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000132464 1001_ $$aBeier, Dagmar$$b0
000132464 245__ $$aMulticenter pilot study of radiochemotherapy as first-line treatment for adults with medulloblastoma (NOA-07).
000132464 260__ $$aOxford$$bOxford Univ. Press$$c2018
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000132464 520__ $$aMedulloblastoma in adult patients is rare, with 0.6 cases per million. Prognosis depends on clinical factors and medulloblastoma entity. No prospective data on the feasibility of radiochemotherapy exist. The German Neuro-Oncology Working Group (NOA) performed a prospective descriptive multicenter single-arm phase II trial to evaluate feasibility and toxicity of radio-polychemotherapy.The NOA-07 trial combined craniospinal irradiation with vincristine, followed by 8 cycles of cisplatin, lomustine, and vincristine. Adverse events, imaging and progression patterns, histological and genetic markers, health-related quality of life (HRQoL), and cognition were evaluated. Primary endpoint was the rate of toxicity-related treatment terminations after 4 chemotherapy cycles, and the toxicity profile. The feasibility goal was reached if at least 45% of patients received at least 4 cycles of maintenance chemotherapy.Thirty patients were evaluable. Each 50% showed classic and desmoplastic/nodular histology. Sixty-seven percent were classified into the sonic hedgehog (SHH) subgroup without TP53 alterations, 13% in wingless (WNT), and 17% in non-WNT/non-SHH. Four cycles of chemotherapy were feasible in the majority (n = 21; 70.0%). Hematological side effects and polyneuropathy were prevalent toxicities. During the active treatment period, HRQoL and verbal fluency improved significantly. The 3-year event-free survival rate was 66.6% at the time of databank lock.Radio-polychemotherapy did lead to considerable toxicity and a high amount of dose reductions throughout the first 4 chemotherapy cycles that may affect efficacy. Thus, we propose frequent patient surveillance using this regimen. Modifications of the regimen may increase feasibility of radio-polychemotherapy of adult patients with medulloblastoma.
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000132464 7001_ $$aProescholdt, Martin$$b1
000132464 7001_ $$aReinert, Christiane$$b2
000132464 7001_ $$aPietsch, Torsten$$b3
000132464 7001_ $$0P:(DE-He78)551bb92841f634070997aa168d818492$$aJones, David$$b4$$udkfz
000132464 7001_ $$0P:(DE-He78)f746aa965c4e1af518b016de3aaff5d9$$aPfister, Stefan$$b5$$udkfz
000132464 7001_ $$aHattingen, Elke$$b6
000132464 7001_ $$aSeidel, Clemens$$b7
000132464 7001_ $$aDirven, Linda$$b8
000132464 7001_ $$aLuerding, Ralf$$b9
000132464 7001_ $$aReijneveld, Jaap$$b10
000132464 7001_ $$aWarmuth-Metz, Monika$$b11
000132464 7001_ $$aBonsanto, Matteo$$b12
000132464 7001_ $$aBremer, Michael$$b13
000132464 7001_ $$aCombs, Stephanie E$$b14
000132464 7001_ $$aRieken, Stefan$$b15
000132464 7001_ $$aHerrlinger, Ulrich$$b16
000132464 7001_ $$aKuntze, Holger$$b17
000132464 7001_ $$aMayer-Steinacker, Regine$$b18
000132464 7001_ $$aMoskopp, Dag$$b19
000132464 7001_ $$aSchneider, Thomas$$b20
000132464 7001_ $$aBeringer, Andreas$$b21
000132464 7001_ $$aSchlegel, Uwe$$b22
000132464 7001_ $$aStummer, Walter$$b23
000132464 7001_ $$aWelker, Helmut$$b24
000132464 7001_ $$aWeyerbrock, Astrid$$b25
000132464 7001_ $$aPaulsen, Frank$$b26
000132464 7001_ $$aRutkowski, Stefan$$b27
000132464 7001_ $$aWeller, Michael$$b28
000132464 7001_ $$0P:(DE-He78)92e9783ca7025f36ce14e12cd348d2ee$$aWick, Wolfgang$$b29$$udkfz
000132464 7001_ $$aKortmann, Rolf-Dieter$$b30
000132464 7001_ $$aBogdahn, Ulrich$$b31
000132464 7001_ $$aHau, Peter$$b32
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