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Reduction of Health Status 7 Years After Addition of Chemotherapy to Craniospinal Irradiation for Medulloblastoma: A Follow-Up Study in PNET 3 Trial Survivors—on Behalf of the CCLG (formerly UKCCSG)

Kim S. Bull, Helen A. Spoudeas, Ghasem Yadegarfar, Colin R. Kennedy

From the Departments of Child Health and Research and Development Support Unit, University of Southampton, Southampton; and the London Centre for Paediatric Endocrinology, University College London, London, United Kingdom

Address reprint requests to Colin Kennedy, MBBS, MD, Mailpoint 803 C/B, University Department of Child Health, Southampton General Hospital, Southampton, SO16 6YD, UK; e-mail: crk1{at}soton.ac.uk

Purpose To compare quality of survival after craniospinal irradiation (CSI) alone with survival after CSI plus chemotherapy (CT) for medulloblastoma.

Patients and Methods Follow-up study of surviving UK patients with medulloblastoma diagnosed between 1992 and 2000 treated according to one or other treatment arm of the PNET 3 controlled trial.

Results Seventy three percent of all 147 eligible patients ages 6.6 to 24.3 years were assessed at a mean of 7.2 years after diagnosis. Health status was significantly poorer in the group treated in the CSI plus CT arm of the trial than in the CSI alone arm, and there were also trends to poorer outcomes for behavior and quality of life scores. The CSI plus CT group were also significantly more restricted physically and needed more therapeutic and educational support. Body mass index, stature, and other endocrine outcomes were similar in the two treatment arms, except for the trend in increased frequency of medical induction of puberty in the CSI plus CT group.

Conclusion The addition of CT to CSI for medulloblastoma was associated with a significant decrease in health status. The effect of the addition of other CT regimens to CSI on quality of survival should be evaluated.

Supported by the Samantha Dickson Brain Tumour Trust and the UK Children's Cancer and Leukaemia Group. Samantha Dickson Brain Tumour Trust supported all study costs, but was not involved in the study conception or design; data acquisition, analysis, or interpretation; report writing; or the decision to submit the paper for publication.

Presented in part at the 11th International Symposium on Pediatric Neurooncology, June 13-16, 2004, Boston MA; Société Internationale d'Oncologie Pédiatrique Brain Tumor Committee, June 9-11, 2005, Tromsø, Norway; and the British Paediatric Neurology Association Annual Scientific meeting, January 18-20, 2006, Bristol, United Kingdom.

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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