METASTATIC MEDULLOBLASTOMA - THE EXPERIENCE OF THE FRENCH COOPERATIVEM7 GROUP

A retrospective analysis was performed to determine the outcome of chi ldren with metastatic medulloblastoma given a standardised treatment p rogramme. Of 68 consecutive patients treated in the French M7 protocol for medulloblastoma, 23 presented with metastatic disease. They were uniformly treated with surgery, and the same protocol of chemotherapy and craniospinal radiotherapy. The 7-year relapse-free survival rate i s 43% for metastatic patients compared to 68% for patients with locali sed disease. Survival did not correlate with age, sex, location of met astases, extent of initial surgery and the dose of radiation therapy o n the posterior fossa. Survival did correlate with the dose to the cra nial field with a threshold dose of 30 Gy. Patients with metastatic di sease have a worse prognosis and require more aggressive therapies at initial presentation. The prognostic impact of the different sites of metastatic disease requires further evaluation in cooperative studies.