Medulloblastomas are a rare disease in adult population. Currently the main treatment consists in surgical resection. There is a lack of prospective evidence and the adequate regimen of chemotherapy and radiotherapy is yet to be defined.
We conducted a retrospective study including adult patients with medulloblastoma treated at a tertiary referral center. The aim of this study was to estimate Overall survival (OS) and disease-free survival (DFS).
We identified a total of 58 patients. Median age was 28 years (range 16 – 62). A total of 26 patients, (44%) received at least one chemotherapy regimen. The most frequent combination was Vincristine/Cisplatin/Cyclophosphamide (VPC) (29%). 43% were treated with a concomitant chemoradiotherapy. DFS was 35.5 months, (range 4-100 months). Patients who underwent partial tumor removal presented 62-month OS. Patients with total resection surgery did not reach median OS (HR 1.98, CI 0.67 – 5.8). Those treated with chemotherapy did not reach OS. Patients without chemotherapy regimen have 62-month OS (HR 0.6 CI 0.19 – 1.8) Patients treated with VPC did not meet median overall survival, meanwhile other regimen implementations demonstrated 43-month OS (HR 2.00 CI 0.71 – 5.62) (p = 0.18). Patients who wereńt treated with chemoradiotherapy did not reach OS vs patients treated with sequential radiotherapy and chemotherapy (HR 0.65, CI 0.21 – 1.99) (P 0.45). Performance status was an important predictor of OS, patients with ECOG 3 demonstrated 12 months of OS meanwhile patients with ECOG 0 – 2 did not reach a median OS (HR 2.7, CI 1.63 – 4.55). Related to adverse events, 16% of patients treated with chemotherapy presented grade 3 and 4 toxicity. 10% of these patients manifested grade 3 or 4 neutropenia. A total of 51 pts (88%) received radiotherapy. 22 patients developed radioepithelitis (38%) and 13 pts developed radiotherapy-associated CNS toxicity.
In this study of 58 adult patients diagnosed with Medulloblastoma the results showed a performance status as an important OS prognostic factor. Sequential chemotherapy or concomitant therapy did not show an OS significance probably related to the size of our population.
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All authors have declared no conflicts of interest.