Acta Neurochirurgica

, Volume 48, Issue 1–2, pp 1–15 | Cite as

Medulloblastoma in childhood. Survival and functional results

  • J. F. Hirsch
  • D. Renier
  • P. Czernichow
  • L. Benveniste
  • A. Pierre-Kahn


The authors report on a series of 57 medulloblastomas in children operated upon between 1964 and 1976. Among these children, 44 completed the treatment with radiotherapy to the whole central nervous system.

The postoperative mortality rate is 10.5%. Postoperative deaths occurred mainly in infants or when a tumour involved the brain stem.

The five-year survival rate is 54% in the whole series. It rose to 71% in the patients who completed the treatment with radiotherapy.

The study shows that the life of survivals is frequently impaired by mental or behavioural disturbances. IQ varies from 70 to 90 in 58% of the children; it is below 70 in 31%. Behavioural disturbances are found in 93% of cases. 82% have defective spatial orientation, dysphasia, or dysgraphia.

In order to evaluate the responsibility of X-ray therapy for the development of these sequelae, the results have been compared to those of a series of cerebellar astrocytomas surgically removed, but not irradiated. The comparison shows that radiotherapy is at least partially responsible for the mental and behavioural disturbances.

No relation was found between these disturbances and a persistent ventricular dilatation or an endocrine dysfunction. However the endocrine assessment showed growth hormone deficiency in 65% of the children, short stature in 55%, and compensated hypothyroïdism in 58%.


Medulloblastoma survival functional results side-effects of radiotherapy 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Abramson, N., Raben, M., Cavanaugh, P. J., Brain tumors in children: analysis of 136 cases. Radiology112 (1974), 669–672.PubMedGoogle Scholar
  2. 2.
    D'Amato, C. J., Hicks, S. P., Effects of low levels of ionizing radiation on the developing cerebral cortex of the rat. Neurology15 (1965), 1104–1115.PubMedGoogle Scholar
  3. 3.
    Aron, B. S., Medulloblastoma in children. Twenty-two years' experience with radiation therapy. Amer. J. Dis. Child.121 (1971), 314–317.PubMedGoogle Scholar
  4. 4.
    Bloom, H. J. G., Wallace, E. N. K., Henk, J. M., The treatment and prognosis of medulloblastoma in children. A study of 82 verified cases. Amer. J. Roentgen.105 (1969), 43–62.PubMedGoogle Scholar
  5. 5.
    Bloom, H. J. G., Concepts in the natural history and treatment of medulloblastoma in children: Increasing survival rates and possible risks with current radiotherapy techniques. C. R. C. Critical Reviews in Radiological Sciences2 (1971), 89–143.Google Scholar
  6. 6.
    Bloom, H. J. G., Walsh, L. S., Tumours of the central nervous system. In: Cancer in children, clinical management. Berlin-Heidelberg-New York: Springer. 1976.Google Scholar
  7. 7.
    Chiland, C., L'enfant de six ans et son avenir. Paris: Presses Universitaires de France. 1971.Google Scholar
  8. 8.
    Clemente, C. D., Yamazaki, J. N., Bennett, L. R., McFall, R. A., Brain radiation in newborn rats and differential effects of increased age. II. Microscopic observations. Neurology10 (1960), 669–675.PubMedGoogle Scholar
  9. 9.
    Collins, V. P., Wilms' tumor: its behavior and prognosis. J. La State Med. Soc.107 (1955), 474–480.PubMedGoogle Scholar
  10. 10.
    Crist, W. M., Ragab, A. H., Vietti, T. J., Ducos, R., Chu, J. Y., Chemotherapy of childhood medulloblastoma. Amer. J. Dis. Child.130 (1976), 639–642.PubMedGoogle Scholar
  11. 11.
    Czernichow, P., Cachin, O., Rappaport, R., Flamant, F., Sarrazin, D., Schweisguth, O., Séquelles endocriniennes des irradiations de la tête et du cou pour tumeurs extra-crâniennes. Arch. franç. Pédiat.34 (1977), 154–164.Google Scholar
  12. 12.
    Diebler, C., Metzger, J., Aicardi, J., Hirsch, J. F., La tomodensitométrie en pédiatrie. Ann. Radiol.20 (1977), 451–460.PubMedGoogle Scholar
  13. 13.
    Gottschalk, L. A., Kunkel, R., Wohl, T. H., Saenger, E. L., Winget, C. N., Total and half body irradiation. Effect on cognitive and emotional processes. Arch. gen. Psychiat.21 (1969), 574–580.PubMedGoogle Scholar
  14. 14.
    Greenwood, M., A report on the natural duration of cancer. Appendice I: The errors of sampling of the survivorship tables. Reports on Public Health and Medical Subjects No. 33, App. I; London: Stationery Office, 1926.Google Scholar
  15. 15.
    Hakansson, C. H., Lindgren, M., Sulg, I. A., E. E. G. effects of postoperative irradiation treatment of brain tumours. Acta Radiol.8 (1969), 301–310.Google Scholar
  16. 16.
    Hardy, D. G., Hope-Stone, H. F., McKenzie, C. G., Scholtz, C. L., Recurrence of medulloblastoma after homogeneous field radiotherapy. Report of three cases. J. Neurosurg.49 (1978), 434–440.PubMedGoogle Scholar
  17. 17.
    Jenkin, R. D. T., Medulloblastoma in childhood: Radiation therapy. Canad. Med. Ass. J.100 (1969), 51–53.PubMedGoogle Scholar
  18. 18.
    Jundt, S., Essai d'une chimiothérapie systématique dans les médulloblastomes de la fosse postérieure chez l'enfant. Neuro-chir.20 (1974), 170–171.Google Scholar
  19. 19.
    Lampert, P. W., Davis, R. L., Delayed effects of radiation on the human central nervous system. “Early” and “late” delayed reactions. Neurology14 (1964), 912–917.PubMedGoogle Scholar
  20. 20.
    Lampkin, B. C., Mauer, A. M., McBride, B. H., Response of medulloblastoma to vincristine sulfate: a case report. Pediatrics39 (1967), 761–763.PubMedGoogle Scholar
  21. 21.
    Lassman, L. P., Pearce, G. W., Gang, J., Effect of vincristine sulfate on the intracranial gliomata of childhood. Brit. J. Surg.53 (1966), 774–777.PubMedGoogle Scholar
  22. 22.
    Lassman, L. P., Diagnosis and management of skeletal metastases from cerebellar medulloblastoma. Child's Brain2 (1976), 38–45.PubMedGoogle Scholar
  23. 23.
    Matson, D. D., Neurosurgery of infancy and childhood. Springfield, Ill.: Ch. C Thomas. 1969.Google Scholar
  24. 24.
    Mealey, J., Jr., Hall, P. V., Medulloblastoma in children. Survival and treatment. J. Neurosurg.46 (1977), 56–64.PubMedGoogle Scholar
  25. 25.
    McFarland, D. R., Horwitz, H., Saenger, E. L., Bahr, G. K., Medulloblastoma. A review of prognosis and survival. Brit. J. Radiol.42 (1969), 198–214.PubMedGoogle Scholar
  26. 26.
    Painter, M. J., Chutorian, A. M., Vilal, S. K., Cerebrovasculopathy following irradiation in childhood. Neurology25 (1975), 189–194.PubMedGoogle Scholar
  27. 27.
    Quest, D. O., Brisman, R., Antunes, J. L., Housepian, E. M., Period of risk for recurrence in medulloblastoma. J. Neurosurg.48 (1978), 159–163.PubMedGoogle Scholar
  28. 28.
    Schjeide, O. A., Yamazaki, J., Haack, K., Ciminelli, E., Clemente, C. D., Biochemical and morphological aspects of radiation inhibition of myelin formation. Acta Radiol. Ther. Phys. Biol.5 (1966), 185–203.PubMedGoogle Scholar
  29. 29.
    Shalet, S. M., Beardwell, C. G., Pearson, D., Morris Jones, P. H., The effects of varying doses of cerebral irradiation on growth hormone production in childhood. Clin. Endocrinol.5 (1976), 287–290.Google Scholar
  30. 30.
    Smith, R. A., Lampe, I., Kahn, P. A., The prognosis of medulloblastoma in children. J. Neurosurg.18 (1961), 91–97.Google Scholar
  31. 31.
    Smith, C. E., Long, D. M., Jones, T. K., Levitt, S. H., Medulloblastoma: an analysis of time-dose relationships and recurrence patterns. Cancer32 (1973), 722–728.PubMedGoogle Scholar
  32. 32.
    Soni, S. S., Marten, G. W., Pittner, S. E., Duenas, D. A., Powazek, M., Effects of central nervous system irradiation on neuropsychologic functioning of children with acute lymphocytic leukemia. New Engl. J. Med.293 (1975), 113–118.PubMedGoogle Scholar
  33. 33.
    Ullmo, D., Lemerle, J., Schweisguth, O., Traumatisme cérébral, traumatisme psychique? Etude de 47 enfants atteints de médulloblastome et de leur devenir. Arch. franç. Pediat.35 (1978), 559–570.Google Scholar
  34. 34.
    Wilson, C. B., Medulloblastoma: current views regarding the tumor and its treatment. Oncology24 (1970), 273–290.PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1979

Authors and Affiliations

  • J. F. Hirsch
    • 1
  • D. Renier
    • 1
  • P. Czernichow
    • 1
  • L. Benveniste
    • 1
  • A. Pierre-Kahn
    • 1
  1. 1.Service de Neuro-ChirurgieHôpital des Enfants MaladesParisFrance

Personalised recommendations