Medulloblastoma in adults: clinical characteristics and treatment

Brandes, Alba A.; Palmisano, Valentina; Monfardini, S.

doi:10.1053/ctrv.1998.0096

Cited by 52 publications

(48 citation statements)

References 54 publications

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“…This is an improvement in comparison to response rates ranging from 40 to 75% with conventional chemotherapy. [2][3][4][5][6][7][8][9] Among patients who had a second recurrence, we report an even longer median time to relapse post high-dose chemotherapy as compared to Dunkel et al (13.5 vs 7 months), with two patients surviving with stable disease. It is interesting to note that patients with metastatic disease (>M0) had a comparable median time to relapse as compared to those with no metastatic disease (16 vs 13 months).…”

Section: Discussionmentioning

confidence: 59%

“…However, long-term follow-up suggests frequent late relapses and overall low cure rates for most patients with medulloblastoma who receive conventional treatment. 1,9 …”

Section: Discussionmentioning

confidence: 99%

“…8 Despite reasonably high response rates of 40-75% with these agents, no long-term disease-free survival has been reported. [1][2][3][4][5][6][7][8][9] Given that these agents are amenable to substantial dose-escalation, evaluation of high-dose chemotherapy (HDCT) and autologous stem cell transplantation (ASCT) has been suggested. 9 Promising results with HDCT/ASCT prompted us to use this form of therapy for young adults with recurrent medulloblastoma, who were otherwise healthy and had no possibility of cure with conventional dose therapy.…”

mentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9] Given that these agents are amenable to substantial dose-escalation, evaluation of high-dose chemotherapy (HDCT) and autologous stem cell transplantation (ASCT) has been suggested. 9 Promising results with HDCT/ASCT prompted us to use this form of therapy for young adults with recurrent medulloblastoma, who were otherwise healthy and had no possibility of cure with conventional dose therapy. [10][11][12][13][14][15] Here, we report the outcomes of six adults who underwent HDCT (cyclophosphamide, carboplatin, thiotepa, etoposide) with ASCT for medulloblastoma relapse.…”

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confidence: 99%

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Possible benefits of high-dose chemotherapy and autologous stem cell transplantation for adults with recurrent medulloblastoma

Zia

Chaudhry

Russell

et al. 2002

Bone Marrow Transplant

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Summary:In an attempt to improve the dismal prognosis of adults with recurrent medulloblastoma, six patients were treated with aggressive salvage therapy including highdose chemotherapy (HDCT) and autologous stem cell transplantation (ASCT). At relapse, all patients underwent surgical debulking followed by HDCT/ASCT and then radiotherapy when possible. The treatment plan included two cycles of HDCT/ASCT; first with cyclophosphamide, etoposide and carboplatin (CECb) and then 2 months later with cyclophosphamide and thiotepa (CT). Three of the six patients received the planned therapy. One patient experienced severe toxicity requiring life-sustaining therapy. This patient developed multi-organ dysfunction including multiple enhancing lesions in both cerebral hemispheres that slowly resolved over several months. Two other patients did not mobilize sufficient stem cells for two ASCT procedures. They received one ASCT conditioned with cyclophosphamide, thiotepa and carboplatin (CTCb). Three of six patients had a complete response (CR); the other three had a partial response (PR). Following the first ASCT, median duration of response was 13.5 months (range 9-29 months) and median survival was 21.5 months (range 12-42 months). There was no treatment-related mortality. We conclude that HDCT/ASCT with CECb-CT or CTCb is active against recurrent medulloblastoma in adults and may be associated with prolonged remissions. Multiple enhancing cerebral lesions on brain MRI early post-HDCT/ASCT may be a consequence of the treatment rather than metastatic disease.

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Section: Discussionmentioning

confidence: 59%

“…However, long-term follow-up suggests frequent late relapses and overall low cure rates for most patients with medulloblastoma who receive conventional treatment. 1,9 …”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Possible benefits of high-dose chemotherapy and autologous stem cell transplantation for adults with recurrent medulloblastoma

Zia

Chaudhry

Russell

et al. 2002

Bone Marrow Transplant

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“…It is common in childhood, but rarely seen at adult age, comprising only 1% of primary brain tumors. [1] There are not many studies concerning the treatment of these tumors. Medulloblastomas most commonly present with signs of increased intracranial pressure, including nocturnal or morning headaches, nausea, vomiting, and altered mental status.…”

Section: Introductionmentioning

confidence: 99%

Cushing's reflex in a rare case of adult medulloblastoma

Aronovich¹,

Scumpia²,

Edwards³

2014

World Journal of Emergency Medicine

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BACKGROUND: Medulloblastoma is a primitive neuro-ectodermal tumor. It is common in childhood, but rarely seen at adult age, comprising only 1% of primary brain tumors. METHODS:We treated a 31-year-old man presented to the emergency department (ED) with a chief complaint of nausea and vomiting for one week duration. Immediate frozen section revealed a grade IV medulloblastoma. During the hospital course, the patient was given craniospinal irradiation with chemotherapy. RESULTS:The patient was eventually discharged from the hospital to an assisted living facility after an uneventful 15-day course with the aid of social work.CONCLUSIONS: Despite intracranial tumors generally being slow growing masses, this patient demonstrates how quickly one can decompensate, and how important it is to recognize these clinical signs and symptoms of an intracranial lesion. Although these symptoms (i.e. Cushing response) are extremely rare, the ED physician should be aware and appreciate their clinical signifi cance.

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Histopathologic grading of adult medulloblastomas

Rodríguez

Eberhart

O’Neill

et al. 2007

Cancer

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The navigator gating and slice tracking approach currently used for respiratory motion compensation during free‐breathing coronary magnetic resonance angiography (MRA) has low imaging efficiency (typically 30–50%), resulting in long imaging times. In this work, a novel respiratory motion correction technique with 100% scan efficiency was developed for free‐breathing whole‐heart coronary MRA. The navigator signal was used as a reference respiratory signal to segment the data into six bins. 3D projection reconstruction k‐space sampling was used for data acquisition and enabled reconstruction of low resolution images within each respiratory bin. The motion between bins was estimated by image registration with a 3D affine transform. The data from the different respiratory bins was retrospectively combined after motion correction to produce the final image. The proposed method was compared with a traditional navigator gating approach in nine healthy subjects. The proposed technique acquired whole‐heart coronary MRA with 1.0 mm3 isotropic spatial resolution in a scan time of 6.8 ± 0.9 min, compared with 16.2 ± 2.8 min for the navigator gating approach. The image quality scores, and length, diameter and sharpness of the right coronary artery (RCA), left anterior descending coronary artery (LAD), and left circumflex coronary artery (LCX) were similar for both approaches (P > 0.05 for all), but the proposed technique reduced scan time by a factor of 2.5. Magn Reson Med, 2011. © 2011 Wiley‐Liss, Inc.

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Medulloblastoma in adults: clinical characteristics and treatment

Cited by 52 publications

References 54 publications

Possible benefits of high-dose chemotherapy and autologous stem cell transplantation for adults with recurrent medulloblastoma

Possible benefits of high-dose chemotherapy and autologous stem cell transplantation for adults with recurrent medulloblastoma

Cushing's reflex in a rare case of adult medulloblastoma

Histopathologic grading of adult medulloblastomas

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