P20.20.B SINGLE-CENTER EXPERIENCE IN THE MANAGEMENT OF ADULT MEDULLOBLASTOMAS: A RETROSPECTIVE ANALYSIS
Bildiriler > Özet Bildiri
Yazarlar: Emine Serra KAMER, E Karaman, M Acar, Yavuz ANACAK
Neuro-Oncology, , , Uluslararası, Özet Bildiri, Scopus, cilt 26, ss v120-v120
DOI: 10.1093/neuonc/noae144.407
Özet
Abstract BACKGROUND Medulloblastoma is a type of brain tumor that is less common in adults than in children. The standard treatment involves surgically removing as much of it as possible, followed by radiation therapy and chemotherapy. However, because this type of tumor is rare in adults, there is limited information available about its clinical characteristics and prognostic factors. This study aims to investigate the clinical features and treatment outcomes of adult patients who received postoperative radiotherapy for medulloblastoma at a single tertiary center. MATERIAL AND METHODS Patients aged 18 or above with a pathologic confirmation of medulloblastoma diagnosis who received postoperative craniospinal irradiation (CSI) at our institution between 2000-2021, was included in the study. Radiotherapy was administered with 3D conformal technique initially to whole cranium and spinal axis to 36Gy, followed by 18Gy boost to posterior fossa or tumor bed with 1.8Gy per fraction. Clinical characteristics, prognostic factors and survival outcomes were obtained from follow-up visits and electronic health records. RESULTS 31 cases (median age:28 (19-44)) were analyzed, of which 54.8% were male. The pathologic diagnoses comprised of 51.6% for desmoplastic/nodular histology, 41.6% classical histology and 6.4% anaplastic histology. 25 cases were at non-metastatic stage according to Chang Classification. Total tumor resection (residual disease <1.5cm2) was achieved in 83.9% cases. Twenty-one cases (67.7%) were categorized as standard risk, while ten were classified as high-risk group. Median treatment time was 47 days (38-71) and time between surgery and radiotherapy was 44 days (14-110). Median follow-up time was 91 months. Overall, 70.4% of patients were alive and no evidence of disease while 8 of patients were deceased. Six deaths were due to disease progression, one to traumatic intracranial hemorrhage, and the cause of death for one patient could not be obtained. 5 and 10-year overall survival was found to be 89.4% and 71.9%, respectively. Sex, histopathologic subtype, risk group were not found to be statistically significant prognostic factors, whereas a prolonged duration between surgery and radiotherapy (> 6 weeks) correlated adversely with prognosis (p: 0.025). Relapse-free survival was estimated to be 71.8% and 68.2% for 5- and 10-years, respectively. Nine recurrences occurred, all being in primary site with two also recurred in spinal axis. Seven cases received surgery, five received chemotherapy and five cases received radiotherapy as a salvage treatment. Five of nine patients were deceased due to disease progression after salvage treatment. CONCLUSION Adult patients with medulloblastoma have a better prognosis compared to pediatric patients. Craniospinal irradiation is a crucial part of local treatment. Extended follow-up is needed to monitor for recurrence and toxicity.