SURVIVAL RESULTS IN ADULT PATIENTS TREATED FOR MEDULLOBLASTOMA

The records of all 27 adult patients (age, greater-than-or-equal-to 16 years) diagnosed with cerebellar medulloblastoma between 1968 and 198 6 were reviewed. Twenty-four patients (89%) were treated with postoper ative megavoltage irradiation. Twenty of these patients underwent cran iospinal irradiation. Sixteen patients received greater than 5000 cGy to the posterior fossa (range, 2340 to 6600 cGy; median, 5490 cGy). Fo rty-eight percent of patients also received adjuvant chemotherapy. A 5 -year and 10-year actuarial survival rate of 48% was achieved. The use of adjuvant chemotherapy did not improve survival in this series. All relapses occurred within 35 months of diagnosis (median time to relap se, 23.5 months), except one patient who had a recurrence in the poste rior fossa at 140 months. The posterior fossa was the most common site of treatment failure and represented 50% of all initial relapses. All survivors had no sequelae, except one in whom leukoencephalopathy dev eloped after craniospinal irradiation and intrathecal methotrexate adm inistration. The survival results obtained in this series compare favo rably with other reported modern adult medulloblastoma series.