Medulloblastoma

Objective To elucidate the diagnosis, treatment and prognosis of medullobla stoma in both children and adults. Methods A retrospective review was conducted in 80 patients with medullobla stoma confirmed pathologically during the period of 1984 and 1995. Multivar iate analysis and comparison were made of the therapeutic effects of operat ion, radiotherapy and chemotherapy as well as the survival period. Results There were 42 males and 38 females with average age at diagnosis be ing 9.1 years in children and 25.1 years in adults. All patients were opera ted on to remove the tumour. Cerebral aqueduct re-opening was got through i n 54 cases (67.5%), and Torkilsen's shunt was carried out at the same time for the rest patients. Seventeen patients had ventriculoperitoneal shunt, a nd 13 of them were performed after surgical excision of the tumour. Complet e follow-up information was obtained in 61 patients (76%) for a period of 6 months to 14 years. During the follow-up, 27 patients received postoperati ve craniospinal irradiation, and 27 local radiation. Forteen patients were subjected to adjuvant chemotherapy. The overall ti-year and 10-year surviva l rates were 50.5% and 27.89% respectively. The 5-year survival rate was hi gher in adults than in children (P < 0.05), whereas the 10-year survival ra te was similar. Thirty-two patients died of relapse or metastasis between 6 months and 10 years after initial surgical therapy, and the mean recurrenc e time was 3.5 years. Conclusions Operation and postoperative regular radiotherapy were important therapeutic modalities for medulloblastoma. Total or subtotal removal of t he tumour combined with craniospinal radiotherapy can improve patients' sur vival rate. The survival period of medulloblastoma patients is consistent w ith Collins law, that is, the period of risk for survival is the age at ini tial diagnosis plus 9 months. Only few patients can gain long-term survival .