caa a22 4500 606214402 CHVBK 20210128105229.0 cr unu---uuuuu 210128e20150701xx s 000 0 eng 10.1007/s00701-015-2444-2 doi (NATIONALLICENCE)springer-10.1007/s00701-015-2444-2 Treatment outcome and patterns of failure in patients of non-pineal supratentorial primitive neuroectodermal tumor: review of literature and clinical experience form a regional cancer center in north India [Elektronische Daten] [Ahitagni Biswas, Supriya Mallick, Suvendu Purkait, Soumyajit Roy, Chitra Sarkar, Sameer Bakhshi, Manmohan Singh, Pramod Julka, Goura Rath] Background: Supra-tentorial primitive neuroectodermal tumors (SPNET) are high-grade, hemispheric tumors, which account for around 2-3% of pediatric brain tumors. We herein intend to report the clinical features and treatment outcome of patients with nonpineal SPNET treated at our institute. Methods: Clinical data were collected by retrospective chart review from 2006 to 2012. Histopathology slides were reviewed, and relevant immunohistochemistry stains were done. Overall survival (OS), recurrence-free survival (RFS) and event-free survival (EFS) were analyzed by the Kaplan-Meier product-limit method. Results: Fifteen patients met the study criterion (male: female = 2:1). Median age at presentation was 11years (range 3-49years). Surgical resection was gross total in 6 (40%) and subtotal in 8 (53.33%) patients. At presentation, two patients had leptomeningeal dissemination. Radiation therapy was delivered in 11 (73.33%) patients: craniospinal irradiation in 8 (36 Gy/20 fractions/4weeks to the craniospinal axis followed by a local boost of 20 Gy/10 fractions/2weeks) and focal RT in 3 patients. Systemic chemotherapy (median 6cycles; range 1-16 cycles), given in 13 (86.67%) patients, included the VAC regimen (vincristine, adriamycin, cyclophosphamide) alternating with IE (ifosfamide,etoposide). After a median follow-up of 22.6months (mean, 24.47months), complete response and progressive disease were noted in 8 (53.33%) and 7 (46.67%) patients, respectively. Median OS was not reached, and estimated median EFS was noted to be 4.12years (actuarial rate of EFS at 2years, 55.2%). Conclusion: Maximal safe resection followed by craniospinal irradiation and systemic chemotherapy with 6-12 cycles of an alternating regimen of VAC and IE is a reasonable treatment strategy in patients with nonpineal SPNET. Springer-Verlag Wien, 2015 Craniospinal irradiation nationallicence Primitive neuroectodermal tumor nationallicence Radiotherapy nationallicence Supratentorial nationallicence Biswas Ahitagni Department of Radiation Oncology, All India Institute of Medical Sciences, 110029, New Delhi, India aut Mallick Supriya Department of Radiation Oncology, All India Institute of Medical Sciences, 110029, New Delhi, India aut Purkait Suvendu Department of Pathology, All India Institute of Medical Sciences, New Delhi, India aut Roy Soumyajit Department of Radiation Oncology, All India Institute of Medical Sciences, 110029, New Delhi, India aut Sarkar Chitra Department of Pathology, All India Institute of Medical Sciences, New Delhi, India aut Bakhshi Sameer Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India aut Singh Manmohan Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India aut Julka Pramod Department of Radiation Oncology, All India Institute of Medical Sciences, 110029, New Delhi, India aut Rath Goura Department of Radiation Oncology, All India Institute of Medical Sciences, 110029, New Delhi, India aut Acta Neurochirurgica Springer Vienna 157/7(2015-07-01), 1251-1266 0001-6268 157:7<1251 2015 157 701 https://doi.org/10.1007/s00701-015-2444-2 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2444-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Biswas Ahitagni Department of Radiation Oncology, All India Institute of Medical Sciences, 110029, New Delhi, India aut NATIONALLICENCE 700 1- Mallick Supriya Department of Radiation Oncology, All India Institute of Medical Sciences, 110029, New Delhi, India aut NATIONALLICENCE 700 1- Purkait Suvendu Department of Pathology, All India Institute of Medical Sciences, New Delhi, India aut NATIONALLICENCE 700 1- Roy Soumyajit Department of Radiation Oncology, All India Institute of Medical Sciences, 110029, New Delhi, India aut NATIONALLICENCE 700 1- Sarkar Chitra Department of Pathology, All India Institute of Medical Sciences, New Delhi, India aut NATIONALLICENCE 700 1- Bakhshi Sameer Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India aut NATIONALLICENCE 700 1- Singh Manmohan Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India aut NATIONALLICENCE 700 1- Julka Pramod Department of Radiation Oncology, All India Institute of Medical Sciences, 110029, New Delhi, India aut NATIONALLICENCE 700 1- Rath Goura Department of Radiation Oncology, All India Institute of Medical Sciences, 110029, New Delhi, India aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/7(2015-07-01), 1251-1266 0001-6268 157:7<1251 2015 157 701 SWISSBIB 60582357X