Medulloblastomas

It is obvious that the past decade has witnessed considerable progress in the management of children with medulloblastoma. Better surgical technique has led to more aggressive surgery with less morbidity. The use of staging has led to reduction in radiation therapy doses in some patients and will, it is hoped, lead to better neuropsychological outcome. The use of adjuvant chemotherapy in high-risk patients is delaying recurrence. It remains unknown, however, whether the patient with a medulloblastoma is ever "cured." Certainly, in the future, control of this tumor will depend on new therapeutic modalities, which will be developed on the basis of a better understanding of the biology of these primitive tumors. A better understanding of tumor immunology, cytogenetics, and biochemistry is a goal for the future.