Pediatric and Adult Medulloblastoma: Experience About 96 Cases

Abstract

Our study is a retrospective analysis of 96 cases of medulloblastoma in children and adults, followed up in the department of radiotherapy of the National Institute of Oncology, over a period of 9 years between January 2002 and December 2010. Medulloblastoma represent, according to literature data, less than 1% of brain tumors in adults, but is the most frequent brain tumor of children. Median age at diagnosis was 8 years for children and 24 years for adults. 63 cases (65.6 %) were males. Symptoms was dominated by intracranial hypertension syndrome occurred in 87 cases (97.8%), associated with a cerebellar syndrome noted in 83 cases (94.3%).The most frequent localization seat in cerebellar vermis in 43 cases (76.8%) for children and in the cerebellar hemisphere in 28 cases (70%) for adults. Diagnosis was based on histological examination of the surgical specimen. Classical histological sub type was predominant 88 patients (91.7% of cases). The first step in the treatment of medulloblastoma is resection of the tumor. Surgical resection was complete in 53 cases (55.2%). Adjuvant radiotherapy associated or not with chemotherapy is essential. Irradiation of the entire central nervous system at the dose of 36 Gy, followed posterior fossa boost to 56 Gy was performed in 74 cases (77.1 %). The 5 year overall survival rate for the whole patients was 50%. Therapeutics advances, especially in radiation therapy techniques, improve the efficiency of the treatment, increasing survival and reducing sequelae