Octreotide in the therapy of recurrent medulloblastomas

Abstract

BACKGROUND:Recurrence of medulloblastoma appears after 30% to 40% of the surgeries. Different from primary medulloblastoma, in which five-year survival rate is 50%, the survival time of relapses much shorter and only 20% of the patients manage to survive a year. There is a logical need for additional methods of treatment of recurrent medulloblastomas. The aim of the study is to determine the effects of intracavitary and long-term subcutaneous application of Sandostatin (octreotide) on the recurrent medulloblastomas. METHODS: Fourteen children aged 4 to 9 years, in which, despite of craniospinal irradiation and chemotherapy came to a recurrence of medulloblastoma during the first 6 months after the surgery, were treated subcutaneously with Sandostatin (octreotide) in a longer period of time. Cerebellar medulloblastomas with a diameter bigger than 20 mm and spinal over 10 mm were removed operatively and octreotide with Beriplast was applied intracavitary. RESULTS: Magnetic resonance of cranioaxis shows that the application of octreotide has caused the disappearance of spinal drop metastases in all 7 patients and the cerebellar metastases smaller than 5 mm in all 4 patients. Subcutaneous application of octreotide combined with intracavitary expresses an antitumoral effect in 2/3 of the relapses. The application of octreotide results with a transformation of ChangÕs stage M0 into M1 in 71.43% of the patients. CONCLUSION: In the case of in loco or metastatic recurrence of medulloblastomas, intracavitarily and subcutaneously applied octreotide results with a regression of the tumor in a 3 year time within 2/3 of the treated patients.

Relapsed High-Risk Medulloblastoma: Stable Disease after Two Years of Treatment with Somatostatin Analog - Case Report

“…The clinical utility of somatostatin analogs in the treatment of medulloblastoma was first reported in 2005 in a Serbian series, which presented 10 of 14 children (72%) with a high-risk of relapsing medulloblastoma having disease involution with the use of octreotide alone [ 9 ]. In adults, the previous clinical experience is reduced to a single case reported in 2008 by Glas, et al with a 43-year old man with a relapsing medulloblastoma who achieved sustained disease response with octreotide; unfortunately, he presented with thrombotic thrombocytopenic purpura by the tenth month of administration and, therefore, the treatment was ended [ 10 ].…”

Anti-angiogenetic metronomic chemotherapy in an adult patient with recurrent medulloblastoma with spinal metastases: a case report

“…Case reports in the literature show encouraging results with second line chemotherapy [10,11], anti-angiogenic drugs [12] and targeted therapy for example with somatostatin analogues [13,14]. Th ese therapies may further improve prognosis and enable "living with cancer" for years even for patients with fatal prognosis like disseminated spinal metastases.…”

Somatostatin and Somatostatin Receptors in Tumour Biology

“…Despite lacking suitable chemotherapy, a therapeutic approach in combination has been employed in brain tumor treatment. Stefanović et al, for the first time, described the use of SST and its analogs in the treatment of medulloblastoma in children [ 171 ]. Previous studies have shown encouraging results in the treatment of medulloblastoma following intrathecal administration of radiolabeled SST analogs despite controversial observations with non-radiolabeled OCT [ 143 , 146 ].…”