Postoperative radiotherapy of childhood medulloblastomas.
The purpose of this work is to review the result of radiotherapy in the treatment of medulloblastoma in pediatric patients. Between 1986 and 1998, 66 children (45 boys and 21 girls) received postoperative irradiation in our institute. Their mean age was 8.29 years. Irradiation was performed by linear accelerator, 36 Gy were applied in the high risk group (partial tumor resection, tumor cell positivity in the liquor, metastases within the central nervous system) and 30 Gy in the low risk group (total tumor resection, negative liquor cytology, no metastases within the central nervous system) on the entire cerebrum and spinal cord. This was followed in both groups by the application of 20-20 Gy boost irradiation on the posterior scala. Studying the survival it has been found that the surgical radicality did not significantly influence the survival chances of patients, however, with the increase in the tumor size the survival chance significantly decreases (p = 0.03). When predicting life expectancy, however, the stage of tumor, the age of patients, the risk group and the M stage yielded essential information. At the age of 8 years and less, the rate of survivors is 67.6%, for those over 8 years is 75.9% (p = 0.21), however the younger age was not significant. The appearance of metastases considerably deteriorates the chances of survival (from 81.5% to 66.7%, p = 0.02). In the low risk group of patients the 5-year survival is 80%, while in the high risk group it is significantly lower, 67.4% (p = 0.04).
Kocsis
B
B
Department of Radiotherapy, Haynal Imre Medical University, National Institute of Oncology, Budapest, Hungary.
Székely
G
G
Pap
L
L
Takácsi-Nagy
Z
Z
Németh
G
G
D000293:Adolescent; D002528:Cerebellar Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008527:Medulloblastoma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D009362:Neoplasm Metastasis; D011184:Postoperative Period; D018714:Radiotherapy, Adjuvant; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis