title: Medulloblastoma: progress over time.
abstract: BACKGROUND
  Medulloblastoma is the most common central nervous system tumour in children aged 0-4 years, with 75% of cases occurring in patients <16 years, and rare in adults. The intent of this audit is to review a single centre's experience and to compare outcomes with other centres' outcomes.
  
  
  METHODS
  This Ethics approved retrospective audit evaluates the paediatric population aged <16 years who received radiotherapy as their initial or salvage treatment at the Prince of Wales Hospital Cancer Centre between 1972 and 2007. The primary and secondary end-points were progression-free survival (PFS) and cancer-specific survival (CSS), with comparisons made between patients treated before and after 1990, and the impact of high- and low-risk disease.
  
  
  RESULTS
  There were 80 eligible patients, 78 who had radiotherapy at initial presentation, and 2 at the time of recurrence. Median age was 6.5 years, 52 were boys and 28 were girls. Seventy-eight patients had a surgical procedure and ultimately received craniospinal radiotherapy. Of these 78 patients, 32 (40%) had a macroscopically complete resection. The 5-year PFS was 69.7%. The 5-year PFS for patients treated pre and post 1990 was 66.1% and 71.8%, respectively. The 5-year CSS for high- and low-risk patients was 61.1% and 78.4%, respectively. Ultimately, 33% of patients were dead due to disease.
  
  
  CONCLUSIONS
  This audit demonstrates those children referred to this facility for treatment have comparable survival to that of other major centres.
authors.affiliation: Department of Radiation Oncology, The Prince of Wales Cancer Centre, Level 2, High Street, Randwick, NSW 2031, Australia.
authors.forename: Robert I
authors.initials: RI
authors.lastname: Smee
authors.forename: Janet R
authors.initials: JR
authors.lastname: Williams
authors.forename: Katie J
authors.initials: KJ
authors.lastname: De-Loyde
authors.forename: Nicola S
authors.initials: NS
authors.lastname: Meagher
authors.forename: Richard
authors.initials: R
authors.lastname: Cohn
mesh_terms: D016543:Central Nervous System Neoplasms / Q000175:diagnosis / Q000532:radiotherapy* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008527:Medulloblastoma / Q000175:diagnosis / Q000532:radiotherapy* / Q000601:surgery; D009364:Neoplasm Recurrence, Local; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed