Cancers (Jan 2022)
Local and Systemic Therapy of Recurrent Medulloblastomas in Children and Adolescents: Results of the P-HIT-REZ 2005 Study
- Christine Gaab,
- Jonas E. Adolph,
- Stephan Tippelt,
- Ruth Mikasch,
- Denise Obrecht,
- Martin Mynarek,
- Stefan Rutkowski,
- Stefan M. Pfister,
- Till Milde,
- Olaf Witt,
- Brigitte Bison,
- Monika Warmuth-Metz,
- Rolf-Dieter Kortmann,
- Stefan Dietzsch,
- Torsten Pietsch,
- Beate Timmermann,
- Ronald Sträter,
- Udo Bode,
- Andreas Faldum,
- Robert Kwiecien,
- Gudrun Fleischhack
Affiliations
- Christine Gaab
- Department of Pediatrics III, Center for Translational Neuro- and Behavioral Sciences (CTNBS), University Hospital of Essen, Hufelandstrasse 55, 45147 Essen, Germany
- Jonas E. Adolph
- Department of Pediatrics III, Center for Translational Neuro- and Behavioral Sciences (CTNBS), University Hospital of Essen, Hufelandstrasse 55, 45147 Essen, Germany
- Stephan Tippelt
- Department of Pediatrics III, Center for Translational Neuro- and Behavioral Sciences (CTNBS), University Hospital of Essen, Hufelandstrasse 55, 45147 Essen, Germany
- Ruth Mikasch
- Department of Pediatrics III, Center for Translational Neuro- and Behavioral Sciences (CTNBS), University Hospital of Essen, Hufelandstrasse 55, 45147 Essen, Germany
- Denise Obrecht
- Department of Pediatric Hematology and Oncology, Center for Obstetrics and Pediatrics, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
- Martin Mynarek
- Department of Pediatric Hematology and Oncology, Center for Obstetrics and Pediatrics, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
- Stefan Rutkowski
- Department of Pediatric Hematology and Oncology, Center for Obstetrics and Pediatrics, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
- Stefan M. Pfister
- Hopp Children’s Cancer Center Heidelberg (KiTZ), 69120 Heidelberg, Germany
- Till Milde
- Hopp Children’s Cancer Center Heidelberg (KiTZ), 69120 Heidelberg, Germany
- Olaf Witt
- Hopp Children’s Cancer Center Heidelberg (KiTZ), 69120 Heidelberg, Germany
- Brigitte Bison
- Department of Neuroradiology, University Hospital Augsburg, 86156 Augsburg, Germany
- Monika Warmuth-Metz
- Institute of Diagnostic and Interventional Neuroradiology, University of Würzburg, 97080 Würzburg, Germany
- Rolf-Dieter Kortmann
- Department of Radio-Oncology, University of Leipzig, 04103 Leipzig, Germany
- Stefan Dietzsch
- Department of Radio-Oncology, University of Leipzig, 04103 Leipzig, Germany
- Torsten Pietsch
- Institute of Neuropathology, DGNN Brain Tumor Reference Center, University of Bonn, 53127 Bonn, Germany
- Beate Timmermann
- Department of Particle Therapy, University Hospital Essen, West German Proton Therapy Centre Essen (WPE), West German Cancer Center (WTZ), German Cancer Consortium (DKTK), 45147 Essen, Germany
- Ronald Sträter
- Department of Pediatric Hematology and Oncology, University Hospital Münster, 48129 Münster, Germany
- Udo Bode
- Department of Pediatric Hematology and Oncology, University Hospital Bonn, 53127 Bonn, Germany
- Andreas Faldum
- Institute of Biostatistics and Clinical Research, Westfälische Wilhelms-Universität Münster, Schmeddingstraße 56, 48149 Münster, Germany
- Robert Kwiecien
- Institute of Biostatistics and Clinical Research, Westfälische Wilhelms-Universität Münster, Schmeddingstraße 56, 48149 Münster, Germany
- Gudrun Fleischhack
- Department of Pediatrics III, Center for Translational Neuro- and Behavioral Sciences (CTNBS), University Hospital of Essen, Hufelandstrasse 55, 45147 Essen, Germany
- DOI
- https://doi.org/10.3390/cancers14030471
- Journal volume & issue
-
Vol. 14,
no. 3
p. 471
Abstract
Recurrent medulloblastomas are associated with survival rates n = 30/93) found mainly in molecular subgroup 3 were associated with markedly worse median PFS (HR: 2.34) and OS (HR: 3.26) in regression analyses. A significant survival advantage was found for the use of volume-reducing surgery as well as radiotherapy. Intravenous chemotherapy with carboplatin and etoposide (ivCHT, n = 28/93) showed improved PFS and OS data and the best objective response rate (ORR) was 66.7% compared to oral temozolomide (oCHT, n = 47/93) which was 34.8%. Intraventricular (n = 43) as well as high-dose chemotherapy (n = 17) at first relapse was not related to a significant survival benefit. Although the results are limited due to a non-randomized study design, they may serve as a basis for future treatment decisions in order to improve the patients’ survival.
Keywords
