Survival and late effects in medulloblastoma patients treated with craniospinal irradiation under three years old.

2.50
Hdl Handle:
http://hdl.handle.net/10541/94828
Title:
Survival and late effects in medulloblastoma patients treated with craniospinal irradiation under three years old.
Authors:
Kiltie, Anne E; Lashford, Linda S; Gattamaneni, Rao
Abstract:
Conventional treatment of medulloblastoma has involved surgery to the primary tumour and radiotherapy to the primary site and craniospinal axis. However CNS irradiation in a young child may result in significant side effects. Thus new treatment strategies have emerged which include chemotherapy, given in order to delay radiotherapy, to enable radiation dose reduction to the primary site and craniospinal axis, or even to eliminate radiotherapy completely. Such treatments have not yet been adequately evaluated in terms of survival and late effects. We report a retrospective study of 37 patients under the age of 36 months treated with postoperative craniospinal irradiation, in which the radiation dose to the neuroaxis was below conventional dosage. The overall actuarial 10-year survival rate was 44% and the actuarial 10-year relapse tree survival rate was 54%. Both radiotherapy and chemotherapy contributed to morbidity and mortality. Tour of 16 patients who survived longer than 10 years had no hard neurological signs; all but one patient have required extra support at school. Of nine patients available for work, two have obtained employment but only one has maintained this. No young adults have married. Despite lower doses of radiation, all but 1 survivor has significant spine shortening, and all who reached final height were short. Further work is needed to complete the profile of late effects in this group, which should include the survivors own perceptions of quality of life. It is hoped that multimodality treatment and supportive care can sustain acceptable survival rates but reduce the burden of late effects.
Affiliation:
Christie Hospital NHS Trust, Manchester, United Kingdom.
Citation:
Survival and late effects in medulloblastoma patients treated with craniospinal irradiation under three years old. 1997, 28 (5):348-54 Med. Pediatr. Oncol.
Journal:
Medical and Pediatric Oncology
Issue Date:
May-1997
URI:
http://hdl.handle.net/10541/94828
DOI:
10.1002/(SICI)1096-911X(199705)28:5<348::AID-MPO4>3.0.CO;2-H
PubMed ID:
9121399
Type:
Article
Language:
en
ISSN:
0098-1532
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorKiltie, Anne Een
dc.contributor.authorLashford, Linda Sen
dc.contributor.authorGattamaneni, Raoen
dc.date.accessioned2010-03-24T11:45:37Z-
dc.date.available2010-03-24T11:45:37Z-
dc.date.issued1997-05-
dc.identifier.citationSurvival and late effects in medulloblastoma patients treated with craniospinal irradiation under three years old. 1997, 28 (5):348-54 Med. Pediatr. Oncol.en
dc.identifier.issn0098-1532-
dc.identifier.pmid9121399-
dc.identifier.doi10.1002/(SICI)1096-911X(199705)28:5<348::AID-MPO4>3.0.CO;2-H-
dc.identifier.urihttp://hdl.handle.net/10541/94828-
dc.description.abstractConventional treatment of medulloblastoma has involved surgery to the primary tumour and radiotherapy to the primary site and craniospinal axis. However CNS irradiation in a young child may result in significant side effects. Thus new treatment strategies have emerged which include chemotherapy, given in order to delay radiotherapy, to enable radiation dose reduction to the primary site and craniospinal axis, or even to eliminate radiotherapy completely. Such treatments have not yet been adequately evaluated in terms of survival and late effects. We report a retrospective study of 37 patients under the age of 36 months treated with postoperative craniospinal irradiation, in which the radiation dose to the neuroaxis was below conventional dosage. The overall actuarial 10-year survival rate was 44% and the actuarial 10-year relapse tree survival rate was 54%. Both radiotherapy and chemotherapy contributed to morbidity and mortality. Tour of 16 patients who survived longer than 10 years had no hard neurological signs; all but one patient have required extra support at school. Of nine patients available for work, two have obtained employment but only one has maintained this. No young adults have married. Despite lower doses of radiation, all but 1 survivor has significant spine shortening, and all who reached final height were short. Further work is needed to complete the profile of late effects in this group, which should include the survivors own perceptions of quality of life. It is hoped that multimodality treatment and supportive care can sustain acceptable survival rates but reduce the burden of late effects.en
dc.language.isoenen
dc.subjectCerebellar Canceren
dc.subject.meshActuarial Analysis-
dc.subject.meshAdolescent-
dc.subject.meshAdult-
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols-
dc.subject.meshBrain-
dc.subject.meshCerebellar Neoplasms-
dc.subject.meshChemotherapy, Adjuvant-
dc.subject.meshChild-
dc.subject.meshChild, Preschool-
dc.subject.meshDisease-Free Survival-
dc.subject.meshFemale-
dc.subject.meshFollow-Up Studies-
dc.subject.meshHumans-
dc.subject.meshInfant-
dc.subject.meshMale-
dc.subject.meshMedulloblastoma-
dc.subject.meshQuality of Life-
dc.subject.meshRadiotherapy Dosage-
dc.subject.meshRadiotherapy, Adjuvant-
dc.subject.meshSpinal Cord-
dc.subject.meshSurvival Analysis-
dc.subject.meshTreatment Outcome-
dc.titleSurvival and late effects in medulloblastoma patients treated with craniospinal irradiation under three years old.en
dc.typeArticleen
dc.contributor.departmentChristie Hospital NHS Trust, Manchester, United Kingdom.en
dc.identifier.journalMedical and Pediatric Oncologyen

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