Role of High-dose Chemotherapy for Recurrent Medulloblastoma and Other CNS Primitive Neuroectodermal Tumors

We summarize data presented on the use of high-dose chemotherapy (HDCT) with stem cell rescue for patients with recurrent medulloblastoma and other primitive neuroectodermal tumors as presented at an international consensus and state of the art workshop held in Milan in 2006. Eight, mainly institutional, studies were presented that included 159 patients who received HDCT of whom 22% were disease-free survivors at the time of reporting. Of those receiving HDCT and who relapsed having received previous radiotherapy, 17.3% were disease-free survivors at the time of reporting. However, from the two national studies that reported results from the time of relapse, only 4.2% were event free survivors. The outlook for previously irradiated patients with recurrent PNETs remains extremely poor and more effective therapeutic approaches are needed.