Clinical Outcomes and Patterns of Failure in Pineoblastoma: A 30-year Single Institution

Experience

Benjamin Farnia, B.A.ASTRO Poster Discussion

September 14, 2014

Purpose

• To update outcomes and assess prognostic factors in patients with pineoblastoma who have been treated with a modern, multimodality approach, including surgery, radiation, and chemotherapy

Overall Survival

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Median OS: 8.7 years with 2- and 5-year actuarial rates of 89.5% and 69.4%.

Disease Free Survival

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Median DFS: 10 years with 2- and 5-year actuarial rates of 84.3% and 62.6%.

Additional Findings

Age

• Univariate analysis failed to correlate age with OS or PFS

• Perhaps with modern treatment, pineoblastoma in children does not necessarily translate to a uniformly poor prognosis as previously thought

Proton vs. Photon Radiation

• As seen in univariate analysis, no difference in survival or recurrence between patients treated with proton- and photon-based therapy

Timing of Radiation

• Neoadjuvant radiation was associated with a longer disease-free survival, p=0.09

• Similar to medulloblastoma, patients who developed recurrent disease following radiation had a worse prognosis compared to patients treated with salvage radiation (numbers too small for statistical significance)

Extent of Radiation Field

• Disease recurrence was more common in patients who received focal radiation initially, compared to patients who received CSI initially, p=0.04

Conclusion

• Modern multimodality treatment of pineoblastoma yields a high rate of overall survival with acceptable short and long-term toxicity