Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Lannering, B; Rutkowski, S; Doz, F; Pizer, B; Gustafsson, G; Navajas, A; Massimino, M; Reddingius, R; Benesch, M; Carrie, C; Taylor, R; Gandola, L; Björk-Eriksson, T; Giralt, J; Oldenburger, F; Pietsch, T; Figarella-Branger, D; Robson, K; Forni, M; Clifford, SC; Warmuth-Metz, M; von Hoff, K; Faldum, A; Mosseri, V; Kortmann, R.
Hyperfractionated Versus Conventional Radiotherapy Followed by Chemotherapy in Standard-Risk Medulloblastoma: Results From the Randomized Multicenter HIT-SIOP PNET 4 Trial.
J Clin Oncol. 2012; 30(26):3187-3193
Doi: 10.1200/JCO.2011.39.8719
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- Co-Autor*innen der Med Uni Graz
- Benesch Martin
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- Abstract:
- Purpose To compare event-free survival (EFS), overall survival (OS), pattern of relapse, and hearing loss in children with standard-risk medulloblastoma treated by postoperative hyperfractionated or conventionally fractionated radiotherapy followed by maintenance chemotherapy. Patients and Methods In all, 340 children age 4 to 21 years from 122 European centers were postoperatively staged and randomly assigned to treatment with hyperfractionated radiotherapy (HFRT) or standard (conventional) fractionated radiotherapy (STRT) followed by a common chemotherapy regimen consisting of eight cycles of cisplatin, lomustine, and vincristine. Results After a median follow-up of 4.8 years (range, 0.1 to 8.3 years), survival rates were not significantly different between the two treatment arms: 5-year EFS was 77% +/- 4% in the STRT group and 78% +/- 4% in the HFRT group; corresponding 5-year OS was 87% +/- 3% and 85% +/- 3%, respectively. A postoperative residual tumor of more than 1.5 cm(2) was the strongest negative prognostic factor. EFS of children with all reference assessments and no large residual tumor was 82% +/- 2% at 5 years. Patients with a delay of more than 7 weeks to the start of RT had a worse prognosis. Severe hearing loss was not significantly different for the two treatment arms at follow-up. Conclusion In this large randomized European study, which enrolled patients with standard-risk medulloblastoma from more than 100 centers, excellent survival rates were achieved in patients without a large postoperative residual tumor and without RT treatment delays. EFS and OS for HFRT was not superior to STRT, which therefore remains standard of care in this disease. J Clin Oncol 30:3187-3193. (C) 2012 by American Society of Clinical Oncology
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