Shortened Treatment Benefits Medulloblastoma Patients

Risk-adapted radiotherapy plus chemotherapy improves survival in high-risk patients

FRIDAY, Sept. 8 (HealthDay News) -- The five-year survival in patients with high-risk medulloblastoma can be improved by using risk-adjusted radiotherapy plus a shortened course of chemotherapy, according to a study published online Sept. 7 in The Lancet Oncology.

After tumor resection, Amar Gajjar, M.D., from St. Jude Children's Research Hospital in Memphis, Tenn., and colleagues treated 119 children with medulloblastoma with risk-adapted levels of craniospinal radiation. Patients were classified as average-risk if they had 1.5 square cm or less of residual tumor and no metastatic disease or as high-risk if they had more than 1.5 square cm of residual tumor and metastatic disease. Six weeks after radiotherapy, patients received dose-intensive cyclophosphamide-based chemotherapy for four months rather than the usual one year.

The researchers found that the five-year overall survival was 85 percent in the average-risk group and 70 percent in the high-risk group, with a five-year event-free survival of 83 percent and 70 percent, respectively. The histological subtype was available for nearly all patients and correlated with the five-year event-free survival, ranging from 57 percent for large-cell anaplastic tumors to 84 percent for classic histology.

"Risk-adapted radiotherapy followed by a shortened schedule of dose-intensive chemotherapy can be used to improve the outcome of patients with high-risk medulloblastoma," Gajjar and colleagues conclude.

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