13 / 99
T
reatment
of
medulloblastoma
in
children
and
adolescents
R
ev
A
ssoc
M
ed
B
ras
2016; 62(4):298-302
301
use of conventional craniospinal radiotherapy (group
treated before 1994) with radiation therapy only in case
of relapse or disease progression. The group receiving
conventional radiotherapy showed significant lowering
of intellectual and academic performance compared with
the group in which radiotherapy was delayed. Radiother-
apy has been avoided in children under 3 years old.
32
Recommendation
Radiotherapy should be avoided or used only in cases of
relapse or lack of tumor control in order to prevent intel-
lectual deficit.
(B)
A
nnex
I: S
earch
strategies
and
number
of
studies
initially
retrieved
from
the
electro
-
nic
search
Search strategy: Natural history
•
•
(“medulloblastoma” [MeSH Terms] OR “medulloblas-
toma” [All Fields]) AND (“natural history” [MeSH
Terms] OR (“natural” [All Fields] AND “history” [All
Fields]) OR “natural history” [All Fields]) – 22.
Search strategy: Effect of the extension of tumor resection
•
•
(“medulloblastoma” [MeSH Terms] OR “medulloblas-
toma” [All Fields]) AND ((“craniotomy” [MeSH Terms]
OR “craniotomy” [All Fields]) OR (“microsurgery”
[MeSH Terms] OR “microsurgery” [All Fields]) OR
(“neurosurgical procedures” [MeSH Terms] OR (“neu-
rosurgical” [All Fields] AND “procedures” [All Fields])
OR “”neurosurgery”[All Fields] OR “neurosurgery”
[MeSH Terms]) OR (“neurosurgical” [All Fields] AND
“procedures” [All Fields]) OR “neurosurgical proce-
dures” [All Fields])) – 960.
Search strategy: Reoperation in the presence of residual tumor
after surgery
•
•
(“medulloblastoma” [MeSH Terms] OR “medulloblas-
toma” [All Fields]) AND (“residual tumour” [All Fields]
OR “neoplasm, residual” [MeSH Terms] OR (“neo-
plasm” [All Fields] AND “residual” [All Fields]) OR “re-
sidual neoplasm” [All Fields] OR (“residual” [All Fields]
AND “tumor” [All Fields]) OR “residual tumor” [All
Fields]) – 124.
Search strategy: Comparison of tumor removal, third-ventricu-
lostomy, and CSF shunt to treat hydrocephalus
•
•
(“medulloblastoma” [MeSH Terms] OR “medullo-
blastoma” [All Fields]) AND (“hydrocephalus” [MeSH
Terms] OR “hydrocephalus” [All Fields]) AND “man-
agement” [All Fields] OR “disease man-agement”
[MeSH Terms] OR (“disease” [All Fields] AND “man-
agement” [All Fields]) OR “disease management” [All
Fields]) OR (“therapy” [Subheading] OR “therapy”
[All Fields] OR “treatment” [All Fields] OR “thera-
peutics” [MeSH Terms] OR “therapeutics” [All
Fields])) – 159.
Search strategy: What is the effect of endoscopic third ventricu-
lostomy in hydrocephalus associated with medulloblastoma com-
pared with ventriculoperitoneal shunt?
•
•
(“medulloblastoma” [MeSH Terms] OR “medulloblas-
toma” [All Fields]) AND (“endoscopic third ventricu-
lostomy” [All Fields] OR “ventriculoperitoneal shunt”
[All Fields]) – 64.
Search strategy: Is it necessary to use radiotherapy in
medulloblastoma?
•
•
“Medulloblastoma/radiotherapy” [Mesh] AND (“ran-
domized controlled trial” [Publication Type] OR “ran-
domized controlled trials as topic” [MeSH Terms] OR
“randomized controlled trial” [All Fields] OR “ran-
domised controlled trial” [All Fields]) – 129.
Search strategy: What is the effect of radiotherapy in children
under 3 years old?
•
•
(“medulloblastoma” [MeSH Terms] OR “medulloblas-
toma” [All Fields]) AND (“radiotherapy” [Subheading]
OR “radiotherapy” [All Fields] OR “radiotherapy”
[MeSH Terms]) AND younger [All Fields] AND (“child”
[MeSH Terms] OR “child” [All Fields] OR “children”
[All Fields]) – 76.
R
eferences
1.
Smee RI, Williams JR, De-Loyde KJ, Meagher NS, Cohn R. Medulloblastoma:
progress over time. J Med Imaging Radiat Oncol. 2012; 56(2):227-34.
2. Albright AL, Wissof JH, Zeltzer PM, Boyett JM, Rorke LB, Stanley P. Effects
of medulloblastoma ressections on outcome in children: a report from the
Children’s Cancer Group. Neurosurgery. 1996; 38(2):265-71.
3. GaffneyCC,SloaneJP,BradleyNJ,BloomHJ.Primitiveneuroectodermaltumours
of the cerebrum. Pathology and treatment. J Neurooncol. 1985; 3(1):23-33.
4.
Muraszko KM, Brahma B, Orringer D. Medulloblastoma. In: Albright AL,
Pollack IF, Adelson PD. Principles and practice of pediatric neurosurgery.
New York: Thieme, 2008. p.613.
5.
Kunschner LJ, Kuttesch J, Hess K, Yung WK. Survival and recurrence factors
in adult medulloblastoma: the M.D. Anderson Cancer Center experience
from 1978 to 1998. Neuro Oncol. 2001; 3(3):167-73.
6.
Boiardi A, Silvani A, Eoli M, Fariselli L, Zappacosta B, Salmaggi A. Embryonal
tumors in the adult population: implications in therapeutic planning. Neurol
Sci. 2000; 21(1):23-30.
7.
Lang SS, Beslow LA, Gabel B, Judkins AR, Fisher MJ, Sutton LN, et al. Surgical
treatment of brain tumors in infants younger than six months of age and
review of the literature. World Neurosurg. 2012; 78(1-2):137-44.
8.
Raimondi AJ, Tomita T. Medulloblastoma in childhood: comparative results
of partial and total resection. Childs Brain. 1979; 5(3):310-28.