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CC BY-NC-ND 4.0 · South Asian J Cancer 2015; 04(04): 174-178
DOI: 10.4103/2278-330X.175954
NEURO ONCOLOGY : Original Article

Outcomes of adult medulloblastoma treated with a multimodality approach: A tertiary cancer center experience

Supriya Mallick
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi
,
Ajeet Kumar Gandhi
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi
,
Rony Benson
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi
,
Daya Nand Sharma
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi
,
Kunhi Parambath Haresh
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi
,
Subhash Gupta
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi
,
Pramod Kumar Julka
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi
,
Goura Kisor Rath
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi
› Author Affiliations Source of Support: Nil.
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Abstract

Objectives: Adult medulloblastoma (AMB) is a rare central nervous system tumor. We aimed to analyze the treatment outcomes of AMB treated at our institute with surgery followed by craniospinal irradiation (CSI) and adjuvant chemotherapy. Methods: We retrospectively evaluated the treatment charts of 31 patients of AMB treated from 2003-2011. The patient demography, treatment details and survival data were collected in a predesigned proforma. Kaplan Meier method was used to analyze disease free survival (DFS) and the impact of prognostic factors was determined by univariate analysis (log rank test). Results: Male: Female ratio was 21:10. Cerebrospinal fluid dissemination was noted in 16% cases. CSI (36 Gray at 1.8 Gray/fraction to entire neuraxis and 20 Gray at 2 Gray/fraction boost to posterior fossa) was used in all cases. 26 patients received adjuvant chemotherapy (carboplatin plus etoposide). Median follows up was 26.85 months (9.47-119.73 months). The estimated 3 and 5 years DFS was found to be 84.9% and 50.7% respectively. On univariate analysis, tumor located laterally had a trend towards better DFS (HR 3.04; 95%CI 0.722 to 12.812; P = 0.07) compared to midline tumors. Other factors like adjuvant chemotherapy, age, gender, surgical extent had no statistically significant impact on survival. Conclusion: The results of our study (largest series from India) show that the regimen of surgery, adjuvant CSI and chemotherapy is feasible and confers descent survival. AMB patients should be treated with a multimodality approach in a tertiary care centre.

Key words

Adult medulloblastoma - chemotherapy - radiation


Publication History

Article published online:
31 December 2020

© 2015. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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