Treatment of children older than 3 years with high-risk medulloblastoma

Standard treatment options for children older than 3 years who are newly diagnosed with medulloblastoma and have metastatic disease or have had a subtotal resection include the following:

In high-risk patients, numerous studies have demonstrated that multimodality therapy improves the duration of disease control and overall disease-free survival.[58,134] Studies show that 50% to 70% of patients with high-risk disease, including those with metastatic disease, will experience long-term disease control.[58,117,134-138]; [139,140][Level of evidence A1]; [141][Level of evidence B4] A completed COG study demonstrated that children with group 3 MYC-amplified tumors who were randomly assigned to receive carboplatin during radiation therapy had improved 5-year EFS and OS rates, compared with those who did not receive carboplatin concurrently with radiation therapy.[135] The optimal treatment for children with SHH-activated, TP53-altered medulloblastoma has not been determined, as less than 30% of patients are expected to survive 5 years from diagnosis after treatment with current therapy.[14]