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Atalar B, Ozsahin M, Call J, Napieralska A, Kamer S, Villa S, Erpolat P, Negretti L, Lassen-Ramshad Y, Onal C, Akyurek S, Ugurluer G, Baumert BG, Servagi-Vernat S, Miller RC, Ozyar E, Sio TT. Treatment outcome and prognostic factors for adult patients with medulloblastoma: The Rare Cancer Network (RCN) experience. Radiother Oncol 2018; 127:96-102. [PMID: 29373196 DOI: 10.1016/j.radonc.2017.12.028] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 11/30/2017] [Accepted: 12/19/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND PURPOSE The optimal treatment for adults with newly diagnosed medulloblastoma (MB) has not been defined. We report a large series of cases from the Rare Cancer Network. MATERIAL AND METHODS Thirteen institutions enrolled 206 MB patients who underwent postoperative radiotherapy (RT) between 1976 and 2014. Log-rank univariate and Cox-modeled multivariate analyses were used to analyze data collected. RESULTS Median patient age was 29 years; follow-up was 31 months. All patients had the tumor resected; surgery was complete in 140 (68%) patients. Postoperative RT was given in 202 (98%) patients, and 94% received craniospinal irradiation (CSI) and, usually, a posterior fossa boost. Ninety-eight (48%) patients had chemotherapy, mostly cisplatin and vincristine-based. The 10-year local control, overall survival, and disease-free survival rates were 46%, 51%, and 38%, respectively. In multivariate analyses, Karnofsky Performance Status (KPS) ≥80 and CSI were significant for disease-free and overall survival (P ≤ .04 for all); receiving chemotherapy and KPS ≥80 correlated with better local-control rates. CONCLUSIONS Patients with high KPS who received CSI had better rates of disease-free and overall survival. Chemotherapy was associated with better local control. These results may serve as a benchmark for future studies designed to improve outcomes for adults with medulloblastoma.
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Affiliation(s)
- Banu Atalar
- Department of Radiation Oncology, Acıbadem University, Istanbul, Turkey.
| | - Mahmut Ozsahin
- Centre Hospitalier Universitaire Vaudois (CHUV), Department of Radiation Oncology, Lausanne, Switzerland
| | - Jason Call
- Department of Radiation Oncology, Mayo Clinic Hospital, Phoenix, AZ, United States
| | - Aleksandra Napieralska
- Radiotherapy Department, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Poland
| | - Serra Kamer
- Department of Radiation Oncology, Ege University, Izmir, Turkey
| | - Salvador Villa
- Radiation Oncology, Catalan Institute of Oncology, Badalona, Catalonia, Spain
| | - Petek Erpolat
- Department of Radiation Oncology, Gazi University, Ankara, Turkey
| | - Laura Negretti
- Centre Hospitalier Universitaire Vaudois (CHUV), Department of Radiation Oncology, Lausanne, Switzerland
| | | | - Cem Onal
- Department of Radiation Oncology, Baskent University, Adana, Turkey
| | - Serap Akyurek
- Department of Radiation Oncology, Ankara University, Ankara, Turkey
| | - Gamze Ugurluer
- Department of Radiation Oncology, Acıbadem University, Istanbul, Turkey
| | - Brigitta G Baumert
- Depts. Radiation Oncology (MAASTRO), GROW, Maastricht University MC, Netherlands; Paracelsus Klinik Osnabrueck and University of Muenster, University Bonn MC, Germany
| | | | - Robert C Miller
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL, United States
| | - Enis Ozyar
- Department of Radiation Oncology, Acıbadem University, Istanbul, Turkey
| | - Terence T Sio
- Department of Radiation Oncology, Mayo Clinic Hospital, Phoenix, AZ, United States
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The Present and Future Opportunities of the Rare Cancer Network: An International Consortium for Advancement of Oncologic Care. Rare Tumors 2015; 7:5998. [PMID: 26500735 PMCID: PMC4600997 DOI: 10.4081/rt.2015.5998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 05/08/2015] [Indexed: 12/28/2022] Open
Abstract
To date, the Rare Cancer Network (RCN) has initiated more than 90 studies and 54 peer-reviewed publications were produced as a result. The Second International Symposium of the Rare Cancer Network recently took place in Istanbul, Turkey on April 17-18, 2015, and update was given on multiple currently ongoing projects, while also giving room for new proposals which will shape the direction of future studies for the group. This companion issue of the RCN Proceedings summarized the findings of this meeting, while also serving as a call for fresh projects and papers which will continue to energize the group and advance the oncologic science. A brief introduction to the principles, history, and vision of the RCN was also included. To review, the academic year of 2014-15 marked an enormous success for the international members of the RCN, with the generation of 8 fully published papers and more than 12 newly proposed topics. By the collective efforts of all RCN members, in the future, we look forward to the upcoming opportunities in continuing to advance the standard of chemo- and radiotherapeutic oncologic care for selected rare tumor topics. The studies of these rare cancers often do not allow the design and execution of prospectively enrolled trials; however, these uncommon malignancies do impact the humankind and add to its suffering globally in significant ways.
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