Medulloblastoma—a review of prognosis and survival

Abstract

Published reports over the last 30 years regarding clinical aspects of medulloblastoma are reviewed with special reference to factors influencing prognosis and survival. The experience at University of Cincinnati College of Medicine is added. Analyses are made concerning the long-term outlook in patients surviving primary surgical and radiological therapy. The behaviour of the disease and the complications occurring in treated patients are described. The importance of adequate irradiation to the posterior fossa is emphasised and the need for prophylactic radiotherapy to the spinal canal is acknowledged, but the necessity for similar prophylactic irradiation to the cerebral hemispheres is questioned. Newer therapeutic approaches such as intrathecal radioiosotope and drug treatment and systemic chemotherapy are also reviewed. Residual neurological defects resulting from the disease (or from its treatment) are frequently seen in survivors, and certain long-term hazards exist associated with extensive irradiation of the cerebrospinal axis. With current methods of therapy the disease appears to be permanently arrested in about 25 per cent of the patients. There is evidence to suggest that survival times may be longer in older patients and that the outlook for females is better than for males.