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Updated: Aug 28, 2026
Isolation, Enrichment, and Maintenance of Medulloblastoma Stem Cells
Published on: September 1, 2010
Childhood medulloblastoma-a single institution's historical perspective on survival and functional morbidity
Kim Phipps1, Matthew A Kirkman1,2, Kristian Aquilina1
1Department of Neurosurgery, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC2N 3JH, UK.
Insights
Revised medulloblastoma treatments did not improve survival rates in children. Extended follow-up is crucial, as late deaths from relapse and secondary cancers occur in a significant percentage of survivors.
Area of Science:
- Pediatric Oncology
- Neuro-Oncology
- Clinical Research
Background:
- Medulloblastoma is a primary brain tumor in children.
- Treatment advancements aim to improve survival and functional outcomes.
- Comparing historical and recent cohorts identifies treatment efficacy.
Purpose of the Study:
- To compare outcomes of a recent pediatric medulloblastoma cohort (1995-2010) with two prior series.
- To analyze the impact of management changes on overall survival (OS) and event-free survival (EFS).
- To assess changes in functional outcomes for long-term survivors.
Main Methods:
- Retrospective review of neuro-oncology and imaging databases.
- Analysis of previously published results from two distinct pediatric medulloblastoma cohorts.
- Comparison of survival statistics and functional outcomes across cohorts.
Main Results:
- No statistically significant improvement in 5-year OS for the 1995-2010 cohort (61.5%) compared to the 1980-1990 cohort (50%).
- Risk-stratified 5-year OS ranged from 50% (high-risk < 3 years) to 77.8% (standard-risk).
- Significant long-term functional deficits observed, including educational issues (67.7%) and hearing impairment (59.7%).
Conclusions:
- Revised chemotherapy and radiation protocols did not yield statistically significant improvements in survival or functional outcomes.
- Extended follow-up is essential to account for late deaths from tumor relapse and secondary malignancies.
- Further research is needed to enhance treatment efficacy and mitigate long-term adverse effects in pediatric medulloblastoma.
Purpose:
To compare results from a third (1995-2010) cohort of children with medulloblastoma with two previous series (J Neurosurg 86:13-21, 1997; Arch Dis Child 54:200-203, 1979) to analyse the effects of management changes aimed at improving both overall and event-free survivals (OS and EFS) and functional outcomes.
Methods:
Review of neuro-oncology and imaging databases and previously published results.
Results:
There was no statistically significant improvement in the 5-year OS for 104 children diagnosed 1995-2010, 61.5% (95% CI, 52.9, 71.6), compared with 50% of the 80 children presenting 1980-1990 (J Neurosurg 86:13-21, 1997) (difference 11.5%; 95% CI, 2.8, 25.4). Five-year OS for 96 children suitable for risk-stratification was overall 66% (95% CI, 57.9, 75.8); standard risk 77.8% (95% CI, 67.4, 89.7); high risk < 3 years 50.0% (95% CI, 32.3, 77.5); high risk ≥ 3 years 54.5% (95% CI, 37.2, 79.9); 5-year EFS were standard risk 68.5% (95% CI, 57.2, 82.1); high risk < 3 years 40.0% (95% CI, 23.4, 68.4); and high risk ≥ 3 years 36.4% (95% CI, 20.9, 63.2); overall 55.2% (95% CI, 46.1, 66.1). Of 62/63 ≥ 5-year survivor, 9 died later from tumour relapse and 4 from second malignancy. Functional outcomes of 62 of the 63 ≥ 5-year survivors: 67.7% had educational issues requiring remedial input; 18% restricted mobility indoors and outdoors; 59.7% hearing impairment (42% prescribed aids).
Conclusions:
1. Comparison of this single-institution series with its predecessor found that revised chemotherapy and RT protocols and greater accuracy of risk stratification did not result in statistically significant improvements in either survival or treatment-related functional disability. 2. Extended (> 5-year) follow-up is essential if 20% of late deaths from relapse and second malignancies are not to be overlooked.
