Local perspective on a rare brain tumour: adult medulloblastoma

Abstract

Combined modality therapy (surgery followed by postoperative radiotherapy and adjuvant chemotherapy) was well tolerated and associated with good outcomes in standard-risk de novo patients. High-risk and recurrent disease patients do extremely poorly regardless of treatment and better treatment strategies are needed in these patients.

Adult medulloblastoma: feasibility and effectiveness of utilising high‐dose chemotherapy with autologous stem cell rescue in newly diagnosed patients

“…Previous series had reported 5-year survival of 70-80% in low-risk adults, regardless of whether adjuvant chemotherapy was administered. 3,4 The outcomes described by Collins et al 1 are encouraging but appear comparable with published literature for this group of patients. Our own series 2 did not find that the use of a more intensive treatment using a triplet chemotherapy regimen improved survival in low-risk patients compared with the doublet regimen although there are clearly caveats to this conclusion.…”

“…Kaplan-Meier representation of OS.bs_bs_banner Letters to the Editor complications of therapy included febrile neutropenia (44% of cycles), ≥grade 3 otoxicicity (33% of cycles), ≥grade 2 renal toxicity (15% of cycles), ≥grade 3 hepatic toxicity (11% of cycles) and ≥grade 3 central nervous system toxicity (4% of cycles). All living patients were contacted by phone in late 2012 by the treating institution, and all reported 'good'/'normal' functional status.As per the experience of Wong et al,1 patients with standard-risk disease appeared to achieve excellent outcomes with medial survival not yet reached. However, unlike the experience of Wong et al,1 all three patients with poor-risk disease features in our series (as per modified Chang criteria or cytogenetic findings) remain alive and disease-free at >28 months (range 28-79 months) post-diagnosis.…”

“…All living patients were contacted by phone in late 2012 by the treating institution, and all reported 'good'/'normal' functional status.As per the experience of Wong et al,1 patients with standard-risk disease appeared to achieve excellent outcomes with medial survival not yet reached. However, unlike the experience of Wong et al,1 all three patients with poor-risk disease features in our series (as per modified Chang criteria or cytogenetic findings) remain alive and disease-free at >28 months (range 28-79 months) post-diagnosis.…”

“…We thank Collins et al 1 for their interest in our paper. 2 Data from Collins et al 1 regarding the use of high-dose chemotherapy/autologous stem cell rescue (HDCT/ ASCR) in patients with de novo adult medulloblastoma are thought provoking.…”

“…We read with great interest the recent article by Wong et al, 1 reporting their local experience of treatment of adult medulloblastoma including adjuvant chemotherapy based on paediatric protocols.…”