Past, current and future protocols for combined modality therapy in childhood medulloblastoma

Radiotherapy plays a major role in the management of brain tumors, together with surgical resection and more recently, chemotherapy. Improved efficacy of radiotherapy, ranging from novel techniques of radiotherapy to combination with (new) chemotherapeutic drugs or agents that selectively target tumor cells, are currently being explored and offer some hope for improvement of the prognosis of primary brain tumors. This approach might also enable reducing radiation doses, thereby potentially decreasing the risk of severe late effects in pediatric brain tumor patients. This review will evaluate past, current and future treatment approaches of combined modality therapy in childhood medulloblastoma.