0000000000590319
AUTHOR
Klaus J. Müller
Postponed Is Not Canceled: Role of Craniospinal Radiation Therapy in the Management of Recurrent Infant Medulloblastoma—An Experience From the HIT-REZ 1997 & 2005 Studies
Purpose To evaluate the efficacy of craniospinal irradiation (CSI) in the management of recurrent infant medulloblastoma after surgery and chemotherapy alone. Methods and Materials Seventeen pediatric medulloblastoma patients registered in the HIT-REZ 1997 and 2005 studies underwent CSI as salvage treatment at first recurrence. All patients had achieved complete remission after first-line treatment consisting of surgery and chemotherapy. Eleven patients showed metastatic disease at relapse. Five patients underwent surgery prior to radiation therapy, which resulted in complete resection in 1 case. In 1 patient, complete resection of the residual tumor was performed after CSI. Eleven patients…
External validation of a prognostic model estimating the survival of patients with recurrent high-grade gliomas after reirradiation
PURPOSE: We aimed to validate a controversial prognostic model for the survival of relapsed malignant glioma patients after reirradiation with an independent, multicentric patient cohort.METHODS AND MATERIALS: A total of 165 malignant glioma patients underwent reirradiation at 4 different institutions between 1994 and 2012. Twenty-two patients had a good (score 1), 44 had a moderate (score 2), and 99 had a poor prognosis (score 3 or 4). Four statistical methods were used to validate the prognostic model: First, we compared survival according to prognostic group in the construction and the validation cohort by visual comparison of the respective Kaplan-Meier plots. Second, discrimination was…
Treatment of Children and Adolescents With Metastatic Medulloblastoma and Prognostic Relevance of Clinical and Biologic Parameters
Purpose To assess an intensified treatment in the context of clinical and biologic risk factors in metastatic medulloblastoma. Patients and Methods Patients (4 to 21 years old, diagnosed between 2001 and 2007) received induction chemotherapy, dose-escalated hyperfractionated craniospinal radiotherapy, and maintenance chemotherapy. Subgroup status and other biologic parameters were assessed. Results In 123 eligible patients (median age, 8.2 years old; median follow-up, 5.38 years), 5-year event-free survival (EFS) and overall survival (OS) were 62% (95% CI, 52 to 72) and 74% (95% CI, 66 to 82), respectively. OS was superior compared with the precedent HIT ’91 trial. The 5-year EFS and OS wer…