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.