Thirty-one children under the age of 15 years with verified medulloblastoma were treated at Addenbrookes Hospital from 1940 to 1976. In addition to surgical treatment, all received high dose irradiation to the whole neuraxis. Nine were still alive in 1979, of whom eight were examined. All these patients showed some residual problems, but five were leading active lives and had only minor physical disability. There was evidence of disturbance in growth, with shortening of the spine in relation to the limbs, in all the children. The height centile was lower than expected from parental height in four and one was severely dwarfed. Growth hormone secretioH in response to exercise was, however, normal in five of six patients tested. Three children also shewed failure of growth of the jaw sufficiently severe to be a cosmetic problem. Frank mental retardation was present in three children. A raised resting TSH level was found in two children, one of whom had a multinodular goiter. Of the three children with severe problems, two had been treated when under two years of age. Long-term follow-up of children who survive medulloblastoma is clearly necessary and consideration should perhaps be given to revision of current treatment regimes m very young children.
Cancer 48:26-30, 1981.
EDULLOBLASTOMA accounts for 20% of all intra-M cranial neoplasms in children under the age of 15 years. The tumor is highly radiosensitive, and traditionally treatment has been surgery followed by intensive craniospinal irradiation. Recent trials have included adjuvant chemotherapy, but whether this effects the prognosis is as yet unknown:> Apart from Bloom's excellent review of the long-term results of treatment in 82 children with medulloblastoma who presented between 1950 and 1964,2 there has been remarkably little published work on the later effects of craniospinal irradiation in childhood. We have therefore examined the survivors among the children who presented with medulloblastoma under the age of 15 years at Addenbrookes Hospital.
Patients and Methods
All children with histologically proven medulloblastoma seen from 1940 to 1976 were included. There were 31 children, 20 boys and 11 girls, their ages ranging from 0.4 to 14 years at the time of diagnosis. Twenty-two children died, from one to 46 months