Medulloblastoma and central nervous system germ cell tumors in adults: is pediatric experience applicable?

Medulloblastoma and central nervous system (CNS) germ cell tumors are very rare in adults, while they account for 25% and 5% of brain tumors in children, respectively (Pastore et al. Eur J Cancer 42:2064–208, 2006 ). Pediatric experiences, mostly from randomized and controlled clinical trials, have...

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Published in:Child's nervous system 2019-12, Vol.35 (12), p.2279-2287
Main Authors: Mascarin, Maurizio, Coassin, Elisa, Franceschi, Enrico, Gandola, Lorenza, Carrabba, Giorgio, Brandes, Alba A, Massimino, Maura
Format: Article
Language:English
Subjects:
Adult
Brain Neoplasms - therapy
Cerebellar Neoplasms - therapy
Child
Female
Humans
Male
Medicine
Medicine & Public Health
Medulloblastoma - therapy
Neoplasms, Germ Cell and Embryonal - therapy
Neurosciences
Neurosurgery
Review Article
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Summary:Medulloblastoma and central nervous system (CNS) germ cell tumors are very rare in adults, while they account for 25% and 5% of brain tumors in children, respectively (Pastore et al. Eur J Cancer 42:2064–208, 2006 ). Pediatric experiences, mostly from randomized and controlled clinical trials, have led to different tailored treatments, based on various risk factors, including histology, and extent of disease. For medulloblastoma, biological features have recently emerged that enable therapies to be scaled down in some cases, or pursued more aggressively in the event of chromosomal and/or genetic alterations (Massimino et al. Crit Rev Oncol Hematol 105:35–51, 2016 ). Such refinements are still impossible for adult patients due to the lack of similar clinical trials that might provide the same or a different understanding regarding patients’ prognosis, long-term survival, quality of life, and acute and late toxicities. This review aims to contribute to the debate on the treatment of adults with these two diseases and promote the creation of broad-based, national and international trials to advance our knowledge in this area and to share the skills between pediatric and adult oncologists as adolescent and young adults (AYA) brain tumor national boards are currently requiring.
ISSN:0256-7040
1433-0350
DOI:10.1007/s00381-019-04340-8