title: Treatment of high risk medulloblastomas in children above the age of 3 years: a SFOP study.
abstract: OBJECTIVE
  Improvement of EFS of children older than 3 years with high risk medulloblastoma.
  
  
  METHODS
  Between 1993 and 1999, 115 patients (3-18 years, mean 8 years) with high risk medulloblastoma were included. After surgery treatment consisted of chemotherapy ('8in1' and etoposide/carboplatin) before and after craniospinal radiotherapy.
  
  
  RESULTS
  Patients were staged using Chang-criteria (PF residue only, M1 and M2/M3) by local investigator as well as by central review panel (82.4% concordance). Chemotherapy was well tolerated without major delays in radiotherapy. With a mean follow up of 81 months (9-119), 5-year EFS was 49.8% and OS 60.1%. In detail according to subgroups EFS was 68.8% for PF residue only, 58.8% for M1 disease and 43.1% for M2/M3.
  
  
  CONCLUSIONS
  M1 patients are legitimate high risk patients. Survival rates are still very low for high risk medulloblastoma patients and future trials should therefore focus on more intensive (chemotherapy/radiotherapy) treatment.
authors.affiliation: Department of Paediatric Oncology, Institut Curie, Service d'Oncologie Pediatrique, 26 rue d'Ulm, 75231 Paris Cedex 05, France.
authors.forename: J
authors.initials: J
authors.lastname: Verlooy
authors.forename: V
authors.initials: V
authors.lastname: Mosseri
authors.forename: S
authors.initials: S
authors.lastname: Bracard
authors.forename: A Lellouch
authors.initials: AL
authors.lastname: Tubiana
authors.forename: C
authors.initials: C
authors.lastname: Kalifa
authors.forename: F
authors.initials: F
authors.lastname: Pichon
authors.forename: D
authors.initials: D
authors.lastname: Frappaz
authors.forename: P
authors.initials: P
authors.lastname: Chastagner
authors.forename: A
authors.initials: A
authors.lastname: Pagnier
authors.forename: A-I
authors.initials: AI
authors.lastname: Bertozzi
authors.forename: J C
authors.initials: JC
authors.lastname: Gentet
authors.forename: E
authors.initials: E
authors.lastname: Sariban
authors.forename: X
authors.initials: X
authors.lastname: Rialland
authors.forename: C
authors.initials: C
authors.lastname: Edan
authors.forename: D
authors.initials: D
authors.lastname: Bours
authors.forename: M
authors.initials: M
authors.lastname: Zerah
authors.forename: C
authors.initials: C
authors.lastname: Le Gales
authors.forename: C
authors.initials: C
authors.lastname: Alapetite
authors.forename: F
authors.initials: F
authors.lastname: Doz
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D002528:Cerebellar Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy / Q000379:methods; D018572:Disease-Free Survival; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D008527:Medulloblastoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D011182:Postoperative Care; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D005047:Etoposide; D016190:Carboplatin