P05.93 Adult medulloblastoma: analysis of use of chemotherapy in clinical practice

摘要

BACKGROUNDAdult medulloblastoma (MB) is rare, accounting for 150–300 new cases in the US annually. Given the low incidence, prospective studies are challenging, and the role of adjuvant chemotherapy in standard risk patients has been controversial. Currently, the best evidence available (Level V) supports the use of upfront chemotherapy. A recent pilot prospective study (NOA-07) proved feasibility of craniospinal irradiation with vincristine, followed by cisplatin, lomustine and vincristine; 4 cycles were feasible in most patients. However, toxicity was substantial. In clinical practice, attempts to ameliorate the intensity of the treatment regimen are common, such as substitution of cisplatin by carboplatin, or removal of vincristine. It is not known if these modifications compromise outcome, and the optimal chemotherapy regimen for adult MB patients to balance efficacy and tolerability has not been established.