Medulloblastoma in children: A correlation between staging and results of treatment

Abstract

Fifty-nine children with cerebellar medulloblastoma were followed prospectively after they were staged and treated consistently with postoperative megavoltage radiotherapy to the entire neural axis. The probabilities of surviving 5 and 10 years were 40.4% and 30.9% respectively; a gradual reduction of the survival rates was observed as the T-category of the tumor increased: i.e. 5 year survival rate was 75% for T 1, 50.5% for T 2, 32.3% for T 3 and 0 for T 4. Children without gross nodular seeding in the subarachnoid space ( M 0 − M 1) had better survival rates than children with gross nodular seeding ( M 2 − M 3). Improved survival rates were observed by increasing the dose of radiation to the posterior fossa. Among children who had similar surgery, those who had T 1 − T 2 tumors fared better than those with TP 3 − T 4 tumors. The short term (up to 4.5 years) survival rates were better for older children but younger children had better long term survival rates. The posterior fossa was involved in 59% of children who developed recurrent tumor; however, in 75% of the recurrent cases either the posterior fossa was not involved or concomitant involvement of another site also was present.