Medulloblastoma: experience of a single institution.

Abstract

The treatment of medulloblastoma has changed considerably during the last decades. Treatment differences between centers may affect a multicenter analysis. We analyzed data from patients of a single institution gathered over a long period of time. Between 1968 and 1995, 60 patients with medulloblastoma were treated at the University of Munster. Thirty-six were male, 24-female. The ages ranged between 11 months and 32 years. Data were retrospectively analyzed from files. Survival was estimated using the Kaplan Meier method and compared using the logranktest and multivariance analysis. The 5-year survival rate was 37%. This included an early mortality of 20% within the first two months, prior to 1980. Significant single, positive, prognostic factors included: no solid metastases (p = 0.001), age > 10 years (p < 0.002); total resection (p < 0.025); posterior fossa radiation with more than 50 Gy (p = 0.04); and intense chemotherapy (p = 0.02). Male patients did slightly worse (not significant). The three-year event-free survival rate of 16 patients treated after 1991 was 70%. The prognosis of medulloblastoma has clearly improved with the reduction of the perioperative mortality, standardized radiotherapy, and the introduction of intense chemotherapy.