
• Jahr Quelle: 2024
• Band/Heft Quelle: 16(2024), 11, Artikel-ID 1955, Seite 1-13
• ISSN Quelle: 2072-6694
• DOI: doi:10.3390/cancers16111955
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: medulloblastoma
• Sach-SW: radiotherapy
• Sach-SW: re-irradiation
• Sach-SW: recurrence
• Sach-SW: resection
• K10plus-PPN: 1910093009

Abstract

Background: Radiotherapy (RT) involving craniospinal irradiation (CSI) is important in the initial treatment of medulloblastoma. At recurrence, the re-irradiation options are limited and associated with severe side-effects. Methods: For pre-irradiated patients, patients with re-irradiation (RT2) were matched by sex, histology, time to recurrence, disease status and treatment at recurrence to patients without RT2. Results: A total of 42 pre-irradiated patients with RT2 were matched to 42 pre-irradiated controls without RT2. RT2 improved the median PFS [21.0 (CI: 15.7-28.7) vs. 12.0 (CI: 8.1-21.0) months] and OS [31.5 (CI: 27.6-64.8) vs. 20.0 (CI: 14.0-36.7) months]. Concerning long-term survival after ten years, RT2 only lead to small improvements in OS [8% (CI: 1.4-45.3) vs. 0%]. RT2 improved survival most without (re)-resection [PFS: 17.5 (CI: 9.7-41.5) vs. 8.0 (CI: 6.6-12.2)/OS: 31.5 (CI: 27.6-NA) vs. 13.3 (CI: 8.1-20.1) months]. In the RT-naïve patients, CSI at recurrence improved their median PFS [25.0 (CI: 16.8-60.6) vs. 6.6 (CI: 1.5-NA) months] and OS [40.2 (CI: 18.7-NA) vs. 12.4 (CI: 4.4-NA) months]. Conclusions: RT2 could improve the median survival in a matched cohort but offered little benefit regarding long-term survival. In RT-naïve patients, CSI greatly improved their median and long-term survival.