ABSTRACT
PURPOSE: Retrospective analysis of the results of 52 children irradiated for a medulloblastoma. PATIENTS AND METHODS: Between 1974 and 2012, 52 children with an average age of 6 years and a half (11 months-17 years and a half) were treated with surgery then with radiotherapy at the Comprehensive Cancer Centre of Strasbourg (France). For 44 children, the treatment consisted of a chemotherapy. RESULTS: After a mean follow-up of 106.6 months (7-446 months), 13 relapses and 24 deaths were observed. Overall survival at 5 years and 10 years were 62% and 57%, respectively. Disease-free survival at 5 years and 10 years were 80% and 63%, respectively. Univariate analysis found the following adverse prognostic factors: the existence of a postoperative residue, the positivity of the cerebrospinal fluid, the metastatic status and medulloblastoma of high-risk. Positivity of the cerebrospinal fluid remains a negative factor in multivariate analysis. CONCLUSION: These results confirm the survival rate obtained by a conventional approach (surgery then irradiation). Insufficiency of results and rarity of medulloblastoma require the establishment of international protocols.
Subject(s)
Cerebellar Neoplasms/mortality , Cerebellar Neoplasms/therapy , Medulloblastoma/mortality , Medulloblastoma/therapy , Adolescent , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cerebellar Neoplasms/cerebrospinal fluid , Cerebellar Neoplasms/pathology , Chemotherapy, Adjuvant , Child , Child, Preschool , Disease-Free Survival , Female , Follow-Up Studies , France/epidemiology , Humans , Infant , Male , Medulloblastoma/cerebrospinal fluid , Medulloblastoma/pathology , Methotrexate/administration & dosage , Neoplasm, Residual/pathology , Procarbazine/administration & dosage , Prognosis , Radiotherapy, Adjuvant , Retrospective Studies , Vincristine/administration & dosageABSTRACT
Medulloblastoma are cerebellar tumours belonging to the group of primitive neuroectodermal tumours (PNET) and are the most common malignant brain tumours of childhood. These tumours are rare and heterogeneous, requiring some multicentric prospective studies and multidisciplinary care. The classical therapeutic approaches are based on clinical, radiological and surgical data. They involve surgery, radiation therapy and chemotherapy. Some histological features were added to characterize risk. More recently, molecular knowledge has allowed to devise risk-adapted strategies and helped to define groups with good outcome and reduce long-term sequelae, improve the prognostic of high-risk medulloblastoma and develop new therapeutic tools.
