TY  - JOUR
A1  - Gaab, Christine
A1  - Adolph, Jonas E.
A1  - Tippelt, Stephan
A1  - Mikasch, Ruth
A1  - Obrecht, Denise
A1  - Mynarek, Martin
A1  - Rutkowski, Stefan
A1  - Pfister, Stefan M.
A1  - Milde, Till
A1  - Witt, Olaf
A1  - Bison, Brigitte
A1  - Warmuth-Metz, Monika
A1  - Kortmann, Rolf-Dieter
A1  - Dietzsch, Stefan
A1  - Pietsch, Torsten
A1  - Timmermann, Beate
A1  - Sträter, Ronald
A1  - Bode, Udo
A1  - Faldum, Andreas
A1  - Kwiecien, Robert
A1  - Fleischhack, Gudrun
T1  - Local and systemic therapy of recurrent medulloblastomas in children and adolescents: results of the P-HIT-REZ 2005 Study
JF  - Cancers
N2  - Recurrent medulloblastomas are associated with survival rates <10%. Adequate multimodal therapy is being discussed as having a major impact on survival. In this study, 93 patients with recurrent medulloblastoma treated in the German P-HIT-REZ 2005 Study were analyzed for survival (PFS, OS) dependent on patient, disease, and treatment characteristics. The median age at the first recurrence was 10.1 years (IQR: 6.9–16.1). Median PFS and OS, at first recurrence, were 7.9 months (CI: 5.7–10.0) and 18.5 months (CI: 13.6–23.5), respectively. Early relapses/progressions (<18 months, n = 30/93) found mainly in molecular subgroup 3 were associated with markedly worse median PFS (HR: 2.34) and OS (HR: 3.26) in regression analyses. A significant survival advantage was found for the use of volume-reducing surgery as well as radiotherapy. Intravenous chemotherapy with carboplatin and etoposide (ivCHT, n = 28/93) showed improved PFS and OS data and the best objective response rate (ORR) was 66.7% compared to oral temozolomide (oCHT, n = 47/93) which was 34.8%. Intraventricular (n = 43) as well as high-dose chemotherapy (n = 17) at first relapse was not related to a significant survival benefit. Although the results are limited due to a non-randomized study design, they may serve as a basis for future treatment decisions in order to improve the patients' survival.
KW  - medulloblastoma
KW  - refractory
KW  - recurrent
KW  - children
KW  - chemotherapy
KW  - surgery
KW  - radiotherapy
KW  - re-irradiation
KW  - intraventricular therapy
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-254809
SN  - 2072-6694
VL  - 14
IS  - 3
ER  -