Radiotherapy for primary brain tumors in very young children.

Ninety-one children younger than age five years have been treated with radiotherapy for primary intracranial tumors. Patients with cerebellar astrocytomas and optic chiasm gliomas did relatively well, whereas brain stem tumors, extensive posterior fossa tumors and cerebral gliomas had a poor prognosis. Medulloblastomas, ependymomas, and midbrain tumors were of intermediate prognosis. There was no definite correlation between age at diagnosis and survival, although patients over 24 months of age seemed to do slightly better. Tumor doses of at least 4000 rad seem necessary for any likelihood of control. Of 63 children diagnosed over five years ago, 27 (43%) survived at least five years. The majority of long-term survivors are leading normal lives, although many have mild impairments.