Multicenter pilot study of radio-chemotherapy as first-line treatment for adults with medulloblastoma (NOA-07)
| Autor: | Holger Kuntze, Andreas Beringer, Jaap C. Reijneveld, Stefan Rutkowski, Clemens Seidel, Torsten Pietsch, Frank Paulsen, Linda Dirven, Peter Hau, Stephanie E. Combs, Astrid Weyerbrock, Ralf Luerding, Dag Moskopp, Christiane Reinert, David T.W. Jones, Elke Hattingen, Rolf-Dieter Kortmann, Martin Proescholdt, Stefan Rieken, Thomas Schneider, Monika Warmuth-Metz, Michael Bremer, Stefan M. Pfister, Wolfgang Wick, Matteo Mario Bonsanto, Ulrich Herrlinger, Walter Stummer, Regine Mayer-Steinacker, Dagmar Beier, Ulrich Bogdahn, Uwe Schlegel, Helmut Welker, Michael Weller |
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| Přispěvatelé: | Neurology, CCA - Cancer Treatment and Quality of Life, CCA - Cancer Treatment and quality of life |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Oncology
cognition Male Cancer Research Lomustine/administration & dosage Pilot Projects Cerebellar Neoplasms/pathology 0302 clinical medicine Craniospinal Irradiation Clinical endpoint Vincristine/administration & dosage Prospective Studies imaging Chemoradiotherapy Middle Aged Prognosis Chemotherapy regimen health-related quality of life Survival Rate Chemotherapy Adjuvant 030220 oncology & carcinogenesis Female medicine.drug Adult medicine.medical_specialty Vincristine medulloblastoma 03 medical and health sciences Young Adult Internal medicine medicine Journal Article Humans Survival rate Medulloblastoma business.industry Medulloblastoma/pathology Lomustine medicine.disease Regimen Feasibility Studies radiochemotherapy Neurology (clinical) Antineoplastic Combined Chemotherapy Protocols/therapeutic use business 030217 neurology & neurosurgery Cisplatin/administration & dosage Follow-Up Studies |
| Zdroj: | Dagmar, D, Proescholdt, M, Reinert, C, Pietsch, T, Jones, D T W, Pfister, S M, Hattingen, E, Seidel, C, Dirven, L, Luerding, R, Reijneveld, J, Warmuth-Metz, M, Bonsanto, M, Bremer, M, Combs, S, Rieken, S, Herrlinger, U, Kuntze, H, Mayer-Steinacker, R, Moskopp, D, Schneider, T, Beringer, A, Schlegel, U, Stummer, W, Welker, H, Weyerbrock, A, Paulsen, F, Rutkowski, S, Weller, M, Wick, W, Kortmann, R-D, Bogdahn, U & Hau, P 2018, ' Multicenter pilot study of radio-chemotherapy as first-line treatment for adults with medulloblastoma (NOA-07) ', Neuro-Oncology, vol. 20, no. 3, pp. 400–410 . https://doi.org/10.1093/neuonc/nox155 Beier, D, Proescholdt, M, Reinert, C, Pietsch, T, Jones, D T W, Pfister, S M, Hattingen, E, Seidel, C, Dirven, L, Luerding, R, Reijneveld, J, Warmuth-Metz, M, Bonsanto, M, Bremer, M, Combs, S E, Rieken, S, Herrlinger, U, Kuntze, H, Mayer-Steinacker, R, Moskopp, D, Schneider, T, Beringer, A, Schlegel, U, Stummer, W, Welker, H, Weyerbrock, A, Paulsen, F, Rutkowski, S, Weller, M, Wick, W, Kortmann, R-D, Bogdahn, U & Hau, P 2018, ' Multicenter pilot study of radiochemotherapy as first-line treatment for adults with medulloblastoma (NOA-07) ', Neuro-Oncology, vol. 20, no. 3, pp. 400-410 . https://doi.org/10.1093/neuonc/nox155 Neuro-oncology, 20(3), 400-410. Oxford University Press Neuro-Oncology, 20(3), 400-410. Oxford University Press |
| ISSN: | 1522-8517 |
| Popis: | Background: Medulloblastoma in adult patients is rare, with 0.6 cases per million. Prognosis depends on clinical factors and medulloblastoma entity. No prospective data on the feasibility of radiochemotherapy exist. The German Neuro-Oncology Working Group (NOA) performed a prospective descriptive multicenter single-arm phase II trial to evaluate feasibility and toxicity of radio-polychemotherapy.Methods: The NOA-07 trial combined craniospinal irradiation with vincristine, followed by 8 cycles of cisplatin, lomustine, and vincristine. Adverse events, imaging and progression patterns, histological and genetic markers, health-related quality of life (HRQoL), and cognition were evaluated. Primary endpoint was the rate of toxicity-related treatment terminations after 4 chemotherapy cycles, and the toxicity profile. The feasibility goal was reached if at least 45% of patients received at least 4 cycles of maintenance chemotherapy.Results: Thirty patients were evaluable. Each 50% showed classic and desmoplastic/nodular histology. Sixty-seven percent were classified into the sonic hedgehog (SHH) subgroup without TP53 alterations, 13% in wingless (WNT), and 17% in non-WNT/non-SHH. Four cycles of chemotherapy were feasible in the majority (n = 21; 70.0%). Hematological side effects and polyneuropathy were prevalent toxicities. During the active treatment period, HRQoL and verbal fluency improved significantly. The 3-year event-free survival rate was 66.6% at the time of databank lock.Conclusions: Radio-polychemotherapy did lead to considerable toxicity and a high amount of dose reductions throughout the first 4 chemotherapy cycles that may affect efficacy. Thus, we propose frequent patient surveillance using this regimen. Modifications of the regimen may increase feasibility of radio-polychemotherapy of adult patients with medulloblastoma. |
| Databáze: | OpenAIRE |
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