J 2017

Evaluation of age-dependent treatment strategies for children and young adults with pineoblastoma: analysis of pooled European Society for Paediatric Oncology (SIOP-E) and US Head Start data

MYNAREK, Martin, Barry PIZER, Christelle DUFOUR, Dannis van VUURDEN, Miklos GARAMI et. al.

Základní údaje

Originální název

Evaluation of age-dependent treatment strategies for children and young adults with pineoblastoma: analysis of pooled European Society for Paediatric Oncology (SIOP-E) and US Head Start data

Autoři

MYNAREK, Martin, Barry PIZER, Christelle DUFOUR, Dannis van VUURDEN, Miklos GARAMI, Maura MASSIMINO, Jason FANGUSARO, Tom DAVIDSON, Maria Joao GIL-DA-COSTA, Jaroslav ŠTĚRBA, Martin BENESCH, Nicolas GERBER, B. Ole JUHNKE, Robert KWIECIEN, Torsten PIETSCH, Marcel KOOL, Steve CLIFFORD, David W. ELLISON, Felice GIANGASPERO, Pieter WESSELING, Floyd GILLES, Nicholas GOTTARDO, Jonathan L. FINLAY, Stefan RUTKOWSKI a Katja von HOFF

Vydání

Neuro-Oncology, Cary, Oxford University Press, 2017, 1522-8517

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30200 3.2 Clinical medicine

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Impakt faktor

Impact factor: 9.384

Organizační jednotka

Lékařská fakulta

UT WoS

000400894900015

Klíčová slova anglicky

high-dose chemotherapy; pediatric; pineoblastoma; radiotherapy; treatment

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 17. 5. 2018 15:39, Soňa Böhmová

Anotace

V originále

Background. Pineoblastoma is a rare pineal region brain tumor. Treatment strategies have reflected those for other malignant embryonal brain tumors. Patients and Methods. Original prospective treatment and outcome data from international trial groups were pooled. Cox regression models were developed considering treatment elements as time-dependent covariates. Results. Data on 135 patients with pineoblastoma aged 0.01-20.7 (median 4.9) years were analyzed. Median observation time was 7.3 years. Favorable prognostic factors were age >= 4 years (hazard ratio [HR] for progression-free survival [PFS] 0.270, P < .001) and administration of radiotherapy (HR for PFS 0.282, P < .001). Metastatic disease (HR for PFS 2.015, P =.006), but not postoperative residual tumor, was associated with unfavorable prognosis. In 57 patients < 4 years old, 5-year PFS/overall survival (OS) were 11 +/- 4%/12 +/- 4%. Two patients survived after chemotherapy only, while 3 of 16 treated with craniospinal irradiation (CSI) with boost, and 3 of 5 treated with high-dose chemotherapy (HDCT) and local radiotherapy survived. In 78 patients aged >= 4 years, PFS/OS were 72 +/- 7%/73 +/- 7% for patients without metastases, and 50 +/- 10%/55 +/- 10% with metastases. Seventy-three patients received radiotherapy (48 conventionally fractionated CSI, median dose 35.0 [ 18.0-45.0] Gy, 19 hyperfractionated CSI, 6 local radiotherapy), with (n = 68) or without (n = 6) chemotherapy. The treatment sequence had no impact; application of HDCT had weak impact on survival in older patients. Conclusion. Survival is poor in young children treated without radiotherapy. In these patients, combination of HDCT and local radiotherapy may warrant further evaluation in the absence of more specific or targeted treatments. CSI combined with chemotherapy is effective for older non-metastatic patients.