Abstract

Among all the childhood central nervous system tumours, medulloblastoma and other neuroectodermal tumours account for 16-25% of cases. The causative factors of medulloblastoma/PNET have not been well established. It is more frequent in boys than in girl and in children than in adults. There was a significant improvement of survival for children diagnosed in 2000-2002 compared to those diagnosed in 1995-1999. The risk of dying was reduced by 30%. Patients are generally divided into risk-stratified schemes on the basis of age, the extent of residual disease, and dissemination. Sixty to 70% of patients older than 3 years are assigned to the average-risk group. High-risk patients include those in the disseminated category, and in North American trials those that have less than a gross or near-total resection, which is arbitrarily defined as 1.5cm 2 of post-operative residual disease. Current and currently planned clinical trials will:(1)evaluate the feasibility of reducing both the dose of craniospinal irradiation and the volume of the posterior fossa radiotherapy boost by the modest intensification of chemotherapy in standard-risk patients;(2)determine whether intensification of chemotherapy or irradiation can improve outcome in patients with high-risk disease;define molecular and biological markers that improve outcome prediction in patients with medulloblastoma and which can be incorporated for front-line stratification of newly defined risk subgroups.

Original languageEnglish
Pages (from-to)65-83
Number of pages19
JournalCritical Reviews in Oncology/Hematology
Volume79
Issue number1
DOIs
Publication statusPublished - Jul 2011

Keywords

  • Late effects
  • Medulloblastoma
  • Pediatric brain tumors
  • Prognosis
  • Rehabilitation in brain tumors

ASJC Scopus subject areas

  • Oncology
  • Hematology
  • Geriatrics and Gerontology

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