Octreotide in the therapy of recurrent medulloblastomas

Abstract

BACKGROUND: Recurrence of medulloblastoma appears after 30% to 40% of the surgeries. Different from primary medulloblastoma, in which five-year survival rate is 50%, the survival time of relapses much shorter and only 20% of the patients manage to survive a year. There is a logical need for additional methods of treatment of recurrent medulloblastomas. The aim of the study is to determine the effects of intracavitary and long-term subcutaneous application of Sandostatin (octreotide) on the recurrent medulloblastomas. METHODS: Fourteen children aged 4 to 9 years, in which, despite of craniospinal irradiation and chemotherapy came to a recurrence of medulloblastoma during the first 6 months after the surgery, were treated subcutaneously with Sandostatin (octreotide) in a longer period of time. Cerebellar medulloblastomas with a diameter bigger than 20 mm and spinal over 10 mm were removed operatively and octreotide with Beriplast was applied intracavitary. RESULTS: Magnetic resonance of cranioaxis shows that the application of octreotide has caused the disappearance of spinal drop metastases in all 7 patients and the cerebellar metastases smaller than 5 mm in all 4 patients. Subcutaneous application of octreotide combined with intracavitary expresses an antitumoral effect in 2/3 of the relapses. The application of octreotide results with a transformation of Chang's stage M0 into M1 in 71.43% of the patients. CONCLUSION: In the case of in loco or metastatic recurrence of medulloblastomas, intracavitarily and subcutaneously applied octreotide results with a regression of the tumor in a 3 year time within 2/3 of the treated patients.