Medulloblastoma in childhood: Long-term results of treatment

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Abstract
Thirty-one children under the age of 15 yr with verified medulloblastoma were treated at Addenbrookes Hospital [Cambridge, England, UK] from 1940-1976. In addition to surgical treatment, all received high dose irradiation to the whole neuraxis. Nine were still alive in 1979, of whom 8 were examined. All these patients showed some residual problems, but 5 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 4; 1 was severely dwarfed. Growth hormone secretion in response to exercise was normal in 5 of 6 patients tested. Three children also showed failure of growth of the jaw sufficiently severe to be a cosmetic problem. Frank mental retardation was present in 3 children. A raised resting TSH level was found in 2 children, 1 of whom had a multinodular goiter. Of the 3 children with severe problems, 2 had been treated when under 2 yr of age. Long-term follow-up of children who survive medulloblastoma is clearly necessary; consideration should perhaps be given to revision of current treatment regimes in very young children.