1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-2-86-b 10.15844/pedneurbriefs-2-11-9 CNS Tumors Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Chemotherapy For Medulloblastoma http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 11 1988 01 08 2016 2 11 86 87 Copyright: © 1988 The Author(s) 1988 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Efficacy of adjuvant chemotherapy for patients with poor-risk medulloblastoma: a preliminary report

The efficacy of adjuvant chemotherapy for patients with poor-risk medulloblastoma/primitive neuroectodermal tumors (MB/PNET) has been studied at the Children’s Hospital of Philadelphia, University of Pennsylvania, PA.

 Adjuvant Chemotherapy Medulloblastoma/Primitive Neuroectodermal Tumors Cyclohexylnitrosourea

The efficacy of adjuvant chemotherapy for patients with poor-risk medulloblastoma/primitive neuroectodermal tumors (MB/PNET) has been studied at the Children’s Hospital of Philadelphia, University of Pennsylvania, PA. Chemotherapy consisted of vincristine during concomitant craniospinal radiation therapy and eight 6-week cycles of vincristine, cis-platinum, and cyclohexylnitrosourea. Twenty five of 26 children (96%) treated remain alive and free of disease at a median of 24 months from diagnosis (range 6-50 mos). Actuarial disease-free survival was statistically significantly better than for control subjects who had received radiation therapy alone during an 8 year period prior to the use of adjuvant chemotherapy. The 2-year disease-free survival was 96% for patients on the protocol of adjuvant chemotherapy as compared to 59% for historical control patients treated with radiotherapy alone. [1]

COMMENT. Surgical excision for the treatment of medulloblastoma has less than a 6 month survival rate, and postoperative radiation of the tumor bed alone has minimal benefit. Irradiation of the tumor bed and the entire neuroaxis provides an overall chance of 30% to 50% for 5 year survival. Patients with clinical evidence of arachnoidal seeding or with gross evidence of seeding at surgery do poorly. Survival without evidence of recurrent tumor for a period exceeding the patient’s age at diagnosis plus 9 months indicates a probably cure (“Collins’ law“). Corticosteroids result in remarkable amelioration of root signs and symptoms and reduction of edema for a brief period. Experience with chemotherapy in the past 25 years has produced better survival rates, and used as an adjuvant these agents are indicated for the poor-risk patients, that is, those less than 5 years of age at diagnosis or with disseminated tumors (Chang stages Ml - M3). [2]

 Packer RJ Siegel KR Sutton LN Evans AE D’Angio G Rorke LB Efficacy of adjuvant chemotherapy for patients with poor-risk medulloblastoma: a preliminary report Ann Neurol 1988 Oct 24 4 503 8 10.1002/ana.410240405 3239953 Groover RV Swaiman KF Wright FS Posterior fossa tumors The practice of pediatric neurology 1982 St. Louis CV Mosby 844 880