Abstract
Purpose
To analyse long-term outcome and clinical prognostic factors in medulloblastoma.
Methods
We analysed 280 patients with medulloblastoma (3–18 years) included from 1991 to 1997
in the randomised multicentre trial HIT‘91 comparing pre-(‘sandwich’) and postradiation
(‘maintenance’) chemotherapy (median follow-up of survivors for 10 years).
Results
In 187 patients with complete staging, overall survival (OS) was higher after maintenance
compared to sandwich treatment for M0 (10-year OS 91% and 62%, p = 0.001) and M1 patients (10-year OS 70% and 34%, p = 0.020). In M2/3 disease, 10-year OS was 42% and 45%. Incomplete staging, metastases,
younger age and sandwich chemotherapy were independent adverse risk factors. Twelve
percent of all relapses (13 of 107) occurred after more than five years, and 12 patients
had secondary neoplasms.
Conclusions
After maintenance therapy, long-term survival was excellent in fully assessable patients
with localised medulloblastoma, and favourable for M1 patients. Patients should be
followed longer for late relapses and secondary tumours.
Keywords
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Article info
Publication history
Published online: March 02, 2009
Accepted:
January 15,
2009
Received:
November 24,
2008
Identification
Copyright
© 2009 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
