1. Clinical Outcomes and Patterns of Failure in Pineoblastoma: A 30-year Single Institution Experience Benjamin Farnia, B.A. ASTRO Poster Discussion September 14, 2014

2. 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

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

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

8. Additional Findings

9. 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

10. Proton vs. Photon Radiation As seen in univariate analysis, no difference in survival or recurrence between patients treated with proton- and photon-based therapy

11. 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)

12. 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

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