Preradiation chemotherapy versus radiotherapy in the treatment of adult meduloblastoma

ABSTRACT

To determine whether preradiotherapy [RT] chemotherapy would improve outcome for medulloblastoma when compared with RI alone. Chemotherapy comprised vincristine 1.5 mg/m2 days], 7 and 14, etaposide 100 mg/m2 days1.2. and 3 and carboplatin 500 mg/m2 days] and 2. Patients age ranged between 16 and 45 years inclusive were randomly assigned to receive 35 Gy craniospinal RT with a 19 Gyposteriorfossa boost, or chemotherapy followed by RT. Ls 0i5[i paienzs randomly assigned to treatment, 25 were treated with RT alone and the other 25 patients were treated with chemotherapy and Irradiation. There was a statistically significant difference in overall survival at 3 years between both arms 58% and 75% respectively. Acute toxicity was limited to alopecia, nausea and hematological toxicities. High grade nausea and vomiting was reported in 4 patients and neuropathy in two patient. Grade 3 or 4 [anemia, neutropenia and thrombocytopenia were recorded in group B, this is attributed to chemotherapy. Improved EFS and OS for chemotherapy group patients compared with RT alone were noticed. Chemotherapy was well tolerated. It is anticipated that this regimen could reduce atotaxicity and nephrotoxicity compared with cisplatin-containing schedule