AIM: While the impact of radiotherapy in the management of medulloblastoma was recognised, the introduction of chemotherapy was investigated in clinical trials and shown to confer an additional advantage. We reviewed the outcome of a series of consecutive patients to assess the impact in a population-based clinical establishment. MATERIALS AND METHODS: A series of 38 children treated for medulloblastoma at Birmingham Children's Hospital between 1994 and 2003 was analysed. The effect of surgery, radiotherapy, chemotherapy and metastasis on survival was analysed. RESULTS: The overall 5-year survival rate was 61.4% for the 36 patients who had resective surgery, while 2 patients had biopsy only and died within a few months. There was no operative mortality. The incidence of hydrocephalus needing permanent shunting was higher in the first 3 years of life (p = 0.007, chi-square). The 5-year survival rate of patients with total and sub-total excision of medulloblastoma was 61.1% and 61.8%, respectively. The 5-year survival rate of patients older than 3 years was 73.4% and for patients under 3 years was 36.3% (p = 0.007, log rank). Metastases at presentation did not influence survival. All deaths occurred in the first 32 months. CONCLUSION: The contribution of chemotherapy in the improvement of the overall survival appears more evident in children younger than 3 years or presenting with metastases. The absence of significant difference in survival between patients with total or sub-total excision of medulloblastoma supports the view that total excision of medulloblastoma can be avoided when the risk for potential intra-operative damage and consequent neurological deficits is high.
AIM: While the impact of radiotherapy in the management of medulloblastoma was recognised, the introduction of chemotherapy was investigated in clinical trials and shown to confer an additional advantage. We reviewed the outcome of a series of consecutive patients to assess the impact in a population-based clinical establishment. MATERIALS AND METHODS: A series of 38 children treated for medulloblastoma at Birmingham Children's Hospital between 1994 and 2003 was analysed. The effect of surgery, radiotherapy, chemotherapy and metastasis on survival was analysed. RESULTS: The overall 5-year survival rate was 61.4% for the 36 patients who had resective surgery, while 2 patients had biopsy only and died within a few months. There was no operative mortality. The incidence of hydrocephalus needing permanent shunting was higher in the first 3 years of life (p = 0.007, chi-square). The 5-year survival rate of patients with total and sub-total excision of medulloblastoma was 61.1% and 61.8%, respectively. The 5-year survival rate of patients older than 3 years was 73.4% and for patients under 3 years was 36.3% (p = 0.007, log rank). Metastases at presentation did not influence survival. All deaths occurred in the first 32 months. CONCLUSION: The contribution of chemotherapy in the improvement of the overall survival appears more evident in children younger than 3 years or presenting with metastases. The absence of significant difference in survival between patients with total or sub-total excision of medulloblastoma supports the view that total excision of medulloblastoma can be avoided when the risk for potential intra-operative damage and consequent neurological deficits is high.
Authors: A E Evans; R D Jenkin; R Sposto; J A Ortega; C B Wilson; W Wara; I J Ertel; S Kramer; C H Chang; S L Leikin Journal: J Neurosurg Date: 1990-04 Impact factor: 5.115
Authors: P M Zeltzer; J M Boyett; J L Finlay; A L Albright; L B Rorke; J M Milstein; J C Allen; K R Stevens; P Stanley; H Li; J H Wisoff; J R Geyer; P McGuire-Cullen; J A Stehbens; S B Shurin; R J Packer Journal: J Clin Oncol Date: 1999-03 Impact factor: 44.544
Authors: Paul Kleihues; David N Louis; Bernd W Scheithauer; Lucy B Rorke; Guido Reifenberger; Peter C Burger; Webster K Cavenee Journal: J Neuropathol Exp Neurol Date: 2002-03 Impact factor: 3.685
Authors: Jonathan A Forbes; Lola B Chambless; Jason G Smith; Curtis A Wushensky; Richard L Lebow; JoAnn Alvarez; Matthew M Pearson Journal: J Neurosurg Pediatr Date: 2011-02 Impact factor: 2.375
Authors: Abd Elrhman Enayet; Mohamed Nabil; Mohamed Reda Rady; Yasser Yousef; Eman Badawy; Mohamed A El Beltagy Journal: Childs Nerv Syst Date: 2021-02-18 Impact factor: 1.475
Authors: Sueli M Oba-Shinjo; Otavia L Caballero; Achim A Jungbluth; Sergio Rosemberg; Lloyd J Old; Andrew J G Simpson; Suely K N Marie Journal: Cancer Immun Date: 2008-04-22
Authors: Livia Garzia; Immacolata Andolfo; Emilio Cusanelli; Natascia Marino; Giuseppe Petrosino; Daniela De Martino; Veronica Esposito; Aldo Galeone; Luigi Navas; Silvia Esposito; Sara Gargiulo; Sarah Fattet; Vittoria Donofrio; Giuseppe Cinalli; Arturo Brunetti; Luigi Del Vecchio; Paul A Northcott; Olivier Delattre; Michael D Taylor; Achille Iolascon; Massimo Zollo Journal: PLoS One Date: 2009-03-24 Impact factor: 3.240