MEDULLOBLASTOMA - SURVIVAL AND LATE RECURRENCE AFTER THE COLLINS RISKPERIOD

Sixty-three patients with cerebellar medulloblastoma were treated betw een 1963 and 1992 at our institution. Among them, 10 patients have sur vived beyond the Collins' risk period. These included 6 males and 4 fe males who ranged in age from 6 months to 12 years at the time of diagn osis. A total removal of the tumor was achieved in 4 patients, while t here was a subtotal removal in 3, and a partial removal in 3. Histolog ically, 6 tumors were classified as a classical type of medulloblastom a, and 4 were diagnosed as being a desmoplastic type. Postoperatively, 9 patients received craniospinal radiation therapy, and one received local radiation to the primary site. During the follow-up period of 3. 9-25.4 years, 5 patients have been in continuous remission for from 14 .2 to 25.4 years and are leading normal lives, 2 have survived for 18. 1 and 18.5 years with mild to moderate neurological deficits, while th e remaining 3 died after the Collins' risk period. Two out of these la st 3 patients were under the age of one year at the time of onset, whi le the remaining one died after a second recurrence. We conclude that careful follow-up is needed for all long-term survivors even after the Collins' risk period, especially for those who were under the age of 1 year at onset and who failed in the initial treatments.