Medulloblastoma in childhood.

Fifty-one patients with medulloblastoma have been treated at the Children's Memorial Hospital during the past 11 years. The ratio between males and females was 2:1. The ages ranged from 4 months to 12 years; 7 patients were less than 12 months old at the time of diagnosis. After 1969, prior to definitive surgery, all patients were given a ventriculo-peritoneal shunt to decompress the hydrocephalus which was invariably present. There were no cases of systemic metastasis related to these shunts. Subsequently, posterior fossa craniotomy was performed, with total or radical resection of tumour in 13 cases, subtotal resection in 20 cases, and partial resection or biopsy in 14 cases. After completion of surgical treatment and radiotherapy, the three-year survival rate was 45.6 per cent and the five-year survival 34.5 per cent. The survival of children given total resection of the tumour was significantly longer, and females survived longer than males. Local recurrence and spinal cord or systemic metastases are discussed. Reexploration of the posterior fossa for recurrences failed to improve the prognosis. Recurrent or metastatic medulloblastoma should be treated by radiotherapy or chemotherapy, or both.