https://orcid.org/0000-0002-3285-3484
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Abstract
Aim: Adult medulloblastomas (MB) are rare, and optimal post-craniospinal irradiation (CSI) chemotherapy is not yet defined. We investigated hematological toxicity in patients treated with platinum–etoposide (EP) post-CSI. Methods: Retrospective, single-institution study to determine hematological toxicity in adult MB patients treated with EP (1995–2022). Results: Thirteen patients with a median follow-up of 50 months (range, 10–233) were analyzed. Four discontinued treatment due to toxicity, one after 1, 3 after 3 cycles. Hematological toxicities included grade 3 (5 patients) and grade 4 (6 patients). Two patients experienced post-treatment progression and died 16 and 37 months from diagnosis. Conclusion: Post-CSI EP demonstrates acceptable hematological toxicity in adult MB. However, the small cohort precludes definitive survival outcome conclusions. Prospective studies for comprehensive comparisons with other regimens are needed in this context.
Plain language summary
Our study aimed to understand the effect of a chemotherapy combination (platinum and etoposide) on blood counts in adult patients with medulloblastoma after craniospinal radiation. Medulloblastoma is a rare brain cancer in adults. We analyzed data from 13 adult patients with medulloblastoma. The results show that the treatment leads to significant blood count-related side effects. Four of the patients discontinued their treatment early. Blood counts improved again after completion of treatment. Two patients had the tumor grow back after treatment and died later. Overall, the effect from this chemotherapy combination on blood counts was felt to be acceptable. The number of patients in this study was small, and more research is needed to determine the overall effectiveness of this treatment.
Tweetable abstract
Retrospective analysis shows acceptable hematological toxicity of post-CSI platinum–etoposide in adult medulloblastoma. #medulloblastoma #chemotherapy
Conclusive and prospective data on chemotherapy after craniospinal irradiation (CSI) in adult medulloblastomas are lacking.
As post-CSI myelosuppression significantly limits the amount of cytotoxic therapy that can be given in these patients, there is a need to define safety and efficacy of less intense regimens in this clinical setting.
This small, retrospective study on 13 patients that received post-CSI in adult medulloblastoma shows significant but reversible hematological toxicity.
Further study is needed to compare toxicity and efficacy of platinum–etoposide with other existing regimens; however, prospective studies will be extremely difficult to conduct due to the rarity of medulloblastomas in adults.
Financial disclosure
This work was supported by The Sidney Kimmel Comprehensive Cancer Center Core Grant (NIH grant P30 CA006973) and the Jane and Robert Gore Family Fund for Cancer Research. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
Competing interests disclosure
The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
Writing disclosure
No writing assistance was utilized in the production of this manuscript.
Ethical conduct of research
The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations.