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@ARTICLE{Beier:132464,
      author       = {D. Beier and M. Proescholdt and C. Reinert and T. Pietsch
                      and D. Jones$^*$ and S. Pfister$^*$ and E. Hattingen and C.
                      Seidel and L. Dirven and R. Luerding and J. Reijneveld and
                      M. Warmuth-Metz and M. Bonsanto and M. Bremer and S. E.
                      Combs and S. Rieken and U. Herrlinger and H. Kuntze and R.
                      Mayer-Steinacker and D. Moskopp and T. Schneider and A.
                      Beringer and U. Schlegel and W. Stummer and H. Welker and A.
                      Weyerbrock and F. Paulsen and S. Rutkowski and M. Weller and
                      W. Wick$^*$ and R.-D. Kortmann and U. Bogdahn and P. Hau},
      title        = {{M}ulticenter pilot study of radiochemotherapy as
                      first-line treatment for adults with medulloblastoma
                      ({NOA}-07).},
      journal      = {Neuro-Oncology},
      volume       = {20},
      number       = {3},
      issn         = {1523-5866},
      address      = {Oxford},
      publisher    = {Oxford Univ. Press},
      reportid     = {DKFZ-2018-00152},
      pages        = {400 - 410},
      year         = {2018},
      abstract     = {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.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.},
      cin          = {B062 / G370},
      ddc          = {610},
      cid          = {I:(DE-He78)B062-20160331 / I:(DE-He78)G370-20160331},
      pnm          = {319H - Addenda (POF3-319H)},
      pid          = {G:(DE-HGF)POF3-319H},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:29016837},
      pmc          = {pmc:PMC5817955},
      doi          = {10.1093/neuonc/nox155},
      url          = {https://inrepo02.dkfz.de/record/132464},
}