Secondary manifestation of medulloblastoma: metastases and local recurrences in 66 patients

摘要: Although primary treatment of medulloblastoma is now successful in a high percentage patients, its secondary manifestations still bear poor prognosis. Thorough studies are therefore pivotal to plan therapeutic approaches for the long-term management medulloblastoma. Here we describe incidence tumour 66 patients single centre who underwent surgery between 1975 and 1990. No patient was excluded due postoperative course. Thirty-five showed evidence growth. Of these, 17 suffered from local recurrence, 27 developed metastastatic disease. The median latencies were 25 months recurrence (n = 17), 11 spinal metastases 10), 15 supratentorial 8), 8 subleptomeningeal dissemination 6), 23 systemic 8). Two metastatic spread posterior fossa. with metastases, 6 fronto-basal lesions. In our 89% lesions occurred within less than 3 years after diagnosis. 85% extra-axial had been treated permanent shunt. Radical resection radiotherapy 30 Gy neuraxis 20 boost fossa an important prognostic factor this series. Patients additional chemotherapy did not benefit significantly treatment. We conclude that optimal should aim at (i) total resection, (ii) avoid shunting, (iii) completion inclusion medial frontobasal cisterns radiotherapeutic regimen. Our analysis suggests adequate screening programmes consist 3-monthly scans first three 6-monthly thereafter.