Journal of Neuro-Oncology

, Volume 103, Issue 3, pp 705–711

Recurrence in childhood medulloblastoma

  • Monika Warmuth-Metz
  • Sophia Blashofer
  • André O. von Bueren
  • Katja von Hoff
  • Brigitte Bison
  • Fabian Pohl
  • Rolf-Dieter Kortmann
  • Torsten Pietsch
  • Stefan Rutkowski
Clinical Study – Patient Study

DOI: 10.1007/s11060-010-0452-x

Cite this article as:
Warmuth-Metz, M., Blashofer, S., von Bueren, A.O. et al. J Neurooncol (2011) 103: 705. doi:10.1007/s11060-010-0452-x

Abstract

Thirty-eight consecutive children treated according to the HIT2000 and HIT91 studies for medulloblastoma who suffered 40 recurrence events were identified from a neuroradiological database. Relapse was associated with younger median age compared with all children treated on HIT2000. Eight patients relapsed with isolated local recurrence. There was no correlation with incomplete surgical removal or violation of the respective treatment protocol. Four patients were younger than 4 years at time of initial presentation and thus were not treated primarily with radiotherapy, suggesting that delayed radiotherapy might be a contributing factor. Meningeal dissemination was present in 32 events; 16 were located in the frontal region, 8 of which were isolated nodular frontal and frontobasal meningeal disease. Circumscribed meningeal recurrences were associated with better overall survival (OS) compared with diffuse, widespread recurrences. Isolated frontobasal meningeal relapses are a well-known phenomenon in medulloblastomas even years after treatment and have been correlated to an underdose of radiation in many literature reports. However, in our patients there was no correlation to possible treatment violations, indicating that inadequate radiation dose to the frontobasal region was unlikely to be a causative factor. Surgical technique varied due to the multicentric nature of our study, so position during surgery was not recognized as a predisposing factor for frontobasal recurrence.

Keywords

MedulloblastomaRelapseMeningeal dissemination

Copyright information

© Springer Science+Business Media, LLC. 2010

Authors and Affiliations

  • Monika Warmuth-Metz
    • 1
  • Sophia Blashofer
    • 1
  • André O. von Bueren
    • 5
  • Katja von Hoff
    • 5
  • Brigitte Bison
    • 1
  • Fabian Pohl
    • 2
  • Rolf-Dieter Kortmann
    • 3
  • Torsten Pietsch
    • 4
  • Stefan Rutkowski
    • 5
  1. 1.Department of Neuroradiology, Reference Center for NeuroradiologyUniversity of WürzburgWürzburgGermany
  2. 2.Department for RadiooncologyUniversity of WürzburgWürzburgGermany
  3. 3.Department of Radiooncology, Reference Center for RadiooncologyUniversity of LeipzigLeipzigGermany
  4. 4.Department of Neuropathology, National Brain Tumor Reference CenterUniversity of BonnBonnGermany
  5. 5.Department of Pediatric Hematology and Oncology, HIT2000 Study CenterUniversity Medical Center Hamburg-EppendorfHamburgGermany