Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

Conventional treatment of medulloblastoma has involved surgery to the primary tumour and radiotherapy to the primary site and craniospinal axis. However CNS irradiation in a young child may result in significant side effects. Thus new treatment strategies have emerged which include chemotherapy, given in order to delay radiotherapy, to enable radiation dose reduction to the primary site and craniospinal axis, or even to eliminate radiotherapy completely. Such treatments have not yet been adequately evaluated in terms of survival and late effects. We report a retrospective study of 37 patients under the age of 36 months treated with postoperative craniospinal irradiation, in which the radiation dose to the neuroaxis was below conventional dosage. The overall actuarial 10-year survival rate was 44% and the actuarial 10-year relapse tree survival rate was 54%. Both radiotherapy and chemotherapy contributed to morbidity and mortality. Tour of 16 patients who survived longer than 10 years had no hard neurological signs; all but one patient have required extra support at school. Of nine patients available for work, two have obtained employment but only one has maintained this. No young adults have married. Despite lower doses of radiation, all but 1 survivor has significant spine shortening, and all who reached final height were short. Further work is needed to complete the profile of late effects in this group, which should include the survivors own perceptions of quality of life. It is hoped that multimodality treatment and supportive care can sustain acceptable survival rates but reduce the burden of late effects.


Journal article


Med Pediatr Oncol

Publication Date





348 - 354


Actuarial Analysis, Adolescent, Adult, Antineoplastic Combined Chemotherapy Protocols, Brain, Cerebellar Neoplasms, Chemotherapy, Adjuvant, Child, Child, Preschool, Disease-Free Survival, Female, Follow-Up Studies, Humans, Infant, Male, Medulloblastoma, Quality of Life, Radiotherapy Dosage, Radiotherapy, Adjuvant, Spinal Cord, Survival Analysis, Treatment Outcome