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Journal of Neuro-Oncology

, Volume 106, Issue 3, pp 595–600 | Cite as

Adult medulloblastoma: multiagent chemotherapy with cisplatinum and etoposide: a single institutional experience

  • A. Silvani
  • P. Gaviani
  • E. Lamperti
  • A. Botturi
  • F. DiMeco
  • A. Franzini
  • P. Ferroli
  • L. Fariselli
  • I. Milanesi
  • A. Erbetta
  • B. Pollo
  • A. Salmaggi
Clinical Study – Patient Study

Abstract

In 1991, a prospective phase II trial was initiated to evaluate the efficacy of treatment for adults with medulloblastoma (MB). After surgery, patients were staged with a neuroradiologic examination of the brain and neuroaxis and by cerebrospinal fluid cytology. All patients received three cycles of upfront cisplatinum (cisplatinum) and etoposide (VP16) chemotherapy followed by cranio-spinal radiation therapy. The current article reports on the long-term results from that trial. After a median follow-up of 14.9 years, among a total of 28 adults with MB, the overall progression-free survival and overall survival (OS) rates at 5 years were 57.6 and 80%, respectively. The median OS for the whole group of patients was 11.3 years. The observed toxicity was mainly hematological, with leukopenia and thrombocytopenia (16% of grades 3 and 4). In summary, in our small series of patients, the role of combination administration of CDDP + VP16 started before the initiation of radiotherapy in reducing recurrences, particularly distant recurrences, remains unclear. To know whether adding chemotherapy to craniospinal radiation in adult therapy increases relapse-free and overall survival, we must await the results of a larger randomized controlled clinical trial.

Keywords

Adult patients Chemotherapy Cisplatinum Etoposide Medulloblastoma 

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Copyright information

© Springer Science+Business Media, LLC. 2011

Authors and Affiliations

  • A. Silvani
    • 1
  • P. Gaviani
    • 1
  • E. Lamperti
    • 1
  • A. Botturi
    • 1
  • F. DiMeco
    • 2
    • 6
  • A. Franzini
    • 2
  • P. Ferroli
    • 2
  • L. Fariselli
    • 3
  • I. Milanesi
    • 3
  • A. Erbetta
    • 4
  • B. Pollo
    • 5
  • A. Salmaggi
    • 1
  1. 1.Department of Neuro-oncologyFondazione IRCCS Istituto Neurologico Carlo BestaMilanItaly
  2. 2.Department of NeurosurgeryFondazione IRCCS Istituto Neurologico Carlo BestaMilanItaly
  3. 3.Department of RadiotherapyFondazione IRCCS Istituto Neurologico Carlo BestaMilanItaly
  4. 4.Department of Neuro-radiology UnitFondazione IRCCS Istituto Neurologico Carlo BestaMilanItaly
  5. 5.Department of Neuro-pathology UnitFondazione IRCCS Istituto Neurologico Carlo BestaMilanItaly
  6. 6.Department of Neurosurgery, The Johns Hopkins HospitalJohns Hopkins UniversityBaltimoreUSA

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