Abstract
In a population-based series of 368 children undergoing surgery for medulloblastoma, 304 (83%) survived to complete a course of radiotherapy. Among those patients who completed radiotherapy, the short-term survival rates were lower for young children (those aged under 5 years) than for older children, but by 6 years the survival rates were very similar (approximately 35%) for children in both age groups. Higher survival rates were obtained in the young children where total macroscopic excision of the tumour was achieved. For older children there was no difference in survival rates between those with total or partial excision, though the survival rate was lower for those whose surgery was limited to biopsy. In young children radiotherapy dose had no effect on survival rates. In older children, survival rates were appreciably higher where doses had been at least 45 Gy to the posterior fossa and 30 Gy to the spinal cord, and there were also fewer spinal cord metastases among those who received a higher spinal cord dose. Ninety (30%) of the 304 children also received chemotherapy as part of their initially planned treatment; a wide variety of protocols was used and no conclusions could be drawn as to the effects on survival rates.
Highlights
The purpose of the present analysis is to examine the possible effects on survival of variations in the initial planned treatment of childhood medulloblastoma
Sixteen further children died before their radiotherapy could be completed, and another was withdrawn from radiotherapy by his parents
The remaining 304 children received a complete course of radiotherapy
Summary
During 1971-77 there were 368 children in Great Britain notified through the national cancer registration scheme with a diagnosis of medulloblastoma which was histologically confirmed following surgery. Confirmation of diagnosis and information on treatment and follow-. All children who were not already known to have died, and who were resident in England and Wales at the time of diagnosis, were "flagged" at the National Health Service Central Register, so that any deaths would automatically be notified to us, and have been followed up to the end of 1982. We have received death certificates for children in Scotland dying of cancer up to the end of 1982; for the purpose of the present analysis we have assumed that children in Scotland not notified to us as having died, were still alive on 31 December 1982. At the time of operation, 40 of the children were aged under 2 years, 88 were aged 2-4, 151 were aged 5-9 and 89 were aged 10-14
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