title: Adult medulloblastoma: a single institution experience.
abstract: Medulloblastoma is an aggressive posterior fossa tumor which is rare in adult. We aim to study the clinical features and outcome of adult medulloblastoma patients, and to identify poor outcome predictors.
  
  
  METHODS
  From January 1995 to December 2006, 35 adult patients (>15 years of age at the time of diagnosis) underwent surgery for medulloblastoma followed by full dose of radiotherapy (54 Gy), with or without systemic chemotherapy.
  
  
  RESULTS
  The mean age was 24 years (maximum 52). There were 19 male and 16 female patients. CSF spread was documented in 23 patients. Eight patients developed relapse. Four patients developed isolated CNS relapse, two patients developed isolated lung metastasis and 2 patients developed both lung metastasis and CNS relapse. The craniospinal radiation dose ranged from 34 to 36 Gy and the total posterior fossa dose ranged from 54 to 56 Gy. The 10 year disease free survival rate reached 65% +/- 10. The relapse free survival was significantly different according to the M stage (M0, M1, M2 & 3), as none of the patients in the M0 group had relapsed while 4 patients in the M1 group and 4 patients in the M2&3 group relapsed (p=0.0026).
  
  
  CONCLUSIONS
  The distinction between adult and pediatric medulloblastoma is not clear. Overall, M stage is an important prognostic factor. Although chemotherapy is a part of standard practice in pediatric treatment protocols, its role in older patients should be further evaluated in clinical studies.
authors.affiliation: Mohamed Nazmy, MBBCh, MSc, MD, FRCR, Asst. Professor Radiation Oncology, NCI Cairo University/KFSH and RC, Email: mnazmy@hotmail.com, Tel: +201224555864 +353894608541.
authors.forename: M
authors.initials: M
authors.lastname: Nazmy
authors.affiliation: Radiation Oncology Department, NCI Cairo University, Egypt.
authors.forename: Y
authors.initials: Y
authors.lastname: Khafaga
authors.affiliation: Radiation Oncology Department King Faisal Specialist Hospital and Research Center.
authors.forename: A
authors.initials: A
authors.lastname: Al Hebshi
authors.affiliation: Neurosurgery Department, King Faisal Specialist Hospital and Research Cente.
authors.forename: M
authors.initials: M
authors.lastname: Hassounah
authors.affiliation: Radiation Oncology Department, NCI Cairo University, Egypt.
authors.forename: S
authors.initials: S
authors.lastname: Albadawy